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Sample records for 10-day sequential regimen

  1. Randomized Controlled Trial Comparing 7-Day Triple, 10-Day Sequential, and 7-Day Concomitant Therapies for Helicobacter pylori Infection

    PubMed Central

    Hsu, Ping-I; Wu, Deng-Chyang; Chen, Wen-Chi; Tseng, Hui-Hwa; Yu, Hsien-Chung; Wang, Huay-Min; Kao, Sung-Shuo; Lai, Kwok-Hung; Chen, Angela

    2014-01-01

    With the rising prevalence of antimicrobial resistance, the failure rate of the standard triple therapy for Helicobacter pylori infection is increasing. Sequential therapy and concomitant therapy have been recommended to replace standard triple therapy for H. pylori eradication in regions with high clarithromycin resistance. The aim of this prospective, randomized, and controlled study was to simultaneously assess the efficacies of 10-day sequential and 7-day concomitant therapies versus a 7-day standard triple therapy for treating H. pylori infection. Consecutive H. pylori-infected subjects were randomly assigned to a 7-day standard triple therapy (pantoprazole, clarithromycin, and amoxicillin for 7 days), a 10-day sequential therapy (pantoprazole and amoxicillin for 5 days, followed by pantoprazole, clarithromycin, and metronidazole for a further 5 days), or a 7-day quadruple therapy (pantoprazole, clarithromycin, amoxicillin, and metronidazole for 7 days). H. pylori status was confirmed 6 weeks after therapy. Three hundred seven H. pylori-infected participants were randomized to receive triple (n = 103), sequential (n = 102), or concomitant (n = 102) therapies. The eradication rates by an intention-to-treat analysis in the three treatment groups were 81.6% (95% confidence interval [CI], 74.1% to 89.0%), 89.2% (95% CI, 83.2% to 95.2%), and 94.1% (95% CI, 89.5% to 98.7%). The seven-day concomitant therapy had a higher eradication rate than did the 7-day triple therapy (difference, 12.5%; 95% CI, 3.7% to 21.3%). There were no significant differences in the eradication rates between the sequential and standard triple therapies. All three treatments exhibited similar frequencies of adverse events (8.7%, 8.8%, and 13.7%, respectively) and drug compliance (99.0%, 98.0%, and 100.0%, respectively). In conclusion, the seven-day concomitant therapy is superior to the 7-day standard triple therapy for H. pylori eradication. Additionally, it is less complex than the 10-day

  2. Rifabutin-based 10-day and 14-day triple therapy as a third-line and fourth-line regimen for Helicobacter pylori eradication: A pilot study

    PubMed Central

    Mori, Hideki; Matsuzaki, Juntaro; Tsugawa, Hitoshi; Fukuhara, Seiichiro; Miyoshi, Sawako; Hirata, Kenro; Seino, Takashi; Matsushita, Misako; Nishizawa, Toshihiro; Masaoka, Tatsuhiro; Kanai, Takanori

    2015-01-01

    Background and aim This prospective randomized study was designed to assess the efficacy of 10-day and 14-day rifabutin-based triple therapy as a third- or fourth-line rescue therapy. Methods Patients who failed first- and second-line eradication therapy were enrolled. H. pylori was isolated from gastric biopsy specimens and the rpoB mutation status, a factor of resistance to rifamycins, and minimum inhibitory concentrations (MICs) of rifabutin and amoxicillin were determined. Enrolled patients were randomly assigned to receive 10-day or 14-day eradication therapy with esomeprazole (20 mg, 4 times a day (q.i.d.)), amoxicillin (500 mg, q.i.d.), and rifabutin (300 mg, once a day (q.d.s.)). Poor compliance was defined as intake of <80% of study drugs. Successful H. pylori eradication was confirmed using a [13C] urea breath test or a stool antigen test, 12 weeks after the end of therapy. Results Twelve patients were assigned to the 10-day group, and 17, to the 14-day group. Intention-to-treat and per-protocol analyses of eradication rates were 83.3% and 81.8% for the 10-day group and 94.1% and 91.7% for the 14-day group, respectively. All patients with rpoB mutation-positive strains (n = 3) showed successful eradication, irrespective of the regimen received. Therapy was stopped due to adverse events in 8.3% and 29.3% of patients in the 10-day and 14-day groups, respectively. Conclusion Both the 10-day and 14-day therapies were effective as rescue regimens. In particular, the 14-day therapy resulted in successful eradication in over 90% of patients, but the 10-day treatment may be enough to obtain a successful eradication rate, considering the tolerability of therapy. PMID:27403304

  3. Advanced neuroblastoma: improved response rate using a multiagent regimen (OPEC) including sequential cisplatin and VM-26.

    PubMed

    Shafford, E A; Rogers, D W; Pritchard, J

    1984-07-01

    Forty-two children, all over one year of age, were given vincristine, cyclophosphamide, and sequentially timed cisplatin and VM-26 (OPEC) or OPEC and doxorubicin (OPEC-D) as initial treatment for newly diagnosed stage III or IV neuroblastoma. Good partial response was achieved in 31 patients (74%) overall and in 28 (78%) of 36 patients whose treatment adhered to the chemotherapy protocol, compared with a 65% response rate achieved in a previous series of children treated with pulsed cyclophosphamide and vincristine with or without doxorubicin. Only six patients, including two of the six children whose treatment did not adhere to protocol, failed to respond, but there were five early deaths from treatment-related complications. Tumor response to OPEC, which was the less toxic of the two regimens, was at least as good as tumor response to OPEC-D. Cisplatin-induced morbidity was clinically significant in only one patient and was avoided in others by careful monitoring of glomerular filtration rate and hearing. Other centers should test the efficacy of OPEC or equivalent regimens in the treatment of advanced neuroblastoma. PMID:6539811

  4. Contraceptive potential of a mifepristone-nomegestrol acetate sequential regimen in women.

    PubMed

    Croxatto, H B; Salvatierra, A M; Fuentealba, B; Massai, R

    1998-12-01

    The effectiveness of a sequential regimen consisting of mifepristone, 10 mg/day for 15 days, followed by nomegestrol acetate (NOMA), 5 mg/day for the next 13 days, for inhibiting ovulation and maintaining regular bleeding cycles was assessed in 10 surgically sterilized volunteers who were followed for one pretreatment and three treated cycles. Hormonal determinations in blood and urine, ovarian ultrasonography, bleeding records in all cycles and an endometrial biopsy taken on day 22-25 of the third treatment cycle were used to monitor the effects of treatment. During treatment, 24 monophasic (no sustained progesterone rise above 12 nmol/l) and six biphasic cycles were recorded. Nine follicular ruptures were detected echographically in these 30 treated cycles, five of which occurred in monophasic cycles. All follicular ruptures occurred on days 1-7 of NOMA treatment. Echographic and endocrine features of ovulatory cycles were both present in only four treated cycles (13.3%). Development of a secretory endometrium was achieved in all cases, but it was always irregular. Regular withdrawal bleeding occurred in all subjects and no adverse reactions were recorded. The ovarian and endometrial effects of this regimen justify testing its contraceptive effectiveness in phase 2 clinical trials. PMID:9886502

  5. A Sequential Phase 2b Trial Design for Evaluating Vaccine Efficacy and Immune Correlates for Multiple HIV Vaccine Regimens

    PubMed Central

    Gilbert, Peter B.; Grove, Douglas; Gabriel, Erin; Huang, Ying; Gray, Glenda; Hammer, Scott M.; Buchbinder, Susan P.; Kublin, James; Corey, Lawrence; Self, Steven G.

    2012-01-01

    Five preventative HIV vaccine efficacy trials have been conducted over the last 12 years, all of which evaluated vaccine efficacy (VE) to prevent HIV infection for a single vaccine regimen versus placebo. Now that one of these trials has supported partial VE of a prime-boost vaccine regimen, there is interest in conducting efficacy trials that simultaneously evaluate multiple prime-boost vaccine regimens against a shared placebo group in the same geographic region, for accelerating the pace of vaccine development. This article proposes such a design, which has main objectives (1) to evaluate VE of each regimen versus placebo against HIV exposures occurring near the time of the immunizations; (2) to evaluate durability of VE for each vaccine regimen showing reliable evidence for positive VE; (3) to expeditiously evaluate the immune correlates of protection if any vaccine regimen shows reliable evidence for positive VE; and (4) to compare VE among the vaccine regimens. The design uses sequential monitoring for the events of vaccine harm, non-efficacy, and high efficacy, selected to weed out poor vaccines as rapidly as possible while guarding against prematurely weeding out a vaccine that does not confer efficacy until most of the immunizations are received. The evaluation of the design shows that testing multiple vaccine regimens is important for providing a well-powered assessment of the correlation of vaccine-induced immune responses with HIV infection, and is critically important for providing a reasonably powered assessment of the value of identified correlates as surrogate endpoints for HIV infection. PMID:23181167

  6. Using a Sequential Regimen to Eliminate Bacteria at Sublethal Antibiotic Dosages

    PubMed Central

    Pena-Miller, Rafael; Reding, Carlos; Jansen, Gunther; Schulenburg, Hinrich; Gudelj, Ivana; Beardmore, Robert

    2015-01-01

    We need to find ways of enhancing the potency of existing antibiotics, and, with this in mind, we begin with an unusual question: how low can antibiotic dosages be and yet bacterial clearance still be observed? Seeking to optimise the simultaneous use of two antibiotics, we use the minimal dose at which clearance is observed in an in vitro experimental model of antibiotic treatment as a criterion to distinguish the best and worst treatments of a bacterium, Escherichia coli. Our aim is to compare a combination treatment consisting of two synergistic antibiotics to so-called sequential treatments in which the choice of antibiotic to administer can change with each round of treatment. Using mathematical predictions validated by the E. coli treatment model, we show that clearance of the bacterium can be achieved using sequential treatments at antibiotic dosages so low that the equivalent two-drug combination treatments are ineffective. Seeking to treat the bacterium in testing circumstances, we purposefully study an E. coli strain that has a multidrug pump encoded in its chromosome that effluxes both antibiotics. Genomic amplifications that increase the number of pumps expressed per cell can cause the failure of high-dose combination treatments, yet, as we show, sequentially treated populations can still collapse. However, dual resistance due to the pump means that the antibiotics must be carefully deployed and not all sublethal sequential treatments succeed. A screen of 136 96-h-long sequential treatments determined five of these that could clear the bacterium at sublethal dosages in all replicate populations, even though none had done so by 24 h. These successes can be attributed to a collateral sensitivity whereby cross-resistance due to the duplicated pump proves insufficient to stop a reduction in E. coli growth rate following drug exchanges, a reduction that proves large enough for appropriately chosen drug switches to clear the bacterium. PMID:25853342

  7. Non-Pegylated Liposomal Doxorubicin-Cyclophosphamide in Sequential Regimens with Taxanes as Neoadjuvant Chemotherapy in Breast Cancer Patients

    PubMed Central

    Vici, Patrizia; Pizzuti, Laura; Gamucci, Teresa; Sergi, Domenico; Conti, Francesca; Zampa, Germano; Del Medico, Pietro; De Vita, Roy; Pozzi, Marcello; Botti, Claudio; Di Filippo, Simona; Tomao, Federica; Sperduti, Isabella; Di Lauro, Luigi

    2014-01-01

    Purpose: Chemotherapy regimens containing anthracyclines and taxanes represent the landmark of neoadjuvant systemic therapy of breast cancer. In advanced breast cancer patients liposomal anthracyclines (LA) have shown similar efficacy and less cardiac toxicity when compared to conventional anthracyclines. We performed this retrospective analysis in order to evaluate the efficacy and tolerability of neoadjuvant regimens including LA outside of clinical trials in routine clinical practice. Methods: Fifty operable or locally advanced, HER2 negative, breast cancer patients were retrospectively identified in 5 Italian cancer centres. Nineteen patients had received 4 cycles of non-pegylated liposomal doxorubicin (NPLD) and cyclophosphamide, followed by 4 cycles of docetaxel, every 3 weeks. In 25 patients the reverse sequence was employed, and a third subgroup of 6 patients received 4 cycles of NPLD/cyclophosphamide every 3 weeks followed by 4 cycles of weekly carboplatin and paclitaxel. Results: We observed 10 pathological complete responses (pCR) (20.0%, 95%CI, 9% to 31%), and 35 (70%, 95%CI, 57.3% to 82.7%) partial responses (pPR), whereas no patients progressed onto therapy. In the small subset of triple negative tumors the pCR rate was 37.5%, and in tumors expressing ER and/or PgR it was 16.7%. A pCR rate of 26.5% was observed in tumors with high Ki-67, whereas in tumors with low Ki-67 only one (6.2%) pCR was observed (p=0.14). Treatments were well tolerated. The most common toxicities were myelosuppression and palmar-plantar erytrodysesthesia; 4 asymptomatic and transient LVEF decrease have been recorded, without any case of clinical cardiotoxicity. Conclusions: NPLD-cyclophosphamide and taxanes sequential regimens were proven effective and well tolerated in breast cancer patients with contra-indication to conventional anthracyclines undergoing neoadjuvant chemotherapy, even outside of clinical trials in everyday clinical practice. PMID:24847380

  8. Modified Sequential Therapy Regimen versus Conventional Triple Therapy for Helicobacter Pylori Eradication in Duodenal Ulcer Patients in China: A Multicenter Clinical Comparative Study.

    PubMed

    Zhou, Ying-Qun; Xu, Ling; Wang, Bing-Fang; Fan, Xiao-Ming; Wu, Jian-Ye; Wang, Chun-Yan; Guo, Chuan-Yong; Xu, Xuan-Fu

    2012-01-01

    Objective. Antimicrobial resistance has decreased eradication rates for Helicobacter pylori infection worldwide. To observe the effect of eradicating Helicobacter pylori (H. pylori) and the treatment of duodenal ulcer by 2 kinds of modified sequential therapy through comparing with that of 10-day standard triple therapy. Methods. A total of 210 patients who were confirmed in duodenal ulcer active or heal period by gastroscopy and H. pylori positive confirmed by rapid urease test, serum anti-H. pylori antibody (ELASE), or histological examination enrolled in the study. All the patients were randomly divided into three groups: group A (70 cases) and group B (70 cases) were provided 10-day modified sequential therapy; group C (70 cases) was provided 10-day standard triple therapy. Patients of group A received 20 mg of Esomeprazole, 500 mg of Clarithromycin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group B received 20 mg of Esomeprazole, 1000 mg of Amoxicillin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group C received 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for standard 10-day therapy. All drugs were given twice daily. H. pylori eradication rate was checked four to eight weeks after taking the medicine by using a (13)C urea breath test. In the first, second, third, seventh, twenty-first, thirty-fifth days respectively, the symptoms of patients such as epigastric gnawing, burning pain, and acidity were evaluated simultaneously. Results. Overall, 210 patients accomplished all therapy schemes, 9 case patients were excluded. The examination result indicated that the H. pylori eradication rate of each group was as follows: group A 92.5% (62/67), group B 86.8% (59/68), and group C 78.8% (52/66). The H. pylori eradication rate of

  9. Quasi-10-day wave in the atmosphere

    NASA Astrophysics Data System (ADS)

    Forbes, Jeffrey M.; Zhang, Xiaoli

    2015-11-01

    In the classical theory of oscillations on a spherical-rotating Earth, the quasi-10-day wave (Q10DW) exists as a westward propagating "free" or "unforced" normal mode oscillation with zonal wave number s = 1. In the present study, we employ Thermosphere Ionosphere Mesosphere Energetics and Dynamics/Sounding of the Atmosphere using Broadband Emission Radiometry temperature measurements between 20 and 100 km and ±50° latitude, and extending from 2002 to 2013, to provide a comprehensive perspective on the Q10DW as it actually exists in the atmosphere. Climatological seasonal-latitudinal structures are presented which demonstrate that the Q10DW is weakest during summer months and equatorward of ±50° latitude but otherwise has amplitudes ranging from 1.0 K at ˜45 km to ˜5 K at 100 km. Seasonal asymmetries and significant interannual variability also exist. The mean period of the Q10DW is 9.8 days with a standard deviation of about 0.4 day. On average the Q10DW conforms reasonably well with theoretical expectations for a normal mode subject to the effects of dissipation and mean winds, at least below 80 km. Above 80 km this conformity often breaks down. Several factors potentially contributing to this nonconformity are discussed.

  10. Clinical efficacy and safety of a short regimen of azithromycin sequential therapy vs standard cefuroxime sequential therapy in the treatment of community-acquired pneumonia: an international, randomized, open-label study.

    PubMed

    Kuzman, I; Daković-Rode, O; Oremus, M; Banaszak, A M

    2005-12-01

    An international, randomized, open-label, comparative study was undertaken in order to assess the efficacy and safety of azithromycin and cefuroxime, short sequential vs standard sequential therapy, respectively, in the treatment of patients with community-acquired pneumonia (CAP). 180 adult patients were included in the study. 89 patients received azithromycin 500 mg intravenously (i.v.) once daily for 1-4 days followed by azithromycin 500 mg orally once daily for 3 days. 91 patients received cefuroxime 1.5 g i.v. three times daily for 1-4 days followed by cefuroxime axetil 500 mg orally twice daily for 7 days. Clinical efficacy was achieved in 67/82 (81.7%) patients treated with azithromycin, and in 73/89 (82.0%) patients treated with cefuroxime. The mean duration of total (i.v. and oral) therapy was significantly shorter for the azithromycin group than for the cefuroxime group (6.2 days vs 10.1 days). Adverse events were recorded in 38.2% of patients treated with azithromycin, and in 29.7% of patients treated with cefuroxime (p = 0.20). Shorter sequential i.v.-to-oral azithromycin therapy of patients with CAP was as effective as standard sequential i.v.-to-oral cefuroxime therapy. PMID:16433194

  11. Extended follow-up of the CYCLOFA-LUNE trial comparing two sequential induction and maintenance treatment regimens for proliferative lupus nephritis based either on cyclophosphamide or on cyclosporine A.

    PubMed

    Závada, J; Sinikka Pesicková, S; Rysavá, R; Horák, P; Hrncír, Z; Lukác, J; Rovensky, J; Vítová, J; Havrda, M; Rychlík, I; Böhmova, J; Vlasáková, V; Slatinská, J; Zadrazil, J; Olejárová, M; Tegzova, D; Tesar, V

    2014-01-01

    Objective To evaluate the extended follow-up of the CYCLOFA-LUNE trial, a randomized prospective trial comparing two sequential induction and maintenance treatment regimens for proliferative lupus nephritis based either on cyclophosphamide (CPH) or cyclosporine A (CyA). Patients and methods Data for kidney function and adverse events were collected by a cross-sectional survey for 38 of 40 patients initially randomized in the CYCLOFA-LUNE trial. Results The median follow-up time was 7.7 years (range 5.0-10.3). Rates of renal impairment and end-stage renal disease, adverse events (death, cardiovascular event, tumor, premature menopause) did not differ between the CPH and CyA group, nor did mean serum creatinine, 24 h proteinuria and SLICC damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressant agents and blood pressure lowering drugs. Conclusion An immunosuppressive regimen based on CyA achieved similar clinical results to that based on CPH in the very long term. PMID:24213308

  12. 10 Days or 10 Weeks: Immersion Programs That Work.

    ERIC Educational Resources Information Center

    Troiani, Elisa A.

    The foreign language faculty at College of Saint Scholastica Minnesota) developed and implemented 10-day Spanish and French immersion programs based on Peace Corps methodology as a means of affording students time for intensive study of those languages, improving students' fluency, and instituting a change in teaching methodology. The first…

  13. Comparison of three different regimens against Helicobacter pylori as a first-line treatment: A randomized clinical trial.

    PubMed

    Kefeli, Ayse; Basyigit, Sebahat; Yeniova, Abdullah Ozgur; Kefeli, Tarık Tayfur; Aslan, Muzaffer; Tanas, Ozlem

    2016-01-01

    Treatments with bismuth-containing quadruple therapy (QT), sequential therapy (ST), or concomitant therapy (CT) have been proposed as empirical first-line regimens for Helicobacter pylori. We compared the efficacy and tolerability of 10 days bismuth-containing quadruple QT, 10 days ST, and 10 days CT with as first-line treatments for H. pylori in a randomized crossover study. The subjects were randomly divided into three groups. The first 130 patients were treated with rabeprazole, bismuth potassium citrate, metronidazole, and tetracycline for 10 days. The second 130 patients in the sequential group were treated with rabeprazole and amoxicillin for 5 days, and then rabeprazole, clarithromycin, and metronidazole for an additional 5 days. The last 130 patients in the concomitant group were treated with rabeprazole, amoxicillin, clarithromycin, and metronidazole for 10 days. H. pylori eradication was confirmed by urea breath test at 6 weeks. The primary outcome was eradication rates of first-line treatment by intention to treat and per protocol (PP) analyzes. There was no difference between the average ages and the male/female ratio of the groups. The PP analysis was performed on 121, 119, and 118 patients in the QT, ST, and CT groups, respectively. In the PP analysis, the successful eradication 94.2% (114/121), 95.0% (113/119), and 95.8% (113/118) the QT, ST, and CT groups, respectively. There was no significant difference among the three groups (p = 0.86). 10 days QT, ST, and CT are highly effective as empirical first-line therapies for H. pylori in the region with high clarithromycin resistance. PMID:26773183

  14. Comparison of three different regimens against Helicobacter pylori as a first-line treatment: A randomized clinical trial

    PubMed Central

    Kefeli, Ayse; Basyigit, Sebahat; Yeniova, Abdullah Ozgur; Kefeli, Tarık Tayfur; Aslan, Muzaffer; Tanas, Ozlem

    2016-01-01

    Treatments with bismuth-containing quadruple therapy (QT), sequential therapy (ST), or concomitant therapy (CT) have been proposed as empirical first-line regimens for Helicobacter pylori. We compared the efficacy and tolerability of 10 days bismuth-containing quadruple QT, 10 days ST, and 10 days CT with as first-line treatments for H. pylori in a randomized crossover study. The subjects were randomly divided into three groups. The first 130 patients were treated with rabeprazole, bismuth potassium citrate, metronidazole, and tetracycline for 10 days. The second 130 patients in the sequential group were treated with rabeprazole and amoxicillin for 5 days, and then rabeprazole, clarithromycin, and metronidazole for an additional 5 days. The last 130 patients in the concomitant group were treated with rabeprazole, amoxicillin, clarithromycin, and metronidazole for 10 days. H. pylori eradication was confirmed by urea breath test at 6 weeks. The primary outcome was eradication rates of first-line treatment by intention to treat and per protocol (PP) analyzes. There was no difference between the average ages and the male/female ratio of the groups. The PP analysis was performed on 121, 119, and 118 patients in the QT, ST, and CT groups, respectively. In the PP analysis, the successful eradication 94.2% (114/121), 95.0% (113/119), and 95.8% (113/118) the QT, ST, and CT groups, respectively. There was no significant difference among the three groups (p = 0.86). 10 days QT, ST, and CT are highly effective as empirical first-line therapies for H. pylori in the region with high clarithromycin resistance. PMID:26773183

  15. Gerson regimen.

    PubMed

    Cassileth, Barrie

    2010-02-01

    The Gerson regimen, developed by Max Gerson in the 1930s, is promoted as an alternative cancer treatment. It involves consuming fresh, raw fruit and vegetable juices, eliminating salt from the diet, taking supplements such as potassium, vitamin B12, thyroid hormone, pancreatic enzymes, and detoxifying liver with coffee enemas to stimulate metabolism. Gerson therapy is based on the theory that cancer is caused by alteration of cell metabolism by toxic environmental substances and processed food, which changes its sodium and potassium content. It emphasizes increasing potassium intake and minimizing sodium consumption in an effort to correct the electrolyte imbalance, repair tissue, and detoxify the liver. The coffee enemas are believed to cause dilation of bile ducts and excretion of toxic breakdown products by the liver and through the colon wall. None of these theories has been substantiated by scientific research. Despite proponents' claims of recovery rates as high as 70% to 90%, case reviews by the National Cancer Institute (NCI) and the New York County Medical Society found no evidence of usefulness for the Gerson diet. An NCI-sponsored study of Gonzalez therapy, which is similar to the Gerson diet, showed that patients with inoperable pancreatic adenocarcinoma who underwent standard chemotherapy with gemcitabine (Gemzar) survived three times longer and had better quality of life than those who chose enzyme treatment, which included pancreatic enzymes, nutritional supplements, detoxification, and an organic diet. PMID:20361473

  16. Enhancing Commitment Improves Adherence to a Medical Regimen.

    ERIC Educational Resources Information Center

    Putnam, Dana E.; And Others

    1994-01-01

    Evaluated commitment-based intervention for improvement of adherence to 10-day antibiotic regimen. Subjects were 60 college students. Experimental subjects made verbal and written commitments for adherence and completed tasks designed to increase their investment in medication regimen. Controls performed similarly structured tasks unrelated to…

  17. Sequential (as Opposed to Simultaneous) Antibiotic Therapy Improves Helicobacter pylori Eradication in the Pediatric Population: A Meta-Analysis.

    PubMed

    Lau, Christine S M; Ward, Amanda; Chamberlain, Ronald S

    2016-06-01

    Helicobacter pylori is a common infection associated with many gastrointestinal diseases. Triple or quadruple therapy is the current recommendation for H pylori eradication in children but is associated with success rates as low as 50%. Recent studies have demonstrated that a 10-day sequential therapy regimen, rather than simultaneous antibiotic administration, achieved eradication rates of nearly 95%. This meta-analysis found that sequential therapy increased eradication rates by 14.2% (relative risk [RR] = 1.142; 95% confidence interval [CI] = 1.082-1.207; P < .001). Ten-day sequential therapy significantly improved H pylori eradication rates compared to the 7-day standard therapy (RR = 1.182; 95% CI = 1.102-1.269; p < .001) and 10-day standard therapy (RR = 1.179; 95% CI = 1.074-1.295; P = .001), but had lower eradication rates compared to 14-day standard therapy (RR = 0.926; 95% CI = 0.811-1.059; P = .261). The use of sequential therapy is associated with increased H pylori eradication rates in children compared to standard therapy of equal or shorter duration. PMID:26297295

  18. Efficacy and Tolerability of 5- vs 10-Day Cefixime Therapy in Acute Exacerbations of Chronic Bronchitis.

    PubMed

    Lorenz, J; Steinfeld, P; Drath, L; Keienburg, T; Troester, K

    1998-01-01

    The efficacy and tolerability of oral cefixime 400mg once daily for 5 days was compared with standard 10-day therapy in a multicentre, double-blind, randomised, controlled clinical trial of 222 patients with acute exacerbations of chronic bronchitis. Clinical and bacteriological efficacy were assessed after 6, 11 and 30 days. A total of 167 patients were evaluable for efficacy on a per-protocol basis. Clinical efficacy (cure or improvement based on the quality and quantity of expectorated sputum and symptoms of dyspnoea) at day 11 was statistically equivalent (p < 0.01) between the treatment groups, with a successful clinical response achieved in 91% (5-day) and 89% (10-day) of patients. Bacteriological efficacy was also similar with 5- and 10-day treatment. During treatment, more patients reported an adverse event possibly or probably related to the study medication in the 10-day than in the 5-day treatment group (19 vs 14%). However, this difference was not statistically significant. Oral cefixime 400mg once daily is an effective and well tolerated treatment for acute exacerbations of chronic bronchitis. Short-term (5-day) therapy offers clinical efficacy similar to that of standard (10-day) therapy. PMID:18370461

  19. 19 CFR 141.82 - Invoice for installment shipments arriving within a period of 10 days.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Invoice for installment shipments arriving within..., DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) ENTRY OF MERCHANDISE Invoices § 141.82 Invoice for installment shipments arriving within a period of 10 days. (a) One invoice...

  20. OBSERVATIONS ON THE 10-DAY CHIRONOMUS TENTANS SURVIVAL AND GROWTH BIOASSAY IN EVALUATING GREAT LAKES SEDIMENTS

    EPA Science Inventory

    A 10-day bioassay with larval chironomids (Chironomus tentans) was used to evaluate sediment samples from harbors at Michigan City, IN, St. Joseph, MI, Grand Haven, MI and Toledo, OH for toxicity, based on the endpoints of survival, dry weight, and growth. Larval responses in se...

  1. 77 FR 64759 - Rescission of 10-Day Agency Discretionary Period in Assigning Unsatisfactory Safety Ratings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-23

    ... Statutory History The Motor Carrier Safety Act of 1990 (1990 Act) (section 15 of the Sanitary Food... Fitness procedures; Safety Ratings, 56 FR 40801, 40802, 40806 (Aug. 18, 1991) (FHWA final rule). \\3\\ http... Federal Motor Carrier Safety Administration 49 CFR Part 385 RIN 2126-AB55 Rescission of 10-Day...

  2. CNES/GRGS 10-day gravity field models (release 2) and their evaluation

    NASA Astrophysics Data System (ADS)

    Bruinsma, Sean; Lemoine, Jean-Michel; Biancale, Richard; Valès, Nicole

    2010-02-01

    GRACE, designed to monitor temporal variations in the fluid mass at the surface of the Earth, is still operating and providing invaluable data 7 years after launch. One hundred and ninety-nine satellite-only geopotential solutions to degree and order 50 were recomputed per 10-day interval for the period 29 July 2002-27 May 2008 using an improved data editing and solution regularization procedure. These release 2 solutions are significantly improved compared to release 1 solutions, the noise over deserts and oceans in the form of North-South striping being reduced by 20-40%. This is thanks to the tailored regularization of each individual Stokes coefficient applied in the solution procedure, and to a time-variable reference model containing mean annual, semiannual and secular variations for degrees 2-50 towards which the variations per 10-day solution are constrained. It may attenuate signals of the order of a few percent, whereas this always occurs when applying a Gaussian smoother even with a half-width smoothing radius as small as 300 km. The uncertainty of an individual point in the time series of a basin expressed in equivalent water height inferred from the 10-day solutions is approximately 20 mm. Comparison of these 10-day solutions to monthly GRACE project solutions (CSR, GFZ and JPL) shows substantial differences. Even for the largest basin, the Amazon, a 15% difference in annual amplitude is found between CNES release 2 and CSR versus GFZ and JPL. The mass-loss estimates for East and West Greenland vary by 100%. Sometimes clear outliers are detected in the GFZ and JPL solutions when a particular basin is studied, which have to be eliminated. In view of the large differences detected between the time series for specific basins, it is hazardous to draw conclusions based on a single solution.

  3. Increased expression of endocytosis-Related proteins in rat hippocampus following 10-day electroconvulsive seizure treatment.

    PubMed

    Enomoto, Shingo; Shimizu, Kunio; Nibuya, Masashi; Toda, Hiroyuki; Yoshino, Aihide; Suzuki, Eiji; Kondo, Takashi; Fukuda, Hiroshi

    2016-06-15

    Although electroconvulsive therapy (ECT) is clinically used for severe depression and drug-resistant Parkinson's disease, its exact biological background and mechanism have not yet been fully elucidated. Two potential explanations have been presented so far to explain the increased neuroplastic and resilient profiles of multiple ECT administrations. One is the alteration of central neurotransmitter receptor densities and the other is the expressional upregulation of brain derived neurotrophic factor in various brain regions with enhanced hippocampal neurogenesis and mossy fiber sprouting. In the present report, western blot analyses revealed significantly upregulated expression of various endocytosis-related proteins following 10-day electroconvulsive seizure (ECS) treatment in rat hippocampal homogenates and hippocampal lipid raft fractions extracted using an ultracentrifugation procedure. Upregulated proteins included endocytosis-related scaffolding proteins (caveolin-1, flotillin-1, and heavy and light chains of clathrin) and small GTPases (Rab5, Rab7, Rab11, and Rab4) specifically expressed on various types of endosomes. Two scaffolding proteins, caveolin-1 and flotillin-1, were also increased in the lipid raft fraction. Together with our previous finding of increased autophagy-related proteins in the hippocampal region, the present results suggest membrane trafficking machinery is enhanced following 10-day ECS treatment. We consider that the membrane trafficking machinery that transports functional proteins in the neuronal cells and from or into the synaptic membranes is one of the new candidates supporting the cellular and behavioral neuroplastic profiles of ECS treatments in animal experiments and ECT administrations in clinical settings. PMID:27177725

  4. BOREAS RSS-7 Regional LAI and FPAR Images From 10-Day AVHRR-LAC Composites

    NASA Technical Reports Server (NTRS)

    Hall, Forrest G. (Editor); Nickeson, Jaime (Editor); Chen, Jing; Cihlar, Josef

    2000-01-01

    The BOReal Ecosystem-Atmosphere Study Remote Sensing Science (BOREAS RSS-7) team collected various data sets to develop and validate an algorithm to allow the retrieval of the spatial distribution of Leaf Area Index (LAI) from remotely sensed images. Advanced Very High Resolution Radiometer (AVHRR) level-4c 10-day composite Normalized Difference Vegetation Index (NDVI) images produced at CCRS were used to produce images of LAI and the Fraction of Photosynthetically Active Radiation (FPAR) absorbed by plant canopies for the three summer IFCs in 1994 across the BOREAS region. The algorithms were developed based on ground measurements and Landsat Thematic Mapper (TM) images. The data are stored in binary image format files.

  5. Effect of acute hypercapnia during 10-day hypoxic bed rest on posterior eye structures.

    PubMed

    Jaki Mekjavic, Polona; Lenassi, Eva; Eiken, Ola; Mekjavic, Igor B

    2016-05-15

    To gain insights into microgravity-induced ophthalmic changes (microgravity ocular syndrome), and as part of a project investigating effects of future planetary habitats, we investigated the effect of acute hypercapnia following 10-day bed rest and hypoxia on posterior eye structures. Female subjects (N = 7) completed three 10-day experimental interventions: 1) normoxic bed rest [NBR; partial pressure of inspired O2 (PiO2 ) = 132.9 ± 0.3 Torr]; 2) hypoxic ambulatory confinement (HAMB; PiO2 = 90.4 ± 0.3 Torr); and 3) hypoxic bed rest (HBR; n = 12; PiO2 = 90.4 ± 0.3 Torr). Before and on the last day of each intervention, optical coherence tomography (OCT) of the optic disk was performed, and the thicknesses of the retinal nerve fiber layer (RNFL), retina, and choroid were measured. OCT examinations were conducted with the subjects breathing the prevailing normocapnic breathing mixture (either normoxic or hypoxic) and then following a 10-min period of breathing the same gas mixture, but with the addition of 1% CO2 Choroidal thickness was greater during both bed-rest conditions (NBR and HBR) compared with the ambulatory (HAMB) condition (ANOVA, P < 0.001). Increases in RNFL thickness compared with baseline were observed in the hypoxic trials (HBR, P < 0.001; and HAMB, P = 0.021), but not the normoxic trial (NBR). A further increase in RNFL thickness (P = 0.019) was observed after the 10-min hypercapnic trial in the NBR condition only. The fact that choroidal thickness was not affected by Po2 or Pco2, but increased by bed rest, suggests a hydrostatic rather than a vasoactive effect. The increments in RNFL thickness were most likely associated with local hypoxia and hypercapnia-induced dilatation of the retinal blood vessels. PMID:27013607

  6. WASP-117b: a 10-day-period Saturn in an eccentric and misaligned orbit

    NASA Astrophysics Data System (ADS)

    Lendl, M.; Triaud, A. H. M. J.; Anderson, D. R.; Collier Cameron, A.; Delrez, L.; Doyle, A. P.; Gillon, M.; Hellier, C.; Jehin, E.; Maxted, P. F. L.; Neveu-VanMalle, M.; Pepe, F.; Pollacco, D.; Queloz, D.; Ségransan, D.; Smalley, B.; Smith, A. M. S.; Udry, S.; Van Grootel, V.; West, R. G.

    2014-08-01

    We report the discovery of WASP-117b, the first planet with a period beyond 10 days found by the WASP survey. The planet has a mass of Mp = 0.2755 ± 0.0089 MJ, a radius of Rp= 1.021_{-0.065+0.076 Rjup} and is in an eccentric (e = 0.302 ± 0.023), 10.02165 ± 0.00055 d orbit around a main-sequence F9 star. The host star's brightness (V = 10.15 mag) makes WASP-117 a good target for follow-up observations, and with a periastron planetary equilibrium temperature of Teq= 1225_{-39+36} K and a low planetary mean density (ρp= 0.259_{-0.048+0.054 ρjup}) it is one of the best targets for transmission spectroscopy among planets with periods around 10 days. From a measurement of the Rossiter-McLaughlin effect, we infer a projected angle between the planetary orbit and stellar spin axes of β = -44 ± 11 deg, and we further derive an orbital obliquity of ψ = 69.6 +4.7-4.1 deg. Owing to the large orbital separation, tidal forces causing orbital circularization and realignment of the planetary orbit with the stellar plane are weak, having had little impact on the planetary orbit over the system lifetime. WASP-117b joins a small sample of transiting giant planets with well characterized orbits at periods above 8 days. Based on data obtained with WASP-South, CORALIE and EulerCam at the Euler-Swiss telescope, TRAPPIST, and HARPS at the ESO 3.6 m telescope (Prog. IDs 087.C-0649, 089.C-0151, 090.C-0540)Photometric and radial velocities are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (ftp://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/568/A81

  7. Assessment of four different test designs for Hyalella azteca 10 days sediment toxicity test

    SciTech Connect

    Ramirez-Romero, P. |; Oris, J.T.; Bailer, J.; DePoy, M.

    1995-12-31

    The purpose of this study was to assess the adequacy of four experimental designs of the Hyalella azteca 10 days sediment toxicity test. The authors conducted a series of sediment toxicity tests using an EPA recommended experimental design (8 chambers with 10 organisms per treatment) and three other designs. These had the same total number of organisms (80) per treatment and the same sediment:water ratio (1:1.5) but different number of chambers (4,2,1). The number of organisms recovered, the time to sort and count the animals, as well as the time to make a water change were compared for these four designs. Logistic regression was used to analyze the recovery data while one-way analysis of variance methods were used to analyze the time responses. The results showed that the four treatments were comparable in terms of proportion of organisms recovered. However, the sorting time and the water change time decreased as the number of chambers decreased, making those designs with less chambers more desirable.

  8. Cardiopulmonary function during 10 days of head-down tilt bedrest.

    PubMed

    Schulz, H; Hillebrecht, A; Karemaker, J M; ten Harkel, A D; Beck, L; Baisch, F; Meyer, M

    1992-01-01

    Pulmonary and cardiovascular responses to simulated weightlessness, i. e. 6 degrees head-down tilt bedrest (HDT) were investigated in six healthy male volunteers (mean age 26 yrs). Pulmonary diffusing capacity, functional residual capacity, pulmonary capillary blood flow, and lung tissue volume were measured by inert gas rebreathing. Heart rate and mean arterial blood pressure were obtained from finger blood pressure readings using a plethysmographic technique (Finapres). The short-term (20 min) response to HDT consisted of a 22% increase in pulmonary blood flow, and 13% and 31% falls in blood pressure and heart rate relative to standing. Functional residual capacity fell by 33%, while lung tissue volume increased insignificantly. Subsequent measurements during 10 days of HDT and 5 days of recovery revealed no further changes in lung volume, lung tissue volume, or blood pressure. However, diffusing capacity fell gradually and remained 4%-5% below baseline values after the 7th day of bedrest and during recovery (p less than 0.05). Pulmonary blood flow decreased by 16% during head-down bedrest and recovered partially within the following 5 days (p less than 0.05). We conclude that during and after simulated weightlessness marked alterations in cardiovascular function and marginal affections of gas exchange can be demonstrated already at rest. They may be considered as contributing factors to orthostatic and exercise intolerance observed after space flight. PMID:1509891

  9. Measurement and reduction of porewater ammonia in 10-day sediment toxicity tests with marine amphipods

    SciTech Connect

    Kohn, N.P.; Karls, R.K.; Barrows, M.E.

    1994-12-31

    Ammonia is recognized as a potential contributor to amphipod toxicity in sediment bioassays, such as those required for dredged material testing. Measurement of ammonia in sediment porewater prior to testing and monitoring of ammonia during testing have not been routinely performed. The U.S. Environmental Protection Agency (EPA) and U.S. Army Corps of Engineers (USACE) have recently provided guidance for reducing sediment porewater ammonia by aeration and by exchange of overlying water prior to introducing test animals. In this study, two amphipod species, Rhepoxynius abronius and Eohaustorius estuarius, were exposed to eight sediment treatments in 10-day solid-phase static bioassays. Ammonia in sediment porewater was measured prior to testing; treatments with > 70 mg/L total ammonia were manipulated to reduce porewater ammonia in the test chambers to {<=}30 mg/L, following procedures in a memorandum by EPA and USACE. Porewater ammonia was also measured {approximately}24 h after test set up (when animals would normally be added), each day of manipulation before animals were added, and also on Days 5 and 9 for the E. estuarius test. The treatment with the highest porewater ammonia concentration was tested with and without manipulation. Reduction of porewater ammonia required up to 2 days. Toxicity was reduced in the manipulated sediments, but was statistically significant relative to control and reference treatments.

  10. Whole body and regional body composition changes following 10-day hypoxic confinement and unloading-inactivity.

    PubMed

    Debevec, Tadej; McDonnell, Adam C; Macdonald, Ian A; Eiken, Ola; Mekjavic, Igor B

    2014-03-01

    Future planetary habitats will expose inhabitants to both reduced gravity and hypoxia. This study investigated the effects of short-term unloading and normobaric hypoxia on whole body and regional body composition (BC). Eleven healthy, recreationally active, male participants with a mean (SD) age of 24 (2) years and body mass index of 22.4 (3.2) kg·m(-2) completed the following 3 10-day campaigns in a randomised, cross-over designed protocol: (i) hypoxic ambulatory confinement (HAMB; FIO2 = 0.147 (0.008); PIO2 = 93.8 (0.9) mm Hg), (ii) hypoxic bed rest (HBR; FIO2 = 0.147 (0.008); PIO2 = 93.8 (0.9) mm Hg), and (iii) normoxic bed rest (NBR; FIO2 = 0.209; PIO2 = 133.5 (0.7) mm Hg). Nutritional requirements were individually precalculated and the actual intake was monitored throughout the study protocol. Body mass, whole body, and regional BC were assessed before and after the campaigns using dual-energy X-ray absorptiometry. The calculated daily targeted energy intake values were 2071 (170) kcal for HBR and NBR and 2417 (200) kcal for HAMB. In both HBR and NBR campaigns the actual energy intake was within the targeted level, whereas in the HAMB the intake was lower than targeted (-8%, p < 0.05). Body mass significantly decreased in all 3 campaigns (-2.1%, -2.8%, and -2.0% for HAMB, HBR, and NBR, respectively; p < 0.05), secondary to a significant decrease in lean mass (-3.8%, -3.8%, -4.3% for HAMB, HBR, and NBR, respectively; p < 0.05) along with a slight, albeit not significant, increase in fat mass. The same trend was observed in the regional BC regardless of the region and the campaign. These results demonstrate that, hypoxia per se, does not seem to alter whole body and regional BC during short-term bed rest. PMID:24552383

  11. A 10-day course of SPA therapy is beneficial for people with severe knee osteoarthritis. A 24-week randomised, controlled pilot study.

    PubMed

    Karagülle, Mine; Karagülle, Müfit Zeki; Karagülle, Oğuz; Dönmez, Arif; Turan, Mustafa

    2007-12-01

    The objective of this study was to test if spa therapy can play a role in the management of severe knee osteoarthritis (OA). Twenty patients with radiologically and clinically severe knee OA were randomly assigned into spa and drug therapy groups. Spa group (n = 10) traveled to a spa town and stayed at a hotel for a 10-day spa therapy course. They followed a balneotherapy regimen including thermal pool baths at 37 degrees C for 20 min two times daily. Drug therapy group (n = 10) stayed at home and followed their individually prescribed drug therapy (NSAIDs and paracetamol). Patients were assessed at baseline (week 0), after spa therapy at 2 weeks (week 2) and during follow-up period at 12 (week 12) and 24 (week 24) weeks by a blinded investigator. Patients assessed with Lequesne algofunctional index (LAFI), pain (visual analogue scale, VAS), patient's and investigator's global evaluation (VAS), ten-stairs stepping up and down time, 15 m walking time and three times squatting up and down time. Significant improvement in pain and LAFI scores were found at week 2, week 12 and week 24 in the spa therapy group compared to baseline. Comparing the two group differences, spa therapy was superior to drug therapy in pain reduction and in physician's global assessment at all time points. This superiority was also found in LAFI scores and patients' global assessments at week 12 and week 24. A 10-day course of spa therapy may be beneficial in short- and medium-term up to 24 weeks by reducing pain and improving functional status and overall well-being in patients with severe knee OA and may be considered as an effective therapeutic tool for such patients in countries like Turkey where it is widely available and (at least partly) reimbursed. PMID:17431728

  12. Comparative efficacy and safety of 3-day azithromycin and 10-day penicillin V treatment of group A beta-hemolytic streptococcal pharyngitis in children.

    PubMed Central

    Pacifico, L; Scopetti, F; Ranucci, A; Pataracchia, M; Savignoni, F; Chiesa, C

    1996-01-01

    The efficacy and safety of a 3-day course of azithromycin oral suspension (10 mg/kg of body weight once daily) were compared with those of penicillin V (50,000 U/kg/day in two divided doses) in children aged 3 to 12 years for the treatment of symptomatic pharyngitis caused by the group A beta-hemolytic streptococcus (GABHS). For the 154 evaluable patients, the original infecting strain of GABHS was eliminated at the end of follow-up (34 to 36 days after treatment started) from 67 (85.8%) of 78 penicillin-treated patients and 41 (53.9%) of 76 azithromycin-treated patients (P < 0.0001). Overall clinical success was achieved in 71 (91.0%) of 78 penicillin V-treated patients and 57 (75.0%) of 76 azithromycin-treated patients (P < 0.05). Potential drug-related adverse events were reported for 5.5 and 8.6% of the penicillin V- and azithromycin-treated patients, respectively (P = 0.6). In the present study, a once-daily (10 mg/kg), 3-day oral regimen of azithromycin was as safe as a 10-day course of penicillin but did not represent an effective alternative to penicillin for the treatment of GABHS pharyngitis, even for those children with azithromycin-susceptible strains. PMID:8849215

  13. Hybrid Therapy Regimen for Helicobacter Pylori Eradication

    PubMed Central

    Song, Zhi-Qiang; Liu, Jian; Zhou, Li-Ya

    2016-01-01

    Objective: Helicobacter pylori (H. pylori) eradication remains a challenge with increasing antibiotic resistance. Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety. However, many issues on hybrid therapy are still unclear such as the eradication efficacy, safety, compliance, influencing factors, correlation with antibiotic resistance, and comparison with other regimens. Therefore, a comprehensive review on the evidence of hybrid therapy for H. pylori infection was conducted. Data Sources: The data used in this review were mainly from PubMed articles published in English up to September 30, 2015, searching by the terms of “Helicobacter pylori” or “H. pylori”, and “hybrid”. Study Selection: Clinical research articles were selected mainly according to their level of relevance to this topic. Results: Totally, 1871 patients of 12 studies received hybrid therapy. The eradication rates were 77.6–97.4% in intention-to-treat and 82.6–99.1% in per-protocol analyses. Compliance was 93.3–100.0%, overall adverse effects rate was 14.5–67.5%, and discontinued medication rate due to adverse effects was 0–6.7%. H. pylori culture and sensitivity test were performed only in 13.3% patients. Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible, isolated metronidazole or clarithromycin resistance, and dual clarithromycin and metronidazole resistance were 98.5%, 97.6%, 92.9%, and 80.0%, respectively. Overall, the efficacy, compliance, and safety of hybrid therapy were similar with sequential or concomitant therapy. However, hybrid therapy might be superior to sequential therapy in Asians. Conclusions: Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions. Dual clarithromycin and metronidazole resistance were the key factor to efficacy. Hybrid therapy was similar to sequential or concomitant

  14. Sequential Therapy versus Triple Therapy for the First Line Treatment of Helicobacter pylori in Korea: A Nationwide Randomized Trial

    PubMed Central

    Kim, Joon Sung; Kim, Byung-Wook; Hong, Su Jin; Kim, Jin Il; Shim, Ki-Nam; Kim, Jie-Hyun; Baik, Gwang Ho; Kim, Sang Wook; Song, Hyun Joo; Kim, Ji Hyun

    2016-01-01

    Background/Aims Eradication of Helicobacter pylori infection with standard triple therapy (TT) has declined primarily because of increased antibiotic resistance. Sequential therapy (ST) has been suggested as an alternative to TT for the first-line treatment of H. pylori. The purpose of this study was to compare the efficacy of ST with TT. Methods This was a multicenter, randomized open-label trial performed at nine centers in Korea. Patients with H. pylori infection were randomly assigned to receive either 7 day TT or 10 day ST. Eradication rates, drug compliance, and adverse events were compared among the two regimens. Results A total of 601 patients were enrolled between March 2011 and September 2014. The intention-to-treat eradication rates were 70.8% for TT and 82.4% for ST (p=0.001). The corresponding per protocol eradication rates were 76.9% and 88.8% for TT and ST, respectively (p=0.000). There were no statistically significant differences between the two regimens with respect to drug compliance and adverse events. Conclusions ST achieved better eradication rates than TT as a first-line therapy for H. pylori eradication in Korea. PMID:27114421

  15. Addition of 10-Day Decitabine to Fludarabine/Total Body Irradiation Conditioning is Feasible and Induces Tumor-Associated Antigen-Specific T Cell Responses.

    PubMed

    Cruijsen, Marjan; Hobo, Willemijn; van der Velden, Walter J F M; Bremmers, Manita E J; Woestenenk, Rob; Bär, Brigitte; Falkenburg, J H Frederik; Kester, Michel; Schaap, Nicolaas P M; Jansen, Joop; Blijlevens, Nicole N M; Dolstra, Harry; Huls, Gerwin

    2016-06-01

    Allogeneic hematopoietic cell transplantation (HCT) offers the possibility of curative therapy for patients with myelodysplastic syndromes (MDS), chronic myelomonocytic leukemia (CMML), and acute myelogenous leukemia (AML). However, post-HCT relapse remains a major problem, particularly in patients with high-risk cytogenetics and in patients who cannot tolerate consolidation chemotherapy (eg, due to previous toxicity). We assessed the toxicity and efficacy of 10-day decitabine (Dec), fludarabine (Flu), and 2 Gy total body irradiation (TBI) as a new conditioning regimen for allogeneic HCT in patients with MDS, CMML, or AML. Thirty patients were enrolled, including 11 with MDS, 2 with CMML, and 17 with AML. Patients received 20 mg/m(2)/day Dec on days -11 to -2, 30 mg/m(2)/day Flu on days -4 to -2, and 2 Gy TBI on day -1, followed by infusion of a donor stem cell graft on day 0. Postgrafting immunosuppression consisted of cyclosporin A and mycophenolate mofetil. At a median follow-up of 443 days, the overall survival was 53%, relapse incidence was 27%, and nonrelapse mortality was 27%. The incidence of severe acute (grade III/IV) graft-versus-host disease (GVHD) was 27%, and that of (predominantly mild) chronic GVHD was 60%. Immunomonitoring studies revealed that specific CD8(+) T cell responses against epigenetically silenced tumor-associated antigens (TAAs), including cancer-testis antigens (MAGE-A1/A2/A3 and PRAME) and RHAMM, occurred more frequently in patients who had received Dec/Flu/TBI conditioning (8 of 11 patients) compared with a control group of patients who had received only Flu/TBI conditioning (2 of 9 patients). In summary, Dec/Flu/TBI conditioning proved feasible and effective and enhanced the induction of TAA-reactive CD8(+) T cell responses in vivo, which may contribute to disease control post-transplantation. PMID:26860635

  16. Sequential Therapy or Standard Triple Therapy for Helicobacter pylori Infection: An Updated Systematic Review.

    PubMed

    Feng, Li; Wen, Mao-Yao; Zhu, Yong-Jun; Men, Ruo-Ting; Yang, Li

    2016-01-01

    The effectiveness of standard triple therapy (STT) for the eradication of Helicobacter pylori has decreased recently. Sequential therapy (SQT) is a new regimen proposed to address this problem. The aim of this study was to compare the efficacy of SQT versus STT for H. pylori eradication. We searched The Cochrane Library, MEDLINE, Web of Science, and EMBASE databases up to July 2014. The risk ratios (RRs) of eradication rate were pooled, with a 95% confidence interval (CI). Thirty-six randomized clinical trials including a total of 10,316 patients met the inclusion criteria. The RR for eradication of H. pylori with SQT compared with STT was 1.14 (95% CI: 1.09-1.17), the eradication rates were 84.1% and 75.1%, respectively. There was significant heterogeneity between trial results (I = 73%; P < 0.00001). Subgroup analyses showed that SQT was superior to both 7- and 10-day STT, but not significantly better than 14-day STT. This superiority existed when patients were treated with either metronidazole or tinidazole. Patients with single clarithromycin-resistant strain showed a greater benefit of SQT over STT (eradication rates 80.9% vs. 40.7%), RR = 1.98 (95% CI: 1.33-2.94). There was no significant difference between groups in terms of the risk of adverse effects. In conclusion, SQT is more efficacious than STT (7 days and 10 days) in the eradication of HP, but the pooled rate seemed suboptimal. Further research is needed to develop more effective therapeutic approaches. Surveillance of resistance rates should be performed to guide treatment. PMID:25569598

  17. Flash Spectroscopy: Emission Lines from the Ionized Circumstellar Material around <10-day-old Type II Supernovae

    NASA Astrophysics Data System (ADS)

    Khazov, D.; Yaron, O.; Gal-Yam, A.; Manulis, I.; Rubin, A.; Kulkarni, S. R.; Arcavi, I.; Kasliwal, M. M.; Ofek, E. O.; Cao, Y.; Perley, D.; Sollerman, J.; Horesh, A.; Sullivan, M.; Filippenko, A. V.; Nugent, P. E.; Howell, D. A.; Cenko, S. B.; Silverman, J. M.; Ebeling, H.; Taddia, F.; Johansson, J.; Laher, R. R.; Surace, J.; Rebbapragada, U. D.; Wozniak, P. R.; Matheson, T.

    2016-02-01

    Supernovae (SNe) embedded in dense circumstellar material (CSM) may show prominent emission lines in their early-time spectra (≤10 days after the explosion), owing to recombination of the CSM ionized by the shock-breakout flash. From such spectra (“flash spectroscopy”), we can measure various physical properties of the CSM, as well as the mass-loss rate of the progenitor during the year prior to its explosion. Searching through the Palomar Transient Factory (PTF and iPTF) SN spectroscopy databases from 2009 through 2014, we found 12 SNe II showing flash-ionized (FI) signatures in their first spectra. All are younger than 10 days. These events constitute 14% of all 84 SNe in our sample having a spectrum within 10 days from explosion, and 18% of SNe II observed at ages <5 days, thereby setting lower limits on the fraction of FI events. We classified as “blue/featureless” (BF) those events having a first spectrum that is similar to that of a blackbody, without any emission or absorption signatures. It is possible that some BF events had FI signatures at an earlier phase than observed, or that they lack dense CSM around the progenitor. Within 2 days after explosion, 8 out of 11 SNe in our sample are either BF events or show FI signatures. Interestingly, we found that 19 out of 21 SNe brighter than an absolute magnitude MR = -18.2 belong to the FI or BF groups, and that all FI events peaked above MR = -17.6 mag, significantly brighter than average SNe II.

  18. The development of a myeloablative, reduced-toxicity, conditioning regimen for cord blood transplantation.

    PubMed

    Mehta, Rohtesh S; Di Stasi, Antonio; Andersson, Borje S; Nieto, Yago; Jones, Roy; de Lima, Marcos; Hosing, Chitra; Popat, Uday; Kebriaei, Partow; Oran, Betul; Alousi, Amin; Rezvani, Katayoun; Qazilbash, Muzaffar; Bashir, Qaiser; Bollard, Catherine; Cooper, Laurence; Worth, Laura; Tewari, Priti; McNiece, Ian; Willhelm, Kaci; Champlin, Richard; Shpall, Elizabeth J

    2014-02-01

    Cord blood transplantation is being used with increasing frequency for patients with high-risk hematologic malignancies. Myeloablative preparative regimens provide antitumor efficacy and facilitate engraftment but are associated with higher morbidity and nonrelapse mortality rates than nonablative regimens. We evaluated 3 sequential myeloablative regimens in the cord blood transplant setting. Regimen 1 (melphalan, fludarabine, and thiotepa) produced prompt engraftment and minimal engraftment failure but was associated with a high nonrelapse mortality rate. Regimen 2 (busulfan and fludarabine) was very well tolerated but was associated with a high rate of engraftment failure and relapse. Regimen 3 (busulfan, clofarabine, fludarabine, and low-dose total body irradiation given 9 days after the chemotherapy) was associated with a low rate of engraftment failure but was logistically difficult to administer. Finally, regimen 3 that included the total body irradiation given immediately after the chemotherapy was well tolerated, with prompt engraftment and tumor control. This latter regimen appears to be effective in preliminary studies and warrants further evaluation. PMID:24169268

  19. Molecular Diagnosis of Long-QT syndrome at 10 Days of Life by Rapid Whole Genome Sequencing

    PubMed Central

    Priest, James R.; Ceresnak, Scott R.; Dewey, Frederick E.; Malloy-Walton, Lindsey E.; Dunn, Kyla; Grove, Megan E.; Perez, Marco V.; Maeda, Katsuhide; Dubin, Anne M.; Ashley, Euan A.

    2014-01-01

    Background The advent of clinical next generation sequencing is rapidly changing the landscape of rare disease medicine. Molecular diagnosis of long QT syndrome (LQTS) can impact clinical management, including risk stratification and selection of pharmacotherapy based on the type of ion channel affected, but results from current gene panel testing requires 4 to 16 weeks before return to clinicians. Objective A term female infant presented with 2:1 atrioventricular block and ventricular arrhythmias consistent with perinatal LQTS, requiring aggressive treatment including epicardial pacemaker, and cardioverter-defibrillator implantation and sympathectomy on day of life two. We sought to provide a rapid molecular diagnosis for optimization of treatment strategies. Methods We performed CLIA-certified rapid whole genome sequencing (WGS) with a speed-optimized bioinformatics platform to achieve molecular diagnosis at 10 days of life. Results We detected a known pathogenic variant in KCNH2 that was demonstrated to be paternally inherited by followup genotyping. The unbiased assessment of the entire catalog of human genes provided by whole genome sequencing revealed a maternally inherited variant of unknown significance in a novel gene. Conclusions Rapid clinical WGS provides faster and more comprehensive diagnostic information by 10 days of life than standard gene-panel testing. In selected clinical scenarios such as perinatal LQTS, rapid WGS may be able to provide more timely and clinically actionable information than a standard commercial test. PMID:24973560

  20. Variation of the cholesterol content in breast milk during 10 days collection at early stages of lactation.

    PubMed

    Kamelska, Anna M; Pietrzak-Fiećko, Renata; Bryl, Krzysztof

    2012-01-01

    More and more research is done concerning nutritional programming. Human milk nutrients which are consumed by infants can influence their health in later life. High level of cholesterol in human milk paradoxically lowers the cholesterol concentration in blood in adults. During the course of human lactation the cholesterol concentration decreases from 31 mg/100cm(3) (colostrum) to 16 mg/100 cm(3) (mature milk). According to Scopesi et al., 2002, Clin Nutr 21: 379-384, cholesterol concentration in mature milk ranged from 6.5 to 18.4 mg/100 cm(3). The aim of the study was to assess the variations in breast milk cholesterol content during 10 day collection at early lactation. 48 samples of human milk were analyzed. Mean age of women was 31 years. Women were collecting samples during 10 days of an early lactation stage (1-3 months after delivery). An Attenuated Total Reflectance Fourier Transformed Infrared (FTIR-ATR) method for easy and rapid determination of cholesterol in human milk was elaborated. Cholesterol content assessed by the FTIR method ranged from 3.36 to 12.98 mg/100 cm(3). Results indicate that milk cholesterol concentration during 10 consecutive days of early lactation is highly variable. Cholesterol content depends on an individual. Therefore it is suggested that not only the period of lactation but also mother's diet, age, season and place of residence are important factors determining cholesterol content. PMID:22540113

  1. Standard Triple Therapy versus Sequential Therapy in Helicobacter pylori Eradication: A Double-Blind, Randomized, and Controlled Trial

    PubMed Central

    Navarro-Rodriguez, Tomás; Teixeira, Ana Cristina Sá; Silva, Fernando Marcuz; Mattar, Rejane; Chinzon, Decio; Haro, Christiane; Moraes-Filho, Joaquim Prado; Fass, Ronnie; Barbuti, Ricardo Correa

    2015-01-01

    Aim. To compare 10-day standard triple therapy versus sequential therapy as first-line treatment in patients infected with H. pylori. Methods. One hundred H. pylori positive patients (diagnosed by rapid urease test and histology), with average age of 47.2, M/F = 28/72, were randomized to receive either standard triple treatment (TT) as follows: lansoprazole 30 mg, clarithromycin 500 mg, and amoxicillin 1 g, b.i.d. for ten days, or sequential treatment (ST) as follows: lansoprazole 30 mg, amoxicillin and placebo 1.0 g b.i.d for the first five days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and tinidazole 500 mg b.i.d, for the remaining five days. Eradication rates were determined 60 days after treatment by urease, histology, or 13C-urea breath test. Results. In intention to treat (ITT) analysis, the rate of H. pylori eradication in the TT and ST groups was the same for both regimens as follows: 86% (43/50), 95% CI 93,3 to 73.4%. In Per protocol (PP) analysis, the rate of H. pylori eradication in the TT and ST groups was 87.8% (43/49), 95% CI 94,5 to 75.3% and 89.6% (43/48), 95% CI 95,8 to 77.3%, respectively. Conclusions. In Brazil, standard triple therapy is as equally effective as sequential therapy in eradicating Helicobacter pylori patients. This study was registered under Clinical Trials with number ISRCTN62400496. PMID:26064098

  2. Aggressive Regimens for Multidrug-Resistant Tuberculosis Reduce Recurrence

    PubMed Central

    Franke, Molly F.; Appleton, Sasha C.; Mitnick, Carole D.; Furin, Jennifer J.; Bayona, Jaime; Chalco, Katiuska; Shin, Sonya; Murray, Megan; Becerra, Mercedes C.

    2013-01-01

    Background. Recurrent tuberculosis disease occurs within 2 years in as few as 1% and as many as 29% of individuals successfully treated for multidrug-resistant (MDR) tuberculosis. A better understanding of treatment-related factors associated with an elevated risk of recurrent tuberculosis after cure is urgently needed to optimize MDR tuberculosis therapy. Methods. We conducted a retrospective cohort study among adults successfully treated for MDR tuberculosis in Peru. We used multivariable Cox proportional hazards regression analysis to examine whether receipt of an aggressive MDR tuberculosis regimen for ≥18 months following sputum conversion from positive to negative was associated with a reduced rate of recurrent tuberculosis. Results. Among 402 patients, the median duration of follow-up was 40.5 months (interquartile range, 21.2–53.4). Receipt of an aggressive MDR tuberculosis regimen for ≥18 months following sputum conversion was associated with a lower risk of recurrent tuberculosis (hazard ratio, 0.40 [95% confidence interval, 0.17–0.96]; P = .04). A baseline diagnosis of diabetes mellitus also predicted recurrent tuberculosis (hazard ratio, 10.47 [95% confidence interval, 2.17–50.60]; P = .004). Conclusions. Individuals who received an aggressive MDR tuberculosis regimen for ≥18 months following sputum conversion experienced a lower rate of recurrence after cure. Efforts to ensure that an aggressive regimen is accessible to all patients with MDR tuberculosis, such as minimization of sequential ineffective regimens, expanded drug access, and development of new MDR tuberculosis compounds, are critical to reducing tuberculosis recurrence in this population. Patients with diabetes mellitus should be carefully managed during initial treatment and followed closely for recurrent disease. PMID:23223591

  3. A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia

    PubMed Central

    2012-01-01

    Introduction The aim of this study was to compare a 7-day course of doripenem to a 10-day course of imipenem-cilastatin for ventilator-associated pneumonia (VAP) due to Gram-negative bacteria. Methods This was a prospective, double-blinded, randomized trial comparing a fixed 7-day course of doripenem one gram as a four-hour infusion every eight hours with a fixed 10-day course of imipenem-cilastatin one gram as a one-hour infusion every eight hours (April 2008 through June 2011). Results The study was stopped prematurely at the recommendation of the Independent Data Monitoring Committee that was blinded to treatment arm assignment and performed a scheduled review of data which showed signals that were close to the pre-specified stopping limits. The final analyses included 274 randomized patients. The clinical cure rate at the end of therapy (EOT) in the microbiological intent-to-treat (MITT) population was numerically lower for patients in the doripenem arm compared to the imipenem-cilastatin arm (45.6% versus 56.8%; 95% CI, -26.3% to 3.8%). Similarly, the clinical cure rate at EOT was numerically lower for patients with Pseudomonas aeruginosa VAP, the most common Gram-negative pathogen, in the doripenem arm compared to the imipenem-cilastatin arm (41.2% versus 60.0%; 95% CI, -57.2 to 19.5). All cause 28-day mortality in the MITT group was numerically greater for patients in the doripenem arm compared to the imipenem-cilastatin arm (21.5% versus 14.8%; 95% CI, -5.0 to 18.5) and for patients with P. aeruginosa VAP (35.3% versus 0.0%; 95% CI, 12.6 to 58.0). Conclusions Among patients with microbiologically confirmed late-onset VAP, a fixed 7-day course of doripenem was found to have non-significant higher rates of clinical failure and mortality compared to a fixed 10-day course of imipenem-cilastatin. Consideration should be given to treating patients with VAP for more than seven days to optimize clinical outcome. Trial Registration ClinicalTrials.gov: NCT00589693

  4. 10 day flight performance of the plant generic bioprocessing apparatus (PGBA) plant growth facility aboard STS-77

    NASA Astrophysics Data System (ADS)

    Hoehn, Alex; Chamberlain, Dale J.; Forsyth, Sasha W.; Hanna, David S.; Scovazzo, Paul; Horner, Michael B.; Stodieck, Louis S.; Todd, Paul; Heyenga, A. Gerard; Kliss, Mark H.; Bula, Raymond; Yetka, Robert

    1997-01-01

    PGBA, a plant growth facility developed for space flight biotechnology research, successfully grew a total of 30 plants in a closed, multi-crop chamber for 10 days aboard the Space Shuttle Endeavor (STS-77). Artemisia annua, Catharanthus roseus, Pinus taeda, Spinacia oleracea and Trifolium repens were the five species studied during this mission. The primary mission objectives were to study the effects of microgravity for commercial and pharmaceutical production purposes. PGBA is a payload that represents a consortium of interests including BioServe Space Technologies (payload sponsor), NASA Ames Research Center (Controlled Ecological Life Support System, CELSS, Flight Program), Wisconsin Center for Space Automation and Robotics (WCSAR), and industrial affiliates (spaceflight effects on plants and formation of plant products such as pharmaceuticals). Although BioServe is responsible for the flight hardware development and integration of PGBA, NASA Ames, WSCAR and industrial affiliates provide significant hardware subsystems and technical biological expertise support.

  5. Helicobacter pylori eradication: Sequential therapy and Lactobacillus reuteri supplementation

    PubMed Central

    Efrati, Cesare; Nicolini, Giorgia; Cannaviello, Claudio; O’Sed, Nicole Piazza; Valabrega, Stefano

    2012-01-01

    AIM: To evaluate the role of sequential therapy and Lactobacillus reuteri (L. reuteri) supplementation, in the eradication treatment of Helicobacter pylori (H. pylori). METHODS: H. pylori infection was diagnosed in 90 adult dyspeptic patients. Patients were excluded if previously treated for H. pylori infection or if they were taking a proton pump inhibitor (PPI), H2-receptor antagonist or antibiotics. Patients were assigned to receive one of the following therapies: (1) 7-d triple therapy (PPI plus clarithromycin and amoxicillin or metronidazole) plus L. reuteri supplementation during antibiotic treatment; (2) 7-d triple therapy plus L. reuteri supplementation after antibiotic treatment; (3) sequential regimen (5-d PPI plus amoxicillin therapy followed by a 5-d PPI, clarithromycin and tinidazole) plus L. reuteri supplementation during antibiotic treatment; and (4) sequential regimen plus L. reuteri supplementation after antibiotic treatment. Successful eradication therapy was defined as a negative urea breath test at least 4 wk following treatment. RESULTS: Ninety adult dyspeptic patients were enrolled, and 83 (30 male, 53 female; mean age 57 ± 13 years) completed the study. Nineteen patients were administered a 7-d triple treatment: 11 with L. reuteri supplementation during and 8 after therapy. Sixty-four patients were administered a sequential regimen: 32 with L. reuteri supplementation during and 32 after therapy. The eradication rate was significantly higher in the sequential group compared with the 7-d triple regimen (88% vs 63%, P = 0.01). No difference was found between two types of PPI. No difference in eradication rates was observed between patients submitted to L. reuteri supplementation during or after antibiotic treatment. Compliance with therapy was excellent in all patients. No difference in adverse effects was observed between the different antibiotic treatments and between patients submitted to L. reuteri supplementation during and after

  6. Tuberculosis treatment and drug regimens.

    PubMed

    Sotgiu, Giovanni; Centis, Rosella; D'ambrosio, Lia; Migliori, Giovanni Battista

    2015-05-01

    Tuberculosis is an airborne infectious disease treated with combination therapeutic regimens. Adherence to long-term antituberculosis therapy is crucial for maintaining adequate blood drug level. The emergence and spread of drug-resistant Mycobacterium tuberculosis strains are mainly favored by the inadequate medical management of the patients. The therapeutic approach for drug-resistant tuberculosis is cumbersome, because of the poor, expensive, less-effective, and toxic alternatives to the first-line drugs. New antituberculosis drugs (bedaquiline and delamanid) have been recently approved by the health authorities, but they cannot represent the definitive solution to the clinical management of drug-resistant tuberculosis forms, particularly in intermediate economy settings where the prevalence of drug resistance is high (China, India, and former Soviet Union countries). New research and development activities are urgently needed. Public health policies are required to preserve the new and old therapeutic options. PMID:25573773

  7. Hand temperature responses to local cooling after a 10-day confinement to normobaric hypoxia with and without exercise.

    PubMed

    Keramidas, M E; Kölegård, R; Mekjavic, I B; Eiken, O

    2015-10-01

    The study examined the effects of a 10-day normobaric hypoxic confinement (FiO2: 0.14), with [hypoxic exercise training (HT); n = 8)] or without [hypoxic ambulatory (HA; n = 6)] exercise, on the hand temperature responses during and after local cold stress. Before and after the confinement, subjects immersed their right hand for 30 min in 8 °C water [cold water immersion (CWI)], followed by a 15-min spontaneous rewarming (RW), while breathing either room air (AIR), or a hypoxic gas mixture (HYPO). The hand temperature responses were monitored with thermocouples and infrared thermography. The confinement did not influence the hand temperature responses of the HA group during the AIR and HYPO CWI and the HYPO RW phases; but it impaired the AIR RW response (-1.3 °C; P = 0.05). After the confinement, the hand temperature responses were unaltered in the HT group throughout the AIR trial. However, the average hand temperature was increased during the HYPO CWI (+0.5 °C; P ≤ 0.05) and RW (+2.4 °C; P ≤ 0.001) phases. Accordingly, present findings suggest that prolonged exposure to normobaric hypoxia per se does not alter the hand temperature responses to local cooling; yet, it impairs the normoxic RW response. Conversely, the combined stimuli of continuous hypoxia and exercise enhance the finger cold-induced vasodilatation and hand RW responses, specifically, under hypoxic conditions. PMID:25039992

  8. Effect of different uncertainty sources on the skill of 10 day ensemble low flow forecasts for two hydrological models

    NASA Astrophysics Data System (ADS)

    Demirel, Mehmet C.; Booij, Martijn J.; Hoekstra, Arjen Y.

    2013-07-01

    This paper aims to investigate the effect of uncertainty originating from model inputs, parameters and initial conditions on 10 day ensemble low flow forecasts. Two hydrological models, GR4J and HBV, are applied to the Moselle River and performance in the calibration, validation and forecast periods, and the effect of different uncertainty sources on the quality of low flow forecasts are compared. The forecasts are generated by using meteorological ensemble forecasts as input to GR4J and HBV. The ensembles provided the uncertainty range for the model inputs. The Generalized Likelihood Uncertainty Estimation (GLUE) approach is used to estimate parameter uncertainty. The quality of the probabilistic low flow forecasts has been assessed by the relative confidence interval, reliability and hit/false alarm rates. The daily observed low flows are mostly captured by the 90% confidence interval for both models. However, GR4J usually overestimates low flows whereas HBV is prone to underestimate them, particularly when the parameter uncertainty is included in the forecasts. The total uncertainty in GR4J outputs is higher than in HBV. The forecasts issued by HBV incorporating input uncertainty resulted in the most reliable forecast distribution. The parameter uncertainty was the main reason reducing the number of hits. The number of false alarms in GR4J is twice the number of false alarms in HBV when considering all uncertainty sources. The results of this study showed that the parameter uncertainty has the largest effect whereas the input uncertainty had the smallest effect on the medium range low flow forecasts.

  9. Assessment of Incremental Dosage Regimen of Combined Oestrogen-Progestogen Oral Contraceptive

    PubMed Central

    Brosens, I. A.; Robertson, W. B.; Van Assche, F. A.

    1974-01-01

    Eighty-six women of proved fertility used an incremental dosage regimen of a combined oral contraceptive for a total of 570 cycles over one year. A daily tablet containing 50 μg of ethinyloestradiol and 50 μg D-norgestrel was taken for 11 days and a daily tablet containing 50 μg ethinyloestradiol and 125 μg D-norgestrel for the next 10 days. Withdrawal bleeding occurred during the tabletfree interval of seven days. The new preparation proved to be an efficient contraceptive, well tolerated, and with few side effects. Women who had gained weight while taking other oral contraceptives lost weight when they changed to the new preparation. The regimen allowed a significant reduction in the cycle dose of progestogen, and these results suggest that a further reduction in the cycle dose of both oestrogen and progestogen may be possible without losing contraceptive efficiency. PMID:4441832

  10. Sequential inductive learning

    SciTech Connect

    Gratch, J.

    1996-12-31

    This article advocates a new model for inductive learning. Called sequential induction, it helps bridge classical fixed-sample learning techniques (which are efficient but difficult to formally characterize), and worst-case approaches (which provide strong statistical guarantees but are too inefficient for practical use). Learning proceeds as a sequence of decisions which are informed by training data. By analyzing induction at the level of these decisions, and by utilizing the only enough data to make each decision, sequential induction provides statistical guarantees but with substantially less data than worst-case methods require. The sequential inductive model is also useful as a method for determining a sufficient sample size for inductive learning and as such, is relevant to learning problems where the preponderance of data or the cost of gathering data precludes the use of traditional methods.

  11. Sequential elution process

    DOEpatents

    Kingsley, Ilse S.

    1987-01-01

    A process and apparatus for the separation of complex mixtures of carbonaceous material by sequential elution with successively stronger solvents. In the process, a column containing glass beads is maintained in a fluidized state by a rapidly flowing stream of a weak solvent, and the sample is injected into this flowing stream such that a portion of the sample is dissolved therein and the remainder of the sample is precipitated therein and collected as a uniform deposit on the glass beads. Successively stronger solvents are then passed through the column to sequentially elute less soluble materials.

  12. Sequential elution process

    DOEpatents

    Kingsley, I.S.

    1987-01-06

    A process and apparatus are disclosed for the separation of complex mixtures of carbonaceous material by sequential elution with successively stronger solvents. In the process, a column containing glass beads is maintained in a fluidized state by a rapidly flowing stream of a weak solvent, and the sample is injected into this flowing stream such that a portion of the sample is dissolved therein and the remainder of the sample is precipitated therein and collected as a uniform deposit on the glass beads. Successively stronger solvents are then passed through the column to sequentially elute less soluble materials. 1 fig.

  13. Gonzalez Regimen (PDQ®)—Patient Version

    Cancer.gov

    Expert-reviewed information summary about the Gonzalez regimen as a treatment for people with cancer. Note: The information in this summary is no longer being updated and is provided for reference purposes only.

  14. Sequential Dependencies in Driving

    ERIC Educational Resources Information Center

    Doshi, Anup; Tran, Cuong; Wilder, Matthew H.; Mozer, Michael C.; Trivedi, Mohan M.

    2012-01-01

    The effect of recent experience on current behavior has been studied extensively in simple laboratory tasks. We explore the nature of sequential effects in the more naturalistic setting of automobile driving. Driving is a safety-critical task in which delayed response times may have severe consequences. Using a realistic driving simulator, we find…

  15. Sequential memory: Binding dynamics

    NASA Astrophysics Data System (ADS)

    Afraimovich, Valentin; Gong, Xue; Rabinovich, Mikhail

    2015-10-01

    Temporal order memories are critical for everyday animal and human functioning. Experiments and our own experience show that the binding or association of various features of an event together and the maintaining of multimodality events in sequential order are the key components of any sequential memories—episodic, semantic, working, etc. We study a robustness of binding sequential dynamics based on our previously introduced model in the form of generalized Lotka-Volterra equations. In the phase space of the model, there exists a multi-dimensional binding heteroclinic network consisting of saddle equilibrium points and heteroclinic trajectories joining them. We prove here the robustness of the binding sequential dynamics, i.e., the feasibility phenomenon for coupled heteroclinic networks: for each collection of successive heteroclinic trajectories inside the unified networks, there is an open set of initial points such that the trajectory going through each of them follows the prescribed collection staying in a small neighborhood of it. We show also that the symbolic complexity function of the system restricted to this neighborhood is a polynomial of degree L - 1, where L is the number of modalities.

  16. Sequential memory: Binding dynamics.

    PubMed

    Afraimovich, Valentin; Gong, Xue; Rabinovich, Mikhail

    2015-10-01

    Temporal order memories are critical for everyday animal and human functioning. Experiments and our own experience show that the binding or association of various features of an event together and the maintaining of multimodality events in sequential order are the key components of any sequential memories-episodic, semantic, working, etc. We study a robustness of binding sequential dynamics based on our previously introduced model in the form of generalized Lotka-Volterra equations. In the phase space of the model, there exists a multi-dimensional binding heteroclinic network consisting of saddle equilibrium points and heteroclinic trajectories joining them. We prove here the robustness of the binding sequential dynamics, i.e., the feasibility phenomenon for coupled heteroclinic networks: for each collection of successive heteroclinic trajectories inside the unified networks, there is an open set of initial points such that the trajectory going through each of them follows the prescribed collection staying in a small neighborhood of it. We show also that the symbolic complexity function of the system restricted to this neighborhood is a polynomial of degree L - 1, where L is the number of modalities. PMID:26520084

  17. Sequential cloning of chromosomes

    SciTech Connect

    Lacks, S.A.

    1991-12-31

    A method for sequential cloning of chromosomal DNA and chromosomal DNA cloned by this method are disclosed. The method includes the selection of a target organism having a segment of chromosomal DNA to be sequentially cloned. A first DNA segment, having a first restriction enzyme site on either side. homologous to the chromosomal DNA to be sequentially cloned is isolated. A first vector product is formed by ligating the homologous segment into a suitably designed vector. The first vector product is circularly integrated into the target organism`s chromosomal DNA. The resulting integrated chromosomal DNA segment includes the homologous DNA segment at either end of the integrated vector segment. The integrated chromosomal DNA is cleaved with a second restriction enzyme and ligated to form a vector-containing plasmid, which is replicated in a host organism. The replicated plasmid is then cleaved with the first restriction enzyme. Next, a DNA segment containing the vector and a segment of DNA homologous to a distal portion of the previously isolated DNA segment is isolated. This segment is then ligated to form a plasmid which is replicated within a suitable host. This plasmid is then circularly integrated into the target chromosomal DNA. The chromosomal DNA containing the circularly integrated vector is treated with a third, retrorestriction enzyme. The cleaved DNA is ligated to give a plasmid that is used to transform a host permissive for replication of its vector. The sequential cloning process continues by repeated cycles of circular integration and excision. The excision is carried out alternately with the second and third enzymes.

  18. Sequential cloning of chromosomes

    DOEpatents

    Lacks, Sanford A.

    1995-07-18

    A method for sequential cloning of chromosomal DNA of a target organism is disclosed. A first DNA segment homologous to the chromosomal DNA to be sequentially cloned is isolated. The first segment has a first restriction enzyme site on either side. A first vector product is formed by ligating the homologous segment into a suitably designed vector. The first vector product is circularly integrated into the target organism's chromosomal DNA. The resulting integrated chromosomal DNA segment includes the homologous DNA segment at either end of the integrated vector segment. The integrated chromosomal DNA is cleaved with a second restriction enzyme and ligated to form a vector-containing plasmid, which is replicated in a host organism. The replicated plasmid is then cleaved with the first restriction enzyme. Next, a DNA segment containing the vector and a segment of DNA homologous to a distal portion of the previously isolated DNA segment is isolated. This segment is then ligated to form a plasmid which is replicated within a suitable host. This plasmid is then circularly integrated into the target chromosomal DNA. The chromosomal DNA containing the circularly integrated vector is treated with a third, retrorestriction (class IIS) enzyme. The cleaved DNA is ligated to give a plasmid that is used to transform a host permissive for replication of its vector. The sequential cloning process continues by repeated cycles of circular integration and excision. The excision is carried out alternately with the second and third enzymes.

  19. Sequential cloning of chromosomes

    DOEpatents

    Lacks, S.A.

    1995-07-18

    A method for sequential cloning of chromosomal DNA of a target organism is disclosed. A first DNA segment homologous to the chromosomal DNA to be sequentially cloned is isolated. The first segment has a first restriction enzyme site on either side. A first vector product is formed by ligating the homologous segment into a suitably designed vector. The first vector product is circularly integrated into the target organism`s chromosomal DNA. The resulting integrated chromosomal DNA segment includes the homologous DNA segment at either end of the integrated vector segment. The integrated chromosomal DNA is cleaved with a second restriction enzyme and ligated to form a vector-containing plasmid, which is replicated in a host organism. The replicated plasmid is then cleaved with the first restriction enzyme. Next, a DNA segment containing the vector and a segment of DNA homologous to a distal portion of the previously isolated DNA segment is isolated. This segment is then ligated to form a plasmid which is replicated within a suitable host. This plasmid is then circularly integrated into the target chromosomal DNA. The chromosomal DNA containing the circularly integrated vector is treated with a third, retrorestriction (class IIS) enzyme. The cleaved DNA is ligated to give a plasmid that is used to transform a host permissive for replication of its vector. The sequential cloning process continues by repeated cycles of circular integration and excision. The excision is carried out alternately with the second and third enzymes. 9 figs.

  20. Inference for the median residual life function in sequential multiple assignment randomized trials

    PubMed Central

    Kidwell, Kelley M.; Ko, Jin H.; Wahed, Abdus S.

    2014-01-01

    In survival analysis, median residual lifetime is often used as a summary measure to assess treatment effectiveness; it is not clear, however, how such a quantity could be estimated for a given dynamic treatment regimen using data from sequential randomized clinical trials. We propose a method to estimate a dynamic treatment regimen-specific median residual life (MERL) function from sequential multiple assignment randomized trials. We present the MERL estimator, which is based on inverse probability weighting, as well as, two variance estimates for the MERL estimator. One variance estimate follows from Lunceford, Davidian and Tsiatis’ 2002 survival function-based variance estimate and the other uses the sandwich estimator. The MERL estimator is evaluated, and its two variance estimates are compared through simulation studies, showing that the estimator and both variance estimates produce approximately unbiased results in large samples. To demonstrate our methods, the estimator has been applied to data from a sequentially randomized leukemia clinical trial. PMID:24254496

  1. [Inhaled corticosteroids: Which regimens are appropriate?].

    PubMed

    Giovannini-Chami, L; Piccini-Bailly, C; Albertini, M

    2016-06-01

    Inhaled corticosteroids are the cornerstone of asthma management. Inhaled corticosteroid regimens differ slightly in various international guidelines on asthma management but are based on the principles of continuous treatment and titration to the lowest effective dose. Several recent studies, nevertheless, appear to demonstrate the potential value of preemptive or "pro re nata" regimens in infants and children. These studies were included in GINA 2015 for children 5 years of age and younger in whom discontinuous treatment is proposed as a second-line option. Should we change our practices after a critical reading of these studies? PMID:27133372

  2. Sequential products on effect algebras

    NASA Astrophysics Data System (ADS)

    Gudder, Stan; Greechie, Richard

    2002-02-01

    A sequential effect algebra (SEA) is an effect algebra on which a sequential product with natural properties is defined. The properties of sequential products on Hilbert space effect algebras are discussed. For a general SEA, relationships between sequential independence, coexistence and compatibility are given. It is shown that the sharp elements of a SEA form an orthomodular poset. The sequential center of a SEA is discussed and a characterization of when the sequential center is isomorphic to a fuzzy set system is presented. It is shown that the existence, of a sequential product is a strong restriction that eliminates many effect algebras from being SEA's. For example, there are no finite nonboolean SEA's, A measure of sharpness called the sharpness index is studied. The existence of horizontal sums of SEA's is characterized and examples of horizontal sums and tensor products are presented.

  3. Enhanced efficacy of sequential administration of Albendazole for the clearance of Wuchereria bancrofti infection: Double blind RCT.

    PubMed

    De Britto, R L; Vanamail, P; Sankari, T; Vijayalakshmi, G; Das, L K; Pani, S P

    2015-06-01

    Till today, there is no effective treatment protocol for the complete clearance of Wuchereria bancrofti (W.b) infection that causes secondary lymphoedema. In a double blind randomized control trial (RCT), 146 asymptomatic W. b infected individuals were randomly assigned to one of the four regimens for 12 days, DEC 300 mg + Doxycycline 100 mg coadministration or DEC 300 mg + Albendazole 400 mg co-administration or DEC 300 mg + Albendazole 400 mg sequential administration or control regimen DEC 300 mg and were followed up at 13, 26 and 52 weeks post-treatment for the clearance of infection. At intake, there was no significant variation in mf counts (F(3,137)=0.044; P=0.988) and antigen levels (F(3,137)=1.433; P=0.236) between the regimens. Primary outcome analysis showed that DEC + Albendazole sequential administration has an enhanced efficacy over DEC + Albendazole co-administration (80.6 Vs 64.7%), and this regimen is significantly different when compared to DEC + doxycycline co-administration and control (P<0.05), in clearing microfilaria in 13 weeks. Secondary outcome analysis showed that, all the trial regimens were comparable to control regimen in clearing antigen (F(3, 109)=0.405; P=0.750). Therefore, DEC + Albendazole sequential administration appears to be a better option for rapid clearance of W. b microfilariae in 13 weeks time. (Clinical trials.gov identifier - NCT02005653). PMID:26691247

  4. Reliable VLSI sequential controllers

    NASA Technical Reports Server (NTRS)

    Whitaker, S.; Maki, G.; Shamanna, M.

    1990-01-01

    A VLSI architecture for synchronous sequential controllers is presented that has attractive qualities for producing reliable circuits. In these circuits, one hardware implementation can realize any flow table with a maximum of 2(exp n) internal states and m inputs. Also all design equations are identical. A real time fault detection means is presented along with a strategy for verifying the correctness of the checking hardware. This self check feature can be employed with no increase in hardware. The architecture can be modified to achieve fail safe designs. With no increase in hardware, an adaptable circuit can be realized that allows replacement of faulty transitions with fault free transitions.

  5. Social Support and Compliance with Hypertension Regimens.

    ERIC Educational Resources Information Center

    Earp, Jo Anne L.

    While research strongly suggests that social support can be effective in helping patients increase their compliance with medical regimens, many more specific questions remain unanswered. These include: (1) how are physicians using social support in an effective manner; (2) what are the most effective ways for physicians and their office staff to…

  6. Concurrent versus Sequential Sorafenib Therapy in Combination with Radiation for Hepatocellular Carcinoma

    PubMed Central

    Chettiar, Sivarajan T.; Aziz, Khaled; Gajula, Rajendra P.; Williams, Russell D.; Kumar, Rachit; Taparra, Kekoa; Zeng, Jing; Cades, Jessica A.; Velarde, Esteban; Menon, Siddharth; Geschwind, Jean F.; Cosgrove, David; Pawlik, Timothy M.; Maitra, Anirban; Wong, John; Hales, Russell K.; Torbenson, Michael S.; Herman, Joseph M.; Tran, Phuoc T.

    2013-01-01

    Sorafenib (SOR) is the only systemic agent known to improve survival for hepatocellular carcinoma (HCC). However, SOR prolongs survival by less than 3 months and does not alter symptomatic progression. To improve outcomes, several phase I-II trials are currently examining SOR with radiation (RT) for HCC utilizing heterogeneous concurrent and sequential treatment regimens. Our study provides preclinical data characterizing the effects of concurrent versus sequential RT-SOR on HCC cells both in vitro and in vivo. Concurrent and sequential RT-SOR regimens were tested for efficacy among 4 HCC cell lines in vitro by assessment of clonogenic survival, apoptosis, cell cycle distribution, and γ-H2AX foci formation. Results were confirmed in vivo by evaluating tumor growth delay and performing immunofluorescence staining in a hind-flank xenograft model. In vitro, concurrent RT-SOR produced radioprotection in 3 of 4 cell lines, whereas sequential RT-SOR produced decreased colony formation among all 4. Sequential RT-SOR increased apoptosis compared to RT alone, while concurrent RT-SOR did not. Sorafenib induced reassortment into less radiosensitive phases of the cell cycle through G1-S delay and cell cycle slowing. More double-strand breaks (DSBs) persisted 24 h post-irradiation for RT alone versus concurrent RT-SOR. In vivo, sequential RT-SOR produced the greatest tumor growth delay, while concurrent RT-SOR was similar to RT alone. More persistent DSBs were observed in xenografts treated with sequential RT-SOR or RT alone versus concurrent RT-SOR. Sequential RT-SOR additionally produced a greater reduction in xenograft tumor vascularity and mitotic index than either concurrent RT-SOR or RT alone. In conclusion, sequential RT-SOR demonstrates greater efficacy against HCC than concurrent RT-SOR both in vitro and in vivo. These results may have implications for clinical decision-making and prospective trial design. PMID:23762417

  7. The structure of sequential effects.

    PubMed

    Gökaydin, Dinis; Navarro, Daniel J; Ma-Wyatt, Anna; Perfors, Amy

    2016-01-01

    There is a long history of research into sequential effects, extending more than one hundred years. The pattern of sequential effects varies widely with both experimental conditions as well as for different individuals performing the same experiment. Yet this great diversity of results is poorly understood, particularly with respect to individual variation, which save for some passing mentions has largely gone unreported in the literature. Here we seek to understand the way in which sequential effects vary by identifying the causes underlying the differences observed in sequential effects. In order to achieve this goal we perform principal component analysis on a dataset of 158 individual results from participants performing different experiments with the aim of identifying hidden variables responsible for sequential effects. We find a latent structure consisting of 3 components related to sequential effects-2 main and 1 minor. A relationship between the 2 main components and the separate processing of stimuli and of responses is proposed on the basis of previous empirical evidence. It is further speculated that the minor component of sequential effects arises as the consequence of processing delays. Independently of the explanation for the latent variables encountered, this work provides a unified descriptive model for a wide range of different types of sequential effects previously identified in the literature. In addition to explaining individual differences themselves, it is demonstrated how the latent structure uncovered here is useful in understanding the classical problem of the dependence of sequential effects on the interval between successive stimuli. PMID:26523425

  8. Intestinal Microbiota of Broiler Chickens As Affected by Litter Management Regimens.

    PubMed

    Wang, Lingling; Lilburn, Mike; Yu, Zhongtang

    2016-01-01

    Poultry litter is a mixture of bedding materials and enteric bacteria excreted by chickens, and it is typically reused for multiple growth cycles in commercial broiler production. Thus, bacteria can be transmitted from one growth cycle to the next via litter. However, it remains poorly understood how litter reuse affects development and composition of chicken gut microbiota. In this study, the effect of litter reuse on the microbiota in litter and in chicken gut was investigated using 2 litter management regimens: fresh vs. reused litter. Samples of ileal mucosa and cecal digesta were collected from young chicks (10 days of age) and mature birds (35 days of age). Based on analysis using DGGE and pyrosequencing of bacterial 16S rRNA gene amplicons, the microbiota of both the ileal mucosa and the cecal contents was affected by both litter management regimen and age of birds. Faecalibacterium, Oscillospira, Butyricicoccus, and one unclassified candidate genus closely related to Ruminococcus were most predominant in the cecal samples, while Lactobacillus was predominant in the ileal samples at both ages and in the cecal samples collected at day 10. At days 10 and 35, 8 and 3 genera, respectively, in the cecal luminal microbiota differed significantly in relative abundance between the 2 litter management regimens. Compared to the fresh litter, reused litter increased predominance of halotolerant/alkaliphilic bacteria and Faecalibacterium prausnitzii, a butyrate-producing gut bacterium. This study suggests that litter management regimens affect the chicken GI microbiota, which may impact the host nutritional status and intestinal health. PMID:27242676

  9. Intestinal Microbiota of Broiler Chickens As Affected by Litter Management Regimens

    PubMed Central

    Wang, Lingling; Lilburn, Mike; Yu, Zhongtang

    2016-01-01

    Poultry litter is a mixture of bedding materials and enteric bacteria excreted by chickens, and it is typically reused for multiple growth cycles in commercial broiler production. Thus, bacteria can be transmitted from one growth cycle to the next via litter. However, it remains poorly understood how litter reuse affects development and composition of chicken gut microbiota. In this study, the effect of litter reuse on the microbiota in litter and in chicken gut was investigated using 2 litter management regimens: fresh vs. reused litter. Samples of ileal mucosa and cecal digesta were collected from young chicks (10 days of age) and mature birds (35 days of age). Based on analysis using DGGE and pyrosequencing of bacterial 16S rRNA gene amplicons, the microbiota of both the ileal mucosa and the cecal contents was affected by both litter management regimen and age of birds. Faecalibacterium, Oscillospira, Butyricicoccus, and one unclassified candidate genus closely related to Ruminococcus were most predominant in the cecal samples, while Lactobacillus was predominant in the ileal samples at both ages and in the cecal samples collected at day 10. At days 10 and 35, 8 and 3 genera, respectively, in the cecal luminal microbiota differed significantly in relative abundance between the 2 litter management regimens. Compared to the fresh litter, reused litter increased predominance of halotolerant/alkaliphilic bacteria and Faecalibacterium prausnitzii, a butyrate-producing gut bacterium. This study suggests that litter management regimens affect the chicken GI microbiota, which may impact the host nutritional status and intestinal health. PMID:27242676

  10. Influence of a 10-Day Mimic of Our Ancient Lifestyle on Anthropometrics and Parameters of Metabolism and Inflammation: The "Study of Origin".

    PubMed

    Pruimboom, Leo; Ruiz-Núñez, Begoña; Raison, Charles L; Muskiet, Frits A J

    2016-01-01

    Chronic low-grade inflammation and insulin resistance are intimately related entities that are common to most, if not all, chronic diseases of affluence. We hypothesized that a short-term intervention based on "ancient stress factors" may improve anthropometrics and clinical chemical indices. We executed a pilot study of whether a 10-day mimic of a hunter-gatherer lifestyle favorably affects anthropometrics and clinical chemical indices. Fifty-five apparently healthy subjects, in 5 groups, engaged in a 10-day trip through the Pyrenees. They walked 14 km/day on average, carrying an 8-kilo backpack. Raw food was provided and self-prepared and water was obtained from waterholes. They slept outside in sleeping bags and were exposed to temperatures ranging from 12 to 42°C. Anthropometric data and fasting blood samples were collected at baseline and the study end. We found important significant changes in most outcomes favoring better metabolic functioning and improved anthropometrics. Coping with "ancient mild stress factors," including physical exercise, thirst, hunger, and climate, may influence immune status and improve anthropometrics and metabolic indices in healthy subjects and possibly patients suffering from metabolic and immunological disorders. PMID:27366752

  11. Influence of a 10-Day Mimic of Our Ancient Lifestyle on Anthropometrics and Parameters of Metabolism and Inflammation: The “Study of Origin”

    PubMed Central

    Ruiz-Núñez, Begoña; Raison, Charles L.; Muskiet, Frits A. J.

    2016-01-01

    Chronic low-grade inflammation and insulin resistance are intimately related entities that are common to most, if not all, chronic diseases of affluence. We hypothesized that a short-term intervention based on “ancient stress factors” may improve anthropometrics and clinical chemical indices. We executed a pilot study of whether a 10-day mimic of a hunter-gatherer lifestyle favorably affects anthropometrics and clinical chemical indices. Fifty-five apparently healthy subjects, in 5 groups, engaged in a 10-day trip through the Pyrenees. They walked 14 km/day on average, carrying an 8-kilo backpack. Raw food was provided and self-prepared and water was obtained from waterholes. They slept outside in sleeping bags and were exposed to temperatures ranging from 12 to 42°C. Anthropometric data and fasting blood samples were collected at baseline and the study end. We found important significant changes in most outcomes favoring better metabolic functioning and improved anthropometrics. Coping with “ancient mild stress factors,” including physical exercise, thirst, hunger, and climate, may influence immune status and improve anthropometrics and metabolic indices in healthy subjects and possibly patients suffering from metabolic and immunological disorders. PMID:27366752

  12. Prophylactic antibiotic regimens in tumour surgery (PARITY)

    PubMed Central

    Investigators, The PARITY

    2015-01-01

    Objective Clinical studies of patients with bone sarcomas have been challenged by insufficient numbers at individual centres to draw valid conclusions. Our objective was to assess the feasibility of conducting a definitive multi-centre randomised controlled trial (RCT) to determine whether a five-day regimen of post-operative antibiotics, in comparison to a 24-hour regimen, decreases surgical site infections in patients undergoing endoprosthetic reconstruction for lower extremity primary bone tumours. Methods We performed a pilot international multi-centre RCT. We used central randomisation to conceal treatment allocation and sham antibiotics to blind participants, surgeons, and data collectors. We determined feasibility by measuring patient enrolment, completeness of follow-up, and protocol deviations for the antibiotic regimens. Results We screened 96 patients and enrolled 60 participants (44 men and 16 women) across 21 sites from four countries over 24 months (mean 2.13 participants per site per year, standard deviation 2.14). One participant was lost to follow-up and one withdrew consent. Complete data were obtained for 98% of eligible patients at two weeks, 83% at six months, and 73% at one year (the remainder with partial data or pending queries). In total, 18 participants missed at least one dose of antibiotics or placebo post-operatively, but 93% of all post-operative doses were administered per protocol. Conclusions It is feasible to conduct a definitive multi-centre RCT of post-operative antibiotic regimens in patients with bone sarcomas, but further expansion of our collaborative network will be critical. We have demonstrated an ability to coordinate in multiple countries, enrol participants, maintain protocol adherence, and minimise losses to follow-up. Cite this article: Bone Joint Res;4:154–162 PMID:26423584

  13. Multi-Attribute Sequential Search

    ERIC Educational Resources Information Center

    Bearden, J. Neil; Connolly, Terry

    2007-01-01

    This article describes empirical and theoretical results from two multi-attribute sequential search tasks. In both tasks, the DM sequentially encounters options described by two attributes and must pay to learn the values of the attributes. In the "continuous" version of the task the DM learns the precise numerical value of an attribute when she…

  14. Student Storytelling through Sequential Art

    ERIC Educational Resources Information Center

    Fay, David

    2007-01-01

    If you are interested in using sequential art forms such as comic books in your EFL classroom, this article is full of helpful advice. Reading sequential art is beneficial because students can work with authentic texts with real language and graphic support. Students can also apply research and cultural knowledge to the creation of their own…

  15. A study on the intra-annual variation and the spatial distribution of precipitation amount and duration over Greece on a 10 day basis

    NASA Astrophysics Data System (ADS)

    Bartzokas, A.; Lolis, C. J.; Metaxas, D. A.

    2003-02-01

    The intra-annual variation of precipitation amount and duration and their spatial distribution during the year are studied on a 10 day basis for the Greek region, using S-mode and T-mode factor analysis. (i) For the intra-annual variation of precipitation amount, two modes were revealed: the first shows one broad maximum during the conventional winter in stations affected by the sea; the second presents two maxima, the first during late autumn-early winter and the second during late spring, corresponding to the northern mainland stations. (ii) For the spatial distribution of precipitation, three main patterns were revealed: the first one is the winter pattern, with the maximum over the west windward area; the second is the summer pattern, with a maximum over the north inland region; and the third is the autumn pattern, with the maximum over northwestern Greece. (iii) For precipitation duration, two types of intra-annual variation were revealed. The first one is similar to the first of the analysis for precipitation amount; the second presents two maxima, the first during the beginning of December and the second during the middle of February, corresponding to the areas of northwestern and northeastern Greece. (iv) For the spatial distribution of precipitation duration, three main patterns were revealed: the first is the summer pattern, which is similar to the second of the analysis for precipitation amount; the second is the winter pattern, with the spatial maximum located over the eastern mainland and western Crete; finally, the third one is the autumn pattern, with the maximum in northwestern Greece. During the third 10 day period of October and the second 10 day period of February, precipitation seems to present singularities, possibly due to fluctuations in atmospheric circulation. The above intra-annual variations and spatial distribution patterns are connected to the seasonal variations of the depression trajectories, the atmospheric instability, the influence

  16. Continuity of the sequential product of sequential quantum effect algebras

    NASA Astrophysics Data System (ADS)

    Lei, Qiang; Su, Xiaochao; Wu, Junde

    2016-04-01

    In order to study quantum measurement theory, sequential product defined by A∘B = A1/2BA1/2 for any two quantum effects A, B has been introduced. Physically motivated conditions ask the sequential product to be continuous with respect to the strong operator topology. In this paper, we study the continuity problems of the sequential product A∘B = A1/2BA1/2 with respect to other important topologies, such as norm topology, weak operator topology, order topology, and interval topology.

  17. Adaptive sequential controller

    DOEpatents

    El-Sharkawi, Mohamed A.; Xing, Jian; Butler, Nicholas G.; Rodriguez, Alonso

    1994-01-01

    An adaptive sequential controller (50/50') for controlling a circuit breaker (52) or other switching device to substantially eliminate transients on a distribution line caused by closing and opening the circuit breaker. The device adaptively compensates for changes in the response time of the circuit breaker due to aging and environmental effects. A potential transformer (70) provides a reference signal corresponding to the zero crossing of the voltage waveform, and a phase shift comparator circuit (96) compares the reference signal to the time at which any transient was produced when the circuit breaker closed, producing a signal indicative of the adaptive adjustment that should be made. Similarly, in controlling the opening of the circuit breaker, a current transformer (88) provides a reference signal that is compared against the time at which any transient is detected when the circuit breaker last opened. An adaptive adjustment circuit (102) produces a compensation time that is appropriately modified to account for changes in the circuit breaker response, including the effect of ambient conditions and aging. When next opened or closed, the circuit breaker is activated at an appropriately compensated time, so that it closes when the voltage crosses zero and opens when the current crosses zero, minimizing any transients on the distribution line. Phase angle can be used to control the opening of the circuit breaker relative to the reference signal provided by the potential transformer.

  18. Helicobacter pylori: Effect of coexisting diseases and update on treatment regimens

    PubMed Central

    Chang, Shen-Shong; Hu, Hsiao-Yun

    2015-01-01

    The presence of concomitant diseases is an independent predictive factor for non-Helicobacter pylori (H. pylori) peptic ulcers. Patients contracting concomitant diseases have an increased risk of developing ulcer disease through pathogenic mechanisms distinct from those of H. pylori infections. Factors other than H. pylori seem critical in peptic ulcer recurrence in end stage renal disease (ESRD) and cirrhotic patients. However, early H. pylori eradication is associated with a reduced risk of recurrent complicated peptic ulcers in patients with ESRD and liver cirrhosis. Resistances to triple therapy are currently detected using culture-based and molecular methods. Culture susceptibility testing before first- or second-line therapy is unadvisable. Using highly effective empiric first-line and rescue regimens can yield acceptable results. Sequential therapy has been included in a recent consensus report as a valid first-line option for eradicating H. pylori in geographic regions with high clarithromycin resistance. Two novel eradication regimens, namely concomitant and hybrid therapy, have proven more effective in patients with dual- (clarithromycin- and metronidazole-) resistant H. pylori strains. We aim to review the prevalence of and eradication therapy for H. pylori infection in patients with ESRD and cirrhosis. Moreover, we summarized the updated H. pylori eradication regimens. PMID:26558147

  19. Potent Rifamycin-Sparing Regimen Cures Guinea Pig Tuberculosis as Rapidly as the Standard Regimen

    PubMed Central

    Dutta, Noton K.; Alsultan, Abdullah; Gniadek, Thomas J.; Belchis, Deborah A.; Pinn, Michael L.; Mdluli, Khisimuzi E.; Nuermberger, Eric L.; Peloquin, Charles A.

    2013-01-01

    Strategies involving new drug combinations, as well as new uses of existing drugs, are urgently needed to reduce the time required to cure patients with drug-sensitive or multidrug-resistant (MDR) tuberculosis (TB). We compared the sterilizing activity of the standard first-line antitubercular regimen, rifampin-isoniazid-pyrazinamide (RHZ), with that of the novel regimen PA-824–moxifloxacin–pyrazinamide (PaMZ), which is currently being studied in clinical trials (NCT01498419), in the guinea pig model of chronic TB infection, in which animals develop necrotic granulomas histologically resembling their human counterparts. Guinea pigs were aerosol infected with ∼2 log10 bacilli of wild-type Mycobacterium tuberculosis H37Rv, and antibiotic treatment was initiated 6 weeks after infection. Separate groups of animals received RHZ, PaMZ, or single or two-drug components of the latter regimen administered at human-equivalent doses 5 days/week for a total of 8 weeks. Relapse rates were assessed 3 months after discontinuation of treatment to determine the sterilizing activity of each combination regimen. PaMZ given at human-equivalent doses was safe and well tolerated for the entire treatment period and rendered guinea pig lungs culture negative more rapidly than RHZ did. After 1 month of treatment, 80% and 50% of animals in the RHZ and PaMZ groups, respectively, had lung culture-positive relapse. Both combination regimens prevented microbiological relapse when administered for a total of 2 months. Our data support the use of PaMZ as a novel isoniazid- and rifamycin-sparing regimen suitable for treatment of both drug-sensitive TB and MDR-TB. PMID:23733473

  20. Herpetic esophagitis following bendamustine-containing regimen

    PubMed Central

    Yamane, Hiromichi; Monobe, Yasumasa; Tanikawa, Tomohiro; Ochi, Nobuaki; Honda, Yoshihiro; Kawamoto, Hirofumi; Takigawa, Nagio

    2016-01-01

    A 76-year-old Japanese woman presented to our hospital with anorexia. Two years before, she was diagnosed with non-Hodgkin’s lymphoma and had received ten cycles of systemic chemotherapy. After salvage chemotherapy with bendamustine and rituximab (B–R), bone marrow suppression had lasted >3 months. Esophagogastroscopy revealed polynesic white protrusions in the mid-esophagus. These lesions were diagnosed as herpetic esophagitis. To the best of our knowledge, there is no other report in which herpetic esophagitis has been documented as an adverse event of B–R regimen. Because the complication could cause symptomatic gastrointestinal discomfort, physicians should be aware of this disease. PMID:27330298

  1. Treatment regimens of classical and newer taxanes.

    PubMed

    Joerger, Markus

    2016-02-01

    The classical taxanes (paclitaxel, docetaxel), the newer taxane cabazitaxel and the nanoparticle-bound nab-paclitaxel are among the most widely used anticancer drugs. The taxanes share the characteristics of extensive hepatic metabolism and biliary excretion, the need for dose adaptation in patients with liver dysfunction, and a substantial pharmacokinetic variability even after taking into account known covariates. Data from clinical studies suggest that optimal scheduling of the taxanes is dependent not only on the specific taxane compound, but also on the tumor type and line of treatment. Still, the optimal dosing regimen (weekly vs 3 weekly) and optimal dose of the taxanes are controversial, as is the value of pharmacological personalization of taxane dosing. In this article, an overview is given on the pharmacological properties of the taxanes, including metabolism, pharmacokinetics-pharmacodynamics and aspects in the clinical use of taxanes. The latter includes the ongoing debate on the most active and safe regimen, the recommended initial dose and the issue of therapeutic drug dosing. PMID:26589792

  2. Sequentially pulsed traveling wave accelerator

    DOEpatents

    Caporaso, George J.; Nelson, Scott D.; Poole, Brian R.

    2009-08-18

    A sequentially pulsed traveling wave compact accelerator having two or more pulse forming lines each with a switch for producing a short acceleration pulse along a short length of a beam tube, and a trigger mechanism for sequentially triggering the switches so that a traveling axial electric field is produced along the beam tube in synchronism with an axially traversing pulsed beam of charged particles to serially impart energy to the particle beam.

  3. Different dosing regimens of repeated ketamine administration have opposite effects on novelty processing in rats.

    PubMed

    Schumacher, Anett; Sivanandan, Brindan; Tolledo, Edgor Cole; Woldegabriel, Jacob; Ito, Rutsuko

    2016-08-01

    Repeated exposure to sub-anesthetic doses of ketamine in rats has been shown to induce cognitive deficits, as well as behavioral changes akin to the negative symptoms of schizophrenia, giving much face validity to the use of ketamine administration as a pharmacological model of schizophrenia. This study sought to further characterize the behavioral effects of two different ketamine pre-treatment regimens, focusing primarily on the effects of repeated ketamine administration on novelty processing, a capacity that is disrupted in schizophrenia. Rats received 5 or 14 intra-peritoneal injections of 30mg/kg ketamine or saline across 5 or 7days, respectively. They were then tested in an associative mismatch detection task to examine their ability to detect novel configurations of familiar audio-visual sequences. Furthermore, rats underwent a sequential novel object and novel object location exploration task. Subsequently, rats were also tested on the delayed matching to place T-maze task, sucrose preference task and locomotor tests involving administering a challenge dose of amphetamine (AMPH). The high-dose ketamine pre-treatment regimen elicited impairments in mismatch detection and working memory. In contrast, the low-dose ketamine pre-treatment regimen improved performance of novelty detection. In addition, low-dose ketamine pre-treated rats showed locomotor sensitization following an AMPH challenge, while the high-dose ketamine pre-treated rats showed an attenuated locomotor response to AMPH, compared to control rats. These findings demonstrate that different regimens of repeated ketamine administration induce alterations in novelty processing in opposite directions, and that differential neural adaptations occurring in the mesolimbic dopamine system may underlie these effects. PMID:27064663

  4. Effects of 10 days 6 degrees head-down tilt on the responses to fluid loading and lower body negative pressure

    NASA Technical Reports Server (NTRS)

    Baisch, F.; Heer, M.; Beck, L.; Blomqvist, C. G.; Kropp, J.; Schulz, H.; Hillebrecht, A.; Meyer, M.

    1991-01-01

    In an international collaborative project six normal male subjects were studied before, during and after 10 days 6 degrees HDT. Fluid intake was controlled at 40 ml/(kgbw day). Urine volume and body weight were determined daily. Fluid loading and LBNP were performed in all three phases of the study. Body weight diminished by 2.6% because of fluid loss. Blood volume diminished by 13%. The responses to fluid loading were similar in the three phases of the study. Sixty minutes after end of infusion only 5.5% of the infused saline remained in the intravascular compartment. Excess interstitial fluid was eliminated in the next 24 hs but a negative balance was recorded also in the following day. The compliance of the lower limbs expressed as the rate of limb volume change/unit LBNP change was increased at the end of the HDT phase and during the post HDT phase. The set point of intravascular volume was defended, as shown by the response to FL. HDT increased the compliance of the lower limbs.

  5. Effects of 10 days 6° head-down tilt on the responses to fluid loading and lower body negative pressure

    NASA Astrophysics Data System (ADS)

    Baisch, F.; Heer, M.; Beck, L.; Blomqvist, C. G.; Kropp, J.; Schulz, H.; Hillebrecht, A.; Meyer, M.

    In an international collaborative project six normal male subjects were studied before, during and after 10 days 6° HDT. Fluid intake was controlled at 40 ml/(kg bw·day). Urine volume and body weight were determined daily. Fluid loading and LBNP were performed in all three phases of the study. Body weight diminished by 2.6% because of fluid loss. Blood volume diminished by 13%. The responses to fluid loading were similar in the three phases of the study. Sixty minutes after end of infusion only 5.5% of the infused saline remained in the intravascular compartment. Excess interstitial fluid was eliminated in the next 24 hs but a negative balance was recorded also in the following day. The compliance of the lower limbs expressed as the rate of limb volume change/unit LBNP change was increased at the end of the HDT phase and during the post HDT phase. The set point of intravascular volume was defended, as shown by the response to FL. HDT increased the compliance of the lower limbs.

  6. Replacement of clarithromycin with azithromycin in triple therapy regimens for the eradication of helicobacter pylori: A randomized clinical trial

    PubMed Central

    Khoshnood, A; Hakimi, P; Salman-Roghani, H; Reza Mirjalili, M

    2014-01-01

    Abstract Background: Eradication of helicobacter pylori is important for treatment of GU but an ideal regimen is not available. HP is resistant to metronidazole and clarithromycin. Clarithromycin is expensive and is not available in under developing countries. This study aimed to compare two regimens containing clarithromycin or azithromycin. Methods: Totally, seventy-eight patients with GU (confirmed with endoscopy) and infection of HP (Confirmed by Rapid Urease Test (RUT)) were allocated to one of the groups of study (35 participants in each group). Two weeks regimen of Clarithromycin (2×500 mg) + Amoxicillin (2×1 gr) + omeprazole (2×20 mg) was administered for group A of patients while group B got a 10 days regimen of Azithromycin (1×250 mg) + 14 days Amoxicillin (2×1 gr) + omeprazole (2×20 mg). At the end of the treatment course, the patients were evaluated according to the side effects of the drugs. In addition, two months after the end of therapy, patients underwent endoscopy and biopsy to evaluate HP eradication. Results: After two weeks, the side effects of the drug were: Nausea 8 patients in group A and 7 patients in group B, Diarrhea 2 patients in group A, 3 patients in group B and vomiting 2 patients in group A, 3 patients in group B. There were no serious side effects in any group. Eradication rate in group A was 82.9% (based on per protocol analysis (PPA)) and 84.6 % (intention to treat (ITT)). In group B, eradication rate was 77.1 % (PPA) and 79.5 % (ITT) (P=0.55). Conclusion: Based on our study results, azithromycin can be used in HP eradication regimen because of its similar efficacy to clarithromycin but also have lower cost, side effects and resistance. PMID:25408735

  7. Sequential Syndrome Decoding of Convolutional Codes

    NASA Technical Reports Server (NTRS)

    Reed, I. S.; Truong, T. K.

    1984-01-01

    The algebraic structure of convolutional codes are reviewed and sequential syndrome decoding is applied to those codes. These concepts are then used to realize by example actual sequential decoding, using the stack algorithm. The Fano metric for use in sequential decoding is modified so that it can be utilized to sequentially find the minimum weight error sequence.

  8. Eradication of Helicobacter pylori in Children by Triple Therapy Regimens of Amoxicillin, Omeprazole, and Clarithromycin or Azithromycin

    PubMed Central

    Esmaeili-Dooki, Mohammad Reza; Shirdel, Hossein; Hajiahmadi, Mahmood

    2015-01-01

    Background and Objectives: The present study aimed to evaluate the effect of classical and azithromycin-containing triple therapy eradication regimen against H. Pylori in children, and to determine the level of patients’ tolerance. Patients and Methods: This single clinical trial was performed in 2014 on 2 to 15 years old children. All children, in whom H. Pylori infection was confirmed through multiple biopsies of the stomach and required treatment, were enrolled in the study. H. Pylori-positive patients were treated alternately with two different drug regimens; Group OCA received clarithromycin 7.5 mg/kg/day every 12 hours for 10 days, amoxicillin 50 mg/kg/day every 12 hours for 10 days, and omeprazole 1 mg/kg/day every 12 hours for two weeks, and Group OAA received azithromycin 10 mg/kg/day once a day (before meal) for 6 days along with amoxicillin and omeprazole. Four to six weeks after completion of treatment, patients’ stool was tested for H. Pylori through the monoclonal method using the Helicobacter antigen quick kit. Results: There were no significant differences between the two groups regarding gender and age of patients. Based on ITT analysis, the therapeutic response in the OAA and OCA groups were 56.2% and 62.5%, respectively (P = 0.40). Drug adverse effects were 15.6% in the OCA and 3.1% in the OAA group (P = 0.19). Conclusions: The therapeutic response was seen in more than half of the patients treated with triple therapy of H. Pylori eradication regimen including azithromycin or clarithromycin, and there was no significant difference between the two treatment groups. PMID:26635936

  9. Ocean-Atmosphere Environments of Antarctic-Region Cold-Air Mesocyclones: Evaluation of Reanalyses for Contrasting Adjacent 10-Day Periods ("Macro-Weather") in Winter.

    NASA Astrophysics Data System (ADS)

    Carleton, A. M.; Auger, J.; Birkel, S. D.; Maasch, K. A.; Mayewski, P. A.; Claud, C.

    2015-12-01

    Mesoscale cyclones in cold-air outbreaks (mesocyclones) feature in the weather and climate of the Antarctic (e.g., Ross Sea) and sub-antarctic (Drake Passage). They adversely impact field operations, and influence snowfall, the ice-sheet mass balance, and sea-air energy fluxes. Although individual mesocyclones are poorly represented on reanalyses, these datasets robustly depict the upper-ocean and troposphere environments in which multiple mesocyclones typically form. A spatial metric of mesocyclone activity—the Meso-Cyclogenesis Potential (MCP)—used ERA-40 anomaly fields of: sea surface temperature (SST) minus marine air temperature (MAT), near-surface winds, 500 hPa air temperature, and the sea-ice edge location. MCP maps composited by teleconnection phases for 1979-2001, broadly correspond to short-period satellite "climatologies" of mesocyclones. Here, we assess 3 reanalysis datasets (CFSR, ERA-I and MERRA) for their reliably to depict MCP patterns on weekly to sub-monthly periods marked by strong regional shifts in mesocyclone activity (frequencies, track densities) occurring during a La Niña winter: June 21-30, 1999 (SE Indian Ocean) and September 1-10, 1999 (Ross Sea sector). All reanalyses depict the marked variations in upper ocean and atmosphere variables between adjacent 10-day periods. Slight differences may owe to model resolution or internal components (land surface, coupled ocean models), and/or how the observations are assimilated. For June 21-30, positive SST-MAT, southerly winds, proximity to the ice edge, and negative T500, accompany increased meso-cyclogenesis. However, for September 1-10, surface forcing does not explain frequent comma cloud "polar lows" north-east of the Ross Sea. Inclusion of the upper-level diffluence (e.g., from Z300 field) in the MCP metric, better depicts the observed mesocyclone activity. MCP patterns on these "macro-weather" time scales appear relatively insensitive to the choice of reanalysis.

  10. Efficacy of a nonsurgical treatment regimen in patients with bisphosphonate-related osteonecrosis of the jaws in Saudi Arabia

    PubMed Central

    2014-01-01

    Objectives: The objective of this study was to evaluate the effectiveness of a nonsurgical treatment regimen in the long-term control of necrotic areas of the jaws and pain in such patients. Methods: A total of 96 patients suffering from the disease were included in this study. All patients received nonsurgical treatment regimen for 10 days, and repeated every 3 months for 2 years. The size of the osteonecrotic lesions was measured and the pain level was self-assessed with a visual analog scale. Results: The patients showed a statistically significant (F = 16.1; p < .01; r2 = .95) gradual decrease in the size of exposed bone areas during the nonsurgical therapy (from 12.5 to 8.8 mm). Pain scores ranged from 0 to 3 score scale. Complete resolution of the disease was observed in some patients. Conclusions: This conservative nonsurgical treatment regimen seems to provide successful treatment in reduction of the sizes of exposed bone areas in the majority of patients. PMID:26770707

  11. A bit serial sequential circuit

    NASA Technical Reports Server (NTRS)

    Hu, S.; Whitaker, S.

    1990-01-01

    Normally a sequential circuit with n state variables consists of n unique hardware realizations, one for each state variable. All variables are processed in parallel. This paper introduces a new sequential circuit architecture that allows the state variables to be realized in a serial manner using only one next state logic circuit. The action of processing the state variables in a serial manner has never been addressed before. This paper presents a general design procedure for circuit construction and initialization. Utilizing pass transistors to form the combinational next state forming logic in synchronous sequential machines, a bit serial state machine can be realized with a single NMOS pass transistor network connected to shift registers. The bit serial state machine occupies less area than other realizations which perform parallel operations. Moreover, the logical circuit of the bit serial state machine can be modified by simply changing the circuit input matrix to develop an adaptive state machine.

  12. Universality of sequential quantum measurements

    NASA Astrophysics Data System (ADS)

    Heinosaari, Teiko; Miyadera, Takayuki

    2015-02-01

    We show that any jointly measurable pair of quantum observables can be obtained in a sequential measurement scheme, even if the second observable will be decided after the first measurement. This means that it is possible to perform a measurement of any quantum observable in a way that does not disturb the subsequent measurements more than is dictated by joint measurability. Only measurements with a specific structure have this universality feature. As a supplementing result, we provide a characterization of all possible joint measurements obtained from a sequential measurement lacking universality.

  13. Pathways through which a regimen of melatonin and retinoic acid induces apoptosis in MCF-7 human breast cancer cells.

    PubMed

    Eck-Enriquez, K; Kiefer, T L; Spriggs, L L; Hill, S M

    2000-06-01

    It has been established that melatonin (Mlt) and retinoic acid, individually, inhibit the proliferation of the estrogen receptor-alpha (ER alpha)-positive MCF-7 breast cancer cell line. Our laboratory has previously demonstrated that Mlt and all-trans-retinoic acid (atRA) not only inhibit the proliferation, but also induce apoptosis of MCF-7 cells when used in a sequential regimen of Mlt followed 24 h later by atRA. Using this same MCF-7 breast cancer cell line, we investigated the potential pathways through which apoptosis is being induced. We found that treatment of MCF-7 cells with Mlt for 24 h before the addition of atRA decreased the protein levels of the death suppressor, Bcl-2, and increased, although with different time courses, the levels of the death promoters, Bax and Bak; however, there was no change in the levels of the tumor suppressor gene, p53. MCF-7 cells treated sequentially with Mlt and atRA also demonstrated an enhanced sensitivity to the apoptotic effects of atRA, which did not appear to be due to increased expression of the retinoic acid receptors, RAR alpha or RXR alpha, but rather to enhanced transcriptional activity of the RAR alpha. These data suggest that the sequential treatment regimen of Mlt and atRA may induce apoptosis by modulation of members of the Bcl-2 family of proteins. Thus, this combinatorial regimen, which reduces the concentration of atRA needed for clinical efficacy while enhancing its anti-tumorigenic activity, could be of great therapeutic benefit, and may, in fact, specifically induce the regression of established breast tumors due to its apoptosis-promoting effects. PMID:10965999

  14. Sequential Processes In Image Generation.

    ERIC Educational Resources Information Center

    Kosslyn, Stephen M.; And Others

    1988-01-01

    Results of three experiments are reported, which indicate that images of simple two-dimensional patterns are formed sequentially. The subjects included 48 undergraduates and 16 members of the Harvard University (Cambridge, Mass.) community. A new objective methodology indicates that images of complex letters require more time to generate. (TJH)

  15. Sequential Effects in Essay Ratings

    ERIC Educational Resources Information Center

    Attali, Yigal

    2011-01-01

    Contrary to previous research on sequential ratings of student performance, this study found that professional essay raters of a large-scale standardized testing program produced ratings that were drawn toward previous ratings, creating an assimilation effect. Longer intervals between the two adjacent ratings and higher degree of agreement with…

  16. In silico evaluation and exploration of antibiotic tuberculosis treatment regimens

    DOE PAGESBeta

    Pienaar, Elsje; Dartois, Véronique; Linderman, Jennifer J.; Kirschner, Denise E.

    2015-11-14

    Improvement in tuberculosis treatment regimens requires selection of antibiotics and dosing schedules from a large design space of possibilities. Incomplete knowledge of antibiotic and host immune dynamics in tuberculosis granulomas impacts clinical trial design and success, and variations among clinical trials hamper side-by-side comparison of regimens. Our objective is to systematically evaluate the efficacy of isoniazid and rifampin regimens, and identify modifications to these antibiotics that improve treatment outcomes. We pair a spatio-temporal computational model of host immunity with pharmacokinetic and pharmacodynamic data on isoniazid and rifampin. The model is calibrated to plasma pharmacokinetic and granuloma bacterial load data frommore » non-human primate models of tuberculosis and to tissue and granuloma measurements of isoniazid and rifampin in rabbit granulomas. We predict the efficacy of regimens containing different doses and frequencies of isoniazid and rifampin. We predict impacts of pharmacokinetic/pharmacodynamic modifications on antibiotic efficacy. We demonstrate that suboptimal antibiotic concentrations within granulomas lead to poor performance of intermittent regimens compared to daily regimens. Improvements from dose and frequency changes are limited by inherent antibiotic properties, and we propose that changes in intracellular accumulation ratios and antimicrobial activity would lead to the most significant improvements in treatment outcomes. Results suggest that an increased risk of drug resistance in fully intermittent as compared to daily regimens arises from higher bacterial population levels early during treatment. In conclusion, our systems pharmacology approach complements efforts to accelerate tuberculosis therapeutic development.« less

  17. Nonequilibrium structure in sequential assembly

    NASA Astrophysics Data System (ADS)

    Popov, Alexander V.; Craven, Galen T.; Hernandez, Rigoberto

    2015-11-01

    The assembly of monomeric constituents into molecular superstructures through sequential-arrival processes has been simulated and theoretically characterized. When the energetic interactions allow for complete overlap of the particles, the model is equivalent to that of the sequential absorption of soft particles on a surface. In the present work, we consider more general cases by including arbitrary aggregating geometries and varying prescriptions of the connectivity network. The resulting theory accounts for the evolution and final-state configurations through a system of equations governing structural generation. We find that particle geometries differ significantly from those in equilibrium. In particular, variations of structural rigidity and morphology tune particle energetics and result in significant variation in the nonequilibrium distributions of the assembly in comparison to the corresponding equilibrium case.

  18. Maintenance immunosuppression regimens: conversion, minimization, withdrawal, and avoidance.

    PubMed

    Yang, Harold

    2006-04-01

    A wide choice of drug combinations is available to clinicians for immunosuppression regimens for their kidney transplant patients. Although many protocols have minimized early graft loss, the optimal long-term regimen is unknown. Recent studies clearly showed that cardiovascular death is now the leading cause of graft loss. Strategies must be developed that address this risk while keeping immunologic events low. Transplant physicians have focused on exploring regimens that minimize or avoid the use of corticosteroids. Studies also have started to explore protocols that minimize calcineurin inhibitor therapy. PMID:16567240

  19. Blocking for Sequential Political Experiments

    PubMed Central

    Moore, Sally A.

    2013-01-01

    In typical political experiments, researchers randomize a set of households, precincts, or individuals to treatments all at once, and characteristics of all units are known at the time of randomization. However, in many other experiments, subjects “trickle in” to be randomized to treatment conditions, usually via complete randomization. To take advantage of the rich background data that researchers often have (but underutilize) in these experiments, we develop methods that use continuous covariates to assign treatments sequentially. We build on biased coin and minimization procedures for discrete covariates and demonstrate that our methods outperform complete randomization, producing better covariate balance in simulated data. We then describe how we selected and deployed a sequential blocking method in a clinical trial and demonstrate the advantages of our having done so. Further, we show how that method would have performed in two larger sequential political trials. Finally, we compare causal effect estimates from differences in means, augmented inverse propensity weighted estimators, and randomization test inversion. PMID:24143061

  20. Chemotherapy Regimen Extends Survival in Advanced Pancreatic Cancer Patients

    Cancer.gov

    A four-drug chemotherapy regimen has produced the longest improvement in survival ever seen in a phase III clinical trial of patients with metastatic pancreatic cancer, one of the deadliest types of cancer.

  1. Gonzalez Regimen (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about the Gonzalez regimen as a treatment for people with cancer. Note: The information in this summary is no longer being updated and is provided for reference purposes only.

  2. New regimens for intravenous acetylcysteine, where are we now?

    PubMed

    Bateman, D Nicholas; Dear, James W; Thomas, Simon H L

    2016-01-01

    Acetylcysteine has been used as a treatment for paracetamol overdose as a 20.25- or 21-h infusion for nearly 40 years. These regimens give 50% of the dose in the first 15 min or 1 h, and are associated with high rates of adverse reactions. A randomised controlled trial has demonstrated that a shorter (12 h) and simpler (two infusions) acetylcysteine regimen using a slower initial infusion rate produces lower rates of adverse events than the original 20.25-h regimen. However, this study was not sufficiently large to show therapeutic equivalence as a hepatoprotective therapy in paracetamol overdose. Two further studies are now reported, which also suggest lower rates of adverse reactions with lower initial rates of acetylcysteine administration. These modified regimens can now be accepted as better tolerated, but it is unlikely that a randomised study of sufficient size to demonstrate non-inferiority of any novel regimen would ever be funded. Against this background we suggest what can be done to establish the efficacy of these less toxic and potentially shorter alternative acetylcysteine regimens and to establish them into routine clinical use. PMID:26666290

  3. Ovarian response to repeated administration of alternating exogenous gonadotropin regimens in the ocelot (Leopardus pardalis) and tigrinus (Leopardus tigrinus).

    PubMed

    da Paz, Regina Celia Rodrigues; Dias, Eduardo Antunes; Adania, Cristina Harumi; Barnabe, Valquíria Hippólito; Barnabe, Renato Campanarut

    2006-10-01

    Exogenous gonadotropins are used to stimulate ovarian follicular growth and ovulation in mammalian species, including wild cats. However, successes in application of assisted reproduction techniques in nondomestic felids have been sparse. Our objectives were to assess the effectiveness of alternating gonadotropin regimens on ovarian responses. Five adult female ocelots and four adult female tigrinus were treated four to six times, using alternating eCG/hCG and pFSH/pLH at 4-month intervals. Laparoscopies were done to assess follicular development and to collect oocytes from matures follicles. The average number of follicles and corpus luteum (CL) per stimulation was higher in ocelots (7.0 +/- 0.8; mean +/- S.E.M.) than in tigrinus (2.5 +/- 0.4; P < 0.05), but the percentage of mature oocytes did not differ between the two species (mean range, 54-55%). Within species, both gonadotropin regimens were equally effective in inducing follicular growth and oocyte maturation. The total number of ovarian structures and oocyte maturation percentages did not decrease in either species with sequential stimulations. In summary, female ocelots and tigrinus continued to respond to repeated alternating ovarian stimulation protocols. In conclusion, the use of alternating gonadotropin regimens may permit more intensive reproductive management in these endangered cats. PMID:16472853

  4. An alternative regimen of hormone replacement therapy to improve patient compliance.

    PubMed

    Kemp, J F; Fryer, J A; Baber, R J

    1989-02-01

    In order to achieve the long-term benefits from hormone replacement therapy of a markedly reduced incidence of heart disease and osteoporosis, a high degree of compliance is essential. In an effort to obtain high compliance, it was decided to introduce a cyclic therapy of 6 months duration using conjugated oestrogens supported by a 10-day course of progestogens. A total of 85 patients were treated prospectively. Compliance was assessed by the number of patients continuing treatment, and endometrial response was assessed by office biopsy and cytological or histological examination. Five patients withdrew, giving an overall compliance rate of 94%. Two have subsequently resumed therapy, thus 98% of those enrolled are currently receiving hormone replacement therapy. No cases of endometrial carcinoma were detected during the trial period of 4 years. Two cases of mild atypical endometrial hyperplasia were detected but both were mild and reverted to secretory or inactive endometrium following progestogen therapy. This regimen provides a viable alternative for those women who are troubled by progestogenic side-effects and monthly withdrawal bleeding. PMID:2562774

  5. Sequential ranging: How it works

    NASA Technical Reports Server (NTRS)

    Baugh, Harold W.

    1993-01-01

    This publication is directed to the users of data from the Sequential Ranging Assembly (SRA), and to others who have a general interest in range measurements. It covers the hardware, the software, and the processes used in acquiring range data; it does not cover analytical aspects such as the theory of modulation, detection, noise spectral density, and other highly technical subjects. In other words, it covers how ranging is done, but not the details of why it works. The publication also includes an appendix that gives a brief discussion of PN ranging, a capability now under development.

  6. A high speed sequential decoder

    NASA Technical Reports Server (NTRS)

    Lum, H., Jr.

    1972-01-01

    The performance and theory of operation for the High Speed Hard Decision Sequential Decoder are delineated. The decoder is a forward error correction system which is capable of accepting data from binary-phase-shift-keyed and quadriphase-shift-keyed modems at input data rates up to 30 megabits per second. Test results show that the decoder is capable of maintaining a composite error rate of 0.00001 at an input E sub b/N sub o of 5.6 db. This performance has been obtained with minimum circuit complexity.

  7. Random sequential adsorption on fractals

    NASA Astrophysics Data System (ADS)

    Ciesla, Michal; Barbasz, Jakub

    2012-07-01

    Irreversible adsorption of spheres on flat collectors having dimension d < 2 is studied. Molecules are adsorbed on Sierpinski's triangle and carpet-like fractals (1 < d < 2), and on general Cantor set (d < 1). Adsorption process is modeled numerically using random sequential adsorption (RSA) algorithm. The paper concentrates on measurement of fundamental properties of coverages, i.e., maximal random coverage ratio and density autocorrelation function, as well as RSA kinetics. Obtained results allow to improve phenomenological relation between maximal random coverage ratio and collector dimension. Moreover, simulations show that, in general, most of known dimensional properties of adsorbed monolayers are valid for non-integer dimensions.

  8. Random sequential adsorption of tetramers

    NASA Astrophysics Data System (ADS)

    Cieśla, Michał

    2013-07-01

    Adsorption of a tetramer built of four identical spheres was studied numerically using the random sequential adsorption (RSA) algorithm. Tetramers were adsorbed on a two-dimensional, flat and homogeneous surface. Two different models of the adsorbate were investigated: a rhomboid and a square one; monomer centres were put on vertices of rhomboids and squares, respectively. Numerical simulations allow us to establish the maximal random coverage ratio as well as the available surface function (ASF), which is crucial for determining kinetics of the adsorption process. These results were compared with data obtained experimentally for KfrA plasmid adsorption. Additionally, the density autocorrelation function was measured.

  9. Random sequential adsorption on fractals.

    PubMed

    Ciesla, Michal; Barbasz, Jakub

    2012-07-28

    Irreversible adsorption of spheres on flat collectors having dimension d < 2 is studied. Molecules are adsorbed on Sierpinski's triangle and carpet-like fractals (1 < d < 2), and on general Cantor set (d < 1). Adsorption process is modeled numerically using random sequential adsorption (RSA) algorithm. The paper concentrates on measurement of fundamental properties of coverages, i.e., maximal random coverage ratio and density autocorrelation function, as well as RSA kinetics. Obtained results allow to improve phenomenological relation between maximal random coverage ratio and collector dimension. Moreover, simulations show that, in general, most of known dimensional properties of adsorbed monolayers are valid for non-integer dimensions. PMID:22852643

  10. Delay test generation for synchronous sequential circuits

    NASA Astrophysics Data System (ADS)

    Devadas, Srinivas

    1989-05-01

    We address the problem of generating tests for delay faults in non-scan synchronous sequential circuits. Delay test generation for sequential circuits is a considerably more difficult problem than delay testing of combinational circuits and has received much less attention. In this paper, we present a method for generating test sequences to detect delay faults in sequential circuits using the stuck-at fault sequential test generator STALLION. The method is complete in that it will generate a delay test sequence for a targeted fault given sufficient CPU time, if such a sequence exists. We term faults for which no delay test sequence exists, under out test methodology, sequentially delay redundant. We describe means of eliminating sequential delay redundancies in logic circuits. We present a partial-scan methodology for enhancing the testability of difficult-to-test of untestable sequential circuits, wherein a small number of flip-flops are selected and made controllable/observable. The selection process guarantees the elimination of all sequential delay redundancies. We show that an intimate relationship exists between state assignment and delay testability of a sequential machine. We describe a state assignment algorithm for the synthesis of sequential machines with maximal delay fault testability. Preliminary experimental results using the test generation, partial-scan and synthesis algorithm are presented.

  11. Do Probiotics Improve Eradication Response to Helicobacter Pylori on Standard Triple or Sequential Therapy?

    PubMed Central

    Dajani, Asad I.; Hammour, Adnan M. Abu; Yang, Ding H.; Chung, Peter C.; Nounou, Mohammed A.; Yuan, KaiTao Y.; Zakaria, Mohammed A.; Schi, Hanping S.

    2013-01-01

    Background: The standard triple therapy for the eradication of Helicobacter pylori consists of a combination of a proton pump inhibitor at a standard dose together with two antibiotics (amoxicillin 1000 mg plus either clarithromycin 500 mg or metronidazole 400 mg) all given twice daily for a period of 7-14 days. Recent reports have shown a dramatic decline in the rate of H. pylori eradication utilizing standard triple therapy from 95% down to 70-80%. Aims: Our study was designed to evaluate the effect of adding a probiotic as an adjuvant to common regimens used for H. pylori eradication. Materials and Methods: An open label randomized observational clinical study was designed to test three different regimens of H. pylori eradication treatment: Standard triple therapy with a concomitant probiotic added at the same time (n = 100), starting the probiotic for 2 weeks before initiating standard triple therapy along with the probiotic (n = 95), and the third regimen consists of the probiotic given concomitantly to sequential treatment (n = 76). The three arms were compared to a control group of patients treated with the traditional standard triple therapy (n = 106). Results: The eradication rate for the traditional standard therapy was 68.9%, and adding the probiotic “Bifidus infantis” to triple therapy, led to a successful rate of eradication of 83% (P < 0.001). Pre-treatment with 2 weeks of B. infantis before adding it to standard triple therapy increased the success rate of eradication to 90.5%. Similar improvement in eradication rate was noted when B. infantis was added as an adjuvant to the sequential therapy leading to an eradication rate of 90.8%. Conclusion: Adding B. infantis as an adjuvant to several therapeutic regimens commonly used for the eradication of H. pylori infection significantly improves the cure rates. PMID:23680708

  12. Counting Pyrazinamide in Regimens for Multidrug-Resistant Tuberculosis

    PubMed Central

    Becerra, Mercedes C.; Tierney, Dylan B.; Rich, Michael L.; Bonilla, Cesar; Bayona, Jaime; McLaughlin, Megan M.; Mitnick, Carole D.

    2015-01-01

    Rationale: For treatment of multidrug-resistant tuberculosis, World Health Organization (WHO) guidelines recommend four likely effective drugs plus pyrazinamide (PZA), irrespective of the likely effectiveness of PZA in an individual patient. Whether this regimen should be supplemented in the absence of likely PZA effectiveness is an open question. Objectives: The objectives of this study were to examine (1) whether individuals receiving four likely effective drugs (based on documented susceptibility or no prior exposure) experienced higher mortality during the intensive phase of treatment than those receiving five likely effective drugs and (2) whether the WHO-recommended regimen (four likely effective drugs plus PZA) may be compromised in individuals in whom PZA is not likely effective. Methods: Among 668 patients, we compared the hazard of death across regimen groups characterized by the number of likely effective drugs and whether pyrazinamide was one of the likely effective drugs. Measurements and Main Results: Relative to five likely effective drugs, regimens of four likely effective drugs and the WHO-recommended regimen used in individuals in whom PZA was not likely effective were associated with higher mortality rates (respectively, adjusted hazard ratio [HR], 2.87; 95% confidence interval [CI], 1.35–6.09 and adjusted HR, 2.76; 95% CI, 0.92–8.27). The mortality rate for a regimen of five likely effective drugs with likely effective PZA was similar to that for the regimen of five likely effective drugs without PZA (HR, 1.00; 95% CI, 0.12–8.00). Conclusions: Mortality may be reduced by the inclusion of five likely effective drugs, including an injectable, during the intensive phase of treatment. If PZA is unlikely to be effective in an individual patient, these results suggest adding a different, likely effective drug. PMID:25664920

  13. Sequentially evolved bilateral epidural haematomas.

    PubMed

    Rochat, P; Johannesen, H H; Poulsgård, L; Bøgeskov, L

    2002-12-01

    Sequentially evolved bilateral epidural haematomas, where the second haematoma evolves after surgical removal of the first haematoma, are rarely reported. We report two cases of this entity. One patient was involved in a road traffic accident and the other was suffering from a head injury after an assault. CT scans showed that both patients had an unilateral epidural haematoma with a thin presumably epidural haemorrhage on the opposite side. Both patients were operated for their epidural haematomas, but did not improve after surgical treatment, and postoperative CT scans revealed evolving of an epidural haematoma on the opposite side. After evacuation of the second epidural haematoma both patients recovered quickly. Sequentially evolved bilateral epidural haematomas are rare, but must be considered in the postoperative intensive care treatment in patients with epidural haematomas. Both cases emphasize the need for intensive care monitoring after an operation for an epidural haematoma and the need for CT scans if the patient does not improve quickly after removal of the haematoma. This is especially important if a small contralateral haematoma is seen on the initial CT scan. PMID:12445923

  14. Quantum estimation via sequential measurements

    NASA Astrophysics Data System (ADS)

    Burgarth, Daniel; Giovannetti, Vittorio; Kato, Airi N.; Yuasa, Kazuya

    2015-11-01

    The problem of estimating a parameter of a quantum system through a series of measurements performed sequentially on a quantum probe is analyzed in the general setting where the underlying statistics is explicitly non-i.i.d. We present a generalization of the central limit theorem in the present context, which under fairly general assumptions shows that as the number N of measurement data increases the probability distribution of functionals of the data (e.g., the average of the data) through which the target parameter is estimated becomes asymptotically normal and independent of the initial state of the probe. At variance with the previous studies (Guţă M 2011 Phys. Rev. A 83 062324; van Horssen M and Guţă M 2015 J. Math. Phys. 56 022109) we take a diagrammatic approach, which allows one to compute not only the leading orders in N of the moments of the average of the data but also those of the correlations among subsequent measurement outcomes. In particular our analysis points out that the latter, which are not available in usual i.i.d. data, can be exploited in order to improve the accuracy of the parameter estimation. An explicit application of our scheme is discussed by studying how the temperature of a thermal reservoir can be estimated via sequential measurements on a quantum probe in contact with the reservoir.

  15. Clarithromycin vs. Gemifloxacin in Quadruple Therapy Regimens for Empiric Primary Treatment of Helicobacter pylori Infection: A Randomized Clinical Trial

    PubMed Central

    Masoodi, Mohsen; Talebi-Taher, Mahshid; Tabatabaie, Khadijeh; Khaleghi, Siamak; Faghihi, Amir-Hossein; Agah, Shahram; Asadi, Reyhaneh

    2015-01-01

    BACKGROUND Eradication of Helicobacter pylori infection plays a crucial role in the treatment of peptic ulcer. Clarithromycin resistance is a major cause of treatment failure. This randomized clinical trial aimed at evaluating the efficacy of a clarithromycin versus gemifloxacin containing quadruple therapy regimen in eradication of H.pylori infection. METHODS In this randomized double blind clinical trial (RCT 2012102011054N2), a total of 120 patients were randomized to two groups of 60 patients each. Patients with proven H.pylori infection were consecutively assigned into two groups to receive OBAG or OBAC in gastroenterology clinic in Rasoul-e- Akram General Hospital in Tehran, Iran. The patients in the OBAG group received omeprazole (20 mg) twice daily, bismuth subcitrate (240 mg) twice daily, amoxicillin (1 gr) twice daily, and gemifloxacin (320 mg) once daily, and those in the OBAC group received omeprazole (20 mg) twice daily, 240 mg of bismuth subcitrate twice daily, amoxicillin (1 gr) twice daily, and clarithromycin (500 mg) twice daily for 10 days. RESULTS Five patients from each group were excluded from the study because of poor compliance, so 110 patients completed the study. The intention-to-treat eradication rate was 61.6% and 66.6% for the OBAC and OBAG groups, respectively. According to the per protocol analysis, the success rates of eradication of H.pylori infection were 67.2% and 72.7% for OBAC and OBAG groups, respectively (p=0.568). CONCLUSION The results of this study suggest that gemifloxacin containing regimen is at least as effective as clarithromycin regimen; hence, this new treatment could be considered as an alternative for the patients who cannot tolerate clarithromycin. PMID:26106468

  16. Adherence to health regimens among frequent attenders of Finnish healthcare

    PubMed Central

    Hirsikangas, Sari; Kanste, Outi; Korpelainen, Juha; Kyngäs, Helvi

    2016-01-01

    Objectives The aim of the study was to describe adherence to health regimens and the factors associated with it among adult frequent attenders (FAs). Design This was a cross-sectional study. The study sample consisted of 462 healthcare FAs in 7 municipal health centres in northern Finland. An FA is a person who has had 8 or more outpatient visits to a GP (in a health centre) or 4 or more outpatient visits to a university hospital during 1 year. The main outcome was self-reported adherence to health regimens. Results Of the FAs, 82% adhered well to their health regimens. Carrying out self-care, medical care and feeling responsible for self-care were the most significant predictors to good adherence in all models. No significant differences in adherence were found in male and female subjects, age groups or educational levels. Support from healthcare providers and support from relatives were not significant predictors of good adherence. Conclusion FAs in Finland adhere well to health regimens and exceptionally well to medication. Variables that predict the best adherence of FAs to health regimens are carrying out self-care, receiving medical care and feeling responsible for self-care. PMID:26996780

  17. Antiplatelet Effect of Sequential Administration of Cilostazol in Patients with Acetylsalycilic Acid Resistance

    PubMed Central

    Cakmak, Muzaffer; Demircelik, Bora; Cetin, Mustafa; Cetin, Zehra; Isık, Serhat; Cıcekcıoglu, Hulya; Ulusoy, Feridun Vasfi; Eryonucu, Beyhan

    2016-01-01

    Background Acetylsalicylic acid (ASA) resistance in patients with coronary artery disease is an important medical problem that can affect treatment decision-making and outcomes. Cilostazol has been investigated to determine its effectiveness in patients with acetylsalicylic acid resistance. The aim of this study was to evaluate the antiplatelet efficacy of sequential administration of CLZ in patients with ASA resistance. Methods A total of 180 patients were enrolled in our study. Patients with stable coronary artery disease were first given orally ASA 100 for 10 days, followed by collagen/epinephrine induced closure time (CTCEPI) measurements. Those who were found to be resistant to orally 100 mg of ASA were given orally 300 mg of ASA for an additional 10 days after which we repeated CTCEPI measurements. Those patients with resistance to orally 300 mg ASA were then given CLZ at a daily dose of orally 200 mg for 10 days followed by a final CTCEPI measurement. Results The rate of resistance to 100 mg ASA was 81/180 (45%) compared to a rate of 35/81 (43.2%) with 300 mg ASA. Of the 35 patients found to be resistant to 300 mg ASA, 22 (62.9%) also failed to respond to CLZ treatment. Overall, sequential administration of 300 mg ASA and 200 mg CLZ resulted in a reduction in the number of non-responders from 45% to 12.2%. Conclusions Initiation of CLZ could be of benefit in some patients with ASA-resistance for whom an effective anti-aggregant effect is of clinical importance. PMID:27274173

  18. Secure sequential transmission of quantum information

    NASA Astrophysics Data System (ADS)

    Jeong, Kabgyun; Kim, Jaewan

    2015-09-01

    We propose a quantum communication protocol that can be used to transmit any quantum state, one party to another via several intermediate nodes, securely on quantum communication network. The scheme makes use of the sequentially chained and approximate version of private quantum channels satisfying certain commutation relation of n-qubit Pauli operations. In this paper, we study the sequential structure, security analysis, and efficiency of the quantum sequential transmission protocol in depth.

  19. Structural features of sequential weak measurements

    NASA Astrophysics Data System (ADS)

    Diósi, Lajos

    2016-07-01

    We discuss the abstract structure of sequential weak measurement (WM) of general observables. In all orders, the sequential WM correlations without postselection yield the corresponding correlations of the Wigner function, offering direct quantum tomography through the moments of the canonical variables. Correlations in spin-1/2 sequential weak measurements coincide with those in strong measurements, they are constrained kinematically, and they are equivalent with single measurements. In sequential WMs with postselection, an anomaly occurs, different from the weak value anomaly of single WMs. In particular, the spread of polarization σ ̂ as measured in double WMs of σ ̂ will diverge for certain orthogonal pre- and postselected states.

  20. Analgesic regimens for third molar surgery: pharmacologic and behavioral considerations.

    PubMed

    Moore, P A; Werther, J R; Seldin, E B; Stevens, C M

    1986-11-01

    The level of pain following the extraction of impacted third molars was evaluated in 75 patients. Participants were administered acetaminophen 1,000 mg or a placebo before surgery. After surgery, acetaminophen 650 mg was administered either at fixed intervals or as needed to relieve pain. When acetaminophen was administered before surgery, the onset of peak pain was delayed and patient discomfort was decreased 3, 4, and 5 hours after surgery. Patients following the fixed interval regimen after surgery experienced more pain overall and requested the backup narcotic analgesic more frequently. Of the regimens tested, patients preferred the regimen of acetaminophen 1,000 mg administered before surgery with acetaminophen administered as needed for pain after surgery. PMID:3465787

  1. Design of initial dosage regimen using a programmable calculator.

    PubMed

    Ritschel, W A; Eldon, M A

    1985-07-01

    A programmable calculator procedure for the determination of dosage regimens to achieve desired steady state concentrations is described. The dosage regimen prediction is based on data from the literature on pharmacokinetic parameters of drugs and correction factors specific for the patient's condition, such as renal failure, geriatric patient and congestive heart failure. The program is designed to generate dosage regimens based on desired steady state trough level, desired steady state peak level, desired mean steady state level, or to fluctuate between desired steady state peak and trough levels. The program can be used for I.V. and extravascular route of administration. A detailed program description and user instructions are presented and illustrated by three examples. PMID:3840551

  2. Sequentially Executed Model Evaluation Framework

    SciTech Connect

    2015-10-20

    Provides a message passing framework between generic input, model and output drivers, and specifies an API for developing such drivers. Also provides batch and real-time controllers which step the model and I/O through the time domain (or other discrete domain), and sample I/O drivers. This is a library framework, and does not, itself, solve any problems or execute any modeling. The SeMe framework aids in development of models which operate on sequential information, such as time-series, where evaluation is based on prior results combined with new data for this iteration. Has applications in quality monitoring, and was developed as part of the CANARY-EDS software, where real-time water quality data is being analyzed for anomalies.

  3. Sequentially Executed Model Evaluation Framework

    SciTech Connect

    2014-02-14

    Provides a message passing framework between generic input, model and output drivers, and specifies an API for developing such drivers. Also provides batch and real-time controllers which step the model and 1/0 through the time domain (or other discrete domain), and sample 1/0 drivers. This is a Framework library framework, and does not, itself, solve any problems or execute any modelling. The SeMe framework aids in development of models which operate on sequential information, such as time-series, where evaluation is based on prior results combined with new data for this iteration. Ha) applications in quality monitoring, and was developed as part of the CANARY-EDS software, where real-time water quality data is being analyzed

  4. Sequential detection of web defects

    DOEpatents

    Eichel, Paul H.; Sleefe, Gerard E.; Stalker, K. Terry; Yee, Amy A.

    2001-01-01

    A system for detecting defects on a moving web having a sequential series of identical frames uses an imaging device to form a real-time camera image of a frame and a comparitor to comparing elements of the camera image with corresponding elements of an image of an exemplar frame. The comparitor provides an acceptable indication if the pair of elements are determined to be statistically identical; and a defective indication if the pair of elements are determined to be statistically not identical. If the pair of elements is neither acceptable nor defective, the comparitor recursively compares the element of said exemplar frame with corresponding elements of other frames on said web until one of the acceptable or defective indications occur.

  5. Sequentially Executed Model Evaluation Framework

    2014-02-14

    Provides a message passing framework between generic input, model and output drivers, and specifies an API for developing such drivers. Also provides batch and real-time controllers which step the model and 1/0 through the time domain (or other discrete domain), and sample 1/0 drivers. This is a Framework library framework, and does not, itself, solve any problems or execute any modelling. The SeMe framework aids in development of models which operate on sequential information, suchmore » as time-series, where evaluation is based on prior results combined with new data for this iteration. Ha) applications in quality monitoring, and was developed as part of the CANARY-EDS software, where real-time water quality data is being analyzed« less

  6. Sequentially Executed Model Evaluation Framework

    2015-10-20

    Provides a message passing framework between generic input, model and output drivers, and specifies an API for developing such drivers. Also provides batch and real-time controllers which step the model and I/O through the time domain (or other discrete domain), and sample I/O drivers. This is a library framework, and does not, itself, solve any problems or execute any modeling. The SeMe framework aids in development of models which operate on sequential information, such asmore » time-series, where evaluation is based on prior results combined with new data for this iteration. Has applications in quality monitoring, and was developed as part of the CANARY-EDS software, where real-time water quality data is being analyzed for anomalies.« less

  7. Sequential power-up circuit

    DOEpatents

    Kronberg, James W.

    1992-01-01

    A sequential power-up circuit for starting several electrical load elements in series to avoid excessive current surge, comprising a voltage ramp generator and a set of voltage comparators, each comparator having a different reference voltage and interfacing with a switch that is capable of turning on one of the load elements. As the voltage rises, it passes the reference voltages one at a time and causes the switch corresponding to that voltage to turn on its load element. The ramp is turned on and off by a single switch or by a logic-level electrical signal. The ramp rate for turning on the load element is relatively slow and the rate for turning the elements off is relatively fast. Optionally, the duration of each interval of time between the turning on of the load elements is programmable.

  8. Sequential power-up circuit

    DOEpatents

    Kronberg, J.W.

    1992-06-02

    A sequential power-up circuit for starting several electrical load elements in series to avoid excessive current surge, comprising a voltage ramp generator and a set of voltage comparators, each comparator having a different reference voltage and interfacing with a switch that is capable of turning on one of the load elements. As the voltage rises, it passes the reference voltages one at a time and causes the switch corresponding to that voltage to turn on its load element. The ramp is turned on and off by a single switch or by a logic-level electrical signal. The ramp rate for turning on the load element is relatively slow and the rate for turning the elements off is relatively fast. Optionally, the duration of each interval of time between the turning on of the load elements is programmable. 2 figs.

  9. Sequential visibility-graph motifs

    NASA Astrophysics Data System (ADS)

    Iacovacci, Jacopo; Lacasa, Lucas

    2016-04-01

    Visibility algorithms transform time series into graphs and encode dynamical information in their topology, paving the way for graph-theoretical time series analysis as well as building a bridge between nonlinear dynamics and network science. In this work we introduce and study the concept of sequential visibility-graph motifs, smaller substructures of n consecutive nodes that appear with characteristic frequencies. We develop a theory to compute in an exact way the motif profiles associated with general classes of deterministic and stochastic dynamics. We find that this simple property is indeed a highly informative and computationally efficient feature capable of distinguishing among different dynamics and robust against noise contamination. We finally confirm that it can be used in practice to perform unsupervised learning, by extracting motif profiles from experimental heart-rate series and being able, accordingly, to disentangle meditative from other relaxation states. Applications of this general theory include the automatic classification and description of physical, biological, and financial time series.

  10. Sequential Therapy with Minocycline and Candesartan Improves Long Term Recovery after Experimental Stroke

    PubMed Central

    Soliman, Sahar; Ishrat, Tauheed; Fouda, Abdelrahman Y.; Patel, Ami; Pillai, Bindu; Fagan, Susan C.

    2015-01-01

    Background Minocycline and candesartan have both shown promise as candidate therapeutics in ischemic stroke, with multiple, and somewhat contrasting, molecular mechanisms. Minocycline is an anti-inflammatory, antioxidant and anti-apoptotic agent and a known inhibitor of matrix metalloproteinases (MMPs). Yet, minocycline exerts antiangiogenic effects both in vivo and in vitro. Candesartan promotes angiogenesis and activates MMPs. Aligning these therapies with the dynamic processes of injury and repair after ischemia is likely to improve success of treatment. Objective In this study, we hypothesize that opposing actions of minocycline and candesartan on angiogenesis, when administered simultaneously, will reduce the benefit of candesartan treatment. Therefore, we propose a sequential combination treatment regimen to yield a better outcome and preserve the proangiogenic potential of candesartan. Methods In vitro angiogenesis was assessed using human brain endothelial cells. In vivo, Wistar rats subjected to 90-minute middle cerebral artery occlusion (MCAO) were randomized into 4 groups: saline, candesartan, minocycline and sequential combination of minocycline and candesartan. Neurobehavioral tests were performed 1, 3, 7 and 14 days after stroke. Brain tissue was collected on day 14 for assessment of infarct size and vascular density. Results Minocycline, when added simultaneously, decreased the proangiogenic effect of candesartan treatment in vitro. Sequential treatment, however, preserved the proangiogenic potential of candesartan both in vivo and in vitro, improved neurobehavioral outcome and reduced infarct size. Conclusion Sequential combination therapy with minocycline and candesartan improves long term recovery and maintains candesartan’s proangiogenic potential. PMID:26004281

  11. Helping Patients Simplify and Safely Use Complex Prescription Regimens

    PubMed Central

    Wolf, Michael S.; Curtis, Laura M.; Waite, Katherine; Bailey, Stacy Cooper; Hedlund, Laurie A.; Davis, Terry C.; Shrank, William H.; Parker, Ruth M.; Wood, Alastair J. J.

    2014-01-01

    Background There is considerable variability in the manner in which prescriptions are written by physicians and transcribed by pharmacists, resulting in patient misunderstanding of label instructions. A ‘universal medication schedule’ (UMS) was recently proposed for standardizing prescribing practices to four daily time intervals thereby helping patients simplify and safely use their medicine. We investigated whether patients consolidate their medications, or if there is evidence of unnecessary regimen complexity that would support standardization. Methods Structured interviews were conducted with 464 adults ages 55–74 who were receiving care at either an academic general medicine practice or one of three federally qualified health centers in Chicago, Illinois. Subjects were given a hypothetical, seven-drug medication regimen and asked to demonstrate how and when they would take all of the medicine in a 24-hour period. The regimen could be consolidated into four dosing episodes per day. The primary outcome was the number of times per day individuals would take medicine. Root causes for patients complicating the regimen (> four times a day) were examined. Results Participants on average identified six times in 24 hours to take the seven drugs (SD=1.8; range 3 to 14). One third (29.3%) found seven or more times per day to take their medicine, while only 14.9% organized the regimen into four or fewer times a day. In multivariable analysis, low literacy was an independent predictor of more times per day for dosing out the regimen (β=0.67; 95% Confidence Interval 0.12 to 1.22, p=0.018). Instructions for two of the drugs were identical, yet 31% of patients did not dose these medicines at the same time. Another set of drugs had similar instructions with the primary exception of one having the added instruction to take “with food and water”. Half (49.5%) of participants dosed these medicines at different times. When medicines had variable expressions of the same

  12. Eruptive furunculosis following the soak and smear regimen.

    PubMed

    Martires, Kathryn; Sukhdeo, Kumar; Meinhardt, Eric

    2015-01-01

    The 'soak and smear' regimen is a highly effective method for localised topical therapy employed by dermatologists for widespread inflammatory skin conditions. The regimen involves application of topical medication under occlusion after soaking in water. Complications from this treatment method are rare. We present a case of multiple, generalised methicillin-resistant Staphylococcus aureus (MRSA)-positive furuncles arising in a patient as an unexpected consequence of therapy. The case highlights an unanticipated risk of a commonly employed treatment amid an epidemic of MRSA in the community. PMID:25694635

  13. Estrogen, testosterone, and sequential movement in men.

    PubMed

    Siegel, Jessica A; Young, Laura A; Neiss, Michelle B; Samuels, Mary H; Roselli, Charles E; Janowsky, Jeri S

    2008-10-01

    Behavioral and physiological data suggest that the striatal dopaminergic system is important in the production and execution of sequential movements. Striatal function is also modulated by sex hormones, and previous studies show that estradiol is related to sequential movement in women. The authors examined whether sex hormones are involved in the production of sequential movement in healthy older and younger men. Testosterone was modified for a 6-week period such that levels in older men matched those of younger men, the conversion of testosterone to estradiol was blocked, the production of testosterone was blocked, or the men received no treatment (placebo). Sequential movement was measured before and after hormone treatment. Older men were slower and more accurate than younger men on the sequential movement task pre- and posttreatment. Hormone manipulation had no effect on movement speed. Hormone levels were not correlated with sequential movement performance in either older or younger men, suggesting that sex hormones do not modulate sequential movement in men, and hormone replacement may not restore a loss of sequential movement ability in elderly men or men with Parkinson's disease. PMID:18823152

  14. Measuring Sequential Processing Skills in Young Children.

    ERIC Educational Resources Information Center

    McDaniel, Ernest D.

    This study investigates (1) the relationship of two potentially valuable measures of sequential processing to each other and to a measure of digit span, and (2) the relationships among tests of sequential processing and other measures of cognitive functioning. Subjects were 188 first grade students who had been screened in kindergarten for risk of…

  15. Unnecessary Complexity of Home Medication Regimens among Seniors

    PubMed Central

    Lindquist, Lee A.; Lindquist, Lucy M.; Zickuhr, Lisa; Friesema, Elisha; Wolf, Michael S.

    2014-01-01

    Objective To determine whether seniors consolidate their home medications or if there is evidence of unnecessary regimen complexity. Methods Face-to-face interviews were conducted with 200 community-dwelling seniors > 70 years in their homes. Subjects demonstrated how they took their medications in a typical day and the number of times a day patients would take medications was calculated. A pharmacist and physician blinded to patient characteristics examined medication regimens and determined the fewest number of times a day they could be taken by subjects. Results Home medication regimens could be simplified for 85 (42.5%) subjects. Of those subjects not optimally consolidating their medications, 53 (26.5%) could have had the number of times a day medications were taken reduced by one time per day; 32 (16.0%) reduced by two times or more. The three most common causes of overcomplexity were (1) misunderstanding medication instructions, (2) concern over drug absorption (i.e. before meals), and (3) perceived drug-drug interactions. Conclusion Almost half of seniors had medication regimens that were unnecessarily complicated and could be simplified. This lack of consolidation potentially impedes medication adherence. Practice Implications Health care providers should ask patients to explicitly detail when medication consumption occurs in the home. PMID:24793007

  16. Health Beliefs and Regimen Adherence of the American Indian Diabetic.

    ERIC Educational Resources Information Center

    Miller, Patricia; And Others

    1987-01-01

    Examines compliance with a medical and behavioral regimen by 60 American Indian diabetics, as it relates to demographic and medical variables, attitudes, perceived beliefs of others, and coping strategies. Concludes that the patient's perceptions of significant others' belief is the best predictor of overall adherence. Contains 29 references. (SV)

  17. Revised Category II regimen as an alternative strategy for retreatment of Category I regimen failure and irregular treatment cases.

    PubMed

    Tabarsi, Payam; Chitsaz, Ehsan; Tabatabaei, Vahid; Baghaei, Parvaneh; Shamaei, Masoud; Farnia, Parisa; Marjani, Majid; Kazempour, Mehdi; Mansouri, Davood; Masjedi, Mohammad R; Velayati, Ali A

    2011-09-01

    Currently, the Category (CAT) II regimen is recommended for patients who have failed the CAT I regimen. We have determined before that prevalence of multidrug-resistant tuberculosis (MDR TB) is relatively high among these patients. On the other hand, the retreatment success rate with CAT II in CAT I treatment failures and defaults is nearly 50%. Therefore, we tried to find another strategy with a higher success rate. From January 2004 to November 2007, 105 patients with pulmonary TB, who failed a prior CAT I regimen or with more than one course of irregular anti-TB treatment, were included in this study, whereas five cases with nontuberculous mycobacteria were excluded. Drug susceptibility testing (DST), for first line anti-TB drugs, and polymerase chain reaction were performed. By the time of availability of DST that took 3 to 4 months, a pilot protocol consisted of isoniazid, rifampin, ethambutol, ofloxacin, cycloserine, and amikacin was started. Then therapeutic regimen was adjusted based on four categories of DST pattern: sensitive, non-MDR pattern, MDR pattern, and culture-negative. Sensitive patients received the standard CAT I regimen, non-MDR patients an individualized regimen based on DST, MDR patients a standard second-line regimen, and culture-negatives a standard CAT I plus a 6-month injectable agent. Treatment outcomes were categorized and analyzed. Forty-eight patients with prior CAT I treatment failure and 52 with more than one irregular treatment courses were included in the analysis. Six percent of subjects had confirmed HIV infection. Seventy-two percent of subjects were assigned to a good outcome and 28% were assigned to a poor outcome group. Seventeen percent were culture-negative. Regarding DST pattern, 13% isolated strains were completely sensitive to first-line drugs. 53% strains were MDR, 10% monodrug-resistant, and 7% polydrug-resistant. There was no significant association between DST pattern and outcome (P = 0.13). The irregular regimen

  18. Sequential provisional implant prosthodontics therapy.

    PubMed

    Zinner, Ira D; Markovits, Stanley; Jansen, Curtis E; Reid, Patrick E; Schnader, Yale E; Shapiro, Herbert J

    2012-01-01

    The fabrication and long-term use of first- and second-stage provisional implant prostheses is critical to create a favorable prognosis for function and esthetics of a fixed-implant supported prosthesis. The fixed metal and acrylic resin cemented first-stage prosthesis, as reviewed in Part I, is needed for prevention of adjacent and opposing tooth movement, pressure on the implant site as well as protection to avoid micromovement of the freshly placed implant body. The second-stage prosthesis, reviewed in Part II, should be used following implant uncovering and abutment installation. The patient wears this provisional prosthesis until maturation of the bone and healing of soft tissues. The second-stage provisional prosthesis is also a fail-safe mechanism for possible early implant failures and also can be used with late failures and/or for the necessity to repair the definitive prosthesis. In addition, the screw-retained provisional prosthesis is used if and when an implant requires removal or other implants are to be placed as in a sequential approach. The creation and use of both first- and second-stage provisional prostheses involve a restorative dentist, dental technician, surgeon, and patient to work as a team. If the dentist alone cannot do diagnosis and treatment planning, surgery, and laboratory techniques, he or she needs help by employing the expertise of a surgeon and a laboratory technician. This team approach is essential for optimum results. PMID:23220306

  19. Sequential dehalogenation of chlorinated ethenes

    SciTech Connect

    Barrio-Lage, G.; Parsons, F.Z.; Nassar, R.S.; Lorenzo, P.A.

    1986-01-01

    Reductive dehalogenation of tetra- and trichloroethene to cis- and trans-1,2-dichloroethene in microcosms simulating groundwater environment has previously been demonstrated. In this study, anoxic microcosms containing organic sediment and water were spiked to contain 5 mg/L of one of the following compounds: 1,1-dichloroethene (1,1-DCE), cis-1,2-dichloroethene (CIS), or trans-1,2-dichloroethene (TRANS). After incubation in the dark at 25/sup 0/ C for up to 6 months, contents were analyzed by gas chromatography and verified by gas chromatography/mass spectrometry in an attempt to identify sequential steps in the transformation process. Vinyl chloride (VC) was produced after 1-2 weeks of incubation in all spiked microcosms, but none was observed in sterile and unspiked controls. Chloroethane (CE) was produced only in microcosms spiked with CIS, indicating isomer specificity and the occurrence of mechanisms other than reductive dechlorination. Kinetic parameters associated with the microbial dehalogenation of 1,1-DCE, CIS, and TRANS were calculated. 11 references, 5 figures, 1 table.

  20. Multilevel sequential Monte Carlo samplers

    DOE PAGESBeta

    Beskos, Alexandros; Jasra, Ajay; Law, Kody; Tempone, Raul; Zhou, Yan

    2016-08-24

    Here, we study the approximation of expectations w.r.t. probability distributions associated to the solution of partial differential equations (PDEs); this scenario appears routinely in Bayesian inverse problems. In practice, one often has to solve the associated PDE numerically, using, for instance finite element methods and leading to a discretisation bias, with the step-size level hL. In addition, the expectation cannot be computed analytically and one often resorts to Monte Carlo methods. In the context of this problem, it is known that the introduction of the multilevel Monte Carlo (MLMC) method can reduce the amount of computational effort to estimate expectations, for a given level of error. This is achieved via a telescoping identity associated to a Monte Carlo approximation of a sequence of probability distributions with discretisation levelsmore » $${\\infty}$$ >h0>h1 ...>hL. In many practical problems of interest, one cannot achieve an i.i.d. sampling of the associated sequence of probability distributions. A sequential Monte Carlo (SMC) version of the MLMC method is introduced to deal with this problem. In conclusion, it is shown that under appropriate assumptions, the attractive property of a reduction of the amount of computational effort to estimate expectations, for a given level of error, can be maintained within the SMC context.« less

  1. Sequentially deployable maneuverable tetrahedral beam

    NASA Technical Reports Server (NTRS)

    Mikulas, M. M., Jr.; Crawford, R. F. (Inventor)

    1985-01-01

    A tetrahedral beam that can be compactly stowed, sequentially deployed, and widely manipulated to provide a structurally sound yet highly maneuverable truss structure is comprised of a number of repeating units of tandem tetralhedral sharing common sides. Fixed length battens are jointed into equilateral triangles called batten frames. Apexes of adjacent triangles are interconnected by longerons having a mid-point folding hinge. Joints, comprised of gussets pivotabley connected by links, permit two independent degrees of rotational freedom between joined adjacent batten frames, and provide a stable structure from packaged configuration to complete deployment. The longerons and joints can be actuated in any sequence, independently of one another. The beam is suited to remote actuation. Longerons may be provided with powered mid-point hinges enabling beam erection and packaging under remote control. Providing one or more longerons with powered telescoping segments permits the shape of the beam central axis to be remotely manipulated so that the beam may function as a remote manipulator arm.

  2. Sequentially deployable maneuverable tetrahedral beam

    NASA Astrophysics Data System (ADS)

    Mikulas, M. M., Jr.; Crawford, R. F.

    1985-12-01

    A tetrahedral beam that can be compactly stowed, sequentially deployed, and widely manipulated to provide a structurally sound yet highly maneuverable truss structure is comprised of a number of repeating units of tandem tetralhedral sharing common sides. Fixed length battens are jointed into equilateral triangles called batten frames. Apexes of adjacent triangles are interconnected by longerons having a mid-point folding hinge. Joints, comprised of gussets pivotabley connected by links, permit two independent degrees of rotational freedom between joined adjacent batten frames, and provide a stable structure from packaged configuration to complete deployment. The longerons and joints can be actuated in any sequence, independently of one another. The beam is suited to remote actuation. Longerons may be provided with powered mid-point hinges enabling beam erection and packaging under remote control. Providing one or more longerons with powered telescoping segments permits the shape of the beam central axis to be remotely manipulated so that the beam may function as a remote manipulator arm.

  3. Current and future insights in H. pylori eradication regimens: the need of tailoring therapy.

    PubMed

    Papastergiou, Vasilios; Georgopoulos, Sotirios D; Karatapanis, Stylianos

    2014-01-01

    Treatment of Helicobacter pylori (H. pylori) infection is crucial for the management of prevalent digestive and more recently also extra-digestive disorders. Rising prevalence of clarithromycin resistance worldwide has accounted for a dramatic decline in the efficacy of standard triple therapies, which should not be prescribed, unless local clarithromycin-resistance is low (<20%) or culture confirms susceptibility to this antibiotic (i,e,; as tailored treatments). Bismuth-quadruple, sequential, non-bismuth quadruple (concomitant), dual-concomitant (hybrid), and levofloxacin-based regimens have been shown to overcome clarithromycin resistance and are now preferred empirical treatments achieving improved eradication rates (>90% in per protocol analysis). In the future, empiric use of both clarithromycin and levofloxacin is likely to become steadily more challenging as even these novel eradication therapies may be prone to the effect of increasing antibiotic resistance. Tailored treatment based on the individual characterization of H. pylori therapeutic susceptibility appears to be a reasonable future alternative, currently limited by the shortcomings of systematically performing H. pylori culture (invasive, expensive, time-consuming). However, recent advances in the genotypic detection of H. pylori susceptibility to antibiotics, and in pharmacogenomics, may represent a breakthrough in our future approach to tailored therapy. Until then, efforts to optimize empirical treatments should continue. PMID:24180408

  4. A test of interventions to increase adherence to hypertensive medical regimens.

    PubMed

    Kirscht, J P; Kirscht, J L; Rosenstock, I M

    1981-01-01

    Low rates of adherence to hypertensive therapy limit patients' securing the full benefits of treatment. While some factors related to adherence have been identified research on the effectiveness of interventions to increase adherence levels is sparse. The present study was designed to assess the impact of a series of different interventions on a group of some 400 patients, all under the care of private physicians in a small community. A factorial design was employed to deliver four, sequential educational interventions, about four months apart, to randomly selected sub-groups. Interviews before and after each intervention provided information concerning self-reported adherence, health status, health beliefs, and personal characteristics. Pertinent medical records and pharmacy data were also obtained. The first intervention - printed material - did not significantly affect adherence. The second and fourth interventions - nurse telephone calls and social support - each increased medication taking and the third intervention - self-monitoring - led to better weight control. There was no cumulative impact of the interventions and different aspects of regimens were not significantly related to one another. PMID:7333851

  5. Mantle cell lymphoma salvage regimen: synergy between a reprogrammed oncolytic virus and two chemotherapeutics

    PubMed Central

    Ungerechts, Guy; Frenzke, Marie E; Yaiw, Koon-Chu; Miest, Tanner; Johnston, Patrick B; Cattaneo, Roberto

    2010-01-01

    MV-PNP HblindantiCD20 is a CD20-targeted and prodrug convertase-armed measles virus (MV) that temporarily controls growth of lymphoma xenografts in SCID mice in combination with fludarabine phosphate. Herein, we examine the replication of this targeted virus and of a vaccine-lineage MV in disease bulks and circulating cells from mantle cell lymphoma (MCL) patients, and show that only the targeted virus is specific for CD20-expressing cells. We then assessed the efficacy of different regimens of administration of this virus in combination with fludarabine and cyclophosphamide (CPA) in a MCL xenograft model. We show that CPA administration before virus enhances oncolytic efficacy, likely through temporary immunosuppression. An interval of one-week between intravenous virus administration and fludarabine treatment further enhanced oncolysis, by synchronizing maximum prodrug convertase expression with fludarabine availability. Finally, three 23-day courses of triple sequential treatment with CPA, virus and fludarabine treatment resulted in complete regression of the xenografts. Secondary disease symptoms interfered with survival, but average survival times increased from 22 to 77 days. These studies document a reprogrammed oncolytic virus consolidating the effects of two chemotherapeutics, a concept well-suited for a phase I clinical trial for MCL patients for whom conventional therapies have failed. PMID:20686506

  6. Adenovirus vector-induced immune responses in nonhuman primates: responses to prime boost regimens1

    PubMed Central

    Tatsis, Nia; Lasaro, Marcio O.; Lin, Shih-Wen; Xiang, Zhi Q.; Zhou, Dongming; DiMenna, Lauren; Li, Hua; Bian, Ang; Abdulla, Sarah; Li, Yan; Giles-Davis, Wynetta; Engram, Jessica; Ratcliffe, Sarah J.; Silvestri, Guido; Ertl, Hildegund C.; Betts, Michael R.

    2009-01-01

    In the phase IIb STEP trial an HIV-1 vaccine based on adenovirus (Ad) vectors of the human serotype 5 (AdHu5) not only failed to induce protection but also increased susceptibility to HIV-1 infection in individuals with pre-existing neutralizing antibodies against AdHu5. The mechanisms underlying the increased HIV-1 acquisition rates have not yet been elucidated. Furthermore, it remains unclear if the lack of the vaccine's efficacy reflects a failure of the concept of T cell-mediated protection against HIV-1 or a product failure of the vaccine. Here we compared two vaccine regimens based on sequential use of AdHu5 vectors or two different chimpanzee derived Ad (AdC) vectors in rhesus macaques that were AdHu5 seropositive or seronegative at the onset of vaccination. Our results show that heterologous booster immunizations with the AdC vectors induced higher T and B cell responses than repeated immunizations with the AdHu5 vector especially in AdHu5-pre-exposed macaques. PMID:19414814

  7. Adenovirus vector-induced immune responses in nonhuman primates: responses to prime boost regimens.

    PubMed

    Tatsis, Nia; Lasaro, Marcio O; Lin, Shih-Wen; Haut, Larissa H; Xiang, Zhi Q; Zhou, Dongming; Dimenna, Lauren; Li, Hua; Bian, Ang; Abdulla, Sarah; Li, Yan; Giles-Davis, Wynetta; Engram, Jessica; Ratcliffe, Sarah J; Silvestri, Guido; Ertl, Hildegund C; Betts, Michael R

    2009-05-15

    In the phase IIb STEP trial an HIV-1 vaccine based on adenovirus (Ad) vectors of the human serotype 5 (AdHu5) not only failed to induce protection but also increased susceptibility to HIV-1 infection in individuals with preexisting neutralizing Abs against AdHu5. The mechanisms underlying the increased HIV-1 acquisition rates have not yet been elucidated. Furthermore, it remains unclear if the lack of the vaccine's efficacy reflects a failure of the concept of T cell-mediated protection against HIV-1 or a product failure of the vaccine. Here, we compared two vaccine regimens based on sequential use of AdHu5 vectors or two different chimpanzee-derived Ad vectors in rhesus macaques that were AdHu5 seropositive or seronegative at the onset of vaccination. Our results show that heterologous booster immunizations with the chimpanzee-derived Ad vectors induced higher T and B cell responses than did repeated immunizations with the AdHu5 vector, especially in AdHu5-preexposed macaques. PMID:19414814

  8. Adherence to treatment of chronic hepatitis C: from interferon containing regimens to interferon and ribavirin free regimens

    PubMed Central

    Younossi, Zobair M.; Stepanova, Maria; Henry, Linda; Nader, Fatema; Younossi, Youssef; Hunt, Sharon

    2016-01-01

    Abstract Patients’ experience during treatment may affect treatment adherence. Our aim was to assess the impact of patient-reported outcomes (PROs) on adherence to different anti-hepatitis C virus (HCV) regimens. Clinical, demographic, and PRO data (short form-36 [SF-36], chronic liver disease questionnaire-hepatitis C version [CLDQ-HCV], functional assessment of chronic illness therapy-fatigue [FACIT-F], work productivity and activity impairment: specific health problem [WPAI:SHP]) from 13 multinational clinical trials of anti-HCV treatment were available. Treatment adherence was defined as >80% of prescribed doses taken. Included were 4825 HCV patients. Regimens were grouped into: interferon- and ribavirin (RBV)-containing (±sofosbuvir [SOF]), interferon-free RBV-containing (RBV + SOF ± ledipasvir [LDV]), and interferon-free RBV-free (LDV/SOF). The adherence to these regimens were 77.6%, 84.3%, and 96.2%, respectively (P < 0.0001). Nonadherent patients were more likely to be unemployed and to have a greater PRO impairment at baseline (up to −5.3% lower PRO scores, P < 0.0001). During treatment with interferon- or RBV-based regimens, nonadherent patients experienced lower PROs and had larger decrements from their baseline PRO scores. In contrast, there were no significant declines in PRO scores (all P > 0.05) for the small number of patients who were nonadherent to LDV/SOF. In multivariate analysis, being treatment-naive, longer treatment duration, and receiving an interferon- or RBV-containing regimen were associated with a lower likelihood of adherence (all P < 0.003). Better baseline and on-treatment PRO scores were associated with a higher likelihood of adherence to interferon and RBV. The use of interferon and/or RBV, longer duration of treatment, and lower baseline and on-treatment PRO scores were linked to a decreased likelihood of being adherent to interferon + RBV-containing or interferon-free RBV-containing antiviral

  9. Adherence to treatment of chronic hepatitis C: from interferon containing regimens to interferon and ribavirin free regimens.

    PubMed

    Younossi, Zobair M; Stepanova, Maria; Henry, Linda; Nader, Fatema; Younossi, Youssef; Hunt, Sharon

    2016-07-01

    Patients' experience during treatment may affect treatment adherence. Our aim was to assess the impact of patient-reported outcomes (PROs) on adherence to different anti-hepatitis C virus (HCV) regimens.Clinical, demographic, and PRO data (short form-36 [SF-36], chronic liver disease questionnaire-hepatitis C version [CLDQ-HCV], functional assessment of chronic illness therapy-fatigue [FACIT-F], work productivity and activity impairment: specific health problem [WPAI:SHP]) from 13 multinational clinical trials of anti-HCV treatment were available. Treatment adherence was defined as >80% of prescribed doses taken.Included were 4825 HCV patients. Regimens were grouped into: interferon- and ribavirin (RBV)-containing (±sofosbuvir [SOF]), interferon-free RBV-containing (RBV + SOF ± ledipasvir [LDV]), and interferon-free RBV-free (LDV/SOF). The adherence to these regimens were 77.6%, 84.3%, and 96.2%, respectively (P < 0.0001). Nonadherent patients were more likely to be unemployed and to have a greater PRO impairment at baseline (up to -5.3% lower PRO scores, P < 0.0001). During treatment with interferon- or RBV-based regimens, nonadherent patients experienced lower PROs and had larger decrements from their baseline PRO scores. In contrast, there were no significant declines in PRO scores (all P > 0.05) for the small number of patients who were nonadherent to LDV/SOF. In multivariate analysis, being treatment-naive, longer treatment duration, and receiving an interferon- or RBV-containing regimen were associated with a lower likelihood of adherence (all P < 0.003). Better baseline and on-treatment PRO scores were associated with a higher likelihood of adherence to interferon and RBV.The use of interferon and/or RBV, longer duration of treatment, and lower baseline and on-treatment PRO scores were linked to a decreased likelihood of being adherent to interferon + RBV-containing or interferon-free RBV-containing antiviral regimens

  10. The nth root of sequential effect algebras

    NASA Astrophysics Data System (ADS)

    Shen, Jun; Wu, Junde

    2010-06-01

    In 2005, Gudder [Int. J. Theor. Phys. 44, 2219 (2005)] presented 25 problems of sequential effect algebras, the 20th problem asked: In a sequential effect algebra, if the square root of some element exists, is it unique? In this paper, we show that for each given positive integer n >1, there is a sequential effect algebra such that the nth root of its some element c is not unique, and the nth root of c is not the kth root of c (k

  11. Optimal individualized dosing strategies: A pharmacologic approach to developing dynamic treatment regimens for continuous-valued treatments.

    PubMed

    Rich, Benjamin; Moodie, Erica E M; Stephens, David A

    2016-05-01

    There have been considerable advances in the methodology for estimating dynamic treatment regimens, and for the design of sequential trials that can be used to collect unconfounded data to inform such regimens. However, relatively little attention has been paid to how such methodology could be used to advance understanding of optimal treatment strategies in a continuous dose setting, even though it is often the case that considerable patient heterogeneity in drug response along with a narrow therapeutic window may necessitate the tailoring of dosing over time. Such is the case with warfarin, a common oral anticoagulant. We propose novel, realistic simulation models based on pharmacokinetic-pharmacodynamic properties of the drug that can be used to evaluate potentially optimal dosing strategies. Our results suggest that this methodology can lead to a dosing strategy that performs well both within and across populations with different pharmacokinetic characteristics, and may assist in the design of randomized trials by narrowing the list of potential dosing strategies to those which are most promising. PMID:26537297

  12. Penalized Q-Learning for Dynamic Treatment Regimens

    PubMed Central

    Song, R.; Wang, W.; Zeng, D.; Kosorok, M. R.

    2014-01-01

    A dynamic treatment regimen incorporates both accrued information and long-term effects of treatment from specially designed clinical trials. As these trials become more and more popular in conjunction with longitudinal data from clinical studies, the development of statistical inference for optimal dynamic treatment regimens is a high priority. In this paper, we propose a new machine learning framework called penalized Q-learning, under which valid statistical inference is established. We also propose a new statistical procedure: individual selection and corresponding methods for incorporating individual selection within penalized Q-learning. Extensive numerical studies are presented which compare the proposed methods with existing methods, under a variety of scenarios, and demonstrate that the proposed approach is both inferentially and computationally superior. It is illustrated with a depression clinical trial study. PMID:26257504

  13. Partition algebraic design of asynchronous sequential circuits

    NASA Technical Reports Server (NTRS)

    Maki, Gary K.; Chen, Kristen Q.; Gopalakrishnan, Suresh K.

    1993-01-01

    Tracey's Theorem has long been recognized as essential in generating state assignments for asynchronous sequential circuits. This paper shows that partitioning variables derived from Tracey's Theorem also has a significant impact in generating the design equations. Moreover, this theorem is important to the fundamental understanding of asynchronous sequential operation. The results of this work simplify asynchronous logic design. Moreover, detection of safe circuits is made easier.

  14. Automated ILA design for synchronous sequential circuits

    NASA Technical Reports Server (NTRS)

    Liu, M. N.; Liu, K. Z.; Maki, G. K.; Whitaker, S. R.

    1991-01-01

    An iterative logic array (ILA) architecture for synchronous sequential circuits is presented. This technique utilizes linear algebra to produce the design equations. The ILA realization of synchronous sequential logic can be fully automated with a computer program. A programmable design procedure is proposed to fullfill the design task and layout generation. A software algorithm in the C language has been developed and tested to generate 1 micron CMOS layouts using the Hewlett-Packard FUNGEN module generator shell.

  15. Quantum union bounds for sequential projective measurements

    NASA Astrophysics Data System (ADS)

    Gao, Jingliang

    2015-11-01

    We present two quantum union bounds for sequential projective measurements. These bounds estimate the disturbance accumulation and probability of outcomes when the measurements are performed sequentially. These results are based on a trigonometric representation of quantum states and should have wide application in quantum information theory for information-processing tasks such as communication and state discrimination, and perhaps even in the analysis of quantum algorithms.

  16. Multidrug-resistant tuberculosis treatment with linezolid-containing regimen

    PubMed Central

    Farshidpour, Maham; Ebrahimi, Golnaz; Mirsaeidi, Mehdi

    2014-01-01

    The following is a case of multidrug-resistant pulmonary tuberculosis (MDR-TB) that was treated successfully with a linezolid-containing regimen. It was found that linezolid is an efficient medicine for MDR-TB treatment with an acceptable side effect profile. Treatment was maintained for 18 months, and closely monitoring toxicities did not reveal evidence of any neurologic adverse effects. However, despite our expectation, thrombocytopenia was seen after 2 years follow-up. PMID:25110635

  17. Short course antiretroviral regimens to reduce maternal transmission of HIV.

    PubMed

    Wilkinson, D; Karim, S S; Coovadia, H M

    1999-02-20

    The ACTG076 trial showed that a complex and expensive antiretroviral regimen reduced mother-to-child HIV transmission by 67%. A more recent Bangkok perinatal HIV study found that oral zidovudine (AZT) given during late pregnancy and labor to non-breast-feeding women reduced the rate of vertical HIV transmission by 51%. These latter findings are particularly interesting to countries unable to afford the more expensive and complex 076 regimen. The reaction to the results of the Bangkok trial may, however, threaten the health of Africa's poorest women and children. Within days of the release of the Thai data, investigators studying other regimens closed recruitment to the placebo arms of their trials, and it has recently become clear that the National Institutes for Health will probably fund no more placebo-controlled trials of interventions designed to reduce maternal HIV transmission. The use of antiretroviral drugs in Africa is unlikely to ever significantly reduce maternal HIV transmission and the incidence of pediatric AIDS. While most of Africa's women have no option to breast-feed, breast-feeding is responsible for one-third of maternal HIV transmission cases. The results of the Thai trials only partially address the needs of African women, for the nutritional, immunological, and birth spacing benefits of breast-feeding should be retained if possible, and formula feeding may stigmatize HIV-infected mothers. The short-course regimen is still expensive to developing countries, and the implementation of a costly, vertical program may also draw financial and human resources from other programs. Placebo-controlled trials to develop simple, cheap, and effective potentially non-drug interventions against vertical HIV transmission should be encouraged in settings in which antiretroviral drugs and formula feeding cannot be safely delivered. PMID:10024252

  18. Care of Patients With HIV Infection: Antiretroviral Drug Regimens.

    PubMed

    Bolduc, Philip; Roder, Navid; Colgate, Emily; Cheeseman, Sarah H

    2016-04-01

    The advent of combination antiretroviral drug regimens has transformed HIV infection from a fatal illness into a manageable chronic condition. All patients with HIV infection should be considered for antiretroviral therapy, regardless of CD4 count or HIV viral load, for individual benefit and to prevent HIV transmission. Antiretroviral drugs affect HIV in several ways: entry inhibitors block HIV entry into CD4 T cells; nucleotide and nucleoside reverse transcriptase inhibitors prevent reverse transcription from RNA to DNA via chain-terminating proteins; nonnucleoside reverse transcriptase inhibitors prevent reverse transcription through enzymatic inhibition; integrase strand transfer inhibitors block integration of viral DNA into cellular DNA; protease inhibitors block maturation and production of the virus. Current guidelines recommend six combination regimens for initial therapy. Five are based on tenofovir and emtricitabine; the other uses abacavir and lamivudine. Five include integrase strand transfer inhibitors. HIV specialists should assist with treating patients with complicated HIV infection, including patients with treatment-resistant HIV infection, coinfection with hepatitis B or C virus, pregnancy, childhood infections, severe opportunistic infections, complex drug interactions, significant drug toxicity, or comorbidities. Family physicians can treat most patients with HIV infection effectively by choosing appropriate treatment regimens, monitoring patients closely, and retaining patients in care. PMID:27092564

  19. Sequential effects in face-attractiveness judgment.

    PubMed

    Kondo, Aki; Takahashi, Kohske; Watanabe, Katsumi

    2012-01-01

    A number of studies have shown that current-trial responses are biased toward the response of the preceding trial in perceptual decisionmaking tasks (the sequential effect-Holland and Lockhead, 1968 Perception & Psychophysics 3 409-414). The sequential effect has been widely observed in evaluation of the physical properties of stimuli as well as more complex properties. However, it is unclear whether subjective decisions (e.g., attractiveness judgments) are also susceptible to the sequential effect. Here, we examined whether the sequential effect would occur in face-attractiveness judgments. Forty-eight pictures of male and female faces were presented successively. Participants rated the attractiveness of each face on a 7-point scale. The results showed that the attractiveness rating of a given face assimilated toward the rating of the preceding trial. In a separate experiment, we provided the average attractiveness rating by others for each trial as feedback. The feedback weakened the sequential effect. These findings suggest that attractiveness judgment is also biased toward the preceding judgment, and hence the sequential effect can be extended into the domain of subjective decisionmaking. PMID:22611662

  20. A comparison between standard triple therapy and sequential therapy on eradication of Helicobacter pylori in uremic patients: A randomized clinical trial

    PubMed Central

    Makhlough, Atieh; Fakheri, Hafez; Farkhani, Ahmad Ramezani; Seddighi, Omid; Hossieni, Seyed Vahid; Khademloo, Mohammad; Bari, Zohreh

    2014-01-01

    Background: The prevalence of peptic ulcer disease in hemodialysis dependent patients is higher than the general population. These patients are also more prone to upper gastrointestinal bleeding. The aim of this study was to compare the effects of a standard triple therapy with a sequential therapy on Helicobacter pylori eradication in azotemic and hemodialysis patients. Materials and Methods: Forty nine hemodialysis and azotemic patients, naïve to H. pylori treatment, were randomized into two groups to receive either standard triple therapy (pantoprazole 40 mg, amoxicillin 500 mg and clarithromycin 250 mg twice a day for 14 days) or a sequential therapy (pantoprazole 40 mg for 10 days, amoxicillin 500 mg twice a day for the first 5 days and clarithromycin 250 mg + tinidazole 500 mg twice a day just during the second 5 days). H. pylori eradication was evaluated by fecal H. pylori antigen assessment 8 weeks after the treatment. Results: Of 49 patients, 45 patients (21 in triple therapy group and 24 in the sequential group) completed the study. Based on intention to treat analysis, H. pylori eradication rates were 66.7% (95% confidence interval [CI]: 47.8-85.5%) in standard triple therapy group and 84% (95% CI: 69.6-98.3%) in sequential therapy group (P = 0.34). Per-protocol (PP) eradication rates were (95% CI: 76.2%. 6-89.3%) 54 and 87.5% (95% CI: 68.8-95.5%), respectively (P = 0.32). Conclusion: According to Maastricht III consensus report, the results of our study showed that sequential therapy might be a better choice compared with the standard triple therapy in azotemic and hemodialysis patients Iran. We propose to assess the effects of shorter-duration sequential therapy (less than 10 days) for H. pylori eradication. PMID:25590026

  1. Sequential Heterotrophy-Dilution-Photoinduction Cultivation of Haematococcus pluvialis for efficient production of astaxanthin.

    PubMed

    Wan, Minxi; Zhang, Zhen; Wang, Jun; Huang, Jianke; Fan, Jianhua; Yu, Anquan; Wang, Weiliang; Li, Yuanguang

    2015-12-01

    A novel cultivation strategy called "Sequential Heterotrophy-Dilution-Photoinduction" was successfully applied in the cultivation of Haematococcus pluvialis to produce astaxanthin effectively. Cells were first cultivated heterotrophically to achieve a high cell density, then were diluted to a suitable concentration and switched to a favorable environment for cells acclimation. Finally, the culture was transferred to high light environment for astaxanthin accumulation. By this strategy, the dry cell weight of 26 g/L and biomass productivity of 64.1mg/L/h were obtained in heterotrophy stage which surpassed ever before reported in literatures. Meanwhile, the cells could accumulate considerable astaxanthin up to 4.6% of dry cell weight after 10 days of photoinduction. Furthermore, the application prospects of the strategy were confirmed further by outdoor experiments. Therefore, this novel strategy provided a promising approach for high-efficient production of natural astaxanthin from H. pluvialis to meet the huge demand of this high value product. PMID:26433152

  2. Modern Sequential Analysis and Its Applications to Computerized Adaptive Testing

    ERIC Educational Resources Information Center

    Bartroff, Jay; Finkelman, Matthew; Lai, Tze Leung

    2008-01-01

    After a brief review of recent advances in sequential analysis involving sequential generalized likelihood ratio tests, we discuss their use in psychometric testing and extend the asymptotic optimality theory of these sequential tests to the case of sequentially generated experiments, of particular interest in computerized adaptive testing. We…

  3. Global eradication rates for Helicobacter pylori infection: systematic review and meta-analysis of sequential therapy

    PubMed Central

    Vakil, Nimish; Vaira, Dino; Scarpignato, Carmelo

    2013-01-01

    Objective To do a systematic review and meta-analysis of studies comparing sequential therapy for eradication of Helicobacter pylori with pre-existing and new therapies, thus providing a glimpse of eradication success worldwide. Design Systematic review and meta-analysis. Data sources Medline, Embase, and Cochrane Central Register of Controlled Trials up to May 2013; abstract books of major European, American, and Asian gastroenterological meetings. Study selection Randomised controlled trials in previously untreated adults, in which sequential therapy was compared with a pre-existing or new therapy. Results 46 randomised controlled trials were reviewed and analysed. 5666 patients were randomised to sequential therapy and 7866 to other (established and new) treatments. The overall eradication rate of sequential therapy was 84.3% (95% confidence interval 82.1% to 86.4%). Sequential therapy was superior to seven day triple therapy (relative risk 1.21, 95% confidence interval 1.17 to 1.25; I2=29.3%; number needed to treat 6 , 95% confidence interval 5% to 7%), marginally superior to 10 day triple therapy (1.11, 1.04 to 1.19; I2= 67.2%; NNT 10, 7 to 15), but not superior to 14 day triple therapy (1.00, 0.94 to 1.06; I2=54.3%), bismuth based therapy (1.01, 0.95 to 1.06; I2=21.1%), and non-bismuth based therapy (0.99, 0.94 to 1.05; I2=52.3%). Data on eradication according to pre-treatment antimicrobial susceptibility testing were available in eight studies, and sequential therapy was able to eradicate 72.8% (61.6% to 82.8%) of the strains resistant to clarithromycin. Conclusions Eradication rates with pre-existing and new therapies for H pylori are suboptimal. Regional monitoring of resistance rates should help to guide treatment, and new agents for treatment need to be developed. PMID:23926315

  4. Antiretroviral Treatment Regimen Outcomes Among HIV-Infected Prisoners

    PubMed Central

    Springer, Sandra A.; Friedland, Gerald H.; Doros, Gheorghe; Pesanti, Edward; Altice, Frederick L.

    2008-01-01

    Background Despite the high prevalence of HIV in correctional settings, the duration of therapy and response to various highly active antiretroviral therapy (HAART) regimens in this setting is unknown. Method Using a retrospective cohort study (1997−2002) of HIV-infected prisoners in Connecticut that linked demographic, pharmacy, and laboratory data, we compared HIV-1 RNA (VL) and CD4 lymphocyte responses to four treatment strategies at baseline and at the end of incarceration. Results Using an analysis of 1,044 incarceration periods or 1,099 subjects for whom ≥6 months of continuous data were available, HAART regimens that included a triple NRTI, two NRTIs + either a PI or NNRTI, or a three-class (NRTI+NNRTI+PI) strategy demonstrated no difference in virological and immunological outcomes. The proportion of subjects who were initiated with NRTI, NNRTI, PI, or three-class regimens were 14%, 32%, 46%, and 8%, respectively. For all study groups, the mean change from baseline in CD4 and VL was +74 cells/μL and −0.93 log10 copies/mL (p < .0001), respectively. Overall, 59% of subjects had an HIV-1 RNA level below the level of detection (<400 copies/mL) by the end of their incarceration. Using Kaplan-Meier curves to examine the time to change in the initial HAART strategy over the incarceration period, the three-class strategy was significantly more likely to be changed earlier than all others (p < .05). Conclusion Although the three-class strategy was less durable, initiating HAART with any strategy resulted in similar and impressive virological and immunological outcomes by the end of incarceration, further supporting prison as an important site for the initiation and provision of effective antiretroviral therapy. PMID:17720660

  5. Estimation of drug dosage regimens with a pharmacokinetic slide rule.

    PubMed

    Straughn, A B; Cruze, C A; Meyer, M C

    1977-02-01

    A pharmacokinetic slide rule to facilitate the computations based on relatively simple pharmacokinetic principles involved in the development of individualized drug dosage regimens is described. The calculations are based on the assumption that the body can be conceived as a one-compartment open model with drug elimination proceeding by apparent first-order kinetics. Examples are presented (1) to illustrate the clinical application of a slide rule to compute the time-course of drug in the body, (2) to calculate steady-state maximum and minimum levels, and accumulation during multiple dosage and (3) to estimate appropriate maintenance doses and intravenous infusion rates. PMID:842548

  6. Nitazoxanide Use as Part of an Empiric Multi-Drug Regimen in Treating Children with Suspected Helicobacter pylori Infection.

    PubMed

    Ramos-Soriano, Asuncion G; Black, Jimmy

    2015-01-01

    Helicobacter pylori, a Gram-negative bacterium found in the human stomach, is often present in patients with chronic gastritis. Traditional treatment for H. pylori infection includes metronidazole or clarithromycin, both being associated with development of resistance. In this retrospective report, we describe our clinical experience using a multi-drug treatment regimen for pediatric H. pylori that included nitazoxanide, a newer nitrothiazole benzamide compound used in treating intestinal protozoa infections. Charts were identified for patients who were treated between January 1, 2008 and December 31, 2013 with an ICD-9-CM code 041.86 (H. pylori) and who underwent elective endoscopy. All patients were exposed to nitazoxanide for 3 days plus azithromycin, and cefixime (or another 3rd-generation oral cephalosporin) for 7-10 days, plus a proton pump inhibitor for 30 days. The clinical cure criteria were predefined. There were 127 individual occurrences or cases identified for inclusion in the review, with 111 occurrences meeting the inclusion criteria. The success rate or clinical cure for the new therapy combination prescribed as defined prior to the chart review was 99 out of 111 cases (89.2%). There were no serious adverse events observed or reported during the treatment of any patient. Approximately 10% of patient charts reflected minor complaints of nausea, vomiting or abdominal cramps during the time of active drug therapy. Nitazoxanide appears to be an effective and well-tolerated option for use in combination with other agents to treat H. pylori-induced gastritis. PMID:25759631

  7. Nitazoxanide Use as Part of an Empiric Multi-Drug Regimen in Treating Children with Suspected Helicobacter pylori Infection

    PubMed Central

    Ramos-Soriano, Asuncion G.; Black, Jimmy

    2015-01-01

    Helicobacter pylori, a Gram-negative bacterium found in the human stomach, is often present in patients with chronic gastritis. Traditional treatment for H. pylori infection includes metronidazole or clarithromycin, both being associated with development of resistance. In this retrospective report, we describe our clinical experience using a multi-drug treatment regimen for pediatric H. pylori that included nitazoxanide, a newer nitrothiazole benzamide compound used in treating intestinal protozoa infections. Charts were identified for patients who were treated between January 1, 2008 and December 31, 2013 with an ICD-9-CM code 041.86 (H. pylori) and who underwent elective endoscopy. All patients were exposed to nitazoxanide for 3 days plus azithromycin, and cefixime (or another 3rd-generation oral cephalosporin) for 7–10 days, plus a proton pump inhibitor for 30 days. The clinical cure criteria were predefined. There were 127 individual occurrences or cases identified for inclusion in the review, with 111 occurrences meeting the inclusion criteria. The success rate or clinical cure for the new therapy combination prescribed as defined prior to the chart review was 99 out of 111 cases (89.2%). There were no serious adverse events observed or reported during the treatment of any patient. Approximately 10% of patient charts reflected minor complaints of nausea, vomiting or abdominal cramps during the time of active drug therapy. Nitazoxanide appears to be an effective and well-tolerated option for use in combination with other agents to treat H. pylori-induced gastritis. PMID:25759631

  8. Rifaximin Plus Levofloxacin-Based Rescue Regimen for the Eradication of Helicobacter pylori

    PubMed Central

    Yun, Sang-Pil; Seon, Han Gyung; Ok, Chang Soo; Yoo, Kwang Ho; Kang, Min Kyung; Kim, Won Hee; Kwon, Chang Il; Ko, Kwang Hyun; Hwang, Seong Gyu; Park, Pil Won

    2012-01-01

    Background/Aims This study assessed the efficacy of a rifaximin plus levofloxacin-based rescue regimen in patients that had failed both triple and quadruple standard regimens for the eradication of Helicobacter pylori. Methods We treated patients for H. pylori between August 2009 and April 2011. The triple regimen consisted of combined treatment with amoxicillin, clarithromycin, and pantoprazole for 1 week. For failed cases, a quadruple regimen of tetracycline, metronidazole, bismuth dicitrate, and lansoprazole for 1 week was administered. The rescue regimen for persistently refractory cases was rifaximin 200 mg t.i.d., levofloxacin 500 mg q.d., and lansoprazole 15 mg b.i.d. for 1 week. Results In total, 482 patients were enrolled in this study. The eradication rates associated with the first and second regimens were 58% and 60%, respectively. Forty-seven out of 58 patients who failed with the second-line regimen received rifaximin plus levofloxacin-based third-line therapy. The eradication rate for the third regimen was 65%. The cumulative eradication rates were 58%, 85%, and 96% for each regimen, respectively. Conclusions A rifaximin plus levofloxacin-based regimen could be an alternative rescue therapy in patients with resistance to both triple and quadruple regimens for the eradication of H. pylori. PMID:23170149

  9. Optimal sequential Bayesian analysis for degradation tests.

    PubMed

    Rodríguez-Narciso, Silvia; Christen, J Andrés

    2016-07-01

    Degradation tests are especially difficult to conduct for items with high reliability. Test costs, caused mainly by prolonged item duration and item destruction costs, establish the necessity of sequential degradation test designs. We propose a methodology that sequentially selects the optimal observation times to measure the degradation, using a convenient rule that maximizes the inference precision and minimizes test costs. In particular our objective is to estimate a quantile of the time to failure distribution, where the degradation process is modelled as a linear model using Bayesian inference. The proposed sequential analysis is based on an index that measures the expected discrepancy between the estimated quantile and its corresponding prediction, using Monte Carlo methods. The procedure was successfully implemented for simulated and real data. PMID:26307336

  10. Test generation for highly sequential circuits

    NASA Astrophysics Data System (ADS)

    Ghosh, Abhijit; Devadas, Srinivas; Newton, A. Richard

    1989-08-01

    We address the problem of generating test sequences for stuck-at faults in non-scan synchronous sequential circuits. We present a novel test procedure that exploits both the structure of the combinational logic in the circuit as well as the sequential behavior of the circuit. In contrast to previous approaches, we decompose the problem of sequential test generation into three subproblems of combinational test generation, fault-free state justification and fault-free state differentiation. We describe fast algorithms for state justification and state differentiation using the ON-sets and OFF-sets of flip-flop inputs and primary outputs. The decomposition of the testing problems into three subproblems rather than the traditional two, performing the justification and differentiation steps on the fault free rather than the faulty machine and the use of efficient techniques for cube intersection results in significant performance improvements over previous approaches.

  11. Batch sequential designs for computer experiments

    SciTech Connect

    Moore, Leslie M; Williams, Brian J; Loeppky, Jason L

    2009-01-01

    Computer models simulating a physical process are used in many areas of science. Due to the complex nature of these codes it is often necessary to approximate the code, which is typically done using a Gaussian process. In many situations the number of code runs available to build the Guassian process approximation is limited. When the initial design is small or the underlying response surface is complicated this can lead to poor approximations of the code output. In order to improve the fit of the model, sequential design strategies must be employed. In this paper we introduce two simple distance based metrics that can be used to augment an initial design in a batch sequential manner. In addition we propose a sequential updating strategy to an orthogonal array based Latin hypercube sample. We show via various real and simulated examples that the distance metrics and the extension of the orthogonal array based Latin hypercubes work well in practice.

  12. A Randomised Trial of empiric 14-day Triple, five-day Concomitant, and ten-day Sequential Therapies for Helicobacter pylori in Seven Latin American Sites

    PubMed Central

    Greenberg, E. Robert; Anderson, Garnet L.; Morgan, Douglas R.; Torres, Javier; Chey, William D.; Bravo, Luis Eduardo; Dominguez, Ricardo L.; Ferreccio, Catterina; Herrero, Rolando; Lazcano-Ponce, Eduardo C.; Meza-Montenegro, Mercedes María; Peña, Rodolfo; Peña, Edgar M.; Salazar-Martínez, Eduardo; Correa, Pelayo; Martínez, María Elena; Valdivieso, Manuel; Goodman, Gary E.; Crowley, John J.; Baker, Laurence H.

    2011-01-01

    Summary Background Evidence from Europe, Asia, and North America suggests that standard three-drug regimens of a proton pump inhibitor plus amoxicillin and clarithromycin are significantly less effective for eradicating Helicobacter pylori (H. pylori) infection than five-day concomitant and ten-day sequential four-drug regimens that include a nitroimidazole. These four-drug regimens also entail fewer antibiotic doses and thus may be suitable for eradication programs in low-resource settings. Studies are limited from Latin America, however, where the burden of H. pylori-associated diseases is high. Methods We randomised 1463 men and women ages 21–65 selected from general populations in Chile, Colombia, Costa Rica, Honduras, Nicaragua, and Mexico (two sites) who tested positive for H. pylori by a urea breath test (UBT) to: 14 days of lansoprazole, amoxicillin, and clarithromycin (standard therapy); five days of lansoprazole, amoxicillin, clarithromycin, and metronidazole (concomitant therapy); or five days of lansoprazole and amoxicillin followed by five of lansoprazole, clarithromycin, and metronidazole (sequential therapy). Eradication was assessed by UBT six–eight weeks after randomisation. Findings In intention-to-treat analyses, the probability of eradication with standard therapy was 82·2%, which was 8·6% higher (95% adjusted CI: 2·6%, 14·5%) than with concomitant therapy (73·6%) and 5·6% higher (95% adjusted CI: −0·04%, 11·6%) than with sequential therapy (76·5%). In analyses limited to the 1314 participants who adhered to their assigned therapy, the probabilities of eradication were 87·1%, 78·7%, and 81·1% with standard, concomitant, and sequential therapies, respectively. Neither four-drug regimen was significantly better than standard triple therapy in any of the seven sites. Interpretation Standard 14-day triple-drug therapy is preferable to five-day concomitant or ten-day sequential four-drug regimens as empiric therapy for H. pylori

  13. Automatic defensive control of asynchronous sequential machines

    NASA Astrophysics Data System (ADS)

    Hammer, Jacob

    2016-01-01

    Control theoretic techniques are utilised to develop automatic controllers that counteract robotic adversarial interventions in the operation of asynchronous sequential machines. The scenario centres on automatic protection against pre-programmed adversarial agents that attempt to subvert the operation of an asynchronous computing system. Necessary and sufficient conditions for the existence of defensive controllers that automatically defeat such adversarial agents are derived. These conditions are stated in terms of skeleton matrices - matrices of zeros and ones obtained directly from the given description of the asynchronous sequential machine being protected. When defensive controllers exist, a procedure for their design is outlined.

  14. Probing Angular Correlations in Sequential Double Ionization

    SciTech Connect

    Fleischer, A.; Woerner, H. J.; Arissian, L.; Liu, L. R.; Meckel, M.; Rippert, A.; Doerner, R.; Villeneuve, D. M.; Corkum, P. B.; Staudte, A.

    2011-09-09

    We study electron correlation in sequential double ionization of noble gas atoms and HCl in intense, femtosecond laser pulses. We measure the photoelectron angular distributions of Ne{sup +} relative to the first electron in a pump-probe experiment with 8 fs, 800 nm, circularly polarized laser pulses at a peak intensity of a few 10{sup 15} W/cm{sup 2}. Using a linear-linear pump-probe setup, we further study He, Ar, and HCl. We find a clear angular correlation between the two ionization steps in the sequential double ionization intensity regime.

  15. Passive Baited Sequential Filth Fly Trap.

    PubMed

    Aldridge, Robert L; Britch, Seth C; Snelling, Melissa; Gutierez, Arturo; White, Gregory; Linthicum, Kenneth J

    2015-09-01

    Filth fly control measures may be optimized with a better understanding of fly population dynamics measured throughout the day. We describe the modification of a commercial motorized sequential mosquito trap to accept liquid odorous bait and leverage a classic inverted-cone design to passively confine flies in 8 modified collection bottles corresponding to 8 intervals. Efficacy trials in a hot-arid desert environment indicate no significant difference (P  =  0.896) between the modified sequential trap and a Rid-Max® fly trap. PMID:26375911

  16. Bilateral sequential Propionibacterium acnes exogenous endophthalmitis.

    PubMed

    Saffra, Norman; Moriarty, Emily; Milman, Tatyana

    2016-12-01

    A 68-year-old man underwent uncomplicated sequential cataract extractions performed more than a year apart. He presented 6 months after the second surgery with persistent intraocular inflammation in both eyes. Cultures from both eyes grew Propionibacterium acnes and he responded well to treatment. Suspicion for delayed-onset post-operative endophthalmitis must remain high in uveitis cases that fail to resolve with anti-inflammatory treatments. The authors believe this is the first reported case of bilateral sequential P. acnes exogenous endophthalmitis. PMID:27220771

  17. 2DPUF: A sequential gaussian puff model

    SciTech Connect

    Addis, R.P.; O`Steen, B.L.

    1990-12-31

    This report documents the Environmental Transport Section`s (ETS) two-dimensional, sequential gaussian puff transport and dispersion model for emergency response. The sequential puff scheme is described, and the dispersion equations are presented. The advantages of this model over the ETS`s PUFF/PLUME model are discussed. Options are calculating a two-dimensional wind field, interpolation procedures, and the wind field grid are described. The various grid systems for puff transport calculations and dose estimates are also described. A flow diagram for the modules comprising the 2DPUF code and a description of each module is presented.

  18. 2DPUF: A sequential gaussian puff model

    SciTech Connect

    Addis, R.P.; O'Steen, B.L.

    1990-01-01

    This report documents the Environmental Transport Section's (ETS) two-dimensional, sequential gaussian puff transport and dispersion model for emergency response. The sequential puff scheme is described, and the dispersion equations are presented. The advantages of this model over the ETS's PUFF/PLUME model are discussed. Options are calculating a two-dimensional wind field, interpolation procedures, and the wind field grid are described. The various grid systems for puff transport calculations and dose estimates are also described. A flow diagram for the modules comprising the 2DPUF code and a description of each module is presented.

  19. Regimen complexity and medication nonadherence in elderly patients

    PubMed Central

    Corsonello, Andrea; Pedone, Claudio; Lattanzio, Fabrizia; Lucchetti, Maria; Garasto, Sabrina; Carbone, Claudia; Greco, Cosetta; Fabbietti, Paolo; Incalzi, Raffaele Antonelli

    2009-01-01

    Objective: To assess whether the number of daily administrations of individual drugs, as a measure of regimen complexity, contributes to the profile of an elderly patient who adheres poorly to the prescribed therapy. Population: Six hundred ninety patients over 64 years who were consecutively admitted to 11 acute medical care and three long term/rehabilitation wards in Italy. Main outcome measure: Self-reported adherence to drugs taken at home before admission was measured by a single question assessment for each listed drug supplemented with a latter question about the circumstances of the missed administration. For cognitively impaired patients the question was put to patients’ relatives or caregivers. Methods: A structured multidimensional assessment was performed to identify nonadherence and its potential correlates. Correlates of nonadherence were identified by multivariable logistic regression. Results: We recorded 44 cases (6.4%) of nonadherence to at least one drug. Being assisted by foreign caregivers (OR 2.17; 95% CI 1.02–4.63) and the use of at least one multiple daily dosing drug (OR 2.99; 95% CI 1.24–7.17) were significant independent correlates of medication nonadherence, while age, selected indexes of frailty and the cumulative number of prescribed drugs were not. Conclusion: Regimen complexity and type of assistance are independent correlates of medication nonadherence. PMID:19436625

  20. Liver irradiation: a potential preparative regimen for hepatocyte transplantation.

    PubMed

    Guha, C; Parashar, B; Deb, N J; Sharma, A; Gorla, G R; Alfieri, A; Roy-Chowdhury, N; Roy-Chowdhury, J; Vikram, B

    2001-02-01

    Advances in the understanding of hepatocyte engraftment and repopulation of the host liver have already led to the use of hepatocyte transplantation (HT) with some success in the treatment of inherited and acquired liver diseases. Wider application of HT is severely limited by the unavailability of large number of transplantable hepatocytes and difficulties associated with transplanting an adequate number of cells for achieving therapeutically satisfactory levels of metabolic correction. Therefore, there is a need for preparative regimens that provide a growth advantage to the transplanted (healthy) hepatocytes over the host's own (diseased) hepatocytes so that the former can repopulate the host liver. We have recently shown that when the liver of recipient rats was subjected to radiotherapy and partial hepatectomy before HT, the transplanted hepatocytes engrafted in and massively repopulated the liver, and also ameliorated the adverse clinical and histopathological changes associated with hepatic irradiation. This protocol was then used as a preparative regimen for transplanting normal hepatocytes into jaundice mutant rats (Gunn strain), which lack hepatic bilirubin-uridinediphosphoglucuronate glucuronosyltransferase and is a model of Crigler-Najjar syndrome Type I. The results showed long-term correction of the metabolic abnormality, suggesting that the transplanted hepatocytes repopulated an irradiated liver and were metabolically functional. This strategy could be useful in the treatment of various genetic, metabolic, or malignant diseases of the liver. PMID:11173140

  1. Adherence With Therapeutic Regimens: Behavioral and Pharmacoeconomic Perspectives.

    PubMed

    Giannetti, Vincent J; Kamal, Khalid M

    2016-04-01

    There is an extensive literature regarding nonadherence with both therapeutic regimens and medication. This literature includes reviews of empirical research regarding the factors associated with nonadherence. Health care system, provider, and patient factors as well as the nature of the illness and therapeutic regimen all effect adherence rates. Different behavioral models for adherence counseling such as the Health Belief Model, the Theory of Reasoned Action, the Medication Interest Model, and Motivational Interviewing have also been reported in the research literature. This article will discuss the development of a brief model for patient counseling with specific techniques illustrated for pharmacists based on empirical findings that have demonstrated effectiveness in the adherence research literature. In addition, the article will address the measurement of the economic impact of medication nonadherence and propose a framework for assessing the cost-effectiveness of pharmacist counseling to increase adherence. The problem of nonadherence has significant effects upon health care expenditures through increase in physician's visits, emergency department incidents, rehospitalizations, and nursing home readmissions. Thus, the overall goal is to assist the pharmacist in developing a brief adherence counseling program in community pharmacy and evaluating the economic feasibility of the intervention demonstrating the value-added proposition of pharmacist intervention. PMID:25292442

  2. Regimen of ovarian stimulation affects oocyte and therefore embryo quality.

    PubMed

    Bosch, Ernesto; Labarta, Elena; Kolibianakis, Efstratios; Rosen, Mitchell; Meldrum, David

    2016-03-01

    Without any doubt the regimen used to mature multiple capable oocytes for IVF impacts IVF outcomes. Studies have indicated that the inclusion of LH activity, adjuvant agents such as growth hormone (GH), and regimens providing for simultaneous action of both LH and FSH during final oocyte maturation may have beneficial effects on IVF outcomes. Because of the difficulty in improving IVF outcomes in poor responders, the studies on GH are of particular interest. As pointed out in this review, the apparent beneficial effects of GH on oocyte competence may also apply to older women or to normal responders with reduced embryo quality. A much more difficult question is whether and how much ovarian stimulation impacts on oocyte competence. Paradoxically it seems that there are not demonstrated differences between the stimulated and the natural unstimulated cycle, whereas studies in laboratory animals and IVF patients have shown deleterious effects of higher compared with lower doses of gonadotropins. Recent studies suggest that the use of high doses of gonadotropins as an independent factor correlates negatively with the probability of live birth, whereas a high ovarian response per se is associated with better cumulative pregnancy rates, owing to the availability of more euploid and good-quality embryos. Although adjunctive use of androgens has not been discussed here, it is briefly covered in the first review of this series. PMID:26826273

  3. Validation of a simplified netilmicin dosage regimen in infants.

    PubMed

    Klingenberg, Claus; Småbrekke, Lars; Lier, Tore; Flaegstad, Trond

    2004-01-01

    The aim of this study was to validate a simplified high-dosage, extended-interval netilmicin dosage regimen for infants. A total of 129 infants receiving 163 treatment courses of netilmicin (6 mg kg every 24 or 36 h depending on gestational age (GA), postnatal age and postmenstrual age) was analysed. Serum netilmicin concentrations were monitored before (Cmin), 30 min (C0.5h) after and 7.5 h (C7.5h) after the third dose. In 110 patients during first week of life mean C0.5h was 10.5 mg/l. Mean C0.5h was significantly lower (9.0 mg/l) in 38 infants older than 1 week of age. 14 of 15 patients with Cmin levels > or = 2 mg/l receiving netilmicin every 36 h were < 28 weeks of gestation. In the first week of life significant correlations between GA and elimination half-life (p < 0.001) and between plasma creatinine and elevated Cmin (p < 0.002) were found, but no correlation between C0.5h and GA. In this high-dosage regimen a dosing interval of 48 h for GA < 29 weeks, 36 h for GA 29-36 weeks and 24 h for full term babies seems appropriate, during first week of life, to avoid the majority of elevated trough levels and still obtain maximal therapeutic efficacy. PMID:15307571

  4. Designing drug regimens for special intensive care unit populations

    PubMed Central

    Erstad, Brian L

    2015-01-01

    This review is intended to help clinicians design drug regimens for special populations of critically ill patients with extremes of body size, habitus and composition that make drug choice or dosing particularly challenging due to the lack of high-level evidence on which to make well-informed clinical decisions. The data sources included a literature search of MEDLINE and EMBASE with reviews of reference lists of retrieved articles. Abstracts of original research investigations and review papers were reviewed for their relevance to drug choice or dosing in the following special critically ill populations: patients with more severe forms of bodyweight or height, patients with amputations or missing limbs, pregnant patients, and patients undergoing extracorporeal membrane oxygenation or plasma exchange. Relevant papers were retrieved and evaluated, and their associated reference lists were reviewed for citations that may have been missed through the electronic search strategy. Relevant original research investigations and review papers that could be used to formulate general principles for drug choice or dosing in special populations of critically ill patients were extracted. Randomized studies with clinically relevant endpoints were not available for performing quantitative analyses. Critically ill patients with changes in body size, habitus and composition require special consideration when designing medication regimens, but there is a paucity of literature on which to make drug-specific, high-level evidence-based recommendations. Based on the evidence that is available, general recommendations are provided for drug choice or dosing in special critically ill populations. PMID:25938029

  5. Metyrapone attenuates the sequential learning deficits but not monoamine depletions following d,l-fenfluramine administration to adult rats.

    PubMed

    Skelton, Matthew R; Blankenmeyer, Tracy L; Gudelsky, Gary A; Brown-Strittholt, Carrie A; Vorhees, Charles V; Williams, Michael T

    2004-12-15

    Fenfluramine (FEN) is a substituted amphetamine known for its anorectic effects, without the stimulatory or abuse potential associated with other amphetamine derivatives. FEN is a potent serotonin (5-HT) releaser and reuptake inhibitor and has been shown to cause depletions of 5-HT that can last days and even weeks after administration. Administration of FEN four times on a single day also causes a prolonged increase of corticosterone (CORT) that lasts approximately 72 h following the first FEN dose. This dosing regimen also produces deficits in sequential learning as measured in the Cincinnati water maze (CWM). Adrenalectomy blocks this effect but removes more than CORT. Accordingly, the purpose of this study was to determine whether inhibiting glucocorticoid production, by administration of the 11 beta-hydroxylase inhibitor metyrapone (MET), will similarly attenuate or eliminate the sequential learning deficits seen with FEN exposure. MET (50 mg/kg) injections were administered 90 min prior to and for 3 days after FEN (four doses given at 2-h intervals). Animals pretreated with MET and treated with FEN showed no sequential learning deficits when tested 1 week following FEN administration compared to FEN alone. The depletions of monoamines were similar following FEN administration, regardless of MET treatment. Taken together, this suggests that a potential mechanism for the sequential learning deficits in FEN-treated animals is a result of prolonged increases in CORT output. PMID:15484208

  6. Forecasting Flooding in the Brahmaputra and Ganges Delta of Bangladesh on Short (1-10 days), Medium (20-30 days) and Seasonal Time Scales (1-6 months)

    NASA Astrophysics Data System (ADS)

    Webster, P. J.; Hoyos, C. D.; Hopson, T. M.; Chang, H.; Jian, J.

    2007-12-01

    Following the devastating flood years of 1998 during which 60% of Bangladesh was under water for a period of 3 months, the Climate Forecast Applications in Bangladesh (CFAB) project was formed with funding by USAID and NSF which eventually resulted in a joint project with the European Centre for Medium Range Weather Forecasting (ECMWF), the Asian Disaster Preparedness Centre (ADPC) and the Bangladesh Flood Forecasting and Warning Centre. The project was organized and developed through the Georgia Institute of Technology. The aim of CFAB was to develop innovative methods of extending the warning of flooding in Bangladesh noting that there was a unique problem: India provided no upstream discharge data to Bangladesh so that before CFAB the maximum lead time of a forecast was that given by measuring river discharge at the India-Bangladesh border: no lead-time at the border and 2 days in the southern parts of the country. Given that the Brahmaputra and Ganges catchment areas had to be regarded as essentially unguaged, it was clear that innovative techniques had to be developed. On of the basic criterion was that the system should provide probabilistic forecasts in order for the Bangladeshis to assess risk. A three-tier system was developed to allow strategic and tactical decisions to be made for agricultural purposes and disaster mitigation: seasonal (1-6 months: strategic), medium range (20-30 days: strategic/tactical) and short range (1-10 days: tactical). The system that has been developed brings together for the first time operational meteorological forecasts (ensemble forecasts from ECMWF), with satellite and discharge data and a suite of hydrological models. In addition, with ADPC and FFWC we have developed an in-country forecast dispersion system that allows a rapid dissemination. The system has proven to be rather successful, especially in the short range. The flooding events of 2004 were forecast with all forecasting tiers at the respective lead time. In

  7. Mathematical Problem Solving through Sequential Process Analysis

    ERIC Educational Resources Information Center

    Codina, A.; Cañadas, M. C.; Castro, E.

    2015-01-01

    Introduction: The macroscopic perspective is one of the frameworks for research on problem solving in mathematics education. Coming from this perspective, our study addresses the stages of thought in mathematical problem solving, offering an innovative approach because we apply sequential relations and global interrelations between the different…

  8. Passive Baited Sequential Filth Fly Trap

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Filth fly control measures may be optimized with a better understanding of fly population dynamics measured throughout the day. We describe the modification of a commercial motorized sequential mosquito trap to accept liquid odorous bait and leverage a classic inverted cone design to passively confi...

  9. NRC PAGE. Sequential Analysis Materials Balance

    SciTech Connect

    Picard, R.

    1992-01-13

    NRCPAGE is used in safeguards applications to detect a recurring loss of special nuclear material by frequent evaluation (sequential analysis) of accountability data. Standard sequential testing procedures are traditionally based on sequences of independent and normally distributed measurements. This same approach can be applied to materials balance (MB) data. Here, the term materials balance has a meaning similar to inventory difference and represents a materials loss indicator localized in time and space. However, distinct MBs cannot be reasonably treated as statistically independent and may not always be reasonably treated as normally distributed. Furthermore, the covariance structure associated with a given MB sequence is not known and must be estimated. Nonindependence is treated by converting the MB sequence to the innovation sequence, sometimes called the ITMUF sequence or the sequence of MUF residuals, which are statistically independent and amenable to sequential test procedures. A one-sided page`s test, effective for a wide range of recurring loss scenarios, is applied to the standardized innovation sequence. The program can be easily modified to suit particular needs; the models for the assumption of multivariate normality for MBs when computing the innovation sequence or the test procedure can be changed as can the input/output format, dimensioning, local error checking, and simulation work. Input files can be sequentially constructed using local text editors to update existing files. Output files can be read by graphics, report writer, or other stand-alone utility routines.

  10. On-line diagnosis of sequential systems

    NASA Technical Reports Server (NTRS)

    Sundstrom, R. J.

    1973-01-01

    A model for on-line diagnosis was investigated for discrete-time systems, and resettable sequential systems. Generalized notions of a realization are discussed along with fault tolerance and errors. Further investigation into the theory of on-line diagnosis is recommended for three levels: binary state-assigned level, logical circuit level, and the subsystem-network level.

  11. Semiannalytical satellite theory and sequential estimation

    NASA Technical Reports Server (NTRS)

    Taylor, S. P.; Cefola, P. J.

    1980-01-01

    Kalman filtering techniques are combined with a semianalytical orbit generator to develop a sequential orbit determination algorithm. The algorithm is investigated for computational efficiency, accuracy, and radius of convergence by comparison with truth ephemerides and a Cowell special perturbations filters (GTDS). Test cases relevant to satellite navigation are examined.

  12. Procedural Network Representations of Sequential Data.

    ERIC Educational Resources Information Center

    Cooke, Nancy J.; And Others

    1996-01-01

    Describes PRONET (PROcedural NETworks), an integrated exploratory sequential data analysis technique that uses Pathfinder network scaling to highlight frequently occurring transitions among user, system, and environmental events. Illustrates the success and limitations of the method through two case studies. Thirteen figures highlight protocols of…

  13. Adaptive sequential testing for multiple comparisons.

    PubMed

    Gao, Ping; Liu, Lingyun; Mehta, Cyrus

    2014-01-01

    We propose a Markov process theory-based adaptive sequential testing procedure for multiple comparisons. The procedure can be used for confirmative trials involving multi-comparisons, including dose selection or population enrichment. Dose or subpopulation selection and sample size modification can be made at any interim analysis. Type I error control is exact. PMID:24926848

  14. Terminating Sequential Delphi Survey Data Collection

    ERIC Educational Resources Information Center

    Kalaian, Sema A.; Kasim, Rafa M.

    2012-01-01

    The Delphi survey technique is an iterative mail or electronic (e-mail or web-based) survey method used to obtain agreement or consensus among a group of experts in a specific field on a particular issue through a well-designed and systematic multiple sequential rounds of survey administrations. Each of the multiple rounds of the Delphi survey…

  15. Sequential Pointing in Children and Adults.

    ERIC Educational Resources Information Center

    Badan, Maryse; Hauert, Claude-Alain; Mounoud, Pierre

    2000-01-01

    Four experiments investigated the development of visuomotor control in sequential pointing in tasks varying in difficulty among 6- to 10-year-olds and adults. Comparisons across difficulty levels and ages suggest that motor development is not a uniform fine-tuning of stable strategies. Findings raise argument for stage characteristics of…

  16. Drying leather with vacuum and toggling sequentially

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We investigated a drying method that will enable leather to be dried under vacuum and stretch sequentially to improve area yield. Vacuum drying offers fast speed at a low temperature, which would be advantageous to heat-vulnerable chrome-free leather. Adding a toggle action after vacuum drying cou...

  17. Adult Word Recognition and Visual Sequential Memory

    ERIC Educational Resources Information Center

    Holmes, V. M.

    2012-01-01

    Two experiments were conducted investigating the role of visual sequential memory skill in the word recognition efficiency of undergraduate university students. Word recognition was assessed in a lexical decision task using regularly and strangely spelt words, and nonwords that were either standard orthographically legal strings or items made from…

  18. Salt water-acclimated pink salmon fry (Oncorhynchus gorbuscha) develop stress-related visceral lesions after 10-day exposure to sublethal concentrations of the water-soluble fraction of North Slope crude oil.

    PubMed

    Brand, D G; Fink, R; Bengeyfield, W; Birtwell, I K; McAllister, C D

    2001-01-01

    Pink salmon fry. Oncorhynchus gorbuscha, after a 10-day exposure to one of two sublethal concentrations (25-54 microg x L(-1) or 178-348 microg x L(-1)) of the water-soluble fractions from Alaska North Slope crude oil, possessed morphologic and stress induced lesions in their hepatic, head kidney and gill tissues. Analysis of livers from oil-exposed fry revealed a variety of hepatocellular changes, including steatosis, nuclear pleomorphism. megalocytosis and necrosis. Epithelial proliferation of the bile ducts also occurred. An increase in the head kidney's interrenal cell nuclear diameter, a biomarker for stress responses, was correlated with hydrocarbon exposure. Gill abnormalities such as eqithelial lifting. fusion, mucous cell hyperplasia and vascular constriction were found in all test groups, but were more severe in fry given the high water soluble fraction of crude oil. The study demonstrated that sublethal exposure to the water-soluble fraction of crude oil results in multiple microscopic lesions (in several viscera) that are consistent with a pronounced response to environmental stress. PMID:11695575

  19. Comparative Effectiveness of Biologic Therapy Regimens for Ankylosing Spondylitis

    PubMed Central

    Chen, Chao; Zhang, XiaoLin; Xiao, Lu; Zhang, XueSong; Ma, XinLong

    2016-01-01

    Abstract To establish the comparative effectiveness of all available biologic therapy regimens for ankylosing spondylitis, we performed a systematic review and a Bayesian network meta-analysis of randomized controlled trials. PubMed, Medline, Embase, Cochrane library, and ClinicalTrials.gov were searched from the inception of each database to June 2015. Systematic review and network meta-analysis was reported according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses. The primary outcome was 20% improvement of Assessments in SpondyloArthritis International Society Response Criteria (ASAS20) at Week 12 or 14; secondary outcomes were ASAS40, ASAS5/6, ASAS partial remission and 50% improvement in baseline Bath ankylosing spondylitis (AS) disease activity index. We reported relative risks and 95% confidence intervals from direct meta-analysis and 95% credible intervals from Bayesian network meta-analysis, and ranked the treatment for outcomes. We also used Grading of Recommendations Assessment, Development and Evaluation criteria to appraise quality of evidence. Fourteen RCTs comprising 2672 active AS patients were included in the network meta-analysis. Most biologic therapy regimens were more effective than placebo regarding all the outcomes assessed, except for secukinumab and tocilizumab. No differences between biologic therapies in the treatment of AS could be found, except for the finding that infliximab 5 mg was superior to tocilizumab. Infliximab 5 mg/kg had the highest probability of being ranked the best for achieving ASAS20, whereas notably, secukinumab had the highest probability of being ranked the second best. Our study suggests that no differences between biologic therapies in the treatment of AS could be found except that infliximab 5 mg was superior to tocilizumab. Infliximab 5 mg/kg seems to be the better biologic therapy regimen

  20. Retrospective evaluation of the MEAM regimen as a conditioning regimen before autologous peripheral blood stem cell transplantation for lymphoma in two centers with different dosing schedules of melphalan.

    PubMed

    Sugimoto, Miyuki; Ito, Shoko; Mashima, Kiyomi; Umino, Kento; Minakata, Daisuke; Nakano, Hirofumi; Yamasaki, Ryoko; Kawasaki, Yasufumi; Ashizawa, Masahiro; Yamamoto, Chihiro; Fujiwara, Shin-Ichiro; Okazuka, Kiyoshi; Hatano, Kaoru; Sato, Kazuya; Oh, Iekuni; Ohmine, Ken; Suzuki, Takahiro; Muroi, Kazuo; Kako, Shinichi; Kanda, Yoshinobu

    2016-09-01

    The BEAM regimen consisting of carmustine (BCNU), etoposide, cytarabine, and melphalan (MEL) is widely used before autologous hematopoietic stem cell transplantation (auto-HSCT) for lymphoma. However, intravenous BCNU is not available in Japan, and therefore, ranimustine (MCNU) has been used instead of BCNU (the MEAM regimen). We retrospectively analyzed the outcome of 79 adult patients who underwent auto-HSCT for lymphoma using this regimen in two centers, with 1- and 2-day dosing of MEL, respectively. Three-year overall survival (OS) and progression-free survival (PFS) probabilities were 77.3 and 56.5 % in the entire population and 71.7 and 58.0 % in patients with diffuse large B cell lymphoma. These outcomes were at least equivalent to those with the BEAM regimen. There was no regimen-related pulmonary toxicity. In a multivariate analysis, older age was the only factor that was significantly associated with for OS. In a comparison of the two MEL dosing schedules, while there was no significant differences in either OS or PFS, diarrhea was observed more frequently with 1-day dosing of MEL. In conclusion, the MEAM regimen appeared to be a promising conditioning regimen in auto-HSCT for lymphoma. A large prospective study is warranted to confirm the current findings. PMID:27365141

  1. Clofarabine and Cytarabine Regimen for Acute Myeloid Leukemia.

    PubMed

    Ho, Kristin V; Solimando, Dominic A; Waddell, J Aubrey

    2015-11-01

    The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast.net; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net. PMID:27621503

  2. Gemcitabine and Carboplatin (Renally Dosed) Regimen for Bladder Cancer

    PubMed Central

    Ryan Pritchard, E.; Waddell, J. Aubrey; Solimando, Dominic A.

    2015-01-01

    The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast.net; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net. PMID:25717204

  3. Doxorubicin and Dacarbazine (AD) Regimen for Soft Tissue Sarcomas

    PubMed Central

    Adkins, Kyle E.; Solimando, Dominic A.; Waddell, J. Aubrey

    2015-01-01

    The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast.net; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net. PMID:26405307

  4. Regimen selection in the OPTIONS trial of HIV salvage therapy: drug resistance, prior therapy, and race–ethnicity determine the degree of regimen complexity

    PubMed Central

    Tashima, Karen T.; Mollan, Katie R.; Na, Lumine; Gandhi, Rajesh T.; Klingman, Karin L.; Fichtenbaum, Carl J.; Andrade, Adriana; Johnson, Victoria A.; Eron, Joseph J.; Smeaton, Laura; Haubrich, Richard H.

    2015-01-01

    Background Regimen selection for highly treatment-experienced patients is complicated. Methods Using a web-based utility, study team members reviewed antiretroviral (ARV) history and resistance data and recommended individual ARV regimens and nucleoside reverse transcriptase inhibitor (NRTI) options for treatment-experienced participants consisting of 3–4 of the following agents: raltegravir (RAL), darunavir (DRV)/ritonavir, tipranavir (TPV)/ritonavir, etravirine (ETR), maraviroc (MVC), and enfuvirtide (ENF). We evaluated team recommendations and site selection of regimen and NRTIs. Associations between baseline factors and the selection of a complex regimen (defined as including four ARV agents or ENF) were explored with logistic regression. Results A total of 413 participants entered the study. Participants initiated the first or second recommended regimen 86% of the time and 21% of participants started a complex regimen. In a multivariable model, ARV resistance to NRTI (odds ratio [OR]=2.2), non-nucleoside reverse transcriptase inhibitor (NNRTI, OR=6.2) or boosted protease inhibitor (PI, OR=6.6), prior use of integrase strand transfer inhibitor (INSTI, OR=25), and race–ethnicity (all P≤0.01) were associated with selection of a complex regimen. Black non-Hispanic (OR=0.5) and Hispanic participants from the continental US (OR=0.2) were less likely to start a complex regimen, compared to white non-Hispanics. Conclusions In this multi-center trial, we developed a web-based utility that facilitated treatment recommendations for highly treatment-experienced patients. Drug resistance, prior INSTI use, and race–ethnicity were key factors in decisions to select a more complex regimen. PMID:26212575

  5. Eradication of Helicobacter pylori: are rifaximin-based regimens effective?

    PubMed

    Gasbarrini, Antonio; Gasbarrini, Giovanni; Pelosini, Iva; Scarpignato, Carmelo

    2006-01-01

    Rifaximin is a non-absorbed semisynthetic rifamycin derivative with a broad spectrum of antibacterial activity including Gram-positive and Gram-negative bacteria, both aerobes and anaerobes. Although originally developed for the treatment of infectious diarrhea, the appreciation of the pathogenic role of gut bacteria in several organic and functional gastrointestinal diseases has increasingly broadened its clinical use. Being the antibiotic active against Helicobacter pylori, even towards clarithromycin-resistant strain, and being the primary resistance very rare, several investigations explored its potential use for eradication of the microorganism. Rifaximin alone proved to be effective, but even the highest dose (1,200 mg daily) gave a cure rate of only 30%. Dual and triple therapies were also studied, with the better results obtained with rifaximin-clarithromycin and rifaximin-clarithromycin-esomeprazole combinations. However, the eradication rates (60-70%) obtained with these regimens were still below the standard set by the Maastricht Consensus guidelines. Although rifaximin-based eradication therapies are promising, new antimicrobial combinations (with and without proton pump inhibitors) need to be explored in well-designed clinical trials including a large cohort of H. pylori-infected patients. The remarkable safety of rifaximin will allow high-dose regimens of longer duration (e.g. 10 or 14 days) to be tested with confidence in the hope of achieving better eradication rates. A drawback of rifaximin could be its inability to reach sufficiently high concentrations in the gastric mucus layer under and within which H. pylori is commonly located and this would likely affect eradication rate. Taking these considerations into account, bioadhesive rifaximin formulations able to better and persistently cover gastric mucosa, or combination with mucolytic agents, such as pronase or acetylcysteine, need to be evaluated in order to better define the place of this

  6. New Regimens to Prevent Tuberculosis in Adults with HIV Infection

    PubMed Central

    Martinson, Neil A.; Barnes, Grace L.; Moulton, Lawrence H.; Msandiwa, Reginah; Hausler, Harry; Ram, Malathi; McIntyre, James A.; Gray, Glenda E.; Chaisson, Richard E.

    2012-01-01

    BACKGROUND Treatment of latent tuberculosis in patients infected with the human immunodeficiency virus (HIV) is efficacious, but few patients around the world receive such treatment. We evaluated three new regimens for latent tuberculosis that may be more potent and durable than standard isoniazid treatment. METHODS We randomly assigned South African adults with HIV infection and a positive tuberculin skin test who were not taking antiretroviral therapy to receive rifapentine (900 mg) plus isoniazid (900 mg) weekly for 12 weeks, rifampin (600 mg) plus isoniazid (900 mg) twice weekly for 12 weeks, isoniazid (300 mg) daily for up to 6 years (continuous isoniazid), or isoniazid (300 mg) daily for 6 months (control group). The primary end point was tuberculosis-free survival. RESULTS The 1148 patients had a median age of 30 years and a median CD4 cell count of 484 per cubic millimeter. Incidence rates of active tuberculosis or death were 3.1 per 100 person-years in the rifapentine–isoniazid group, 2.9 per 100 person-years in the rifampin–isoniazid group, and 2.7 per 100 person-years in the continuous-isoniazid group, as compared with 3.6 per 100 person-years in the control group (P>0.05 for all comparisons). Serious adverse reactions were more common in the continuous-isoniazid group (18.4 per 100 person-years) than in the other treatment groups (8.7 to 15.4 per 100 person-years). Two of 58 isolates of Mycobacterium tuberculosis (3.4%) were found to have multidrug resistance. CONCLUSIONS On the basis of the expected rates of tuberculosis in this population of HIV-infected adults, all secondary prophylactic regimens were effective. Neither a 3-month course of intermittent rifapentine or rifampin with isoniazid nor continuous isoniazid was superior to 6 months of isoniazid. PMID:21732833

  7. A Microarray Analysis of the Temporal Response of Liver to Methylprednisolone: A Comparative Analysis of Two Dosing Regimens

    PubMed Central

    Almon, Richard R.; DuBois, Debra C.; Jusko, William J.

    2014-01-01

    Microarray analyses were performed on livers from adrenalectomized male Wistar rats chronically infused with methylprednisolone (MPL) (0.3 mg/kg·h) using Alzet mini-osmotic pumps for periods ranging from 6 h to 7 d. Four control and 40 drug-treated animals were killed at 10 different times during drug infusion. Total RNA preparations from the livers of these animals were hybridized to 44 individual Affymetrix REA230A gene chips, generating data for 15,967 different probe sets for each chip. A series of three filters were applied sequentially. These filters were designed to eliminate probe sets that were not expressed in the tissue, were not regulated by the drug, or did not meet defined quality control standards. These filters eliminated 13,978 probe sets (87.5%) leaving a remainder of 1989 probe sets for further consideration. We previously described a similar dataset obtained from animals after administration of a single dose of MPL (50 mg/kg given iv). That study involved 16 time points over a 72-h period. A similar filtering schema applied to the single-bolus-dose data-set identified 1519 probe sets as being regulated by MPL. A comparison of datasets from the two different dosing regimens identified 358 genes that were regulated by MPL in response to both dosing regimens. Regulated genes were grouped into 13 categories, mainly on gene product function. The temporal profiles of these common genes were subjected to detailed scrutiny. Examination of temporal profiles demonstrates that current perspectives on the mechanism of glucocorticoid action cannot entirely explain the temporal profiles of these regulated genes. PMID:17303664

  8. Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians

    PubMed Central

    Nappi, Rossella E.; Kaunitz, Andrew M.; Bitzer, Johannes

    2016-01-01

    ABSTRACT Objectives: The clinical utility of extended regimen combined oral contraceptives (COCs) is increasingly being recognised. Our objective was to understand the attitudes of women and clinicians about the use of these regimens. We present the rationale for extended regimen COCs from a historical perspective, and trace their evolution and growing popularity in light of their clinical benefits. We conclude by offering potential strategies for counselling women about extended regimen COC options. Methods: We conducted a MEDLINE search to identify and summarise studies of extended regimen COCs, focusing on attitudes of women and clinicians regarding efficacy, safety/tolerability and fewer scheduled bleeding episodes and other potential benefits. Results: The body of contemporary literature on extended regimen COCs suggests that their contraceptive efficacy is comparable to that of conventional 28-day (i.e., 21/7) regimens. For women seeking contraception that allows infrequent scheduled bleeding episodes, particularly those who suffer from hormone withdrawal symptoms and cyclical symptoms (e.g., headache, mood changes, dysmenorrhoea, heavy menstrual bleeding), extended regimen COCs are an effective and safe option. Although satisfaction with extended regimen COCs in clinical trials is high, misperceptions about continuous hormone use may still limit the widespread acceptance of this approach. Conclusions: Despite the widespread acceptance among clinicians of extended regimen COCs as an effective and safe contraceptive option, these regimens are underused, likely due to a lack of awareness about their availability and utility among women. Improved patient education and counselling regarding the safety and benefits of extended regimen COCs may help women make more informed contraceptive choices. PMID:26572318

  9. Effect of sequential application of topical adapalene and clindamycin phosphate in the treatment of Japanese patients with acne vulgaris.

    PubMed

    Kubota, Yasuo; Munehiro, Asuka; Shirahige, Yoshie; Nakai, Kozo; Katsuura, Junko; Moriue, Tetsuya; Murakami, Yumi; Matsunaka, Hiroshi; Yoneda, Kozo

    2012-02-01

    The efficacy of combined therapy with a retinoid and antibiotic for Japanese patients with acne vulgaris remains to be established. Further, maintenance strategies limiting the use of topical retinoids must be identified. The objectives of this study are to determine the efficacy of sequential application of topical adapalene and clindamycin phosphate and to assess the impact of this regimen on patients' quality of life. Sixty-six patients were recruited. The regimen comprised two phases. For the 4-week initial treatment, 1% clindamycin phosphate gel was applied twice daily and 0.1% adapalene gel, once. In the 4-week maintenance phase, patients were randomly assigned to the OD group (adapalene applied once daily) or the TW group (adapalene applied once daily on 2 days per week). The acne severity score, lesion counts, microcomedone count, and sebum amount were measured. Quality of life (QOL) was assessed using Skindex-16. All parameters improved significantly by week 4 of initial treatment. No statistically significant differences were found in the improvement of clinical findings between the groups. All QOL scores improved significantly and did not significantly differ between the groups. Our regimen may enable clinical control of acne in Japanese patients and improve their QOL. For limiting retinoid use, weekly application of adapalene during maintenance is suitable. PMID:21254867

  10. Lung Volume Measured during Sequential Swallowing in Healthy Young Adults

    ERIC Educational Resources Information Center

    Hegland, Karen Wheeler; Huber, Jessica E.; Pitts, Teresa; Davenport, Paul W.; Sapienza, Christine M.

    2011-01-01

    Purpose: Outcomes from studying the coordinative relationship between respiratory and swallow subsystems are inconsistent for sequential swallows, and the lung volume at the initiation of sequential swallowing remains undefined. The first goal of this study was to quantify the lung volume at initiation of sequential swallowing ingestion cycles and…

  11. Sequential shrink photolithography for plastic microlens arrays

    NASA Astrophysics Data System (ADS)

    Dyer, David; Shreim, Samir; Jayadev, Shreshta; Lew, Valerie; Botvinick, Elliot; Khine, Michelle

    2011-07-01

    Endeavoring to push the boundaries of microfabrication with shrinkable polymers, we have developed a sequential shrink photolithography process. We demonstrate the utility of this approach by rapidly fabricating plastic microlens arrays. First, we create a mask out of the children's toy Shrinky Dinks by simply printing dots using a standard desktop printer. Upon retraction of this pre-stressed thermoplastic sheet, the dots shrink to a fraction of their original size, which we then lithographically transfer onto photoresist-coated commodity shrink wrap film. This shrink film reduces in area by 95% when briefly heated, creating smooth convex photoresist bumps down to 30 µm. Taken together, this sequential shrink process provides a complete process to create microlenses, with an almost 99% reduction in area from the original pattern size. Finally, with a lithography molding step, we emboss these bumps into optical grade plastics such as cyclic olefin copolymer for functional microlens arrays.

  12. Sequential Treatment of Biofilms with Aztreonam and Tobramycin Is a Novel Strategy for Combating Pseudomonas aeruginosa Chronic Respiratory Infections.

    PubMed

    Rojo-Molinero, Estrella; Macià, María D; Rubio, Rosa; Moyà, Bartolomé; Cabot, Gabriel; López-Causapé, Carla; Pérez, José L; Cantón, Rafael; Oliver, Antonio

    2016-05-01

    Traditional therapeutic strategies to control chronic colonization in cystic fibrosis (CF) patients are based on the use of a single nebulized antibiotic. In this study, we evaluated the therapeutic efficacy and dynamics of antibiotic resistance in Pseudomonas aeruginosa biofilms under sequential therapy with inhaled aztreonam (ATM) and tobramycin (TOB). Laboratory strains PAO1, PAOMS (hypermutable), PAOMA (mucoid), and PAOMSA (mucoid and hypermutable) and two hypermutable CF strains, 146-HSE (Liverpool epidemic strain [LES-1]) and 1089-HSE (ST1089), were used. Biofilms were developed using the flow cell system. Mature biofilms were challenged with peak and 1/10-peak concentrations of ATM (700 mg/liter and 70 mg/liter), TOB (1,000 mg/liter and 100 mg/liter), and their alternations (ATM/TOB/ATM and TOB/ATM/TOB) for 2 (t = 2), 4 (t = 4), and 6 days (t = 6). The numbers of viable cells (CFU) and resistant mutants were determined. Biofilm structural dynamics were monitored by confocal laser scanning microscopy and processed with COMSTAT and IMARIS software programs. TOB monotherapy produced an intense decrease in CFU that was not always correlated with a reduction in biomass and/or a bactericidal effect on biofilms, particularly for the CF strains. The ATM monotherapy bactericidal effect was lower, but effects on biofilm biomass and/or structure, including intense filamentation, were documented. The alternation of TOB and ATM led to an enhancement of the antibiofilm activity against laboratory and CF strains compared to that with the individual regimens, potentiating the bactericidal effect and/or the reduction in biomass, particularly at peak concentrations. Resistant mutants were not documented in any of the regimens at the peak concentrations and only anecdotally at the 1/10-peak concentrations. These results support the clinical evaluation of sequential regimens with inhaled antibiotics in CF, as opposed to the current maintenance treatments with just one

  13. Comparative Study of Apo-Cetirizine Single Therapy and Intermittent Sequential Therapy with Cetirizine, Loratadine and Chlorpheniramine in Allergic Rhinitis.

    PubMed

    Safavi Naini, Ali; Ghorbani, Jahangir; Mazloom, Ebrahim

    2016-09-01

    There are limited numbers of articles, studying combined use of antihistamines. In this study, we compare single therapy of Apo-Cetirizine with a new regimen of intermittent sequential therapy with cetirizine, loratadine and chlorpheniramine in treatment of seasonal allergic rhinitis. This randomized clinical trial was performed between April and September at the peak prevalence of seasonal allergic rhinitis. Fifty-four eligible patients diagnosed clinically to have seasonal allergic rhinitis were randomized in two groups: 24 cases in single therapy arm, received Apo-Cetirizine 10 mg tablet daily and in other arm, 30 patients received sequential regimen of cetirizine 10 mg tablet, loratadine 10 mg tablet and chlorpheniramine 4 mg tablet, one tablet each day. Major Symptom Complex Score (MSCS) and Total Symptom Complex Score (TSCS) of patients were recorded before treatment and after 30 days of treatment in two groups. The average post-treatment MSCS and TSCS in combination therapy group showed better improvement than single therapy group but difference was not statistically significant (p value = 0.053 and p value = 0.104 respectively). Combination therapy regimen was better in improvement of nasal congestion (p value = 0.006). There were no significant difference between two groups in efficacy, side effects and patient's satisfaction. Combination therapy would be effective on a wide spectrum of symptoms with lower price and theoretically offers lower chance of tolerance and re-appearance of complaints. PMID:27508135

  14. Heat accumulation during sequential cortical bone drilling.

    PubMed

    Palmisano, Andrew C; Tai, Bruce L; Belmont, Barry; Irwin, Todd A; Shih, Albert; Holmes, James R

    2016-03-01

    Significant research exists regarding heat production during single-hole bone drilling. No published data exist regarding repetitive sequential drilling. This study elucidates the phenomenon of heat accumulation for sequential drilling with both Kirschner wires (K wires) and standard two-flute twist drills. It was hypothesized that cumulative heat would result in a higher temperature with each subsequent drill pass. Nine holes in a 3 × 3 array were drilled sequentially on moistened cadaveric tibia bone kept at body temperature (about 37 °C). Four thermocouples were placed at the center of four adjacent holes and 2 mm below the surface. A battery-driven hand drill guided by a servo-controlled motion system was used. Six samples were drilled with each tool (2.0 mm K wire and 2.0 and 2.5 mm standard drills). K wire drilling increased temperature from 5 °C at the first hole to 20 °C at holes 6 through 9. A similar trend was found in standard drills with less significant increments. The maximum temperatures of both tools increased from <0.5 °C to nearly 13 °C. The difference between drill sizes was found to be insignificant (P > 0.05). In conclusion, heat accumulated during sequential drilling, with size difference being insignificant. K wire produced more heat than its twist-drill counterparts. This study has demonstrated the heat accumulation phenomenon and its significant effect on temperature. Maximizing the drilling field and reducing the number of drill passes may decrease bone injury. PMID:26334198

  15. Managing numerical errors in random sequential adsorption

    NASA Astrophysics Data System (ADS)

    Cieśla, Michał; Nowak, Aleksandra

    2016-09-01

    Aim of this study is to examine the influence of a finite surface size and a finite simulation time on a packing fraction estimated using random sequential adsorption simulations. The goal of particular interest is providing hints on simulation setup to achieve desired level of accuracy. The analysis is based on properties of saturated random packing of disks on continuous and flat surfaces of different sizes.

  16. Echocardiographic hemodynamic study during ultrafiltration sequential dialysis.

    PubMed

    Cini, G; Camici, M; Pentimone, F; Palla, R

    1982-01-01

    4 patients on regular dialysis were studied by the echocardiographic method during ultrafiltration and dialysis performed sequentially according to two different protocols. Blood pressure, heart rate, cardiac output, stroke volume, systolic and diastolic dimension of the left ventricle, systolic and diastolic volumes of the left ventricle, ejection fraction, shortening fraction and total peripheral vascular resistance index were measured. During ultrafiltration there is an increase of the total peripheral vascular resistance index. Myocardial contractility improves only during dialysis. Physiopathologic implications are discussed. PMID:7099320

  17. Sequential and Parallel Algorithms for Spherical Interpolation

    NASA Astrophysics Data System (ADS)

    De Rossi, Alessandra

    2007-09-01

    Given a large set of scattered points on a sphere and their associated real values, we analyze sequential and parallel algorithms for the construction of a function defined on the sphere satisfying the interpolation conditions. The algorithms we implemented are based on a local interpolation method using spherical radial basis functions and the Inverse Distance Weighted method. Several numerical results show accuracy and efficiency of the algorithms.

  18. Analytic sequential methods for detecting network intrusions

    NASA Astrophysics Data System (ADS)

    Chen, Xinjia; Walker, Ernest

    2014-05-01

    In this paper, we propose an analytic sequential methods for detecting port-scan attackers which routinely perform random "portscans" of IP addresses to find vulnerable servers to compromise. In addition to rigorously control the probability of falsely implicating benign remote hosts as malicious, our method performs significantly faster than other current solutions. We have developed explicit formulae for quick determination of the parameters of the new detection algorithm.

  19. Sequential decision analysis for nonstationary stochastic processes

    NASA Technical Reports Server (NTRS)

    Schaefer, B.

    1974-01-01

    A formulation of the problem of making decisions concerning the state of nonstationary stochastic processes is given. An optimal decision rule, for the case in which the stochastic process is independent of the decisions made, is derived. It is shown that this rule is a generalization of the Bayesian likelihood ratio test; and an analog to Wald's sequential likelihood ratio test is given, in which the optimal thresholds may vary with time.

  20. Extended series expansions for random sequential adsorption

    NASA Astrophysics Data System (ADS)

    Gan, Chee Kwan; Wang, Jian-Sheng

    1998-02-01

    We express the coverage (occupation fraction) θ in powers of time t for four models of two-dimensional lattice random sequential adsorption (RSA) to very high orders by improving an algorithm developed by the present authors [J. Phys. A 29, L177 (1996)]. Each of these series is, to the best of our knowledge, the longest at the present. We analyze the series and deduce accurate estimates for the jamming coverage of the models.

  1. Sequential posttranslational modifications regulate PKC degradation

    PubMed Central

    Wang, Yan; Wang, Yangbo; Zhang, Huijun; Gao, Yingwei; Huang, Chao; Zhou, Aiwu; Zhou, Yi; Li, Yong

    2016-01-01

    Cross-talk among different types of posttranslational modifications (PTMs) has emerged as an important regulatory mechanism for protein function. Here we elucidate a mechanism that controls PKCα stability via a sequential cascade of PTMs. We demonstrate that PKCα dephosphorylation decreases its sumoylation, which in turn promotes its ubiquitination and ultimately enhances its degradation via the ubiquitin-proteasome pathway. These findings provide a molecular explanation for the activation-induced down-regulation of PKC proteins. PMID:26564794

  2. Sequential analysis of uncommon adverse outcomes.

    PubMed

    Morton, A; Mengersen, K; Waterhouse, M; Steiner, S; Looke, D

    2010-10-01

    Sequential analysis of uncommon adverse outcomes (AEs) such as surgical site infections (SSIs) is desirable. Short postoperative lengths of stay (LOS) result in many SSIs occurring after discharge and they are often superficial. Deep and organ space (complex) SSIs occur less frequently but are detected more reliably and are suitable for monitoring wound care. Those occurring post-discharge usually require readmissison and can be counted accurately. Sequential analysis of meticillin-resistant Staphylococcus aureus bacteraemia is also needed. The key to prevention is to implement systems based on evidence, e.g. using 'bundles' and checklists. Regular mortality and morbidity audit meetings are required and these may need to be followed by independent audits. Sequential statistical analysis is desirable for data presentation, to detect changes, and to discourage tampering with processes when occasional AEs occur in a reliable system. Tabulations and cumulative observed minus expected (O-E) charts and funnel plots are valuable, supplemented in the presence of apparent 'runs' of AEs by cumulative sum analysis. Used prospectively, they may enable staff to visualise and detect patterns or shifts in rates and counts that might not otherwise be apparent. PMID:20656377

  3. Coherent versus incoherent sequential quantum measurements

    SciTech Connect

    Filip, Radim

    2011-03-15

    We compare a trade-off between knowledge and decoherence for the incoherent and coherent partial sequential compatible measurements on single-qubit systems. The individual partial measurement nondestructively monitors basis states of the system by single-qubit meter. For the same decoherence caused by this unbiased measurement, the individual coherent measurement gives more knowledge than the incoherent one. For identical sequential coherent measurements, knowledge accumulated not additively increases more slowly than for the incoherent measurements. The overall knowledge can be accumulated using an adaptive measurement strategy on the meters if the single-qubit coherence of meters is kept. On the other hand, preservation of the mutual qubit coherence between the meters necessary for the collective measurement strategy is not required. A loss of single-qubit coherence degrades the coherent measurements back to the incoherent ones. Since the decoherence caused by the measurement process is a quadratic function of knowledge extracted by the individual measurement, Zeno-like behavior can be observed for repetitive weak compatible measurements. This unconditional universal effect does not depend on any dynamics of the qubit and it is a direct consequence of optimally controlled sequential evolution of quantum information.

  4. Sequential injection immunoassay for environmental measurements.

    PubMed

    Soh, Nobuaki; Tanaka, Mayumi; Hirakawa, Koji; Zhang, RuiQi; Nakajima, Hizuru; Nakano, Koji; Imato, Toshihiko

    2011-01-01

    Sequential injection immunoassay systems for environmental measurements based on the selective immunoreaction between antigen and antibody were described. A sequential injection analysis (SIA) technique is suitable to be applied for the procedure of enzyme-linked immunosorbent assay (ELISA), because the washing and the addition of reagent solutions can be automated by using a computer-controlled syringe pump and switching valve. We selected vitellogenin (Vg), which is a biomarker for evaluating environmental risk caused by endocrine-disrupting chemicals in the hydrosphere, and linear alkylbenzene sulfonates (LAS) and alkylphenol polyethoxylates (APEO), which are versatile surfactants, as target analytes in the flow immunoassay systems. For Vg monitoring, SIA systems based on spectrophotometric, chemiluminescence, and electrochemical determinations were constructed. On the other hand, chemiluminescence determination was applied to the detection of LAS and APEO. For APEO, an SIA system combined with surface plasmon resonance (SPR) sensor was also developed. These new sequential injection immunoassay systems are expected to be useful systems for environmental analysis. PMID:22076332

  5. Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy

    PubMed Central

    Guinto, Valerie T; De Guia, Blanca; Festin, Mario R; Dowswell, Therese

    2014-01-01

    Background Asymptomatic bacteriuria occurs in 5% to 10% of pregnancies and, if left untreated, can lead to serious complications. Objectives To assess which antibiotic is most effective and least harmful as initial treatment for asymptomatic bacteriuria in pregnancy. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (March 2010) and reference lists of retrieved studies. Selection criteria Randomized controlled trials comparing two antibiotic regimens for treating asymptomatic bacteriuria. Data collection and analysis Review authors independently screened the studies for inclusion and extracted data. Main results We included five studies involving 1140 women with asymptomatic bacteriuria. We did not perform meta-analysis; each trial examined different antibiotic regimens and so we were not able to pool results. In a study comparing a single dose of fosfomycin trometamol 3 g with a five-day course of cefuroxime, there was no significant difference in persistent infection (risk ratio (RR) 1.36, 95% confidence interval (CI) 0.24 to 7.75), shift to other antibiotics (RR 0.08, 95% CI 0.00 to 1.45), or in allergy or pruritus (RR 2.73, 95% CI 0.11 to 65.24). A comparison of seven-day courses of 400 mg pivmecillinam versus 500 mg ampicillin, both given four times daily, showed no significant difference in persistent infection at two weeks or recurrent infection, but there was an increase in vomiting (RR 4.57, 95% CI 1.40 to 14.90) and women were more likely to stop treatment early with pivmecillinam (RR 8.82, 95% CI 1.16 to 66.95). When cephalexin 1 g versus Miraxid® (pivmecillinam 200 mg and pivampicillin 250 mg) were given twice-daily for three days, there was no significant difference in persistent or recurrent infection. A one- versus seven-day course of nitrofurantoin resulted in more persistent infection with the shorter course (RR 1.76, 95% CI 1.29 to 2.40), but no significant difference in symptomatic infection at two weeks

  6. Sequential cancer immunotherapy: targeted activity of dimeric TNF and IL-8

    PubMed Central

    Adrian, Nicole; Siebenborn, Uta; Fadle, Natalie; Plesko, Margarita; Fischer, Eliane; Wüest, Thomas; Stenner, Frank; Mertens, Joachim C.; Knuth, Alexander; Ritter, Gerd; Old, Lloyd J.; Renner, Christoph

    2009-01-01

    Polymorphonuclear neutrophils (PMNs) are potent effectors of inflammation and their attempts to respond to cancer are suggested by their systemic, regional and intratumoral activation. We previously reported on the recruitment of CD11b+ leukocytes due to tumor site-specific enrichment of TNF activity after intravenous administration of a dimeric TNF immunokine with specificity for fibroblast activation protein (FAP). However, TNF-induced chemo-attraction and extravasation of PMNs from blood into the tumor is a multistep process essentially mediated by interleukin 8. With the aim to amplify the TNF-induced and IL-8-mediated chemotactic response, we generated immunocytokines by N-terminal fusion of a human anti-FAP scFv fragment with human IL-8 (IL-872) and its N-terminally truncated form IL-83-72. Due to the dramatic difference in chemotaxis induction in vitro, we favored the mature chemokine fused to the anti-FAP scFv for further investigation in vivo. BALB/c nu/nu mice were simultaneously xenografted with FAP-positive or -negative tumors and extended chemo-attraction of PMNs was only detectable in FAP-expressing tissue after intravenous administration of the anti-FAP scFv-IL-872 construct. As TNF-activated PMNs are likewise producers and primary targets for IL-8, we investigated the therapeutic efficacy of co-administration of both effectors: Sequential application of scFv-IL-872 and dimeric IgG1-TNF fusion proteins significantly enhanced anti-tumor activity when compared either to a single effector treatment regimen or sequential application of non-targeted cytokines, indicating that the tumor-restricted sequential application of IL-872 and TNF is a promising approach for cancer therapy. PMID:19267427

  7. Sequential Bayesian Detection: A Model-Based Approach

    SciTech Connect

    Sullivan, E J; Candy, J V

    2007-08-13

    Sequential detection theory has been known for a long time evolving in the late 1940's by Wald and followed by Middleton's classic exposition in the 1960's coupled with the concurrent enabling technology of digital computer systems and the development of sequential processors. Its development, when coupled to modern sequential model-based processors, offers a reasonable way to attack physics-based problems. In this chapter, the fundamentals of the sequential detection are reviewed from the Neyman-Pearson theoretical perspective and formulated for both linear and nonlinear (approximate) Gauss-Markov, state-space representations. We review the development of modern sequential detectors and incorporate the sequential model-based processors as an integral part of their solution. Motivated by a wealth of physics-based detection problems, we show how both linear and nonlinear processors can seamlessly be embedded into the sequential detection framework to provide a powerful approach to solving non-stationary detection problems.

  8. Sequential Bayesian Detection: A Model-Based Approach

    SciTech Connect

    Candy, J V

    2008-12-08

    Sequential detection theory has been known for a long time evolving in the late 1940's by Wald and followed by Middleton's classic exposition in the 1960's coupled with the concurrent enabling technology of digital computer systems and the development of sequential processors. Its development, when coupled to modern sequential model-based processors, offers a reasonable way to attack physics-based problems. In this chapter, the fundamentals of the sequential detection are reviewed from the Neyman-Pearson theoretical perspective and formulated for both linear and nonlinear (approximate) Gauss-Markov, state-space representations. We review the development of modern sequential detectors and incorporate the sequential model-based processors as an integral part of their solution. Motivated by a wealth of physics-based detection problems, we show how both linear and nonlinear processors can seamlessly be embedded into the sequential detection framework to provide a powerful approach to solving non-stationary detection problems.

  9. Pharmacoeconomic consequences of variable patient compliance with prescribed drug regimens.

    PubMed

    Urquhart, J

    1999-03-01

    Variable compliance with prescribed drug regimens is a leading source of variability in drug response. Specifics differ by drug and disease. The role of variable compliance was clearly defined in 2 trials of lipid-lowering agents, cholestyramine and gemfibrozil, in which exceptionally careful measurements of compliance were made, which has not been done in later trials. Economic consequences of variable compliance are estimated by converting dose-dependent changes in absolute risk of incident coronary disease into the unicohort format, which designates how many patients must be treated to prevent, in a given time, a defined 'coronary event'. Two strong influences on the costs of treatment are: (i) the shape of the relation between drug intake and risk reduction; and (ii) the strength of the linkage between intake and prescription refills. The intake-effect relation for cholestyramine is linear, making compliance-neutral the cost to prevent 1 coronary event, provided that refills match intake. If refills exceed intake, treatment costs rise. The intake-effect relation for gemfibrozil is more typically nonlinear, so poorer compliers purchase and take the drug in amounts that have little benefit, increasing the cost to prevent 1 coronary event. If refills run at a higher rate than intake, costs increase still further. A key question for future study is: do policies that encourage timely refills increase compliance enough to offset their potential to waste money in the purchasing of an untaken drug? PMID:10537430

  10. 5-day/5-drug myeloablative outpatient regimen for resistant neuroblastoma.

    PubMed

    Kushner, B H; Modak, S; Kramer, K; Basu, E M; Roberts, S S; Cheung, N-Kv

    2013-05-01

    5-day/5-drug (5D/5D) is a novel high-dose regimen administered with autologous hematopoietic SCT (HSCT). It was designed to maximize cytoreduction via high dosing of synergistically interacting agents, while minimizing morbidity in patients with resistant neuroblastoma (NB) and ineligible for clinical trials due to myelosuppression from previous therapy. 5D/5D comprises carboplatin 500 mg/m(2)/day on days 1-2, irinotecan 50 mg/m(2)/day on days 1-3, temozolomide 250 mg/m(2)/day on days 1-3, etoposide 200 mg/m(2)/day on days 3-5 and cyclophosphamide 70 mg/kg/day on days 4-5. HSCT is on day 8. Sixteen patients received 21 courses. Treatment was in the outpatient clinic. Responses were noted against progressive disease (PD) that had developed while patients were off, or receiving only low-dose, chemotherapy but not against PD that emerged despite high-dose chemotherapy. Responses were also seen in patients with PD or stable disease after (131)I-metaiodobenzylguanidine therapy. Grade 3 toxicities were limited to transient elevations in liver enzymes (three courses) and hyponatremia (one course). Bacteremia occurred in 2/21 (10%) courses. Hematological recovery allowed patients to be enrolled on clinical trials. In conclusion, 5D/5D (including HSCT) spares vital organs, entails modest morbidity, shows activity against resistant NB and helps patients meet eligibility requirements for formal clinical trials. PMID:23085829

  11. Analytical verification of waterborne chemical treatment regimens in hatchery raceways

    USGS Publications Warehouse

    Rach, J.J.; Ramsay, R.T.

    2000-01-01

    Chemical therapy for control and prevention of fish diseases is a necessary and common practice in aquaculture. Many factors affect the accuracy of a chemical treatment application, such as the functioning of the chemical delivery system, calculation of chemical quantities to be delivered, water temperature, geometry of the culture unit, inlet-outlet structure, the influence of aerators, wind movement, and measurement of water volumes and flow rates. Three separate trials were conducted at the Osceola Fish Hatchery, a facility of the Wisconsin Department of Natural Resources, evaluating the accuracy of flow-through hydrogen peroxide treatments applied to 1, 3, or 9 raceways that were connected in series. Raceways were treated with 50 or 75 ??L/L of hydrogen peroxide for 30 min. Chemical concentrations were determined titrimetrically. The target treatment regimen was not realized in any of the applications. Chemical concentrations dropped and exposure times increased with each additional raceway treated in series. Single introduction of a therapeutant to more than three raceways in series is not recommended. Factors that interfered with the accuracy of the treatments were culture unit configuration, aeration, and flow rates. Several treatment modifications were identified that would result in more accurate chemical treatments.

  12. Computational oncology - mathematical modelling of drug regimens for precision medicine.

    PubMed

    Barbolosi, Dominique; Ciccolini, Joseph; Lacarelle, Bruno; Barlési, Fabrice; André, Nicolas

    2016-04-01

    Computational oncology is a generic term that encompasses any form of computer-based modelling relating to tumour biology and cancer therapy. Mathematical modelling can be used to probe the pharmacokinetics and pharmacodynamics relationships of the available anticancer agents in order to improve treatment. As a result of the ever-growing numbers of druggable molecular targets and possible drug combinations, obtaining an optimal toxicity-efficacy balance is an increasingly complex task. Consequently, standard empirical approaches to optimizing drug dosing and scheduling in patients are now of limited utility; mathematical modelling can substantially advance this practice through improved rationalization of therapeutic strategies. The implementation of mathematical modelling tools is an emerging trend, but remains largely insufficient to meet clinical needs; at the bedside, anticancer drugs continue to be prescribed and administered according to standard schedules. To shift the therapeutic paradigm towards personalized care, precision medicine in oncology requires powerful new resources for both researchers and clinicians. Mathematical modelling is an attractive approach that could help to refine treatment modalities at all phases of research and development, and in routine patient care. Reviewing preclinical and clinical examples, we highlight the current achievements and limitations with regard to computational modelling of drug regimens, and discuss the potential future implementation of this strategy to achieve precision medicine in oncology. PMID:26598946

  13. Comparison of Non-myeloablative Conditioning Regimens for Lymphoproliferative Disorders

    PubMed Central

    Hong, Sanghee; Le-Rademacher, Jennifer; Artz, Andrew; McCarthy, Philip L.; Logan, Brent R.; Pasquini, Marcelo C.

    2014-01-01

    Hematopoietic cell transplantation (HCT) with non-myeloablative conditioning (NMA) for lymphoproliferative diseases (LD) includes fludarabine with and without low-dose total body irradiation (TBI). Transplant outcomes were compared among patients ≥40 years with LD who received a HCT with TBI (N=382) and no-TBI (N=515) NMA from 2001 to 2011. The groups were comparable except for donor, graft, prophylaxis for graft-versus-host disease (GVHD), disease status and year of HCT. Cumulative incidences of grades II–IV GVHD at 100 days, were 29% and 20% (p=0.001), and chronic GVHD at 1 year were 54% and 44% (p=0.004) for TBI and no-TBI, respectively. Multivariate analysis of progression/relapse, treatment failure and mortality showed no outcome differences by conditioning. Full donor chimerism at day 100 was observed in 82% vs. 64% in the TBI and no-TBI groups, respectively (p=0.006). Subset of four most common conditioning/ GVHD prophylaxis combinations demonstrated higher rates of grades II–IV acute (p<0.001) and chronic GVHD (p<0.001) among recipients of TBI-mycophenolate mofetil (MMF) compared to other combinations. TBI-based NMA conditioning induces faster full donor chimerism but overall survival outcomes are comparable to no-TBI regimens. Combination of TBI and MMF are associated with higher rates of GVHD without impact on survival outcomes in patients with LD. PMID:25437248

  14. Oxygen regimen in the human peripheral tissue during space flights.

    PubMed

    Haase, H; Kovalenko, E A; Vacek, A; Bobrovnickij, M P; Jarsumbeck, B; Semencov, V N; Sarol, Z; Hideg, J; Zlatarev, K

    1986-05-01

    A survey of the results of the experiment "Oxygen," carried out within the scope of the INTER-KOSMOS program in members of the permanent crews and of international visiting expeditions to the Soviet orbital station Salyut-6, is given. During the 7-day space flights of the international visiting expeditions a significant decrease in pO2ic by 3.28 kPa was observed. Local oxygen utilization reduced significantly by 0.44 kPa. During hyperventilation testing after return to earth a statistically significant decrease in the peak value by 1.39 kPa was noted. In the long-term crews of the orbital station Salyut-6 the highest decrease in pO2ic of 3.8 kPa and the absolutely lowest value of 3.4 -/+ 0.5 kPa during space flight were observed. The decrease in local oxygen utilization during the flight of 0.8 kPa/min was greater than that of the visiting crews. The results indicate the importance of investigating the dynamics of the oxygen regimen for medical control of the crew members both during the space flight and during the readaptation phase after return to earth. PMID:11542832

  15. Using cost as a consideration for antiretroviral regimen selection: an example using average wholesale prices.

    PubMed

    Grimes, Richard M; Shenouda, Tina A

    2013-01-01

    Funding for the AIDS Drug Assistance Program (ADAP) has lagged behind the number of persons needing antiretroviral therapy, leading to waiting lists and reduction of needed treatments and services. This paper demonstrates a method of providing more treatment for the same amount of money by selecting clinically equivalent, but lower-cost drug regimens. Average wholesale prices (AWPs) were used to calculate the annual costs of preferred, alternative, and acceptable regimens. The cost of each regimen was divided into $1,000,000 to determine how many patients could be treated per $1,000,000 that an ADAP had to spend. AWPs for preferred regimens ranged from $25,318 to 35,645 per year. For alternative regimens, the range of annual AWPs was $22,002-$32,335. The range for the acceptable regimens was $19,031-$31,543. The range of person treated per $1,000,000 per year was from 28 to 52. Funding shortages will lead ADAPs to resort to waiting lists or other means of denying appropriate care unless alternative approaches to treatment are sought. Cost conscious selection of regimens where there is no harm to individual patients is one alternative approach. Medical conditions that allow exceptions to lower-cost-based regimens must be developed with the assistance of clinicians. PMID:23438066

  16. Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines

    MedlinePlus

    HIV Treatment Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines (Last updated 3/1/2016; last reviewed 3/1/2016) ... maintain long-term medication adherence. Before starting an HIV regimen, talk to your health care provider about ...

  17. Role of Taxane and Anthracycline Combination Regimens in the Management of Advanced Breast Cancer

    PubMed Central

    Zheng, Ruinian; Han, Shuai; Duan, Chongyang; Chen, Kexu; You, Zhijian; Jia, Jun; Lin, Shunhuan; Liang, Liming; Liu, Aixue; Long, Huidong; Wang, Senming

    2015-01-01

    Abstract The clinical benefits provided by using combined taxanes and anthracyclines in first-line chemotherapy for metastatic breast carcinoma (MBC) remain uncertain. This meta-analysis compares the benefits of using a combination of anthracyclines along with taxanes versus using single-agent-based chemotherapeutic regimens in the treatment of MBC. Relevant clinical trials as well as abstracts from articles presented at major cancer conferences were searched in various databases including PubMed, Embase, and Cochrane Library. The relevant studies had a primary endpoint of overall survival (OS) and secondary endpoints that included progression-free survival (PFS), time-to-treatment failure (TTF), time to progression (TTP), objective response rate (ORR), disease control rate (DCR), and safety. The hazard ratios of OS, PFS, TTF, and TTP, the odds ratios of ORR and DCR, and the risk ratios (RRs) for grades 1–2 and 3–4 toxicities were extracted from the retrieved studies and analyzed using various statistical methods. Meta-analytic estimates were derived from a random-effect model. Fifteen trials were included in the final meta-analysis, and the results suggest that chemotherapy with combined anthracyclines and taxanes does not significantly improve the OS of MBC patients when compared with the OS achieved using separate taxane or anthracycline-based regimens. Compared with taxane-based regimens, combined taxane along with anthracycline regimens failed to significantly improve TTP, ORR, or DCR, but did significantly improve TTP and ORR when compared with anthracycline-based regimens. Furthermore, both individual taxane-based and anthracycline-based regimens produced fewer toxic reactions compared to combined taxane along with anthracycline regimens. Taxane-based regimens had lower RRs for side effects of neutropenia, infection/febrile neutropenia, nausea, and vomiting, whereas patients receiving anthracycline-based regimens had lower RRs for neutropenia, infection

  18. Satisfaction with the Health Care Provider and Regimen Adherence in Minority Youth with Type 1 Diabetes.

    PubMed

    Taylor, Cortney J; La Greca, Annette; Valenzuela, Jessica M; Hsin, Olivia; Delamater, Alan M

    2016-09-01

    To assess whether satisfaction with the health-care provider is related to regimen adherence among primarily minority youth with type 1 diabetes. Youth with type 1 diabetes (n = 169; M age = 13.88; 52 % female; 70 % Hispanic) and their parents completed questionnaires that assessed their own satisfaction with the health-care provider and youths' adherence to diabetes self-care behaviors. Higher youth and parent patient-provider relationship satisfaction was associated with higher regimen adherence. Gender affected the relationship between satisfaction and regimen adherence, such that for girls, greater satisfaction was associated with better adherence; this was not the case for boys. Patient satisfaction with the health care provider is important for regimen adherence among primarily minority youth with type 1 diabetes, particularly for girls. Future research might focus on improving youths' relationships with their health care providers as a potential pathway to improve regimen adherence. PMID:27365095

  19. An intraoperative irrigation regimen to reduce the surgical site infection rate following adolescent idiopathic scoliosis surgery.

    PubMed

    Herwijnen, B van; Evans, N R; Dare, C J; Davies, E M

    2016-05-01

    Introduction The aim of this study was to compare the efficacy of a gentamicin antibiotic intraoperative irrigation regimen (regimen A) with a povidone-iodine intraoperative irrigation regimen (regimen B) and to evaluate the ability of adjunctive local vancomycin powder (regimen C) to reduce the surgical site infection (SSI) rate following idiopathic scoliosis correction. Methods This was a retrospective, single centre, two-surgeon cohort study of paediatric scoliosis procedures involving 118 patients under the age of 18 years who underwent correction for idiopathic scoliosis over a period of 42 months. Patients' baseline characteristics, pseudarthrosis and rates of SSI were compared. Results Baseline characteristics were comparable in all three groups, with the exception of sex distribution. Over a quarter (27%) of patients with regimen B were male compared with 13% and 6% for regimens A and C respectively. Patients were mostly followed up for a minimum of 12 months. The SSI rate for both superficial and deep infections was higher with regimen A (26.7%) than with regimens B and C (7.0% and 6.3% respectively). The SSI rates for regimens B and C were comparable. No patients developed complications related to vancomycin toxicity, metalwork failure or pseudarthrosis. Conclusions Wound irrigation with a povidone-iodine solution reduces SSIs following adolescent idiopathic scoliosis surgery. The direct application of vancomycin powder to the wound is safe but does not reduce the SSI rate further in low risk patients. Additional studies are needed to elucidate whether it is effective at higher doses and in high risk patient groups. PMID:27087324

  20. Aggressive Regimens for Multidrug-Resistant Tuberculosis Decrease All-Cause Mortality

    PubMed Central

    Mitnick, Carole D.; Franke, Molly F.; Rich, Michael L.; Alcantara Viru, Felix A.; Appleton, Sasha C.; Atwood, Sidney S.; Bayona, Jaime N.; Bonilla, Cesar A.; Chalco, Katiuska; Fraser, Hamish S. F.; Furin, Jennifer J.; Guerra, Dalia; Hurtado, Rocio M.; Joseph, Keith; Llaro, Karim; Mestanza, Lorena; Mukherjee, Joia S.; Muñoz, Maribel; Palacios, Eda; Sanchez, Epifanio; Seung, Kwonjune J.; Shin, Sonya S.; Sloutsky, Alexander; Tolman, Arielle W.; Becerra, Mercedes C.

    2013-01-01

    Rationale A better understanding of the composition of optimal treatment regimens for multidrug-resistant tuberculosis (MDR-TB) is essential for expanding universal access to effective treatment and for developing new therapies for MDR-TB. Analysis of observational data may inform the definition of an optimized regimen. Objectives This study assessed the impact of an aggressive regimen–one containing at least five likely effective drugs, including a fluoroquinolone and injectable–on treatment outcomes in a large MDR-TB patient cohort. Methods This was a retrospective cohort study of patients treated in a national outpatient program in Peru between 1999 and 2002. We examined the association between receiving an aggressive regimen and the rate of death. Measurements and Main Results In total, 669 patients were treated with individualized regimens for laboratory-confirmed MDR-TB. Isolates were resistant to a mean of 5.4 (SD 1.7) drugs. Cure or completion was achieved in 66.1% (442) of patients; death occurred in 20.8% (139). Patients who received an aggressive regimen were less likely to die (crude hazard ratio [HR]: 0.62; 95% CI: 0.44,0.89), compared to those who did not receive such a regimen. This association held in analyses adjusted for comorbidities and indicators of severity (adjusted HR: 0.63; 95% CI: 0.43,0.93). Conclusions The aggressive regimen is a robust predictor of MDR-TB treatment outcome. TB policy makers and program directors should consider this standard as they design and implement regimens for patients with drug-resistant disease. Furthermore, the aggressive regimen should be considered the standard background regimen when designing randomized trials of treatment for drug-resistant TB. PMID:23516529

  1. Therapeutic efficacy of alternative primaquine regimens to standard treatment in preventing relapses by Plasmodium vivax

    PubMed Central

    Tamayo Perez, María-Eulalia; Aguirre-Acevedo, Daniel Camilo

    2015-01-01

    Objective: To compare efficacy and safety of primaquine regimens currently used to prevent relapses by P. vivax. Methods: A systematic review was carried out to identify clinical trials evaluating efficacy and safety to prevent malaria recurrences by P. vivax of primaquine regimen 0.5 mg/kg/ day for 7 or 14 days compared to standard regimen of 0.25 mg/kg/day for 14 days. Efficacy of primaquine according to cumulative incidence of recurrences after 28 days was determined. The overall relative risk with fixed-effects meta-analysis was estimated. Results: For the regimen 0.5 mg/kg/day/7 days were identified 7 studies, which showed an incidence of recurrence between 0% and 20% with follow-up 60-210 days; only 4 studies comparing with the standard regimen 0.25 mg/kg/day/14 days and no difference in recurrences between both regimens (RR= 0.977, 95% CI= 0.670 to 1.423) were found. 3 clinical trials using regimen 0.5 mg/kg/day/14 days with an incidence of recurrences between 1.8% and 18.0% during 330-365 days were identified; only one study comparing with the standard regimen (RR= 0.846, 95% CI= 0.484 to 1.477). High risk of bias and differences in handling of included studies were found. Conclusion: Available evidence is insufficient to determine whether currently PQ regimens used as alternative rather than standard treatment have better efficacy and safety in preventing relapse of P. vivax. Clinical trials are required to guide changes in treatment regimen of malaria vivax. PMID:26848199

  2. Nonlinear interferometry approach to photonic sequential logic

    NASA Astrophysics Data System (ADS)

    Mabuchi, Hideo

    2011-10-01

    Motivated by rapidly advancing capabilities for extensive nanoscale patterning of optical materials, I propose an approach to implementing photonic sequential logic that exploits circuit-scale phase coherence for efficient realizations of fundamental components such as a NAND-gate-with-fanout and a bistable latch. Kerr-nonlinear optical resonators are utilized in combination with interference effects to drive the binary logic. Quantum-optical input-output models are characterized numerically using design parameters that yield attojoule-scale energy separation between the latch states.

  3. Sequential quantum teleportation of optical coherent states

    SciTech Connect

    Yonezawa, Hidehiro; Furusawa, Akira; Loock, Peter van

    2007-09-15

    We demonstrate a sequence of two quantum teleportations of optical coherent states, combining two high-fidelity teleporters for continuous variables. In our experiment, the individual teleportation fidelities are evaluated as F{sub 1}=0.70{+-}0.02 and F{sub 2}=0.75{+-}0.02, while the fidelity between the input and the sequentially teleported states is determined as F{sup (2)}=0.57{+-}0.02. This still exceeds the optimal fidelity of one half for classical teleportation of arbitrary coherent states and almost attains the value of the first (unsequential) quantum teleportation experiment with optical coherent states.

  4. Pass-transistor asynchronous sequential circuits

    NASA Astrophysics Data System (ADS)

    Whitaker, Sterling R.; Maki, Gary K.

    1989-02-01

    Design methods for asynchronous sequential pass-transistor circuits, which result in circuits that are hazard- and critical-race-free and which have added degrees of freedom for the input signals, are discussed. The design procedures are straightforward and easy to implement. Two single-transition-time state assignment methods are presented, and hardware bounds for each are established. A surprising result is that the hardware realizations for each next state variable and output variable is identical for a given flow table. Thus, a state machine with N states and M outputs can be constructed using a single layout replicated N + M times.

  5. A sequential framework for image change detection.

    PubMed

    Lingg, Andrew J; Zelnio, Edmund; Garber, Fred; Rigling, Brian D

    2014-05-01

    We present a sequential framework for change detection. This framework allows us to use multiple images from reference and mission passes of a scene of interest in order to improve detection performance. It includes a change statistic that is easily updated when additional data becomes available. Detection performance using this statistic is predictable when the reference and image data are drawn from known distributions. We verify our performance prediction by simulation. Additionally, we show that detection performance improves with additional measurements on a set of synthetic aperture radar images and a set of visible images with unknown probability distributions. PMID:24818249

  6. Sequential cooling insert for turbine stator vane

    SciTech Connect

    Jones, Russel B; Krueger, Judson J; Plank, William L

    2014-11-04

    A sequential impingement cooling insert for a turbine stator vane that forms a double impingement for the pressure and suction sides of the vane or a triple impingement. The insert is formed from a sheet metal formed in a zigzag shape that forms a series of alternating impingement cooling channels with return air channels, where pressure side and suction side impingement cooling plates are secured over the zigzag shaped main piece. Another embodiment includes the insert formed from one or two blocks of material in which the impingement channels and return air channels are machined into each block.

  7. Sequential cooling insert for turbine stator vane

    SciTech Connect

    Jones, Russell B; Krueger, Judson J; Plank, William L

    2014-04-01

    A sequential impingement cooling insert for a turbine stator vane that forms a double impingement for the pressure and suction sides of the vane or a triple impingement. The insert is formed from a sheet metal formed in a zigzag shape that forms a series of alternating impingement cooling channels with return air channels, where pressure side and suction side impingement cooling plates are secured over the zigzag shaped main piece. Another embodiment includes the insert formed from one or two blocks of material in which the impingement channels and return air channels are machined into each block.

  8. Sequential decision rules for failure detection

    NASA Technical Reports Server (NTRS)

    Chow, E. Y.; Willsky, A. S.

    1981-01-01

    The formulation of the decision making of a failure detection process as a Bayes sequential decision problem (BSDP) provides a simple conceptualization of the decision rule design problem. As the optimal Bayes rule is not computable, a methodology that is based on the Baysian approach and aimed at a reduced computational requirement is developed for designing suboptimal rules. A numerical algorithm is constructed to facilitate the design and performance evaluation of these suboptimal rules. The result of applying this design methodology to an example shows that this approach is a useful one.

  9. Random sequential adsorption of trimers and hexamers.

    PubMed

    Cieśla, Michał; Barbasz, Jakub

    2013-12-01

    Adsorption of trimers and hexamers built of identical spheres was studied numerically using the random sequential adsorption (RSA) algorithm. Particles were adsorbed on a two-dimensional, flat and homogeneous surface. Numerical simulations allowed us to determine the maximal random coverage ratio, RSA kinetics as well as the available surface function (ASF), which is crucial for determining the kinetics of the adsorption process obtained experimentally. Additionally, the density autocorrelation function was measured. All the results were compared with previous results obtained for spheres, dimers and tetramers. PMID:24193213

  10. [Successful treatment with high-dose methotrexate/cytarabine regimen in a patient in SMILE regimen-resistant extranodal natural killer/T-cell lymphoma].

    PubMed

    Saburi, Masuho; Itani, Kazuhito; Nagamatsu, Kentarou; Miyazaki, Yasuhiko; Otsuka, Eiichi; Urabe, Shogo; Saburi, Yoshio

    2014-01-01

    A 28-year-old man complained of pain in the oral mucosa and pharynx in March 2011, and then developed fever and generalized swelling of the cheek. In March 2012, a gum biopsy led to a diagnosis of extranodal natural killer/T-cell lymphoma (ENKL). (18)F-FDG-PET revealed significant uptake in the mouth, tonsils, jawbone, shoulder blade, humerus, ilium, femur, and spleen. After two courses of the SMILE (dexamethasone, methotrexate (MTX), ifosfamide, L-asparaginase, etoposide) regimen, the response was stable disease. However, a high-dose MTX/cytarabine (MA) regimen was effective. After three courses of the MA regimen, a partial response was achieved. Then, allogeneic bone marrow transplantation from an unrelated donor was performed. At 10 months after transplantation, there was no sign of recurrence. Although the optimal treatment for ENKL refractory to the SMILE regimen has yet to be established, our case suggests the MA regimen to be a potentially effective treatment option. PMID:24492044

  11. Hybrid Computerized Adaptive Testing: From Group Sequential Design to Fully Sequential Design

    ERIC Educational Resources Information Center

    Wang, Shiyu; Lin, Haiyan; Chang, Hua-Hua; Douglas, Jeff

    2016-01-01

    Computerized adaptive testing (CAT) and multistage testing (MST) have become two of the most popular modes in large-scale computer-based sequential testing. Though most designs of CAT and MST exhibit strength and weakness in recent large-scale implementations, there is no simple answer to the question of which design is better because different…

  12. Efficient Controls for Finitely Convergent Sequential Algorithms

    PubMed Central

    Chen, Wei; Herman, Gabor T.

    2010-01-01

    Finding a feasible point that satisfies a set of constraints is a common task in scientific computing: examples are the linear feasibility problem and the convex feasibility problem. Finitely convergent sequential algorithms can be used for solving such problems; an example of such an algorithm is ART3, which is defined in such a way that its control is cyclic in the sense that during its execution it repeatedly cycles through the given constraints. Previously we found a variant of ART3 whose control is no longer cyclic, but which is still finitely convergent and in practice it usually converges faster than ART3 does. In this paper we propose a general methodology for automatic transformation of finitely convergent sequential algorithms in such a way that (i) finite convergence is retained and (ii) the speed of convergence is improved. The first of these two properties is proven by mathematical theorems, the second is illustrated by applying the algorithms to a practical problem. PMID:20953327

  13. Inverse sequential simulation: Performance and implementation details

    NASA Astrophysics Data System (ADS)

    Xu, Teng; Gómez-Hernández, J. Jaime

    2015-12-01

    For good groundwater flow and solute transport numerical modeling, it is important to characterize the formation properties. In this paper, we analyze the performance and important implementation details of a new approach for stochastic inverse modeling called inverse sequential simulation (iSS). This approach is capable of characterizing conductivity fields with heterogeneity patterns difficult to capture by standard multiGaussian-based inverse approaches. The method is based on the multivariate sequential simulation principle, but the covariances and cross-covariances used to compute the local conditional probability distributions are computed by simple co-kriging which are derived from an ensemble of conductivity and piezometric head fields, in a similar manner as the experimental covariances are computed in an ensemble Kalman filtering. A sensitivity analysis is performed on a synthetic aquifer regarding the number of members of the ensemble of realizations, the number of conditioning data, the number of piezometers at which piezometric heads are observed, and the number of nodes retained within the search neighborhood at the moment of computing the local conditional probabilities. The results show the importance of having a sufficiently large number of all of the mentioned parameters for the algorithm to characterize properly hydraulic conductivity fields with clear non-multiGaussian features.

  14. Multiplexed protein profiling by sequential affinity capture.

    PubMed

    Ayoglu, Burcu; Birgersson, Elin; Mezger, Anja; Nilsson, Mats; Uhlén, Mathias; Nilsson, Peter; Schwenk, Jochen M

    2016-04-01

    Antibody microarrays enable parallelized and miniaturized analysis of clinical samples, and have proven to provide novel insights for the analysis of different proteomes. However, there are concerns that the performance of such direct labeling and single antibody assays are prone to off-target binding due to the sample context. To improve selectivity and sensitivity while maintaining the possibility to conduct multiplexed protein profiling, we developed a multiplexed and semi-automated sequential capture assay. This novel bead-based procedure encompasses a first antigen capture, labeling of captured protein targets on magnetic particles, combinatorial target elution and a read-out by a secondary capture bead array. We demonstrate in a proof-of-concept setting that target detection via two sequential affinity interactions reduced off-target contribution, while lowered background and noise levels, improved correlation to clinical values compared to single binder assays. We also compared sensitivity levels with single binder and classical sandwich assays, explored the possibility for DNA-based signal amplification, and demonstrate the applicability of the dual capture bead-based antibody microarray for biomarker analysis. Hence, the described concept enhances the possibilities for antibody array assays to be utilized for protein profiling in body fluids and beyond. PMID:26935855

  15. Sequential BART for imputation of missing covariates.

    PubMed

    Xu, Dandan; Daniels, Michael J; Winterstein, Almut G

    2016-07-01

    To conduct comparative effectiveness research using electronic health records (EHR), many covariates are typically needed to adjust for selection and confounding biases. Unfortunately, it is typical to have missingness in these covariates. Just using cases with complete covariates will result in considerable efficiency losses and likely bias. Here, we consider the covariates missing at random with missing data mechanism either depending on the response or not. Standard methods for multiple imputation can either fail to capture nonlinear relationships or suffer from the incompatibility and uncongeniality issues. We explore a flexible Bayesian nonparametric approach to impute the missing covariates, which involves factoring the joint distribution of the covariates with missingness into a set of sequential conditionals and applying Bayesian additive regression trees to model each of these univariate conditionals. Using data augmentation, the posterior for each conditional can be sampled simultaneously. We provide details on the computational algorithm and make comparisons to other methods, including parametric sequential imputation and two versions of multiple imputation by chained equations. We illustrate the proposed approach on EHR data from an affiliated tertiary care institution to examine factors related to hyperglycemia. PMID:26980459

  16. Noncommutative Biology: Sequential Regulation of Complex Networks

    PubMed Central

    Letsou, William; Cai, Long

    2016-01-01

    Single-cell variability in gene expression is important for generating distinct cell types, but it is unclear how cells use the same set of regulatory molecules to specifically control similarly regulated genes. While combinatorial binding of transcription factors at promoters has been proposed as a solution for cell-type specific gene expression, we found that such models resulted in substantial information bottlenecks. We sought to understand the consequences of adopting sequential logic wherein the time-ordering of factors informs the final outcome. We showed that with noncommutative control, it is possible to independently control targets that would otherwise be activated simultaneously using combinatorial logic. Consequently, sequential logic overcomes the information bottleneck inherent in complex networks. We derived scaling laws for two noncommutative models of regulation, motivated by phosphorylation/neural networks and chromosome folding, respectively, and showed that they scale super-exponentially in the number of regulators. We also showed that specificity in control is robust to the loss of a regulator. Lastly, we connected these theoretical results to real biological networks that demonstrate specificity in the context of promiscuity. These results show that achieving a desired outcome often necessitates roundabout steps. PMID:27560383

  17. Noncommutative Biology: Sequential Regulation of Complex Networks.

    PubMed

    Letsou, William; Cai, Long

    2016-08-01

    Single-cell variability in gene expression is important for generating distinct cell types, but it is unclear how cells use the same set of regulatory molecules to specifically control similarly regulated genes. While combinatorial binding of transcription factors at promoters has been proposed as a solution for cell-type specific gene expression, we found that such models resulted in substantial information bottlenecks. We sought to understand the consequences of adopting sequential logic wherein the time-ordering of factors informs the final outcome. We showed that with noncommutative control, it is possible to independently control targets that would otherwise be activated simultaneously using combinatorial logic. Consequently, sequential logic overcomes the information bottleneck inherent in complex networks. We derived scaling laws for two noncommutative models of regulation, motivated by phosphorylation/neural networks and chromosome folding, respectively, and showed that they scale super-exponentially in the number of regulators. We also showed that specificity in control is robust to the loss of a regulator. Lastly, we connected these theoretical results to real biological networks that demonstrate specificity in the context of promiscuity. These results show that achieving a desired outcome often necessitates roundabout steps. PMID:27560383

  18. Sequential processing during noun phrase production.

    PubMed

    Bürki, Audrey; Sadat, Jasmin; Dubarry, Anne-Sophie; Alario, F-Xavier

    2016-01-01

    This study examined whether the brain operations involved during the processing of successive words in multi word noun phrase production take place sequentially or simultaneously. German speakers named pictures while ignoring a written distractor superimposed on the picture (picture-word interference paradigm) using the definite determiner and corresponding German noun. The gender congruency and the phonological congruency (i.e., overlap in first phonemes) between target and distractor were manipulated. Naming responses and EEG were recorded. The behavioural performance replicated both the phonology and the gender congruency effects (i.e., shorter naming latencies for gender congruent than incongruent and for phonologically congruent than incongruent trials). The phonological and gender manipulations also influenced the EEG data. Crucially, the two effects occurred in different time windows and over different sets of electrodes. The phonological effect was observed substantially earlier than the gender congruency effect. This finding suggests that the processing of determiners and nouns during determiner noun phrase production occurs at least partly sequentially. PMID:26407338

  19. In silico evaluation and exploration of antibiotic tuberculosis treatment regimens

    SciTech Connect

    Pienaar, Elsje; Dartois, Véronique; Linderman, Jennifer J.; Kirschner, Denise E.

    2015-11-14

    Improvement in tuberculosis treatment regimens requires selection of antibiotics and dosing schedules from a large design space of possibilities. Incomplete knowledge of antibiotic and host immune dynamics in tuberculosis granulomas impacts clinical trial design and success, and variations among clinical trials hamper side-by-side comparison of regimens. Our objective is to systematically evaluate the efficacy of isoniazid and rifampin regimens, and identify modifications to these antibiotics that improve treatment outcomes. We pair a spatio-temporal computational model of host immunity with pharmacokinetic and pharmacodynamic data on isoniazid and rifampin. The model is calibrated to plasma pharmacokinetic and granuloma bacterial load data from non-human primate models of tuberculosis and to tissue and granuloma measurements of isoniazid and rifampin in rabbit granulomas. We predict the efficacy of regimens containing different doses and frequencies of isoniazid and rifampin. We predict impacts of pharmacokinetic/pharmacodynamic modifications on antibiotic efficacy. We demonstrate that suboptimal antibiotic concentrations within granulomas lead to poor performance of intermittent regimens compared to daily regimens. Improvements from dose and frequency changes are limited by inherent antibiotic properties, and we propose that changes in intracellular accumulation ratios and antimicrobial activity would lead to the most significant improvements in treatment outcomes. Results suggest that an increased risk of drug resistance in fully intermittent as compared to daily regimens arises from higher bacterial population levels early during treatment. In conclusion, our systems pharmacology approach complements efforts to accelerate tuberculosis therapeutic development.

  20. G-sequentially connectedness for topological groups with operations

    NASA Astrophysics Data System (ADS)

    Mucuk, Osman; Cakalli, Huseyin

    2016-08-01

    It is a well-known fact that for a Hausdorff topological group X, the limits of convergent sequences in X define a function denoted by lim from the set of all convergent sequences in X to X. This notion has been modified by Connor and Grosse-Erdmann for real functions by replacing lim with an arbitrary linear functional G defined on a linear subspace of the vector space of all real sequences. Recently some authors have extended the concept to the topological group setting and introduced the concepts of G-sequential continuity, G-sequential compactness and G-sequential connectedness. In this work, we present some results about G-sequentially closures, G-sequentially connectedness and fundamental system of G-sequentially open neighbourhoods for topological group with operations which include topological groups, topological rings without identity, R-modules, Lie algebras, Jordan algebras, and many others.

  1. Changing convention in combination oral contraceptives: estradiol and nomegestrol acetate in a monophasic 24/4 regimen.

    PubMed

    Shulman, Lee P

    2013-07-01

    Initial oral contraceptive regimens were characterised by high doses of ethinylestradiol (EE) and a progestogen in a 21-day regimen that either included seven additional hormone-free tablets or simply the 21 days of combination hormonal tablets. These regimens were developed to ensure high contraceptive effectiveness, regular and predictable withdrawal bleeding episodes to mimic a menstrual cycle, and minimal unscheduled vaginal bleeding. However, these regimens were associated with adverse tolerability and safety issues resulting from the dose and characteristics of their hormonal components. Attempts to ameliorate these adverse issues included the development of lower-dose EE regimens, the incorporation of new progestogens, multiphasic regimens, and reduced hormone-free interval regimens. However, the EE component has remained a constant until the recent approval of combination oral contraceptives with an estrogen component other than EE. The development and introduction of an estradiol-based oral contraceptive regimen is presented in this review. PMID:23709606

  2. Modified sequential therapy vs quadruple therapy as initial therapy in patients with Helicobacter infection

    PubMed Central

    Liao, Xiao-Min; Nong, Gao-Hui; Chen, Mei-Zu; Huang, Xue-Ping; Cong, Yun-Yan; Huang, Yi-Ying; Wu, Bai-He; Wei, Jin-Qi

    2015-01-01

    . Symptomatic improvements in the presentation of stomachache, acid regurgitation, and burning sensation were not significantly different between the two groups. CONCLUSION: Ilaprazole-based 10-d standard quadruple therapy does not offer an incremental benefit over modified sequential therapy for the treatment of H. pylori infection, as both treatment regimens appear to be effective, safe, and well-tolerated as initial treatment options. PMID:26034367

  3. Selecting the optimal antithrombotic regimen for patients with acute coronary syndromes undergoing percutaneous coronary intervention

    PubMed Central

    Parikh, Shailja V; Keeley, Ellen C

    2009-01-01

    The wide variety of anticoagulant and antiplatelet agents available for clinical use has made choosing the optimal antithrombotic regimen for patients with acute coronary syndromes undergoing percutaneous coronary intervention a complex task. While there is no single best regimen, from a risk-benefit ratio standpoint, particular regimens may be considered optimal for different patients. We review the mechanisms of action for the commonly prescribed antithrombotic medications, summarize pertinent data from randomized trials on their use in acute coronary syndromes, and provide an algorithm (incorporating data from these trials as well as risk assessment instruments) that will help guide the decision-making process. PMID:19707287

  4. Antiretroviral Regimens in Pregnancy and Breast-Feeding in Botswana

    PubMed Central

    Shapiro, R.L.; Hughes, M.D.; Ogwu, A.; Kitch, D.; Lockman, S.; Moffat, C.; Makhema, J.; Moyo, S.; Thior, I.; McIntosh, K.; van Widenfelt, E.; Leidner, J.; Powis, K.; Asmelash, A.; Tumbare, E.; Zwerski, S.; Sharma, U.; Handelsman, E.; Mburu, K.; Jayeoba, O.; Moko, E.; Souda, S.; Lubega, E.; Akhtar, M.; Wester, C.; Tuomola, R.; Snowden, W.; Martinez-Tristani, M.; Mazhani, L.; Essex, M.

    2010-01-01

    BACKGROUND The most effective highly active antiretroviral therapy (HAART) to prevent mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) in pregnancy and its efficacy during breast-feeding are unknown. METHODS We randomly assigned 560 HIV-1–infected pregnant women (CD4+ count, ≥200 cells per cubic millimeter) to receive coformulated abacavir, zidovudine, and lamivudine (the nucleoside reverse-transcriptase inhibitor [NRTI] group) or lopinavir–ritonavir plus zidovudine-lamivudine (the protease-inhibitor group) from 26 to 34 weeks’ gestation through planned weaning by 6 months post partum. A total of 170 women with CD4+ counts of less than 200 cells per cubic millimeter received nevirapine plus zidovudine–lamivudine (the observational group). Infants received single-dose nevirapine and 4 weeks of zidovudine. RESULTS The rate of virologic suppression to less than 400 copies per milliliter was high and did not differ significantly among the three groups at delivery (96% in the NRTI group, 93% in the protease-inhibitor group, and 94% in the observational group) or throughout the breast-feeding period (92% in the NRTI group, 93% in the protease-inhibitor group, and 95% in the observational group). By 6 months of age, 8 of 709 live-born infants (1.1%) were infected (95% confidence interval [CI], 0.5 to 2.2): 6 were infected in utero (4 in the NRTI group, 1 in the protease-inhibitor group, and 1 in the observational group), and 2 were infected during the breast-feeding period (in the NRTI group). Treatment-limiting adverse events occurred in 2% of women in the NRTI group, 2% of women in the protease-inhibitor group, and 11% of women in the observational group. CONCLUSIONS All regimens of HAART from pregnancy through 6 months post partum resulted in high rates of virologic suppression, with an overall rate of mother-to-child transmission of 1.1%. (ClinicalTrials.gov number, NCT00270296.) PMID:20554983

  5. Daily feeding regimen impacts pig growth and behavior.

    PubMed

    Colpoys, Jessica D; Johnson, Anna K; Gabler, Nicholas K

    2016-05-15

    A primary swine production goal is to increase efficiency of lean tissue gains. While many swine production systems currently utilize ad libitum feeding, recent research suggests that altering feeding patterns may impact feed efficiency. Therefore, the objective of this study was to compare two feeding patterns and evaluate their impact on whole body tissue accretion, feeding behavior and activity in growing pigs. Forty eight individually housed gilts (55.9±5.2kg on test BW) were assigned into one of two feeding treatments: 1) Free access to the feeder (Free Access) or 2) twice daily access where gilts were allowed to eat ad libitum between 08:00-09:00h and again from 17:00-18:00h (2×). Pig performance was recorded weekly for 55days and average daily gain (ADG), average daily feed intake (ADFI), and gain:feed (G:F) was calculated. Body composition was assessed in 12 gilts per treatment using dual X-ray absorptiometry (DXA) at day -3 and 55 of treatment, and tissue accretion rates were calculated. Gilt behaviors were assessed via video analysis during week 7 and included time spent eating, feeding rate, enrichment interaction, postural changes, standing, sitting, and lying behaviors. Gilts fed 2× had lower ADG and ADFI compared to Free Access gilts (P≤0.01); however, no treatment difference in G:F was observed (P=0.83). At day 55 gilts fed 2× had a lower fat:protein compared to Free Access gilts (P=0.05). Fat, lean, and protein accretion rates were lower in gilts fed 2× compared to those fed Free Access (P=0.01). Gilts fed 2× ate less frequently and for a shorter duration of time, interacted with enrichment more frequently (P≤0.005), and tended to have less frequent postural changes compared to Free Access gilts (P=0.08). No treatment differences were observed in duration of time spent standing, sitting, or lying (P≥0.39). Although feed regimen did not alter feed efficiency, these data indicate that twice daily feeding reduced gilt adiposity and growth

  6. Sequential generation of matrix-product states in cavity QED

    SciTech Connect

    Schoen, C.; Hammerer, K.; Wolf, M. M.; Cirac, J. I.; Solano, E.

    2007-03-15

    We study the sequential generation of entangled photonic and atomic multiqubit states in the realm of cavity QED. We extend the work of C. Schoen et al. [Phys. Rev. Lett. 95, 110503 (2005)], where it was shown that all states generated in a sequential manner can be classified efficiently in terms of matrix-product states. In particular, we consider two scenarios: photonic multiqubit states sequentially generated at the cavity output of a single-photon source and atomic multiqubit states generated by their sequential interaction with the same cavity mode.

  7. Generic sequential sampling for metamodel approximations

    SciTech Connect

    Turner, C. J.; Campbell, M. I.

    2003-01-01

    Metamodels approximate complex multivariate data sets from simulations and experiments. These data sets often are not based on an explicitly defined function. The resulting metamodel represents a complex system's behavior for subsequent analysis or optimization. Often an exhaustive data search to obtain the data for the metalnodel is impossible, so an intelligent sampling strategy is necessary. While inultiple approaches have been advocated, the majority of these approaches were developed in support of a particular class of metamodel, known as a Kriging. A more generic, cotninonsense approach to this problem allows sequential sampling techniques to be applied to other types of metamodeis. This research compares recent search techniques for Kriging inetamodels with a generic, inulti-criteria approach combined with a new type of B-spline metamodel. This B-spline metamodel is competitive with prior results obtained with a Kriging metamodel. Furthermore, the results of this research highlight several important features necessary for these techniques to be extended to more complex domains.

  8. Collaborative, Sequential and Isolated Decisions in Design

    NASA Technical Reports Server (NTRS)

    Lewis, Kemper; Mistree, Farrokh

    1997-01-01

    The Massachusetts Institute of Technology (MIT) Commission on Industrial Productivity, in their report Made in America, found that six recurring weaknesses were hampering American manufacturing industries. The two weaknesses most relevant to product development were 1) technological weakness in development and production, and 2) failures in cooperation. The remedies to these weaknesses are considered the essential twin pillars of CE: 1) improved development process, and 2) closer cooperation. In the MIT report, it is recognized that total cooperation among teams in a CE environment is rare in American industry, while the majority of the design research in mathematically modeling CE has assumed total cooperation. In this paper, we present mathematical constructs, based on game theoretic principles, to model degrees of collaboration characterized by approximate cooperation, sequential decision making and isolation. The design of a pressure vessel and a passenger aircraft are included as illustrative examples.

  9. A flexible sequential Gaussian simulation program: USGSIM

    NASA Astrophysics Data System (ADS)

    Manchuk, John G.; Deutsch, Clayton V.

    2012-04-01

    Sequential Gaussian simulation is a widely used algorithm for the stochastic characterization of properties from various earth science disciplines. Many variants have been developed to deal with the increasing complexity of modeling applications. The program described in this paper is a flexible, tested, and documented implementation. Multiple variables can be cosimulated within different rock types simultaneously. The stepwise transform is integrated into the program as are collocated cokriging, collocated cokriging with the intrinsic model, and cokriging with a linear model of coregionalization for the cosimulation of multiple variables. Multiple secondary data can be incorporated using locally varying means, collocated cokriging, and Bayesian updating. The search options and other parameters are flexible within rock types. Fortran source code and a compiled executable are provided.

  10. Random sequential adsorption of starlike particles.

    PubMed

    Cieśla, Michał; Karbowniczek, Paweł

    2015-04-01

    Random packing of surfaceless starlike particles built of 3 to 50 line segments was studied using random sequential adsorption algorithm. Numerical simulations allow us to determine saturated packing densities as well as the first two virial expansion coefficients for such objects. Measured kinetics of the packing growth supports the power law known to be valid for particles with a finite surface; however, the dependence of the exponent in this law on the number of star arms is unexpected. The density autocorrelation function shows fast superexponential decay as for disks, but the typical distance between closest stars is much smaller than between disks of the similar size, especially for a small number of arms. PMID:25974505

  11. Automatic exposure control for space sequential camera

    NASA Technical Reports Server (NTRS)

    Mcatee, G. E., Jr.; Stoap, L. J.; Solheim, C. D.; Sharpsteen, J. T.

    1975-01-01

    The final report for the automatic exposure control study for space sequential cameras, for the NASA Johnson Space Center is presented. The material is shown in the same sequence that the work was performed. The purpose of the automatic exposure control is to automatically control the lens iris as well as the camera shutter so that the subject is properly exposed on the film. A study of design approaches is presented. Analysis of the light range of the spectrum covered indicates that the practical range would be from approximately 20 to 6,000 foot-lamberts, or about nine f-stops. Observation of film available from space flights shows that optimum scene illumination is apparently not present in vehicle interior photography as well as in vehicle-to-vehicle situations. The evaluation test procedure for a breadboard, and the results, which provided information for the design of a brassboard are given.

  12. Prototype color field sequential television lens assembly

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The design, development, and evaluation of a prototype modular lens assembly with a self-contained field sequential color wheel is presented. The design of a color wheel of maximum efficiency, the selection of spectral filters, and the design of a quiet, efficient wheel drive system are included. Design tradeoffs considered for each aspect of the modular assembly are discussed. Emphasis is placed on achieving a design which can be attached directly to an unmodified camera, thus permitting use of the assembly in evaluating various candidate camera and sensor designs. A technique is described which permits maintaining high optical efficiency with an unmodified camera. A motor synchronization system is developed which requires only the vertical synchronization signal as a reference frequency input. Equations and tradeoff curves are developed to permit optimizing the filter wheel aperture shapes for a variety of different design conditions.

  13. Mechanistic studies on a sequential PDT protocol

    NASA Astrophysics Data System (ADS)

    Kessel, David

    2016-03-01

    A low (~LD15) PDT dose resulting in selective lysosomal photodamage can markedly promote photokilling by subsequent photodamage targeted to mitochondria. Experimental data are consistent with the proposal that cleavage of the autophagyassociated protein ATG5 to a pro-apoptotic fragment is responsible for this effect. This process is known to be dependent on the proteolytic activity of calpain. We have proposed that Ca2+ released from photodamaged lysosomes is the trigger for ATG5 cleavage. We can now document the conversion of ATG5 to the truncated form after lysosomal photodamage. Photofrin, a photosensitizer that targets both mitochondria and lysosomes, can be used for either phase of the sequential PDT process. The ability of Photofrin to target both loci may explain the well-documented efficacy of this agent.

  14. Random sequential adsorption on imprecise lattice.

    PubMed

    Privman, Vladimir; Yan, Han

    2016-06-28

    We report a surprising result, established by numerical simulations and analytical arguments for a one-dimensional lattice model of random sequential adsorption, that even an arbitrarily small imprecision in the lattice-site localization changes the convergence to jamming from fast, exponential, to slow, power-law, with, for some parameter values, a discontinuous jump in the jamming coverage value. This finding has implications for irreversible deposition on patterned substrates with pre-made landing sites for particle attachment. We also consider a general problem of the particle (depositing object) size not an exact multiple of the lattice spacing, and the lattice sites themselves imprecise, broadened into allowed-deposition intervals. Regions of exponential vs. power-law convergence to jamming are identified, and certain conclusions regarding the jamming coverage are argued for analytically and confirmed numerically. PMID:27369530

  15. Prosody and alignment: a sequential perspective

    NASA Astrophysics Data System (ADS)

    Szczepek Reed, Beatrice

    2010-12-01

    In their analysis of a corpus of classroom interactions in an inner city high school, Roth and Tobin describe how teachers and students accomplish interactional alignment by prosodically matching each other's turns. Prosodic matching, and specific prosodic patterns are interpreted as signs of, and contributions to successful interactional outcomes and positive emotions. Lack of prosodic matching, and other specific prosodic patterns are interpreted as features of unsuccessful interactions, and negative emotions. This forum focuses on the article's analysis of the relation between interpersonal alignment, emotion and prosody. It argues that prosodic matching, and other prosodic linking practices, play a primarily sequential role, i.e. one that displays the way in which participants place and design their turns in relation to other participants' turns. Prosodic matching, rather than being a conversational action in itself, is argued to be an interactional practice (Schegloff 1997), which is not always employed for the accomplishment of `positive', or aligning actions.

  16. Range filtering for sequential GPS receivers

    NASA Technical Reports Server (NTRS)

    Paielli, Russell

    1987-01-01

    The filtering of the satellite range and range-rate measurements from single channel sequential Global Positioning System receivers is usually done with an extended Kalman filter which has state variables defined in terms of an orthogonal navigation reference frame. An attractive suboptimal alternative is range-domain filtering, in which the individual satellite measurements are filtered separately before they are combined for the navigation solution. The main advantages of range-domain filtering are decreased processing and storage requirements and simplified tuning. Several range filter mechanization alternatives are presented, along with an innovative approach for combining the filtered range-domain quantities to determine the navigation state estimate. In addition, a method is outlined for incorporating measurements from auxiliary sensors such as altimeters into the navigation state estimation scheme similarly to the satellite measurements. A method is also described for incorporating inertial measurements into the navigation state estimator as a process driver.

  17. Adaptive sequential methods for detecting network intrusions

    NASA Astrophysics Data System (ADS)

    Chen, Xinjia; Walker, Ernest

    2013-06-01

    In this paper, we propose new sequential methods for detecting port-scan attackers which routinely perform random "portscans" of IP addresses to find vulnerable servers to compromise. In addition to rigorously control the probability of falsely implicating benign remote hosts as malicious, our method performs significantly faster than other current solutions. Moreover, our method guarantees that the maximum amount of observational time is bounded. In contrast to the previous most effective method, Threshold Random Walk Algorithm, which is explicit and analytical in nature, our proposed algorithm involve parameters to be determined by numerical methods. We have introduced computational techniques such as iterative minimax optimization for quick determination of the parameters of the new detection algorithm. A framework of multi-valued decision for detecting portscanners and DoS attacks is also proposed.

  18. Sequential monitoring of beach litter using webcams.

    PubMed

    Kako, Shin'ichiro; Isobe, Atsuhiko; Magome, Shinya

    2010-05-01

    This study attempts to establish a system for the sequential monitoring of beach litter using webcams placed at the Ookushi beach, Goto Islands, Japan, to establish the temporal variability in the quantities of beach litter every 90 min over a one and a half year period. The time series of the quantities of beach litter, computed by counting pixels with a greater lightness than a threshold value in photographs, shows that litter does not increase monotonically on the beach, but fluctuates mainly on a monthly time scale or less. To investigate what factors influence this variability, the time derivative of the quantity of beach litter is compared with satellite-derived wind speeds. It is found that the beach litter quantities vary largely with winds, but there may be other influencing factors. PMID:20392465

  19. Sequential sampling and paradoxes of risky choice.

    PubMed

    Bhatia, Sudeep

    2014-10-01

    The common-ratio, common-consequence, reflection, and event-splitting effects are some of the best-known findings in decision-making research. They represent robust violations of expected utility theory, and together form a benchmark against which descriptive theories of risky choice are tested. These effects are not currently predicted by sequential sampling models of risky choice, such as decision field theory (Busemeyer & Townsend 1993). This paper, however, shows that a minor extension to decision field theory, which allows for stochastic error in event sampling, can provide a parsimonious, cognitively plausible explanation for these effects. Moreover, these effects are guaranteed to emerge for a large range of parameter values, including best-fit parameters obtained from preexisting choice data. PMID:24898202

  20. Sequential composition of dynamically dexterous robot behaviors

    SciTech Connect

    Burridge, R.R.; Rizzi, A.A.; Koditschek, D.E.

    1999-06-01

    The authors report on efforts to develop a sequential robot controller-composition technique in the context of dexterous batting maneuvers. A robot with a flat paddle is required to strike repeatedly at a thrown ball until the ball is brought to rest on the paddle at a specified location. The robot`s reachable workspace is blocked by an obstacle that disconnects the free space formed when the ball and paddle remain in contact, forcing the machine to let go for a time to bring the ball to the desired state. The controller compositions the authors create guarantee that a ball introduced in the safe workspace remains there and is ultimately brought to the goal. They report on experimental results from an implementation of these formal composition methods, and present descriptive statistics characterizing the experiments.

  1. Giant intracranial aneurysms: rapid sequential computed tomography

    SciTech Connect

    Pinto, R.S.; Cohen, W.A.; Kricheff, I.I.; Redington, R.W.; Berninger, W.H.

    1982-11-01

    Giant intracranial aneurysms often present as mass lesions rather than with subarachnoid hemorrhage. Routine computed tomographic (CT) scans with contrast material will generally detect them, but erroneous diagnosis of basal meningioma is possible. Rapid sequential scanning (dynamic CT) after bolus injection of 40 ml of Renografin-76 can conclusively demonstrate an intracranial aneurysm, differentiating it from other lesions by transit-time analysis of the passage of contrast medium. In five patients, the dynamics of contrast bolus transit in aneurysms were consistently different from the dynamics in pituitary tumors, craniopharyngiomas, and meningiomas, thereby allowing a specific diagnosis. Dynamic CT was also useful after treatment of the aneurysms by carotid artery ligation and may be used as an alternative to angiographic evaluation in determining luminal patency or thrombosis.

  2. Search properties of some sequential decoding algorithms.

    NASA Technical Reports Server (NTRS)

    Geist, J. M.

    1973-01-01

    Sequential decoding procedures are studied in the context of selecting a path through a tree. Several algorithms are considered, and their properties are compared. It is shown that the stack algorithm introduced by Zigangirov (1966) and by Jelinek (1969) is essentially equivalent to the Fano algorithm with regard to the set of nodes examined and the path selected, although the description, implementation, and action of the two algorithms are quite different. A modified Fano algorithm is introduced, in which the quantizing parameter is eliminated. It can be inferred from limited simulation results that, at least in some applications, the new algorithm is computationally inferior to the old. However, it is of some theoretical interest since the conventional Fano algorithm may be considered to be a quantized version of it.

  3. Simultaneous better than sequential for brief presentations

    NASA Astrophysics Data System (ADS)

    Hung, George K.; Wilder, Joseph; Curry, Reates; Julesz, Bela

    1995-03-01

    During perceptually intensive tasks such as reading, there is a bottleneck in the information transfer between the large number of alphanumeric characters available and the acquiring of these characters. This is due mainly to the limited number of characters that one can report at a glance (also known as the "magic number 7 +/- 2") [Psychol. Rev. 63, 81 (1956)]. To examine where in the perceptual pathway this bottleneck occurred, several investigators tested and compared performance with simultaneous and with sequential target presentations [J. Exp. Psychol. 79, 1 (1969); 93, 72 (1972); Percept. Psychophys. 14, 231 (1973)]. They found that performance was nearly equal in the two cases and concluded that the bottleneck must be due to the limitation of short-term memory. However, these studies were

  4. Sequential scintigraphic staging of small cell carcinoma

    SciTech Connect

    Bitran, J.D.; Bekerman, C.; Pinsky, S.

    1981-04-15

    Thirty patients with small cell carcinoma (SCC) of the lung were sequentially staged following a history and physical exam with liver, bran, bone, and gallium-67 citrate scans. Scintigraphic evaluation disclosed 7 of 30 patients (23%) with advanced disease, stage IIIM1. When Gallium-67 scans were used as the sole criteria for staging, they proved to be accurate and identified six of the seven patients with occult metastatic disease. Gallium-67 scans proved to be accurate in detecting thoracic and extrathoracic metastases in the 30 patients with SCC, especially within the liver and lymph node-bearing area. The diagnostic accuracy of gallium-67 fell in regions such as bone or brain. Despite the limitations of gallium-67 scanning, the authors conclude that these scans are useful in staging patients with SCC and should be the initial scans used in staging such patients.

  5. Sequential imposed layer epitaxy of cuprate films

    SciTech Connect

    Laguees, M.; Tebbji, H.; Mairet, V.; Hatterer, C.; Beuran, C.F.; Hass, N.; Xu, X.Z. ); Cavellin, C.D. )

    1994-02-01

    Layer-by-layer epitaxy has been used to grow cuprate films since the discovery of high-Tc compounds. This deposition technique is in principle suitable for the growth of layered crystalline structures. However, the sequential deposition of atomic layer by atomic layer of cuprate compounds has presently not been optimized. Nevertheless, this deposition process is the only one which allows one to build artificial cell structures such as Bi[sub 2]Sr[sub 2]Ca[sub (n[minus]1)]Cu[sub n]O[sub y] with n as large as 10. This process will also be the best one to grow films of the so-called infinite layer phase compounds belonging to the Sr[sub 1[minus]x]Ca[sub x]CuO[sub 2] family, in order to improve the transport properties and the morphological properties of the cuprate films. When performed at high substrate temperature (typically more than 600[degree]C), the layer-by-layer epitaxy of cuprates exhibits usually 3D aggregate nucleation. Then the growth of the film no longer obeys the layer-by-layer sequence imposed during the deposition. We present here two experimental situations of true 2D sequential imposed layer epitaxy; the growth at 500[degree]C under atomic oxygen pressure of Bi[sub 2]Sr[sub 2]CuO[sub 6] and of Sr[sub 1[minus]x]Ca[sub y]CuO[sub 2] phases. 20 refs., 2 figs.

  6. Sequential effects: Superstition or rational behavior?

    PubMed Central

    Yu, Angela J.; Cohen, Jonathan D.

    2012-01-01

    In a variety of behavioral tasks, subjects exhibit an automatic and apparently suboptimal sequential effect: they respond more rapidly and accurately to a stimulus if it reinforces a local pattern in stimulus history, such as a string of repetitions or alternations, compared to when it violates such a pattern. This is often the case even if the local trends arise by chance in the context of a randomized design, such that stimulus history has no real predictive power. In this work, we use a normative Bayesian framework to examine the hypothesis that such idiosyncrasies may reflect the inadvertent engagement of mechanisms critical for adapting to a changing environment. We show that prior belief in non-stationarity can induce experimentally observed sequential effects in an otherwise Bayes-optimal algorithm. The Bayesian algorithm is shown to be well approximated by linear-exponential filtering of past observations, a feature also apparent in the behavioral data. We derive an explicit relationship between the parameters and computations of the exact Bayesian algorithm and those of the approximate linear-exponential filter. Since the latter is equivalent to a leaky-integration process, a commonly used model of neuronal dynamics underlying perceptual decision-making and trial-to-trial dependencies, our model provides a principled account of why such dynamics are useful. We also show that parameter-tuning of the leaky-integration process is possible, using stochastic gradient descent based only on the noisy binary inputs. This is a proof of concept that not only can neurons implement near-optimal prediction based on standard neuronal dynamics, but that they can also learn to tune the processing parameters without explicitly representing probabilities. PMID:26412953

  7. Skin dose differences between intensity-modulated radiation therapy and volumetric-modulated arc therapy and between boost and integrated treatment regimens for treating head and neck and other cancer sites in patients.

    PubMed

    Penoncello, Gregory P; Ding, George X

    2016-01-01

    The purpose of this study was (1) to evaluate dose to skin between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) treatment techniques for target sites in the head and neck, pelvis, and brain and (2) to determine if the treatment dose and fractionation regimen affect the skin dose between traditional sequential boost and integrated boost regimens for patients with head and neck cancer. A total of 19 patients and 48 plans were evaluated. The Eclipse (v11) treatment planning system was used to plan therapy in 9 patients with head and neck cancer, 5 patients with prostate cancer, and 5 patients with brain cancer with VMAT and static-field IMRT. The mean skin dose and the maximum dose to a contiguous volume of 2cm(3) for head and neck plans and brain plans and a contiguous volume of 5cm(3) for pelvis plans were compared for each treatment technique. Of the 9 patients with head and neck cancer, 3 underwent an integrated boost regimen. One integrated boost plan was replanned with IMRT and VMAT using a traditional boost regimen. For target sites located in the head and neck, VMAT reduced the mean dose and contiguous hot spot most noticeably in the shoulder region by 5.6% and 5.4%, respectively. When using an integrated boost regimen, the contiguous hot spot skin dose in the shoulder was larger on average than a traditional boost pattern by 26.5% and the mean skin dose was larger by 1.7%. VMAT techniques largely decrease the contiguous hot spot in the skin in the pelvis by an average of 36% compared with IMRT. For the same target coverage, VMAT can reduce the skin dose in all the regions of the body, but more noticeably in the shoulders in patients with head and neck and pelvis cancer. We also found that using integrated boost regimens in patients with head and neck cancer leads to higher shoulder skin doses compared with traditional boost regimens. PMID:26764180

  8. A Phase II Study of a Dose-Density Regimen With Fluorouracil, Epirubicin, and Cyclophosphamide on Days 1 and 4 Every 14 Days With Filgrastim Support Followed by Weekly Paclitaxel in Women With Primary Breast Cancer

    PubMed Central

    Pietri, Elisabetta; Andreis, Daniele; Fabbri, Francesca; Menna, Cecilia; Schirone, Alessio; Kopf, Barbara; Rocca, Andrea; Amadori, Dino

    2015-01-01

    Background. Recent evidence shows that use of anthracycline and taxane adjuvant chemotherapy and dose-dense regimens, consisting of more frequent administration of the drugs, have improved outcomes for breast cancer patients. In this study, we evaluated administration of an epirubicin-based regimen with paclitaxel in a sequential, dose-dense schedule as adjuvant treatment for patients with high-risk primary breast cancer. Methods. In a phase II Simon two-stage design study, we evaluated the feasibility of a modified fluorouracil, epirubicin, and cyclophosphamide (FEC) regimen at high dose intensity (fluorouracil 500 mg/m2 i.v. on days 1 and 4, epirubicin 60 mg/m2 i.v. on days 1 and 4, and cyclophosphamide 500 mg/m2 i.v. on days 1 and 4; all drugs were administered every 14 days for 3 cycles) with granulocyte colony-stimulating factor support followed by dose-intense weekly paclitaxel 100 mg/m2 for 8 cycles. In 11 patients with breast cancer following quadrantectomy (n = 8) or modified radical mastectomy (n = 3), any grade 3 (G3) or higher nonhematologic toxicity (excluding alopecia, nausea or vomiting, and bone pain, which might be a consequence of the administration of filgrastim) and adherence to the scheduled dose-dense treatment (deliverability) were monitored with the purpose of enrolling an additional 27 patients in the case of a satisfying toxicity profile and deliverability of the planned treatment (at least 7 patients completing the treatment). Results. Five of 11 patients experienced G3 or higher nonhematologic toxicity during the FEC regimen. We did not observe G3 or higher nonhematologic toxicity related to paclitaxel treatment. In particular, three patients experienced G3 fatigue, one patient had G3 oral mucositis, three patients had G3 hypokalemia, one patient had G3 syncope, one patient had G3 transaminitis (alanine aminotransferase), one patient experienced G4 pulmonary thromboembolism, and 1 patient had a G3 breast infection. Four of 11 patients

  9. Fewer doses of HPV vaccine result in immune response similar to three-dose regimen

    Cancer.gov

    NCI scientists report that two doses of a human papillomavirus (HPV) vaccine, trademarked as Cervarix, resulted in similar serum antibody levels against two of the most carcinogenic types of HPV (16 and 18), compared to a standard three dose regimen.

  10. Complications in neonates of mothers with gestational diabetes mellitus receiving insulin therapy versus dietary regimen

    PubMed Central

    Fazel-Sarjoui, Zhaleh; Khodayari Namin, Amirali; Kamali, Maryam; Khodayari Namin, Nazanin; Tajik, Ali

    2016-01-01

    Background: Gestational diabetes mellitus (GDM) is a common obstetrical complication with both maternal and fetal side effects. Objective: This study was performed to determine the complications in neonates of mothers with GDM receiving insulin vs. dietary regimen. Materials and Methods: In this prospective cohort study, 140 neonates of mothers with GDM attending Javaheri Hospital of Azad University in Tehran in 2013 and 2014 were enrolled and the complications in those receiving insulin versus. dietary regimen were compared. Results: The results demonstrated that 95.7% of those who received a dietary regimen and 85.7% among those who received insulin had a good outcome showing statistically significant differences (p=0.042). The mortality rate was not differed among the patients in two groups (p>0.05). Conclusion: According to the results of this study, it may be concluded that the frequency of complications in neonates of cases with GDM is getting less by receiving dietary regimen. PMID:27351030

  11. Calculator programs to deal with non-steady state, multiple dosage regimen clinical pharmacokinetics.

    PubMed

    Ensom, R J; Nakagawa, R S

    1983-07-01

    Serum drug levels have become a useful tool in the optimization of dosage requirements for several therapeutically important drugs. In the acute care situation the interpretation of these levels is complicated by multiple dosage regimens and inadequate time to achieve steady-state serum drug levels. Mathematical equations describing first order single compartment pharmacokinetics have been compiled. An alpha-numeric programmable calculator has been programmed to accept information regarding up to seven different serial dosage regimens. The calculator is also programmed to predict concentrations at any time during a complex set of dosage regimens or peak, trough, and average concentrations given a maintenance dosage regimen. Examples are given to demonstrate the usefulness of the programs in the clinical setting. PMID:6688607

  12. Sequential estimation of surface water mass changes from daily satellite gravimetry data

    NASA Astrophysics Data System (ADS)

    Ramillien, G. L.; Frappart, F.; Gratton, S.; Vasseur, X.

    2015-03-01

    We propose a recursive Kalman filtering approach to map regional spatio-temporal variations of terrestrial water mass over large continental areas, such as South America. Instead of correcting hydrology model outputs by the GRACE observations using a Kalman filter estimation strategy, regional 2-by-2 degree water mass solutions are constructed by integration of daily potential differences deduced from GRACE K-band range rate (KBRR) measurements. Recovery of regional water mass anomaly averages obtained by accumulation of information of daily noise-free simulated GRACE data shows that convergence is relatively fast and yields accurate solutions. In the case of cumulating real GRACE KBRR data contaminated by observational noise, the sequential method of step-by-step integration provides estimates of water mass variation for the period 2004-2011 by considering a set of suitable a priori error uncertainty parameters to stabilize the inversion. Spatial and temporal averages of the Kalman filter solutions over river basin surfaces are consistent with the ones computed using global monthly/10-day GRACE solutions from official providers CSR, GFZ and JPL. They are also highly correlated to in situ records of river discharges (70-95 %), especially for the Obidos station where the total outflow of the Amazon River is measured. The sparse daily coverage of the GRACE satellite tracks limits the time resolution of the regional Kalman filter solutions, and thus the detection of short-term hydrological events.

  13. Comparison of Two High-Dose Magnesium Infusion Regimens in the Treatment of Status Asthmaticus

    PubMed Central

    Vaiyani, Danish

    2016-01-01

    OBJECTIVES: To determine the feasibility and safety of a simplified high-dose magnesium sulfate infusion (sHDMI) for the treatment of status asthmaticus. METHODS: We retrospectively compared 2 different high-dose magnesium sulfate infusion regimens, as adjunctive treatment in status asthmatics, using data that were preciously collected. The initial high-dose, prolonged magnesium infusion (HDMI) regimen consisted of a loading dose of 75 mg/kg (weight ≤ 30 kg) or 50 mg/kg (weight > 30 kg) over a period of 30 to 45 minutes followed by a continuous infusion of 40 mg/kg/hr for an additional 4 hours. This was compared to the sHDMI regimen that consisted of 50 mg/kg/hr for 5 hours. No loading dose was given to the patients in the sHDMI arm. Obese patients were dosed by using ideal body weight. Physiologic parameters (i.e., heart rate, blood pressure, respiratory rate, oxygen saturation) and serum magnesium (SrMg) concentrations were monitored during administration of magnesium sulfate. RESULTS: Nineteen patients receiving the initial HDMI regimen were compared with 10 patients who received the sHDMI regimen. There was no significant difference in SrMg concentrations or physiologic parameters between the 2 dose regimens. CONCLUSIONS: The HDMI and sHDMI regimens both produced SrMg concentrations that are associated with bronchodilation. The safety profile was also similar for the 2 regimens. The unambiguity of sHDMI has the potential to reduce medication errors that are associated with calculation of the loading dose, product preparation, and ultimate administration. PMID:27453701

  14. Dietary regimens of athletes competing at the Delhi 2010 Commonwealth Games.

    PubMed

    Pelly, Fiona E; Burkhart, Sarah J

    2014-02-01

    The aim of this study was to investigate the dietary regimens reported by athletes competing at a major international competition and report whether these were based on nutrient composition, religious beliefs, cultural eating style, food intolerance or avoidance of certain ingredients. A questionnaire was randomly distributed to 351 athletes in the main dining hall of the athletes' village over the three main meal periods during the Delhi 2010 Commonwealth Games (23rd Sept-14th Oct, 2010). The majority (n = 218, 62%) of athletes reported following one or more dietary regimens, with 50% (n = 174) following a diet based on the nutrient composition of the food. Significantly more athletes from weight category and aesthetic sports (28%, p = .005) and from power/sprint sports (41%, p = .004) followed low fat and high protein regimens respectively. Other specialized dietary regimens were followed by 33% of participants, with avoidance of red meat (13%), vegetarian (7%), Halal (6%), and low lactose regimens (5%) reported most frequently. Significantly more athletes from non-Western regions followed a vegetarian diet (p < .001), while more vegetarians reported avoiding additives (p = .013) and wheat (p ≤ .001). A Western style of eating was the most commonly reported cultural regimen (72% of total with 23% from non-Western regions). Those following a Western diet were significantly more likely to report following a regimen based on nutrient composition (p = .02). As a high proportion of athletes from differing countries and sports follow specialized dietary regimens, caterers and organizers should ensure that adequate nutrition support and food items are available at similar events. PMID:23918635

  15. Cost description of chemotherapy regimens for the treatment of metastatic pancreas cancer.

    PubMed

    Goldstein, Daniel A; Krishna, Kavya; Flowers, Christopher R; El-Rayes, Bassel F; Bekaii-Saab, Tanios; Noonan, Anne M

    2016-05-01

    Multiple chemotherapy regimens are available for the treatment of metastatic pancreas cancer (mPCA). Choice of regimen is based on the patient's performance status and toxicity profile of the regimen. The objective of this study was to analyze the costs of first-line regimens to further aid in decision-making and develop a platform upon which to assess value. We calculated the monthly cost for individual standard regimens (gemcitabine, gemcitabine/nab-paclitaxel, gemcitabine/erlotinib and FOLFIRINOX) and the overall treatment cost for a course of therapy based on the median progression-free survival achieved in published studies. In addition to cost of drugs, we included administration costs and costs of toxicities (including growth factor support, blood product transfusion and hospitalization for toxicities). Costs for administration and management of adverse events were based on Medicare reimbursement rates for hospital and physician services. Drug costs were based on Medicare average sale prices (all 2014 US$). The monthly costs for gemcitabine, FOLFIRINOX, gemcitabine/erlotinib and gemcitabine/nab-paclitaxel were $1363, $7234, $8007 and $12,221, respectively. The overall treatment costs for a course of the same regimens based on median PFS were $5043, $46,298, $51,004 and $67,216, respectively. The choice of chemotherapy regimen for mPCA should be based on tolerability and efficacy of the regimen individualized to patient's performance status. Healthcare systems have finite resources; thus, there is increasing emphasis on metrics to define value in health care when outcomes of therapy are similar or produce marked differences in value. These data provide useful financial information to incorporate into the decision-making process. PMID:27067436

  16. SIMILAR OUTCOMES USING MYELOABLATIVE VERSUS REDUCED INTENSITY ALLOGENEIC TRANSPLANT PREPARATIVE REGIMENS FOR AML OR MDS

    PubMed Central

    Luger, Selina M.; Ringdén, Olle; Zhang, Mei-Jie; Pérez, Waleska S.; Bishop, Michael R.; Bornhauser, Martin; Bredeson, Christopher N.; Cairo, Mitchell S.; Copelan, Edward A.; Gale, Robert Peter; Giralt, Sergio A.; Gulbas, Zafer; Gupta, Vikas; Hale, Gregory A.; Lazarus, Hillard M.; Lewis, Victor Anthony; Lill, Michael C.; McCarthy, Philip L.; Weisdorf, Daniel J.; Pulsipher, Michael A.

    2011-01-01

    Although reduced intensity (RIC) and nonmyeloablative (NMA) conditioning regimens have been used for over a decade, their relative efficacy versus myeloablative (MA) approaches to allogeneic hematopoietic cell transplantation (HCT) in patients with acute myelogenous leukemia (AML) and myelodysplasia (MDS) is unknown. We compared disease status, donor, graft and recipient characteristics with outcomes of 3731 MA with 1448 RIC/NMA procedures performed at 217 centers between 1997 and 2004. Five year univariate probabilities and multivariate relative risk (RR) outcomes of relapse, transplant related mortality (TRM), disease free survival (DFS) and overall survival (OS) are reported. Adjusted OS at 5 years was 34%, 33%, and 26% for MA, RIC and NMA transplants, respectively. NMA conditioning resulted in inferior DFS and OS but there was no difference in DFS and OS between RIC and MA regimens. Late TRM negates early decreases in toxicity with RIC and NMA regimens. Our data suggest higher regimen intensity may contribute to optimal survival in patients with AML/MDS, suggesting roles for both regimen intensity and graft vs. leukemia in these diseases. Prospective studies comparing regimens are needed to confirm this finding and determine the optimal approach to patients who are eligible for either MA or RIC/NMA conditioning. PMID:21441963

  17. Development and Implementation of a Double-Blind Corticosteroid-Tapering Regimen for a Clinical Trial

    PubMed Central

    Collinson, Neil; Tuckwell, Katie; Habeck, Frank; Chapman, Monique; Klearman, Micki; Stone, John H.

    2015-01-01

    We describe the design and operationalization of a blinded corticosteroid-tapering regimen for a randomized trial of tocilizumab in giant cell arteritis (GCA). To our knowledge, no clinical trial in any disease has ever employed a blinded corticosteroid-tapering regimen, but this was necessary to the design of our trial which is likely to be relevant to other investigations of steroid-sparing regimens. Two standardized corticosteroid-tapering regimens are required for this GCA trial: a 6-month regimen in 3 arms (taken with tocilizumab 162 mg subcutaneously weekly or every other week or with placebo) and a 12-month regimen with placebo (fourth arm). Investigators select initial prednisone doses, tapered in an open-label fashion until 20 mg/day. Doses <20 mg/day are blinded. At least 27 blinded blister packs are required to ensure blinding and encourage compliance. This permits all possible daily doses but requires ≤5 capsules/day. The number of capsules taken at any point during tapering is identical across groups. Our approach may be extrapolated to trials beyond GCA. PMID:25878667

  18. Altering Antimalarial Drug Regimens May Dramatically Enhance and Restore Drug Effectiveness.

    PubMed

    Kay, Katherine; Hodel, Eva Maria; Hastings, Ian M

    2015-10-01

    There is considerable concern that malaria parasites are starting to evolve resistance to the current generation of antimalarial drugs, the artemisinin-based combination therapies (ACTs). We use pharmacological modeling to investigate changes in ACT effectiveness likely to occur if current regimens are extended from 3 to 5 days or, alternatively, given twice daily over 3 days. We show that the pharmacology of artemisinins allows both regimen changes to substantially increase the artemisinin killing rate. Malaria patients rarely contain more than 10(12) parasites, while the standard dosing regimens allow approximately 1 in 10(10) parasites to survive artemisinin treatment. Parasite survival falls dramatically, to around 1 in 10(17) parasites if the dose is extended or split; theoretically, this increase in drug killing appears to be more than sufficient to restore failing ACT efficacy. One of the most widely used dosing regimens, artemether-lumefantrine, already successfully employs a twice-daily dosing regimen, and we argue that twice-daily dosing should be incorporated into all ACT regimen design considerations as a simple and effective way of ensuring the continued long-term effectiveness of ACTs. PMID:26239993

  19. Altering Antimalarial Drug Regimens May Dramatically Enhance and Restore Drug Effectiveness

    PubMed Central

    Hodel, Eva Maria; Hastings, Ian M.

    2015-01-01

    There is considerable concern that malaria parasites are starting to evolve resistance to the current generation of antimalarial drugs, the artemisinin-based combination therapies (ACTs). We use pharmacological modeling to investigate changes in ACT effectiveness likely to occur if current regimens are extended from 3 to 5 days or, alternatively, given twice daily over 3 days. We show that the pharmacology of artemisinins allows both regimen changes to substantially increase the artemisinin killing rate. Malaria patients rarely contain more than 1012 parasites, while the standard dosing regimens allow approximately 1 in 1010 parasites to survive artemisinin treatment. Parasite survival falls dramatically, to around 1 in 1017 parasites if the dose is extended or split; theoretically, this increase in drug killing appears to be more than sufficient to restore failing ACT efficacy. One of the most widely used dosing regimens, artemether-lumefantrine, already successfully employs a twice-daily dosing regimen, and we argue that twice-daily dosing should be incorporated into all ACT regimen design considerations as a simple and effective way of ensuring the continued long-term effectiveness of ACTs. PMID:26239993

  20. Pushing the envelope—nonmyeloablative and reduced intensity preparative regimens for allogeneic hematopoietic transplantation

    PubMed Central

    Pingali, SR; Champlin, RE

    2016-01-01

    Allogeneic hematopoietic cell transplantation (HCT) was originally developed to allow delivery of myeloablative doses of chemotherapy and radiotherapy. With better understanding of disease pathophysiology, the graft vs malignancy (GVM) effect of allogeneic hematopoietic transplantation and toxicities associated with myeloablative conditioning (MAC) regimens, the focus shifted to developing less toxic conditioning regimens to reduce treatment-related morbidity without compromising survival. Although HCT with MAC is preferred to reduced intensity conditioning (RIC) for most patients ≤ 60 years with AML/myelodysplastic syndrome and ALL, RIC and nonmyeloablative (NMA) regimens allow HCT for many otherwise ineligible patients. Reduced intensity preparative regimens have produced high rates of PFS for diagnoses, which are highly sensitive to GVM. Relapse of the malignancy is the major cause of treatment failure with RIC/NMA HCT. Incorporation of novel agents like bortezomib or lenalidomide, addition of cellular immunotherapy and use of targeted radiation therapies could further improve outcome. In this review, we discuss commonly used RIC/NMA regimens and promising novel regimens. PMID:25985053

  1. Thalidomide-based induction regimens are as effective as bortezomib-based regimens in elderly patients with multiple myeloma with cereblon expression.

    PubMed

    Jung, Sung-Hoon; Choi, Hyun-Jung; Shin, Myung-Geun; Lee, Seung-Shin; Hwang, Eu Chang; Jung, Tae-Young; Cho, Min-Seok; Yang, Deok-Hwan; Ahn, Jae-Sook; Kim, Yeo-Kyeoung; Kim, Hyeoung-Joon; Lee, Je-Jung

    2016-10-01

    Cereblon (CRBN) has been identified as a primary target of immunomodulatory drugs and is considered a biomarker for the prediction of outcomes after thalidomide- or lenalidomide-based treatments. In this study, we evaluated CRBN expression in bone marrow (BM) tissue at diagnosis and investigated the relationship between CRBN expression and treatment outcomes after thalidomide- or bortezomib-based front-line therapies in 89 elderly patients with multiple myeloma (MM). CRBN expression at the time of diagnosis was evaluated with immunohistochemical (IHC) staining for myeloma cells in paraffin wax-embedded BM tissue. CRBN-immunostained slides were scored by intensity and diffuseness, and a total score of >6 was defined as CRBN-positive (CRBN(+)). Thirty-eight patients (45.2 %) were CRBN(+). Among patients treated with thalidomide-based regimens, CRBN(+) patients showed a better treatment response than did CRBN-negative patients (35.0 vs. 11.8 % complete response rate, respectively; HR = 4.038, P = 0.137). During a median follow-up of 31.8 months, patients treated with bortezomib-based regimens had a longer time to progression (TTP) than did patients treated with thalidomide-based regimens (15.6 vs. 13.2 months, respectively; P = 0.047), but early mortality occurred frequently in patients treated with bortezomib-based regimens. Additionally, there was no significant difference in survival outcomes between thalidomide- and bortezomib-based regimens in CRBN(+) patients (median TTP, 13.8 vs. 15.6 months, respectively; P = 0.842 and median OS, 39.3 vs. 30.1 months, respectively; P = 0.074). These data suggest that thalidomide-based regimens are as effective as bortezomib-based regimens in elderly patients with MM who are CRBN(+). Thus, CRBN positivity, by IHC staining, may be useful in deciding appropriate treatment options in elderly patients with MM. PMID:27365142

  2. Implications of Tracey's theorem to asynchronous sequential circuit design

    NASA Technical Reports Server (NTRS)

    Gopalakrishnan, S.; Kim, G.; Maki, G.

    1990-01-01

    Tracey's Theorem has long been recognized as essential in generating state assignments for asynchronous sequential circuits. This paper shows that Tracey's Theorem also has a significant impact in generating the design equations. Moreover, this theorem is important to the fundamental understanding of asynchronous sequential operation. The results of this work simplify asynchronous logic design. Moreover, detection of safe circuits is made easier.

  3. Derivation of sequential, real-time, process-control programs

    NASA Technical Reports Server (NTRS)

    Marzullo, Keith; Schneider, Fred B.; Budhiraja, Navin

    1991-01-01

    The use of weakest-precondition predicate transformers in the derivation of sequential, process-control software is discussed. Only one extension to Dijkstra's calculus for deriving ordinary sequential programs was found to be necessary: function-valued auxiliary variables. These auxiliary variables are needed for reasoning about states of a physical process that exists during program transitions.

  4. A Bayesian Theory of Sequential Causal Learning and Abstract Transfer

    ERIC Educational Resources Information Center

    Lu, Hongjing; Rojas, Randall R.; Beckers, Tom; Yuille, Alan L.

    2016-01-01

    Two key research issues in the field of causal learning are how people acquire causal knowledge when observing data that are presented sequentially, and the level of abstraction at which learning takes place. Does sequential causal learning solely involve the acquisition of specific cause-effect links, or do learners also acquire knowledge about…

  5. Lag Sequential Analysis: Taking Consultation Communication Research to the Movies.

    ERIC Educational Resources Information Center

    Benes, Kathryn M.; Gutkin, Terry B.; Kramer, Jack J.

    1995-01-01

    Describes lag-sequential analysis and its unique contributions to research literature, addressing communication processes in school-based consultation. For purposes of demonstrating the application and potential utility of lag-sequential analysis, article analyzes the communication behaviors of two consultants. Considers directions for future…

  6. The Relevance of Visual Sequential Memory to Reading.

    ERIC Educational Resources Information Center

    Crispin, Lisa; And Others

    1984-01-01

    Results of three visual sequential memory tests and a group reading test given to 19 elementary students are discussed in terms of task analysis and structuralist approaches to analysis of reading skills. Relation of visual sequential memory to other reading subskills is considered in light of current reasearch. (CMG)

  7. Sequential Effects on Speeded Information Processing: A Developmental Study

    ERIC Educational Resources Information Center

    Smulders, S.F.A.; Notebaert, W.; Meijer, M.; Crone, E.A.; van der Molen, M.W.; Soetens, E.

    2005-01-01

    Two experiments were performed to assess age-related changes in sequential effects on choice reaction time (RT). Sequential effects portray the influence of previous trials on the RT to the current stimulus. In Experiment 1, three age groups (7-9, 10-12, and 18-25 years) performed a spatially compatible choice task, with response-to-stimulus…

  8. Induction of simultaneous and sequential malolactic fermentation in durian wine.

    PubMed

    Taniasuri, Fransisca; Lee, Pin-Rou; Liu, Shao-Quan

    2016-08-01

    This study represented for the first time the impact of malolactic fermentation (MLF) induced by Oenococcus oeni and its inoculation strategies (simultaneous vs. sequential) on the fermentation performance as well as aroma compound profile of durian wine. There was no negative impact of simultaneous inoculation of O. oeni and Saccharomyces cerevisiae on the growth and fermentation kinetics of S. cerevisiae as compared to sequential fermentation. Simultaneous MLF did not lead to an excessive increase in volatile acidity as compared to sequential MLF. The kinetic changes of organic acids (i.e. malic, lactic, succinic, acetic and α-ketoglutaric acids) varied with simultaneous and sequential MLF relative to yeast alone. MLF, regardless of inoculation mode, resulted in higher production of fermentation-derived volatiles as compared to control (alcoholic fermentation only), including esters, volatile fatty acids, and terpenes, except for higher alcohols. Most indigenous volatile sulphur compounds in durian were decreased to trace levels with little differences among the control, simultaneous and sequential MLF. Among the different wines, the wine with simultaneous MLF had higher concentrations of terpenes and acetate esters while sequential MLF had increased concentrations of medium- and long-chain ethyl esters. Relative to alcoholic fermentation only, both simultaneous and sequential MLF reduced acetaldehyde substantially with sequential MLF being more effective. These findings illustrate that MLF is an effective and novel way of modulating the volatile and aroma compound profile of durian wine. PMID:27104664

  9. Decision Making and Learning while Taking Sequential Risks

    ERIC Educational Resources Information Center

    Pleskac, Timothy J.

    2008-01-01

    A sequential risk-taking paradigm used to identify real-world risk takers invokes both learning and decision processes. This article expands the paradigm to a larger class of tasks with different stochastic environments and different learning requirements. Generalizing a Bayesian sequential risk-taking model to the larger set of tasks clarifies…

  10. Development of Decision Making: Sequential versus Integrative Rules

    ERIC Educational Resources Information Center

    Jansen, Brenda R. J.; van Duijvenvoorde, Anna C. K.; Huizenga, Hilde M.

    2012-01-01

    Decisions can be made by applying a variety of decision-making rules--sequential rules in which decisions are based on a sequential evaluation of choice dimensions and the integrative normative rule in which decisions are based on an integration of choice dimensions. In this study, we investigated the developmental trajectory of such…

  11. Applications of Bayesian Decision Theory to Sequential Mastery Testing.

    ERIC Educational Resources Information Center

    Vos, Hans J.

    1999-01-01

    Formulates optimal sequential rules for mastery testing using an approach derived from Bayesian sequential decision theory to consider both threshold and linear loss structures. Adopts the binomial probability distribution as the psychometric model. Provides an empirical example for concept-learning in medicine. (SLD)

  12. Comparative Impact of Suppressive Antiretroviral Regimens on the CD4/CD8 T-Cell Ratio

    PubMed Central

    Masiá, Mar; Padilla, Sergio; Barber, Xavier; Sanchis, Marina; Terol, Gertrudis; Lidón, Fernando; Gutiérrez, Félix

    2016-01-01

    Abstract Although different factors have been implicated in the CD4/CD8 T-cell ratio recovery in HIV-infected patients who receive effective antiretroviral therapy (ART), limited information exists on the influence of the regimen composition. A longitudinal study carried out in a prospective, single-center cohort of HIV-infected patients. ART regimens including non-nucleoside reverse transcriptase inhibitors (NNRTI), protease inhibitors (PI), or integrase strand transfer inhibitors (INSTI) from patients who achieved long-term (≥6-month duration) virological suppression (HIV-RNA < 400 copies/mL) from January 1998 to June 2014 were analyzed. The impact of ART composition on the changes of the CD4/CD8 T-cell ratio was modeled using a mixed linear approach with adjustment for possible confounders. A total of 1068 ART regimens from 570 patients were analyzed. Mean (SD) age of the patients was 42.15 (10.68) years and 276 (48.42%) had hepatitis C virus (HCV) coinfection. Five hundred fifty-eight (52.25%) regimens were PI-based, 439 (40.10%) NNRTI-based, and 71 (6.65%) INSTI-based; 487 (45.60%) were initial regimens, 476 (44.57%) simplification, and 105 (9.83%) salvage regimens. Median (IQR) number of regimens was 1 (1–2) per patient, of 29 (14–58) months duration, and 4 (3–7) CD4/CD8 measurements per regimen. The median baseline CD4/CD8 ratio was 0.42, 0.50, and 0.54, respectively, with the PI-, NNRTI-, and INSTI-based regimens (P = 0.0073). Overall median (IQR) increase of CD4/CD8 ratio was 0.0245 (−0.0352–0.0690) per year, and a CD4/CD8 ratio ≥1 was achieved in 19.35% of the cases with PI-based, 25.97% with NNRTI-based, and 22.54% with INSTI-based regimens (P = 0.1406). In the adjusted model, the mean CD4/CD8 T-cell ratio increase was higher with NNRTI-based regimens compared for PI-based (estimated coefficient for PI [95% CI], −0.0912 [−0.1604 to −0.0219], P = 0.009). Also, a higher CD4/CD8 baseline ratio was associated with higher

  13. Effect of weaning status and implant regimen on growth, performance, and carcass characteristics of steers.

    PubMed

    Schoonmaker, J P; Fluharty, F L; Loerch, S C; Turner, T B; Moeller, S J; Wulf, D M

    2001-05-01

    One hundred forty-three Angus x Simmental crossbred steers (initial BW = 155.1 +/- 4.5 kg) were used in a 2-yr study (yr 1, n = 67; yr 2, n = 76) to determine the effects of weaning age, implant regimen, and the weaning age x implant regimen interaction on steer growth and performance, organ mass, carcass characteristics, and cooked beef palatability. Steers were early-weaned at an average age of 108 d (EW) or normally weaned at an average age of 202 d (NW) and allotted by weight to an aggressive or nonaggressive implant regimen. On their respective weaning dates, EW and NW steers were penned individually and fed a grain-based diet until they were slaughtered at a final BW of 546 kg. A subsample of steers (n = 2 per treatment) were slaughtered at 254 kg. At 254 kg, EW steers implanted with the aggressive implant regimen had 64% greater backfat depth than those implanted with the nonaggressive implant regimen; conversely, NW steers implanted with the aggressive implant regimen had 52% lower backfat depth than those implanted with the nonaggressive implant regimen (weaning status x implant regimen interaction; P < 0.01). A similar interaction was observed for empty visceral organ weights. Early-weaned steers were younger (354.7 vs 372.4 d; P < 0.01) at final slaughter but were in the feedlot longer (246.5 vs 169.6 d; P < 0.01) than NW steers, whereas the aggressive implant regimen decreased days fed (203.3 vs 212.7; P < 0.07) compared to the nonaggressive implant regimen. Overall ADG was greater for EW than for NW steers (1.61 vs 1.50 kg/d; P < 0.01) and for the aggressive compared with the nonaggressive implant regimen (1.59 vs 1.52 kg/d; P < 0.02). Early-weaned steers consumed less DM per day (7.4 vs 8.5 kg/d; P < 0.01) and were more efficient (0.217 vs 0.208 kg/kg; P < 0.02) but consumed more total DM (1,817 vs 1,429 kg; P < 0.01) than NW steers while in the feedlot. Implant regimen did not affect DMI (P > 0.37) or feed efficiency (P > 0.15). Weaning status did

  14. Cost-Utility Analysis of IEV Drug Regimen Versus ESHAP Drug Regimen for the Patients With Relapsed and Refractory Hodgkin and Non-Hodgkin’s Lymphoma in Iran

    PubMed Central

    Hatam, Nahid; Dehghani, Mehdi; Habibian, Mostafa; Jafari, Abdosaleh

    2015-01-01

    Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program. Objectives: The aim of this study was to perform a cost-utility analysis of IEV regimen (ifosfamide, epirubicin and etoposide) versus ESHAP regimen (etoposide, methylprednisolone, high-dose cytarabine, and cisplatin) in patients with lymphoma in the south of Iran. Patients and Methods: This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Using decision tree, expected costs, quality -adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) were estimated. In addition, the robustness of results was examined by sensitivity analysis. Results: The results of this study indicated that the total lymphoma patients were about 65 people that 27 patients received IEV regimen and 38 patients ESHAP (43 patients with Hodgkin’s and 22 with non-Hodgkin lymphoma). The results of decision tree showed that in the IEV arm, the expected cost was $20952.93 and the expected QALYs was 3.89 and in the ESHAP arm, the expected cost was $31691.74 and the expected QALYs was 3.86. Based on the results of the study, IEV regimen was cost-effective alternative to the ESHAP regimen. Conclusions: According to the results of this study, it is recommended that oncologists use IEV instead of ESHAP in the treatment of patients with lymphoma and because of high costs of IEV drug costs, it is suggested that IEV drugs should be covered by insurance. PMID:26634115

  15. Influence of gender membership on sequential decisions of face attractiveness.

    PubMed

    Kondo, Aki; Takahashi, Kohske; Watanabe, Katsumi

    2013-10-01

    Responses in a current trial are biased by the stimulus and response in the preceding trial. In a mixed-category sequence, the sequential dependency is weaker when the stimuli of the current and preceding trials fall under different categories. In the present study, we investigated the influence of the gender membership of faces on the sequential dependency. Forty-eight pictures of male and female faces were presented successively. Participants rated the attractiveness, roundness, or intelligence of each face on a 7-point scale. The sequential effect was robustly observed, irrespective of the property to be judged. However, between-gender sequential dependency was weaker than within-gender dependency only in the attractiveness judgment. These findings suggest that the gender of faces serves as a cue for forming category representations when face attractiveness is of interest, and hence that the formation of categories in sequential decisions is an adaptive process that depends on the property to be judged. PMID:24037595

  16. Hearing outcome after sequential cholesteatoma surgery.

    PubMed

    Lailach, Susen; Zahnert, Thomas; Lasurashvili, Nikoloz; Kemper, Max; Beleites, Thomas; Neudert, Marcus

    2016-08-01

    The objective of this study was to assess hearing outcome after sequential cholesteatoma surgery stratified for exclusively transcanal technique (ETC), combined transcanal and transmastoidal technique (TCM) and canal wall down surgery (CWD) and to analyze the impact of ossicular reconstruction technique (partial ossicular replacement prostheses/PORP and total ossicular replacement prostheses/TORP) on hearing outcome. This study is a retrospective case review and clinical case study conducted in a tertiary referral center. Patients who underwent 376 cholesteatoma surgeries (2007-2009) and 92 ears in clinical re-examination at least 12 months postoperatively were included. Sequential cholesteatoma surgery with ETC, TCM, or CWD; ossiculoplasty with PORP or TORP were the interventions administered. Pre- and postoperative air-bone gap (ABG) and air conduction threshold (AC) for 0.5-3 kHz were the main outcome measures. Overall, the mean preoperative ABG decreased from 25.3 ± 1.3 to 19.8 ± 0.9 dB with a mean ABG closure of 5.4 ± 1.3 dB (p ≤ 0.001). According to surgical technique, the postoperative ABG after CWD 23.5 ± 2.1 was significantly worse compared to ETC (17.3 ± 1.0 dB, p < 0.05) and TCM (19.4 ± 1.3 dB). A significant ABG closure was observed after ETC (6.8 ± 2.0 dB, p < 0.01) and TCM (6.5 ± 2.0 dB, p < 0.01) contrary to CWD (2.1 ± 2.9 dB, p > 0.05). Patients receiving PORP showed a significantly less ABG postoperatively (19.0 ± 0.9 dB, p ≤ 0.05) compared to the TORP group (24.1 ± 2.5 dB). However, a significant hearing gain was assessed after PORP- (4.7 ± 1.6 dB, p ≤ 0.01) and TORP- implantation (10.4 ± 3.7 dB, p ≤ 0.01). Sequential cholesteatoma surgery allowed for an excellent hearing outcome postoperatively. An intact posterior canal wall and a present stapes suprastructure were identified to predict a significantly superior hearing result. In addition to the technical and prosthetic

  17. Relative Bioavailability of Fentanyl Following Various Dosing Regimens of Fentanyl Buccal Tablet in Healthy Japanese Volunteers

    PubMed Central

    Darwish, Mona; Tempero, Kenneth; Jiang, John G; Simonson, Philip G

    2008-01-01

    Background Fentanyl buccal tablet (FBT; FENTORA®, Cephalon, Inc., Frazer, PA, USA) is indicated in the US for breakthrough pain in patients with cancer who are already receiving and are tolerant to around-the-clock opioid therapy for underlying persistent cancer pain. For each individual patient, FBT should be titrated to the effective dose. Objective The primary objective was to characterize the pharmacokinetic parameters of FBT 400 µg administered as a single 400 µg tablet (regimen A) or as two 200 µg tablets given simultaneously (regimen B) and determine whether these are bioequivalent in healthy Japanese volunteers. Regimen C (two 200 µg tablets 30 minutes apart) was also compared as a secondary objective. Methods Healthy Japanese adults received regimens A, B, and C in a crossover fashion. Naltrexone was given to minimize the opioid effects of fentanyl. Serum fentanyl concentrations were determined in venous blood collected through 36 hours post dose. Regimens were declared bioequivalent with respect to bioavailability (as reflected by AUC0–∞, AUC0–last, and Cmax) if the 90% confidence interval (CI) of the regimens' ratio fell within 0.80–1.25 (80%–125%). Results Twenty-nine volunteers (13 men, 16 women) were enrolled; 24 completed the study. Regimens A and B had bioequivalent systemic exposure parameters (B/A [90% CI]: AUC0–∞108.4 [103.4, 113.7], AUC0–last 106.1 [100.7, 111.7], and Cmax 92.3 [83.2, 102.4]). Regimen C was bioequivalent to both A and B for AUCs, but only to B for Cmax. Median time to Cmax was 45 minutes for regimen A and 60 minutes for regimens B and C. The most frequent AEs were dizziness, application-site erythema, headache, somnolence, nausea, and vomiting. All AEs were mild or moderate. Conclusions Bioavailability of fentanyl after FBT 400 µg administered as a single tablet was bioequivalent to that after 2 simultaneously administered 200 µg tablets in healthy Japanese volunteers. AEs were mild or moderate. PMID

  18. Influenza viral load and peramivir kinetics after single administration and proposal of regimens for peramivir administration against resistant variants.

    PubMed

    Sato, Masatoki; Ito, Masaki; Suzuki, Shigeo; Sakuma, Hiroko; Takeyama, Aya; Oda, Shinichi; Watanabe, Masahiro; Hashimoto, Koichi; Miyazaki, Kyohei; Kawasaki, Yukihiko; Hosoya, Mitsuaki

    2015-03-01

    We estimated the efficacy of the current single administration of peramivir on the basis of peramivir pharmacokinetics in the upper respiratory tract (URT) and determined the predictive peramivir concentration-time curve to assess its efficacy against viruses with decreased susceptibility to neuraminidase inhibitors. Serum, nasal swab, or aspiration samples were collected from 28 patients treated with 10 mg/kg body weight peramivir. The sequential influenza viral RNA load and susceptibility after peramivir administration were measured using a quantitative real-time reverse transcription-PCR and neuraminidase inhibition assay. The peramivir concentrations in the serum and URT after a single administration at 10 mg/kg were measured, and the predictive blood and URT peramivir concentration-time curves were determined to assess various administration regimens against resistant variants. The peramivir concentration decreased to <0.1% of the maximum concentration of drug in serum (Cmax) at 24 h after administration. Rapid elimination of peramivir from the URT by 48 h after administration may contribute to an increase in the influenza A viral load after day 3 but not to a decrease in the influenza B viral load, despite the absence of a decrease in the susceptibility to peramivir. A longer maintenance of a high level of peramivir in the URT is expected by divided administration rather than once-daily administration. When no clinical improvement is observed in patients with normal susceptibility influenza A and B, peramivir readministration should be considered. In severe cases caused by resistant variants, better inhibitory effectiveness and less frequent adverse events are expected by divided administration rather than once-daily administration with an increased dosage. PMID:25547357

  19. Influenza Viral Load and Peramivir Kinetics after Single Administration and Proposal of Regimens for Peramivir Administration against Resistant Variants

    PubMed Central

    Ito, Masaki; Suzuki, Shigeo; Sakuma, Hiroko; Takeyama, Aya; Oda, Shinichi; Watanabe, Masahiro; Hashimoto, Koichi; Miyazaki, Kyohei; Kawasaki, Yukihiko; Hosoya, Mitsuaki

    2014-01-01

    We estimated the efficacy of the current single administration of peramivir on the basis of peramivir pharmacokinetics in the upper respiratory tract (URT) and determined the predictive peramivir concentration-time curve to assess its efficacy against viruses with decreased susceptibility to neuraminidase inhibitors. Serum, nasal swab, or aspiration samples were collected from 28 patients treated with 10 mg/kg body weight peramivir. The sequential influenza viral RNA load and susceptibility after peramivir administration were measured using a quantitative real-time reverse transcription-PCR and neuraminidase inhibition assay. The peramivir concentrations in the serum and URT after a single administration at 10 mg/kg were measured, and the predictive blood and URT peramivir concentration-time curves were determined to assess various administration regimens against resistant variants. The peramivir concentration decreased to <0.1% of the maximum concentration of drug in serum (Cmax) at 24 h after administration. Rapid elimination of peramivir from the URT by 48 h after administration may contribute to an increase in the influenza A viral load after day 3 but not to a decrease in the influenza B viral load, despite the absence of a decrease in the susceptibility to peramivir. A longer maintenance of a high level of peramivir in the URT is expected by divided administration rather than once-daily administration. When no clinical improvement is observed in patients with normal susceptibility influenza A and B, peramivir readministration should be considered. In severe cases caused by resistant variants, better inhibitory effectiveness and less frequent adverse events are expected by divided administration rather than once-daily administration with an increased dosage. PMID:25547357

  20. Motif-Optimized Subtype A HIV Envelope-based DNA Vaccines Rapidly Elicit Neutralizing Antibodies When Delivered Sequentially

    PubMed Central

    Pissani, Franco; Malherbe, Delphine C.; Robins, Harlan; DeFilippis, Victor R.; Park, Byung; Sellhorn, George; Stamatatos, Leonidas; Overbaugh, Julie; Haigwood, Nancy L.

    2012-01-01

    HIV-1 infection results in the development of a diverging quasispecies unique to each infected individual. Envelope (Env)-specific neutralizing antibodies (NAbs) typically develop over months to years after infection and initially are limited to the infecting virus. In some subjects, antibody responses develop that neutralize heterologous isolates (HNAbs), a phenomenon termed broadening of the NAb response. Studies of co-crystalized antibodies and proteins have facilitated the identification of some targets of broadly neutralizing monoclonal antibodies (NmAbs) capable of neutralizing many or most heterologous viruses; however, the ontogeny of these antibodies in vivo remains elusive. We hypothesize that Env protein escape variants stimulate broad NAb development in vivo and could generate such NAbs when used as immunogens. Here we test this hypothesis in rabbits using HIV Env vaccines featuring: (1) use of individual quasispecies env variants derived from an HIV-1 subtype A-infected subject exhibiting high levels of NAbs within the first year of infection that increased and broadened with time; (2) motif optimization of envs to enhance in vivo expression of DNA formulated as vaccines; and (3) a combined DNA plus protein boosting regimen. Vaccines consisted of multiple env variants delivered sequentially and a simpler regimen that utilized only the least and most divergent clones. The simpler regimen was as effective as the more complex approach in generating modest HNAbs and was more efficient when modified, motif-optimized DNA was used in combination with trimeric gp140 protein. This is a rationally designed strategy that facilitates future vaccine design by addressing the difficult problem of generating HNAbs to HIV by empirically testing the immunogenicity of naturally occurring quasispecies env variants. PMID:22749601

  1. Classifying insulin regimens--difficulties and proposal for comprehensive new definitions.

    PubMed

    Neu, A; Lange, K; Barrett, T; Cameron, F; Dorchy, H; Hoey, H; Jarosz-Chobot, P; Mortensen, H B; Robert, J-J; Robertson, K; de Beaufort, C

    2015-09-01

    Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1 diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the concepts 'conventional' and 'intensified', several other terms for the characterization of insulin regimens are in use: Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) are most frequently used, although none of these expressions is clearly or consistently defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen. PMID:25865149

  2. The role of feeding regimens in regulating metabolism of sexually mature broiler breeders.

    PubMed

    Ekmay, R D; de Beer, M; Rosebrough, R W; Richards, M P; McMurtry, J P; Coon, C N

    2010-06-01

    A trial was conducted to determine the effects of different rearing feed regimens on plasma hormone and metabolite levels and hepatic lipid metabolism and gene expression on sexually mature broiler breeders. Cobb 500 birds were divided into 2 groups at 4 wk and fed either an everyday (ED) or skip-a-day (SKP) regimen. At 24 wk of age, all birds were switched over to an ED regimen. At 26.4 wk, breeder hens were randomly selected and killed at intervals after feeding. Livers were sampled from 4 hens at 4-h intervals for 24 h for a total of 28 samples per treatment. Blood was sampled from 4 hens per sampling time; sampling times were 0, 30, and 60 min and 2 and 4 h after feeding and then every 4 h up to 24 h for a total of 36 samples per treatment. Main feeding regimen, time, and interaction effects were analyzed. Significant interaction effects were found between time and feeding regimen for acetyl-coenzyme A carboxylase and malic enzyme mRNA expression. The peak for acetyl-coenzyme A carboxylase expression was higher in ED-reared birds, whereas the peak for malic enzyme expression was higher in SKP-reared birds. Overall, plasma levels of insulin-like growth factor-II were higher in SKP-reared birds. Overall, plasma corticosterone levels were also higher in SKP-reared birds and significant interaction effects between time and feeding regimen were seen. The expression of apolipoprotein A1 was significantly higher in ED-reared birds: significant interaction effects were also noted. Other researchers also found some of the differences observed in the present study in 16-wk-old pullets. In summary, different feeding regimens alter metabolic responses, some of which carry over into sexual maturity. PMID:20460664

  3. Outcome after Transplantation According to Reduced-Intensity Conditioning Regimen in Patients Undergoing Transplantation for Myelofibrosis.

    PubMed

    Robin, Marie; Porcher, Raphael; Wolschke, Christine; Sicre de Fontbrune, Flore; Alchalby, Haefaa; Christopeit, Maximilian; Cassinat, Bruno; Zabelina, Tatjana; Peffault de Latour, Régis; Ayuk, Francis; Socié, Gérard; Kröger, Nicolaus

    2016-07-01

    Allogeneic hematopoietic stem cell transplantation remains the sole curative option for myelofibrosis. Many transplantation recipients receive a reduced-intensity conditioning (RIC) regimen owing to age or comorbidities; however, there is little published evidence to guide the choice of RIC regimen. In this study, we compared outcomes in patients who received 1 of 2 frequently used RIC regimens for patients with myelofibrosis: fludarabine-busulfan (FB) and fludarabine-melphalan (FM). A total of 160 patients underwent a RIC allograft procedure (FB group, n = 105; FM group, n = 55). We have developed a complex statistical model involving weighting and adjustment to permit comparison between these 2 groups. After weighting, the incidence of acute graft-versus-host disease (GVHD) was 62% in the FM group and 31% in the FB group (P = .001), and the corresponding incidence of chronic GVHD was 49% and 53%, respectively. The 7-year progression-free survival was were 52% in the FM group versus 33% in the FB group, and the 7-year overall survival rate 52% in the FM group versus 59% in the FB group. Nonrelapse mortality (NRM) was 43% in the FM group and 31% in the FB group. Multivariable analyses revealed no significant differences in PFS between the 2 groups; however, the relapse rate was significantly lower in the FM group (hazard ratio, 9.21; P = .008), whereas a trend toward reduced NRM was seen in the FB group (hazard ratio, 0.51; P = .068). In conclusion, both regimens appear to be efficient in mediating disease control and can be used to successfully condition patients with myelofibrosis. The FM regimen appears to induce more NRM than the FB regimen, but with augmented control of disease, leading to comparable overall survival rates for both regimens. PMID:26970380

  4. The importance of the regimen of screening in maximizing the benefit and minimizing the harms

    PubMed Central

    Li, Kunwei; Yip, Rowena; Salvatore, Mary; Yankelevitz, David F.

    2016-01-01

    Background In CT screening for lung cancer, the regimen of screening is critical in diagnosing lung cancer early while limiting unnecessary tests and invasive procedures. The International Early Lung Cancer Action Program (I-ELCAP) has developed a regimen based on evidence collected in the I-ELCAP cohort of more than 70,000 participants. Methods Important in the development of the regimen is the recognition of the profound difference between the first, baseline round of screening and all subsequent rounds of repeat screening. For each person undergoing screening, the baseline round happens only once while repeat rounds will be performed annually for many years. This difference needs to be clearly recognized as it is these annual rounds which allow for identification of small, early, yet aggressive, lung cancers which have high cure rates despite their aggressiveness. The importance of nodule consistency and size are key factors in the regimen. The regimen needs to be continuously updated by incorporating advances in technology and knowledge. Results The use of the I-ELCAP regimen reduces the workup of participants in the screening program to less than 10% in the baseline round and less than 6% in the annual repeat rounds. By use of this regimen, estimated cure rate of lung cancers diagnosed under screening is 80% or higher in both baseline and annual repeat rounds. Conclusions The I-ELCAP collaboration provides a new paradigm that answers the 2002 NCI call for multiple approaches to address relevant questions about screening and the Institute of Medicine (IOM) Roundtable on Evidence-based Medicine from the National Academy of Science’s call for a “new clinical research paradigm that takes better advantage of data generated in the course of healthcare delivery would speed and improve the development of evidence for real-world decision making”. PMID:27195271

  5. Sequential experimental design based generalised ANOVA

    NASA Astrophysics Data System (ADS)

    Chakraborty, Souvik; Chowdhury, Rajib

    2016-07-01

    Over the last decade, surrogate modelling technique has gained wide popularity in the field of uncertainty quantification, optimization, model exploration and sensitivity analysis. This approach relies on experimental design to generate training points and regression/interpolation for generating the surrogate. In this work, it is argued that conventional experimental design may render a surrogate model inefficient. In order to address this issue, this paper presents a novel distribution adaptive sequential experimental design (DA-SED). The proposed DA-SED has been coupled with a variant of generalised analysis of variance (G-ANOVA), developed by representing the component function using the generalised polynomial chaos expansion. Moreover, generalised analytical expressions for calculating the first two statistical moments of the response, which are utilized in predicting the probability of failure, have also been developed. The proposed approach has been utilized in predicting probability of failure of three structural mechanics problems. It is observed that the proposed approach yields accurate and computationally efficient estimate of the failure probability.

  6. Sequential Immune Responses: The Weapons of Immunity

    PubMed Central

    Mills, Charles D.; Ley, Klaus; Buchmann, Kurt; Canton, Johnathan

    2016-01-01

    Sequential immune responses (SIR) is a new model that describes what ‘immunity’ means in higher animals. Existing models, such as self/nonself discrimination or danger, focus on how immune responses are initiated. However, initiation is not protection. SIR describes the actual immune responses that provide protection. SIR resulted from a comprehensive analysis of the evolution of immune systems that revealed that several very different types of host innate responses occur (and at different tempos) which together provide host protection. SIR1 uses rapidly activated enzymes like the NADPH oxidases and is present in all animal cells. SIR2 is mediated by the first ‘immune’ cells: macrophage-like cells. SIR3 evolved in animals like invertebrates and provides enhanced protection through advanced macrophage recognition and killing of pathogens and through other innate immune cells such as neutrophils. Finally, in vertebrates, macrophages developed SIR4: the ability to present antigens to T cells. Though much slower than SIR1–3, adaptive responses provide a unique new protection for higher vertebrates. Importantly, newer SIR responses were added on top of older, evolutionarily conserved functions to provide ‘layers’ of host protection. SIR transcends existing models by elucidating the different weapons of immunity that provide host protection in higher animals. PMID:25871013

  7. Multifunctional Magnetoliposomes for Sequential Controlled Release.

    PubMed

    Salvatore, Annalisa; Montis, Costanza; Berti, Debora; Baglioni, Piero

    2016-08-23

    The simultaneous or sequential delivery of multiple therapeutic active principles to a specific target is one of the main challenges of nanomedicine. This goal requires the construction of complex devices often extremely time and cost consuming. Supramolecular self-assemblies, with building blocks of different nature, each providing a specific function to the final construct, can combine a facile synthetic route with a high tunability and structural control. In this study we provide the proof-of-principle of a drug delivery system, DDS, constituted of (i) liposomes, providing a fully biocompatible lipid scaffold suitable to host both hydrophobic and hydrophilic drugs; (ii) a double-stranded DNA conjugated with a cholesteryl unit that spontaneously inserts into the lipid membrane; and (iii) hydrophobic and hydrophilic superparamagnetic iron oxide nanoparticles (SPIONs) embedded inside the lipid membrane of liposomes or connected to the DNA, respectively. Upon application of an alternating magnetic field, the SPIONs can trigger, through thermal activation, the release of a DNA strand or of the liposomal payload, depending on the frequency and the application time of the field, as proved by both steady-state and time-resolved fluorescence studies. This feature is due to the different localization of the two kinds of SPIONS within the construct and demonstrates the feasibility of a multifunctional DDS, built up from self-assembly of biocompatible building blocks. PMID:27504891

  8. DNA-nanostructure-assembly by sequential spotting

    PubMed Central

    2011-01-01

    Background The ability to create nanostructures with biomolecules is one of the key elements in nanobiotechnology. One of the problems is the expensive and mostly custom made equipment which is needed for their development. We intended to reduce material costs and aimed at miniaturization of the necessary tools that are essential for nanofabrication. Thus we combined the capabilities of molecular ink lithography with DNA-self-assembling capabilities to arrange DNA in an independent array which allows addressing molecules in nanoscale dimensions. Results For the construction of DNA based nanostructures a method is presented that allows an arrangement of DNA strands in such a way that they can form a grid that only depends on the spotted pattern of the anchor molecules. An atomic force microscope (AFM) has been used for molecular ink lithography to generate small spots. The sequential spotting process allows the immobilization of several different functional biomolecules with a single AFM-tip. This grid which delivers specific addresses for the prepared DNA-strand serves as a two-dimensional anchor to arrange the sequence according to the pattern. Once the DNA-nanoarray has been formed, it can be functionalized by PNA (peptide nucleic acid) to incorporate advanced structures. Conclusions The production of DNA-nanoarrays is a promising task for nanobiotechnology. The described method allows convenient and low cost preparation of nanoarrays. PNA can be used for complex functionalization purposes as well as a structural element. PMID:22099392

  9. Bilingual control: sequential memory in language switching.

    PubMed

    Declerck, Mathieu; Philipp, Andrea M; Koch, Iring

    2013-11-01

    To investigate bilingual language control, prior language switching studies presented visual objects, which had to be named in different languages, typically indicated by a visual cue. The present study examined language switching of predictable responses by introducing a novel sequence-based language switching paradigm. In 4 experiments, sequential responses (i.e., weekdays, numbers or new sequences) and an alternating language sequence (e.g., L1-L1-L2-L2) were implemented, both of which were memory based. Our data revealed switch costs, showing that a language switch is associated with worse performance compared with a language repetition, and mixing costs, which constitutes the performance difference between pure and mixed language blocks, even while producing entirely predictable responses (i.e., language and concept). Additionally, we found these switch costs with overlearned and new sequences and found that switch costs were reduced with longer preparation time. The obtained data are consistent with a proactive interference account, such as the inhibitory control model. PMID:23773181

  10. Sequential Auctions in Uncertain Information Settings

    NASA Astrophysics Data System (ADS)

    Fatima, Shaheen; Wooldridge, Michael; Jennings, Nicholas R.

    This paper analyzes sequential auctions for private value objects using second-price sealed-bid rules. Now, the equilibrium bids for such auctions depend on the information uncertainty of the bidders. Specifically, there are three key auction parameters that the bidders could be uncertain about: the valuations of the objects for sale, the number of objects for sale, and the number of participating bidders. We analyse the bidding behaviour for each of these three sources of uncertainty. For each setting, we first find the equilibrium bidding strategies for the individual auctions that comprise a series. Then we analyze the effect of these uncertainties on the computational and economic properties of the equilibrium solution. The former analysis is essential if we want to use software agents to bid on our behalf. The latter is essential because both the auctioneer and the bidders want to know how these uncertainties affect their profits. Thus we compare the outcomes for these settings from the perspective of the bidders (i.e., in terms of their profits), from the perspective of the auctioneer (i.e., in terms of his revenue), and from a global perspective (i.e., in terms of auction efficiency).

  11. Sequential detection of learning in cognitive diagnosis.

    PubMed

    Ye, Sangbeak; Fellouris, Georgios; Culpepper, Steven; Douglas, Jeff

    2016-05-01

    In order to look more closely at the many particular skills examinees utilize to answer items, cognitive diagnosis models have received much attention, and perhaps are preferable to item response models that ordinarily involve just one or a few broadly defined skills, when the objective is to hasten learning. If these fine-grained skills can be identified, a sharpened focus on learning and remediation can be achieved. The focus here is on how to detect when learning has taken place for a particular attribute and efficiently guide a student through a sequence of items to ultimately attain mastery of all attributes while administering as few items as possible. This can be seen as a problem in sequential change-point detection for which there is a long history and a well-developed literature. Though some ad hoc rules for determining learning may be used, such as stopping after M consecutive items have been successfully answered, more efficient methods that are optimal under various conditions are available. The CUSUM, Shiryaev-Roberts and Shiryaev procedures can dramatically reduce the time required to detect learning while maintaining rigorous Type I error control, and they are studied in this context through simulation. Future directions for modelling and detection of learning are discussed. PMID:26931602

  12. Field-Sequential Electronic Stereoscopic Projector

    NASA Astrophysics Data System (ADS)

    Lipton, Lenny

    1989-07-01

    Culminating a research and development project spanning many years, StereoGraphics Corporation has succeeded in bringing to market the first field-sequential electronic stereoscopic projector. The product is based on a modification of Electrohome and Barco projectors. Our design goal was to produce a projector capable of displaying an image on a six-foot (or larger) diagonal screen for an audience of 50 or 60 people, or for an individual using a simulator. A second goal was to produce an image that required only passive polarizing glasses rather than powered, tethered visors. Two major design challenges posed themselves. First, it was necessary to create an electro-optical modulator which could switch the characteristic of polarized light at field rate, and second, it was necessary to produce a bright green CRT with short persistence to prevent crosstalk between left and right fields. To solve the first problem, development was undertaken to produce the required electro-optical modulator. The second problem was solved with the help of a vendor specializing in high performance CRT's.

  13. Online Sequential Extreme Learning Machine With Kernels.

    PubMed

    Scardapane, Simone; Comminiello, Danilo; Scarpiniti, Michele; Uncini, Aurelio

    2015-09-01

    The extreme learning machine (ELM) was recently proposed as a unifying framework for different families of learning algorithms. The classical ELM model consists of a linear combination of a fixed number of nonlinear expansions of the input vector. Learning in ELM is hence equivalent to finding the optimal weights that minimize the error on a dataset. The update works in batch mode, either with explicit feature mappings or with implicit mappings defined by kernels. Although an online version has been proposed for the former, no work has been done up to this point for the latter, and whether an efficient learning algorithm for online kernel-based ELM exists remains an open problem. By explicating some connections between nonlinear adaptive filtering and ELM theory, in this brief, we present an algorithm for this task. In particular, we propose a straightforward extension of the well-known kernel recursive least-squares, belonging to the kernel adaptive filtering (KAF) family, to the ELM framework. We call the resulting algorithm the kernel online sequential ELM (KOS-ELM). Moreover, we consider two different criteria used in the KAF field to obtain sparse filters and extend them to our context. We show that KOS-ELM, with their integration, can result in a highly efficient algorithm, both in terms of obtained generalization error and training time. Empirical evaluations demonstrate interesting results on some benchmarking datasets. PMID:25561597

  14. Constraint-based evaluation of sequential procedures

    NASA Technical Reports Server (NTRS)

    Barry, Matthew R.

    1990-01-01

    Constraining the operation of an agent requires knowledge of the restrictions to physical and temporal capabilities of that agent, as well as an inherent understanding of the desires being processed by that agent. Usually a set of constraints are available that must be adhered to in order to foster safe operations. In the worst case, violation of a constraint may be cause to terminate operation. If the agent is carrying out a plan, then a method for predicting the agent's desires, and therefore possible constraint violations, is required. The conceptualization of constraint-based reasoning used herein assumes that a system knows how to select a constraint for application as well as how to apply that constraint once it is selected. The application of constraint-based reasoning for evaluating certain kinds of plans known as sequential procedures is discussed. By decomposing these plans, it is possible to apply context dependent constraints in production system fashion without incorporating knowledge of the original planning process.

  15. Testing constrained sequential dominance models of neutrinos

    NASA Astrophysics Data System (ADS)

    Björkeroth, Fredrik; King, Stephen F.

    2015-12-01

    Constrained sequential dominance (CSD) is a natural framework for implementing the see-saw mechanism of neutrino masses which allows the mixing angles and phases to be accurately predicted in terms of relatively few input parameters. We analyze a class of CSD(n) models where, in the flavour basis, two right-handed neutrinos are dominantly responsible for the ‘atmospheric’ and ‘solar’ neutrino masses with Yukawa couplings to ({ν }e,{ν }μ ,{ν }τ ) proportional to (0,1,1) and (1,n,n-2), respectively, where n is a positive integer. These coupling patterns may arise in indirect family symmetry models based on A 4. With two right-handed neutrinos, using a χ 2 test, we find a good agreement with data for CSD(3) and CSD(4) where the entire Pontecorvo-Maki-Nakagawa-Sakata mixing matrix is controlled by a single phase η, which takes simple values, leading to accurate predictions for mixing angles and the magnitude of the oscillation phase | {δ }{CP}| . We carefully study the perturbing effect of a third ‘decoupled’ right-handed neutrino, leading to a bound on the lightest physical neutrino mass {m}1{{≲ }}1 meV for the viable cases, corresponding to a normal neutrino mass hierarchy. We also discuss a direct link between the oscillation phase {δ }{CP} and leptogenesis in CSD(n) due to the same see-saw phase η appearing in both the neutrino mass matrix and leptogenesis.

  16. Sequential dynamical systems with threshold functions.

    SciTech Connect

    Barrett, C. L.; Hunt, H. B.; Marathe, M. V.; Ravi, S. S.; Rosenkrantz, D. J.; Stearns, R. E.

    2001-01-01

    A sequential dynamical system (SDS) (see [BH+01] and the references therein) consists of an undirected graph G(V,E) where each node {nu} {epsilon} V is associated with a Boolean state (s{sub {nu}}) and a symmetric Boolean function f{sub {nu}} (called the local transition function at {nu}). The inputs to f{sub {nu}} are s{sub {nu}} and the states of all the nodes adjacent to {nu}. In each step of the SDS, the nodes update their state values using their local transition functions in the order specified by a given permutation {pi} of the nodes. A configuration of the SDS is an n-tuple (b{sub 1}, b{sub 2}...,b{sub n}) where n = |V| and b{sub i} {epsilon} {l_brace}0,1{r_brace} is the state value of node {nu}{sub i}. The system starts in a specified initial configuration and each step of the SDS produces a (possibly new) configuration.

  17. Sequential Changepoint Approach for Online Community Detection

    NASA Astrophysics Data System (ADS)

    Marangoni-Simonsen, David; Xie, Yao

    2015-08-01

    We present new algorithms for detecting the emergence of a community in large networks from sequential observations. The networks are modeled using Erdos-Renyi random graphs with edges forming between nodes in the community with higher probability. Based on statistical changepoint detection methodology, we develop three algorithms: the Exhaustive Search (ES), the mixture, and the Hierarchical Mixture (H-Mix) methods. Performance of these methods is evaluated by the average run length (ARL), which captures the frequency of false alarms, and the detection delay. Numerical comparisons show that the ES method performs the best; however, it is exponentially complex. The mixture method is polynomially complex by exploiting the fact that the size of the community is typically small in a large network. However, it may react to a group of active edges that do not form a community. This issue is resolved by the H-Mix method, which is based on a dendrogram decomposition of the network. We present an asymptotic analytical expression for ARL of the mixture method when the threshold is large. Numerical simulation verifies that our approximation is accurate even in the non-asymptotic regime. Hence, it can be used to determine a desired threshold efficiently. Finally, numerical examples show that the mixture and the H-Mix methods can both detect a community quickly with a lower complexity than the ES method.

  18. Social Influences in Sequential Decision Making

    PubMed Central

    Schöbel, Markus; Rieskamp, Jörg; Huber, Rafael

    2016-01-01

    People often make decisions in a social environment. The present work examines social influence on people’s decisions in a sequential decision-making situation. In the first experimental study, we implemented an information cascade paradigm, illustrating that people infer information from decisions of others and use this information to make their own decisions. We followed a cognitive modeling approach to elicit the weight people give to social as compared to private individual information. The proposed social influence model shows that participants overweight their own private information relative to social information, contrary to the normative Bayesian account. In our second study, we embedded the abstract decision problem of Study 1 in a medical decision-making problem. We examined whether in a medical situation people also take others’ authority into account in addition to the information that their decisions convey. The social influence model illustrates that people weight social information differentially according to the authority of other decision makers. The influence of authority was strongest when an authority's decision contrasted with private information. Both studies illustrate how the social environment provides sources of information that people integrate differently for their decisions. PMID:26784448

  19. The Origin of Sequential Chromospheric Brightening

    NASA Astrophysics Data System (ADS)

    Kirk, Michael S.; Balasubramaniam, K. S.; Jackiewicz, Jason; Gilbert, Holly

    2016-05-01

    Sequential Chromospheric Brightenings (SCBs) are often observed in the immediate vicinity of erupting flares and are associated with coronal mass ejections. When SCBs are observed, they routinely appear before the peak emission of the flare and several hours before the first detection of a coupled CME. Since their initial discovery in 2005, there have been several subsequent investigations of SCBs. In each case, these sudden, small-scale brightenings provide vital clues regarding the mechanisms of large-scale energy release in the solar atmosphere. We make use of an automated detection algorithm developed by Kirk et al. (2013) to extract the physical qualities of SCBs in 11 flares of varying size and intensity. Using complementary magnetic field measurements, we also model the potential field beneath these brightenings. We conclude that SCBs originate in the lower corona around 0.1 R⊙ above the photosphere, propagate away from the flare center at speeds 35 ‑ 85 km s‑1, and have typical photosphere magnetic intensities 257± 37 G. In light of these measurements, we conclude that SCBs are distinctive chromospheric signatures of erupting coronal mass ejections.

  20. Cooperation induced by random sequential exclusion

    NASA Astrophysics Data System (ADS)

    Li, Kun; Cong, Rui; Wang, Long

    2016-06-01

    Social exclusion is a common and powerful tool to penalize deviators in human societies, and thus to effectively elevate collaborative efforts. Current models on the evolution of exclusion behaviors mostly assume that each peer excluder independently makes the decision to expel the defectors, but has no idea what others in the group would do or how the actual punishment effect will be. Thus, a more realistic model, random sequential exclusion, is proposed. In this mechanism, each excluder has to pay an extra scheduling cost and then all the excluders are arranged in a random order to implement the exclusion actions. If one free rider has already been excluded by an excluder, the remaining excluders will not participate in expelling this defector. We find that this mechanism can help stabilize cooperation under more unfavorable conditions than the normal peer exclusion can do, either in well-mixed population or on social networks. However, too large a scheduling cost may undermine the advantage of this mechanism. Our work validates the fact that collaborative practice among punishers plays an important role in further boosting cooperation.

  1. Sequential control by speed drive for ac motor

    NASA Astrophysics Data System (ADS)

    Barsoum, Nader

    2012-11-01

    The speed drive for ac motor is widely used in the industrial field to allow direct control for the speed and torque without any feedback from the motor shaft. By using the ABB ACS800 speed drive unit, the speed and torque can be controlled using sequential control method. Sequential control is one of the application control method provided in the ABB ACS800 Drive, where a set of events or action performed in a particular order one after the other to control the speed and torque of the ac motor. It was claimed that sequential control method is using the preset seven constant speeds being provided in ABB ACS800 drive to control the speed and torque in a continuous and sequential manner. The characteristics and features of controlling the speed and torque using sequential control method can be investigated by observing the graphs and curves plotted which are obtained from the practical result. Sequential control can run either in the Direct Torque Control (DTC) or Scalar motor control mode. By using sequential control method, the ABB ACS800 drive can be programmed to run the motor automatically according to the time setting of the seven preset constant speeds. Besides, the intention of this project is to generate a new form of the experimental set up.

  2. Improving the recognition of eating gestures using intergesture sequential dependencies.

    PubMed

    Ramos-Garcia, Raul I; Muth, Eric R; Gowdy, John N; Hoover, Adam W

    2015-05-01

    This paper considers the problem of recognizing eating gestures by tracking wrist motion. Eating gestures are activities commonly undertaken during the consumption of a meal, such as sipping a drink of liquid or using utensils to cut food. Each of these gestures causes a pattern of wrist motion that can be tracked to automatically identify the activity. Previous works have studied this problem at the level of a single gesture. In this paper, we demonstrate that individual gestures have sequential dependence. To study this, three types of classifiers were built: 1) a K-nearest neighbor classifier which uses no sequential context, 2) a hidden Markov model (HMM) which captures the sequential context of subgesture motions, and 3) HMMs that model intergesture sequential dependencies. We built first-order to sixth-order HMMs to evaluate the usefulness of increasing amounts of sequential dependence to aid recognition. On a dataset of 25 meals, we found that the baseline accuracies for the KNN and the subgesture HMM classifiers were 75.8% and 84.3%, respectively. Using HMMs that model intergesture sequential dependencies, we were able to increase accuracy to up to 96.5%. These results demonstrate that sequential dependencies exist between eating gestures and that they can be exploited to improve recognition accuracy. PMID:24919205

  3. Hand hygiene regimens for the reduction of risk in food service environments.

    PubMed

    Edmonds, Sarah L; McCormack, Robert R; Zhou, Sifang Steve; Macinga, David R; Fricker, Christopher M

    2012-07-01

    Pathogenic strains of Escherichia coli and human norovirus are the main etiologic agents of foodborne illness resulting from inadequate hand hygiene practices by food service workers. This study was conducted to evaluate the antibacterial and antiviral efficacy of various hand hygiene product regimens under different soil conditions representative of those in food service settings and assess the impact of product formulation on this efficacy. On hands contaminated with chicken broth containing E. coli, representing a moderate soil load, a regimen combining an antimicrobial hand washing product with a 70% ethanol advanced formula (EtOH AF) gel achieved a 5.22-log reduction, whereas a nonantimicrobial hand washing product alone achieved a 3.10log reduction. When hands were heavily soiled from handling ground beef containing E. coli, a wash-sanitize regimen with a 0.5% chloroxylenol antimicrobial hand washing product and the 70% EtOH AF gel achieved a 4.60-log reduction, whereas a wash-sanitize regimen with a 62% EtOH foam achieved a 4.11-log reduction. Sanitizing with the 70% EtOH AF gel alone was more effective than hand washing with a nonantimicrobial product for reducing murine norovirus (MNV), a surrogate for human norovirus, with 2.60- and 1.79-log reductions, respectively. When combined with hand washing, the 70% EtOH AF gel produced a 3.19-log reduction against MNV. A regimen using the SaniTwice protocol with the 70% EtOH AF gel produced a 4.04-log reduction against MNV. These data suggest that although the process of hand washing helped to remove pathogens from the hands, use of a wash-sanitize regimen was even more effective for reducing organisms. Use of a high-efficacy sanitizer as part of a wash-sanitize regimen further increased the efficacy of the regimen. The use of a well-formulated alcohol-based hand rub as part of a wash-sanitize regimen should be considered as a means to reduce risk of infection transmission in food service facilities. PMID

  4. Evaluation of an Alternative Intravenous N-Acetylcysteine Regimen in Pediatric Patients

    PubMed Central

    Sandritter, Tracy L.; Lowry, Jennifer A.; Algren, D. Adam

    2015-01-01

    OBJECTIVE: Conventionally, intravenous N-acetylcysteine (IV-NAC) administration is a 3-bag regimen administered over the course of 21 hours, which increases the risk of reconstitution and administration errors. To minimize errors, an alternative IV-NAC regimen consists of a loading dose (150 mg/kg) followed by a maintenance infusion (15 mg/kg/hr) until termination criteria are met. The aim was to determine the clinical outcomes of an alternative IV-NAC regimen in pediatric patients. METHODS: A retrospective review of pharmacy dispensing records and diagnostic codes at a pediatric hospital identified patients who received alternative IV-NAC dosing from March 1, 2008, to September 10, 2012, for acetaminophen overdoses. Exclusion criteria included chronic liver disease, initiation of oral or other IV-NAC regimens, and initiation of standard IV-NAC infusion prior to facility transfer. Clinical and laboratory data were abstracted from the electronic medical record. Descriptive statistics were utilized. Clinical outcomes and adverse drug reaction incidences were compared between the alternative and Food and Drug Administration (FDA)–approved IV-NAC regimens. RESULTS: Fifty-nine patients (mean age 13.4 ± 4.3 years; range: 2 months-18 years) with acetaminophen overdoses were identified. Upon IV-NAC discontinuation, 45 patients had normal alanine transaminase (ALT) concentrations, while 14 patients' ALT concentrations remained elevated (median 140 units/L) but were trending downward. Two patients (3.4%) developed hepatotoxicity (aspartate transaminase/ALT > 1000 units/L). No patients developed hepatic failure, were listed for a liver transplant, were intubated, underwent hemodialysis, or died. Two patients (3.4%) developed anaphylactoid reactions. No known medication or administration errors occurred. Clinical outcome incidences of the studied endpoints with the alternative IV-NAC regimen are at the lower end of published incidence ranges compared to the FDA IV

  5. [Sequential Chemoradiotherapy for Advanced Head and Neck Cancer: A Clinical Study with 33 Cases].

    PubMed

    Takahashi, Katsumasa; Nakajima, Kyoko; Murata, Takaaki; Shino, Masato; Nikkuni, Osamu; Toyoda, Minoru; Takayasu, Yukihiro; Chikamatsu, Kazuaki

    2016-05-01

    A total of 33 patients with advanced head and neck cancer (AHNC) treated with sequential chemoradiotherapy (SCRT) were retrospectively evaluated at Gunma University Hospital between 2009 and 2011. The regimen of SCRT was docetaxel, cisplatin, and fluorouracil (TPF)-based induction chemotherapy (ICT), accompanied by docetaxel and cisplatin-based concurrent chemoradiotherapy (CCRT), and oral administration of TS-1 after that. The response rate was 61%, the 3-year overall survival rate was 42%, the non-tumor-bearing survival rate was 27%, and the tumor-bearing survival rate was 15%. Fourteen of 33 patients were tumor-free, and their 3-year overall survival rate was surprisingly 86%. On the other hand, 3-year overall survival rate in the remaining 19 patients was significantly low. To select good response cases for ICT was important. In such cases, TPF should be applied repeatedly, which achieved a 61% response rate even in AHNC. A long-term TS-1 oral medication suppressed cancer regrowth and contributed to long-term survival. PMID:27459819

  6. Aluminum uptake and inhibition of enamel dissolution by sequential treatments with aluminum solutions.

    PubMed

    Kleber, C J; Putt, M S

    1994-01-01

    The effects of sequentially applied solutions containing aluminum (Al) on enamel uptake and inhibition of acid dissolution were investigated. Following 10 consecutive 5-min treatments with seven Al solutions varying in concentration from 0.15 to 2.0 mmol/l, the subsequent acid dissolution of enamel was progressively reduced from 0 to over 70%. Teeth treated with 1.5 mmol/l Al from 1 to 30 consecutive 5-min periods demonstrated a stepwise increase in the reduction of enamel acid dissolution ranging from about 10 to 90%. Following the same treatment regimen, the amount of Al deposited in the enamel varied from 2,500 ppm after a single 5-min application to approximately 9,000 ppm after 20 or 30 consecutive treatments. These experiments showed that teeth repeatedly exposed to low concentrations of Al solutions (i.e. < 2 mmol/l) progressively accumulated significant amounts of Al in the surface enamel, which was associated with a concomitant decrease in the acid dissolution rate of enamel. PMID:7850841

  7. Sequential Immunization Elicits Broadly Neutralizing Anti-HIV-1 Antibodies in Ig Knockin Mice.

    PubMed

    Escolano, Amelia; Steichen, Jon M; Dosenovic, Pia; Kulp, Daniel W; Golijanin, Jovana; Sok, Devin; Freund, Natalia T; Gitlin, Alexander D; Oliveira, Thiago; Araki, Tatsuya; Lowe, Sarina; Chen, Spencer T; Heinemann, Jennifer; Yao, Kai-Hui; Georgeson, Erik; Saye-Francisco, Karen L; Gazumyan, Anna; Adachi, Yumiko; Kubitz, Michael; Burton, Dennis R; Schief, William R; Nussenzweig, Michel C

    2016-09-01

    A vaccine that elicits broadly neutralizing antibodies (bNAbs) against HIV-1 is likely to be protective, but this has not been achieved. To explore immunization regimens that might elicit bNAbs, we produced and immunized mice expressing the predicted germline PGT121, a bNAb specific for the V3-loop and surrounding glycans on the HIV-1 spike. Priming with an epitope-modified immunogen designed to activate germline antibody-expressing B cells, followed by ELISA-guided boosting with a sequence of directional immunogens, native-like trimers with decreasing epitope modification, elicited heterologous tier-2-neutralizing responses. In contrast, repeated immunization with the priming immunogen did not. Antibody cloning confirmed elicitation of high levels of somatic mutation and tier-2-neutralizing antibodies resembling the authentic human bNAb. Our data establish that sequential immunization with specifically designed immunogens can induce high levels of somatic mutation and shepherd antibody maturation to produce bNAbs from their inferred germline precursors. PMID:27610569

  8. Post-treatment sequential ultrasound imaging of follicular cyst in a crossbred dairy cow.

    PubMed

    Khan, F A; Khan, Muqtaza Manzoor; Prasad, Shiv

    2015-03-01

    Several studies in dairy cattle have investigated the final outcome of different treatment regimens in follicular cyst condition. However, sequential monitoring of the response of follicular cysts to these treatments is rather scanty. In this paper, we present the response of a large follicular cyst in a pluriparous crossbred dairy cow with prolonged conception failure to human chorionic gonadotropin, hCG (3,000 IU; day 0) and cloprostenol (500 μg; day 9) treatment. Using transrectal ultrasonography (USG), reproductive tract was imaged daily beginning day 0 until day 11. The follicular cyst showed a consistent regression to a very small anechoic area on day 7 and was undetectable thereafter. Concurrently, there was development of a new dominant follicle that was first detected on day 4 and showed progressive growth to preovulatory stage. The cow was inseminated and ovulation occurred, as diagnosed by the presence of a corpus luteum (CL) 7 days later, but conception did not occur. The animal was re-inseminated after estrus detection in the estrous cycle that immediately followed. Pregnancy diagnosis was performed on 30 and 60 days post-insemination (DPI) and the cow was confirmed to be pregnant. This paper underscores the importance of diagnostic ultrasound in veterinary medicine, especially in the management of reproductive problems. PMID:25767638

  9. Sequential multiple assignment randomized trial (SMART) with adaptive randomization for quality improvement in depression treatment program.

    PubMed

    Cheung, Ying Kuen; Chakraborty, Bibhas; Davidson, Karina W

    2015-06-01

    Implementation study is an important tool for deploying state-of-the-art treatments from clinical efficacy studies into a treatment program, with the dual goals of learning about effectiveness of the treatments and improving the quality of care for patients enrolled into the program. In this article, we deal with the design of a treatment program of dynamic treatment regimens (DTRs) for patients with depression post-acute coronary syndrome. We introduce a novel adaptive randomization scheme for a sequential multiple assignment randomized trial of DTRs. Our approach adapts the randomization probabilities to favor treatment sequences having comparatively superior Q-functions used in Q-learning. The proposed approach addresses three main concerns of an implementation study: it allows incorporation of historical data or opinions, it includes randomization for learning purposes, and it aims to improve care via adaptation throughout the program. We demonstrate how to apply our method to design a depression treatment program using data from a previous study. By simulation, we illustrate that the inputs from historical data are important for the program performance measured by the expected outcomes of the enrollees, but also show that the adaptive randomization scheme is able to compensate poorly specified historical inputs by improving patient outcomes within a reasonable horizon. The simulation results also confirm that the proposed design allows efficient learning of the treatments by alleviating the curse of dimensionality. PMID:25354029

  10. A prospective study of 2 sedation regimens in children: chloral hydrate, meperidine, and hydroxyzine versus midazolam, meperidine, and hydroxyzine.

    PubMed

    Sheroan, Marianne M; Dilley, Diane C; Lucas, Warner J; Vann, William F

    2006-01-01

    The aim of this study was to compare both the behavioral and physiological effects of 2 drug regimens in children: chloral hydrate (CH), meperidine (M), and hydroxyzine (H) (regimen A) versus midazolam (MZ), M, and H (regimen B). Patients between 24 and 54 months of age were examined by crossover study design. Behavior was analyzed objectively by the North Carolina Behavior Rating System and subjectively through an operator and monitor success scale. Physiological data were recorded every 5 minutes and at critical points throughout the appointment. Sixteen patients completed this study. No significant differences in behavior were noted by the North Carolina Behavior Rating System or the operator and monitor success scale. A quiet or annoyed behavior was observed 93% and 90% of the time for regimen A and regimen B, respectively. Using the operator and monitor success scale, 63% of regimen A and 56% of regimen B sedations were successful. No statistically significant differences were noted in any of the physiological parameters between the 2 regimens. Ten episodes of hemoglobin desaturation were detected with regimen A sedations. There were no differences between the sedative drug regimens CH/M/H and MZ/M/H for behavioral outcomes or physiological parameters. PMID:17175821

  11. The sequential trauma score - a new instrument for the sequential mortality prediction in major trauma*

    PubMed Central

    2010-01-01

    Background There are several well established scores for the assessment of the prognosis of major trauma patients that all have in common that they can be calculated at the earliest during intensive care unit stay. We intended to develop a sequential trauma score (STS) that allows prognosis at several early stages based on the information that is available at a particular time. Study design In a retrospective, multicenter study using data derived from the Trauma Registry of the German Trauma Society (2002-2006), we identified the most relevant prognostic factors from the patients basic data (P), prehospital phase (A), early (B1), and late (B2) trauma room phase. Univariate and logistic regression models as well as score quality criteria and the explanatory power have been calculated. Results A total of 2,354 patients with complete data were identified. From the patients basic data (P), logistic regression showed that age was a significant predictor of survival (AUCmodel p, area under the curve = 0.63). Logistic regression of the prehospital data (A) showed that blood pressure, pulse rate, Glasgow coma scale (GCS), and anisocoria were significant predictors (AUCmodel A = 0.76; AUCmodel P + A = 0.82). Logistic regression of the early trauma room phase (B1) showed that peripheral oxygen saturation, GCS, anisocoria, base excess, and thromboplastin time to be significant predictors of survival (AUCmodel B1 = 0.78; AUCmodel P +A + B1 = 0.85). Multivariate analysis of the late trauma room phase (B2) detected cardiac massage, abbreviated injury score (AIS) of the head ≥ 3, the maximum AIS, the need for transfusion or massive blood transfusion, to be the most important predictors (AUCmodel B2 = 0.84; AUCfinal model P + A + B1 + B2 = 0.90). The explanatory power - a tool for the assessment of the relative impact of each segment to mortality - is 25% for P, 7% for A, 17% for B1 and 51% for B2. A spreadsheet for the easy calculation of the sequential trauma score is

  12. Cleansing the colon in gallium-67 scintigraphy: a prospective comparison of regimens

    SciTech Connect

    Novetsky, G.J.; Turner, D.A.; Ali, A.; Raynor, W.J.; Fordham, E.W.

    1981-11-01

    Colonic accumulation of gallium-67 frequently complicates the interpretation of gallium-67 scintigrams. Although various modes of cleansing the colon prior to scintigraphy have been suggested, there is controversy over their efficacy and none have been tested prospectively. Three hundred nine patients undergoing gallium-67 scintigraphy were randomly assigned to one of four cleansing regimens: (1) a high fiber diet (78 patients); (2) castor oil (76); (3) milk of magnesia and cascara (76); and (4) no preparation (79). Patient compliance rates for the four regimens were 17%, 32%, 36%, and 46%, respectively. After noncompliant patients were excluded, gallium-67 scintigrams were graded for colonic activity on a scale of 0-3 by three independent, experienced observers. Gallium-67 activity in the colon was significantly less after adminstration of castor oil than after no prepartion (p = 0.083). Regimen 3 did not produce significantly better results than regimen 4 (p = 0.42). A major impediment to the success of any cleansing regimen seems to be poor compliance of patients.

  13. Cleansing the colon in gallium-67 scintigraphy: a prospective comparison of regimens

    SciTech Connect

    Novetsky, G.J.; Turner, D.A.; Ali, A.; Raynor, W.J. Jr.; Fordham, E.W.

    1981-01-01

    Colonic accumulation of gallium-67 frequently complicates the interpretation of gallium-67 scintigrams. Although various modes of cleansing the colon prior to scintigraphy have been suggested, there is controversy over their efficacy and none have been tested prospectively. Three hundred nine patients undergoing gallium-67 scintigraphy were randomly assigned to one of four cleansing regimens: (1) a high fiber diet (78 patients); (2) castor oil (76); (3) milk of magnesia and cascara (76); and (4) not preparation (79). Patient compliance rates for the four regimens were 17%, 32%, 36%, and 46%, respectively. After noncompliant patients were excluded, gallium-67 scintigrams were graded for colonic activity on a scale of 0-3 by three independent, experienced observers. Gallium-67 activity in the colon was significantly less after administration of castor oil than after no preparation (p . 0.047). A high fiber diet also resulted in a substantial reduction of colonic activity when compared with no preparation; the difference, however, was not statistically significant (p . 0.083). Regimen 3 did not produce significantly better results than regimen 4 (p . 0.42). A major impediment to the success of any cleansing regimen seems to be poor compliance of patients.

  14. Effect of different bleaching regimens on the flexural strength of hybrid composite resin

    PubMed Central

    Feiz, Atiyeh; Samanian, Noushmehr; Davoudi, Amin; Badrian, Hamid

    2016-01-01

    Background: The entire effects of different bleaching regimens on the mechanical properties of composite resins have remained unknown. The purpose of this study was to evaluate the effects of different bleaching regimens on the flexural strength (FS) of hybrid composite resins. Materials and Methods: In this in vitro study, 80 bar-shaped specimens of hybrid composite resins were fabricated and randomly divided into four groups, 20 specimens in each group. First group (C) was considered as control. The other groups were treated by home bleaching (HB) agent, in-office bleaching (IB) agent, and the combination regimens (HIB), respectively. The FS was evaluated by three-point bending test by using a Universal Testing Machine. All data were analyzed by using Statistical Package for the Social Sciences (SPSS) software version 18, analysis of variance (ANOVA), and Turkey's post hoc statistical tests (α = 0.05). Results: The maximum mean value of FS was seen in HB group with significant differences to other groups (P < 0.05). Also, the minimum FS was observed in group HIB. Conclusion: Application of different bleaching regimens does not have any adverse effect on the FS of hybrid composite resins. However, the administration of HB regimens seemed to have lesser negative impact on the FS. PMID:27099423

  15. Practical application of genomics to the development of a topical cosmetic anti-aging regimen.

    PubMed

    Kaczvinsky, Joseph R; Bertucci, Vince; Fu, Juian-juian Jan

    2011-01-01

    The development of topical cosmetic anti-aging products is becoming increasingly sophisticated. This is demonstrated by the benefit agents selected and the scientific approaches used to identify them, treatment protocols that increasingly incorporate multi-product regimens, and the level of rigor in the clinical testing used to demonstrate efficacy. Consistent with these principles, a new cosmetic anti-aging regimen was recently developed. The key product ingredients were identified based on an understanding of the key mechanistic themes associated with aging at the genomic level coupled with appropriate in vitro testing. The products were designed to provide optimum benefits when used in combination in a regimen format. This cosmetic regimen was then tested for efficacy against the appearance of facial wrinkles in a 24-week clinical trial compared with 0.02% tretinoin, a recognized benchmark prescription treatment for facial wrinkling. The cosmetic regimen significantly improved wrinkle appearance after 8 weeks relative to tretinoin and was better tolerated. Wrinkle appearance benefits from the two treatments in cohorts of subjects who continued treatment through 24 weeks were also comparable. PMID:21833464

  16. Comparing interval and continuous exercise training regimens on neurotrophic factors in rat brain.

    PubMed

    Afzalpour, Mohammad Esmaiel; Chadorneshin, Hossein Taheri; Foadoddini, Mohsen; Eivari, Hossein Abtahi

    2015-08-01

    The research literature suggests that oxidative stress and pro-inflammatory factors influence neurotrophins in vitro. However, there is insufficient information about their effects on exercise training conditions, especially during high intensity trainings. This study aimed to compare the effects of 6weeks of high intensity interval and continuous training regimens on brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), hydrogen peroxide (H2O2), and tumor necrosis factor alpha (TNF-α) in the rat brain. For this purpose, twenty-four Albino Wistar rats were divided into sedentary control (SC), high intensity interval training (HIIT), and continuous training (CT) groups. Both HIIT and CT regimens increased H2O2 level and TNF-α concentration in the brain, and the alterations made were greater following HIIT than CT. In addition, both HIIT and CT regimens increased BDNF and GDNF concentrations significantly, with a higher elevation following HIIT than CT. Furthermore, H2O2 level and TNF-α concentration correlated positively with both BDNF and GDNF concentrations. Generally, high intensity interval training regimen, rather than continuous training regimen, is highly potential to improve BDNF and GDNF through a greater increase in H2O2 and TNF-α as oxidative stress and pro-inflammatory factors. PMID:25868740

  17. Large-scale sequential quadratic programming algorithms

    SciTech Connect

    Eldersveld, S.K.

    1992-09-01

    The problem addressed is the general nonlinear programming problem: finding a local minimizer for a nonlinear function subject to a mixture of nonlinear equality and inequality constraints. The methods studied are in the class of sequential quadratic programming (SQP) algorithms, which have previously proved successful for problems of moderate size. Our goal is to devise an SQP algorithm that is applicable to large-scale optimization problems, using sparse data structures and storing less curvature information but maintaining the property of superlinear convergence. The main features are: 1. The use of a quasi-Newton approximation to the reduced Hessian of the Lagrangian function. Only an estimate of the reduced Hessian matrix is required by our algorithm. The impact of not having available the full Hessian approximation is studied and alternative estimates are constructed. 2. The use of a transformation matrix Q. This allows the QP gradient to be computed easily when only the reduced Hessian approximation is maintained. 3. The use of a reduced-gradient form of the basis for the null space of the working set. This choice of basis is more practical than an orthogonal null-space basis for large-scale problems. The continuity condition for this choice is proven. 4. The use of incomplete solutions of quadratic programming subproblems. Certain iterates generated by an active-set method for the QP subproblem are used in place of the QP minimizer to define the search direction for the nonlinear problem. An implementation of the new algorithm has been obtained by modifying the code MINOS. Results and comparisons with MINOS and NPSOL are given for the new algorithm on a set of 92 test problems.

  18. Sequential Hybrid Procedure for Persistent Atrial Fibrillation

    PubMed Central

    Bulava, Alan; Mokracek, Ales; Hanis, Jiri; Kurfirst, Vojtech; Eisenberger, Martin; Pesl, Ladislav

    2015-01-01

    Background Catheter ablation of persistent atrial fibrillation yields an unsatisfactorily high number of failures. The hybrid approach has recently emerged as a technique that overcomes the limitations of both surgical and catheter procedures alone. Methods and Results We investigated the sequential (staged) hybrid method, which consists of a surgical thoracoscopic radiofrequency ablation procedure followed by radiofrequency catheter ablation 6 to 8 weeks later using the CARTO 3 mapping system. Fifty consecutive patients (mean age 62±7 years, 32 males) with long‐standing persistent atrial fibrillation (41±34 months) and a dilated left atrium (>45 mm) were included and prospectively followed in an unblinded registry. During the electrophysiological part of the study, all 4 pulmonary veins were found to be isolated in 36 (72%) patients and a complete box‐lesion was confirmed in 14 (28%) patients. All gaps were successfully re‐ablated. Twelve months after the completed hybrid ablation, 47 patients (94%) were in normal sinus rhythm (4 patients with paroxysmal atrial fibrillation required propafenone and 1 patient underwent a redo catheter procedure). The majority of arrhythmias recurred during the first 3 months. Beyond 12 months, there were no arrhythmia recurrences detected. The surgical part of the procedure was complicated by 7 (13.7%) major complications, while no serious adverse events were recorded during the radiofrequency catheter part of the procedure. Conclusions The staged hybrid epicardial–endocardial treatment of long‐standing persistent atrial fibrillation seems to be extremely effective in maintenance of normal sinus rhythm compared to radiofrequency catheter or surgical ablation alone. Epicardial ablation alone cannot guarantee durable transmural lesions. Clinical Trial Registration URL: www.ablace.cz Unique identifier: cz‐060520121617 PMID:25809548

  19. Pharmacokinetic estimation for therapeutic dosage regimens (PETDR)--a software program designed to determine intravenous drug dosage regimens for veterinary applications.

    PubMed

    Riviere, J E; Frazier, D L; Tippitt, W L

    1988-12-01

    Pharmacokinetic estimation for therapeutic dosage regimens (PETDR) is a soft-ware program used to design individualized intravenous dosage regimens, determine concentration-time profiles, predict serum concentrations at a specific time after intravenous dosing and predict the time after the last dose to achieve a specified concentration of drug. The reference pharmacokinetic parameters may be based on an individual animal's pharmacokinetic disposition of drug or on FARAD (Food Animal Residue Avoidance Databank) mean population kinetic parameters. An individual animal's kinetic parameters may be input for predetermined analysis or the program can calculate these values by input of raw serum concentration-time data. The program allows the user to specify certain parameters of the dosage regimen, then calculates the other parameters (given desired maximum and minimum serum concentrations, dose and interval are calculated; given desired maximum serum concentration and interval, dose is calculated, etc.). Given the kinetic parameters, the dose and dosing interval, the program calculates and plots the serum concentration-time profile of the drug for that animal. The time and the number of doses to reach steady state can be calculated as well as the determination of loading dose. The percentage of the time of a dosing interval at steady state that the serum concentration is above a specific minimum inhibitory concentration (MIC) allows evaluation of efficacy of an antimicrobial regimen. Similarly, the time to reach a specific concentration (e.g. residue tolerance) or the MIC of a drug can be calculated. Legal tissue tolerances can be accessed from FARAD to aid in predicting for what period of time illegal residues will remain in the animal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3210265

  20. A single tablet regimen is associated with higher adherence and viral suppression than multiple tablet regimens in HIV+ homeless and marginally housed people

    PubMed Central

    Bangsberg, David R; Ragland, Kathleen; Monk, Alex; Deeks, Steven G

    2013-01-01

    Although, single tablet regimen (STR) efavirenz, emtricibine, and tenofovir disoproxil fumarate (EFV/FTC/TDF) may be appealing in HIV infected persons who are at high risk for non-adherence, the degree to which this simplified formulation affects adherence is not known. The virologic effectiveness of this STR in a potentially non-adherent population remains a concern, given the rapid selection of drug-resistance seen with these drugs. We performed a prospective observational study assessing adherence and virologic response to EFV/FTC/TDF STR among a cohort of homeless and marginally housed individuals. We compared adherence and viral suppression to historical controls followed in the same cohort. Adherence was higher in EFV/FTC/TDF STR regimen compared to non-one-pill once daily therapy (p=0.0060) after controlling for multiple confounders. Viral suppression (HIV RNA <50 c/ml) was greater in EFV/FTC/TDF STR than non-one pill daily regimens (69.2% vs 46.5%; p=0.02), but there was no difference in viral suppression after controlling for adherence. Once daily EFV/TNF/FTC STR appears to be a reasonable option for individuals with multiple barriers to adherence. Randomized clinical trials addressing various therapeutic strategies for this patient population are needed. PMID:21045636

  1. Clinical benefits of bortezomib-containing regimens for newly diagnosed AL amyloidosis with severe cardiac impairment.

    PubMed

    Tsukune, Yutaka; Yahata, Yuriko; Sasaki, Makoto; Hiki, Makoto; Tsutsui, Miyuki; Hamano, Yasuharu; Itoh, Seigo; Miyazaki, Tetsuro; Dohi, Tomotaka; Maruyama, Masaki; Gotoh, Akihiko; Komatsu, Norio

    2016-08-01

    Cardiac amyloid light-chain amyloidosis (AL amyloidosis) is a rare disease with a very poor prognosis, associated with plasma cell dyscrasias such as monoclonal gammopathy of undetermined significance and multiple myeloma. Though bortezomib-containing regimens have achieved high hematologic response rates, there are still few reports describing the outcomes of Japanese patients. Six patients with severe cardiac AL amyloidosis were treated with bortezomib-containing regimens. Involved free light chain (iFLC) decreased immediately in most of these cases. However, the condition of heart failure and N-terminal pro-B-type natriuretic peptide (NT-proBNP) worsened in the early phase of this treatment and then improved several months later. At 29 months, the median duration of follow-up (2-47months), all patients remain alive except one who died of sudden cardiac arrest. Bortezomib-containing regimens are considered to be among the effective treatments for severe cardiac AL amyloidosis. PMID:27599413

  2. Antiretroviral regimen and suboptimal medication adherence are associated with low-level human immunodeficiency virus viremia.

    PubMed

    Konstantopoulos, Christina; Ribaudo, Heather; Ragland, Kathleen; Bangsberg, David R; Li, Jonathan Z

    2015-01-01

    Episodes of human immunodeficiency virus low-level viremia (LLV) are common in the clinical setting, but its association with antiretroviral therapy (ART) regimen and adherence remains unclear. Antiretroviral therapy adherence was evaluated in participants of the Research on Access to Care in the Homeless cohort by unannounced pill counts. Factors associated with increased risk of LLV include treatment with a protease inhibitor (PI)-based regimen (ritonavir-boosted PI vs nonnucleoside reverse-transcriptase inhibitor: adjusted hazard ratio [HR], 3.1; P = .01) and lower ART adherence over the past 3 months (HR, 1.1 per 5% decreased adherence, adjusted; P = .050). Patients with LLV may benefit from ART adherence counseling and potentially regimen modification. PMID:25884007

  3. Treatment regimens for rifampicin-resistant tuberculosis: highlighting a research gap.

    PubMed

    Stagg, H R; Hatherell, H-A; Lipman, M C; Harris, R J; Abubakar, I

    2016-07-01

    Treatment guidance for non-multidrug-resistant (MDR) rifampicin-resistant (RMP-R) tuberculosis (TB) is variable. We aimed to undertake a systematic review and meta-analysis of the randomised controlled trial (RCT) data behind such guidelines to identify the most efficacious treatment regimens. Ovid MEDLINE, the Web of Science and EMBASE were mined using search terms for TB, drug therapy and RCTs. Despite 12 604 records being retrieved, only three studies reported treatment outcomes by regimen for patients with non-MDR RMP-R disease, preventing meta-analysis. Our systematic review highlights a substantial gap in the literature regarding evidence-based treatment regimens for RMP-R TB. PMID:27287636

  4. Poor response to tuberculosis treatment with regimens without rifampicin in immunosuppressed AIDS patients.

    PubMed

    O'Donnel, M M; Souza Carvalho, S; Gadelha, A J; Morgado, M G; Galhardo, M C G; Lourenço, M C; Rolla, V C

    2002-12-01

    A prospective study was conducted on 79 advanced immunosuppressed AIDS patients from 1997 to 1999, during which nine cases of tuberculosis (TB) were diagnosed. The main clinical and laboratory characteristics and the response to TB treatment were reviewed. The clinical manifestations of TB were: pulmonary (six cases), extrapulmonary (two cases) and disseminated (one case). These patients were being treated with highly active antiretroviral treatment (HAART) and were not responding. In three cases an optional regimen without rifampicin (RMP) was indicated to maintain HAART during TB treatment. A clinical response to TB treatment (disappearance of fever) was observed in 6/9 patients during a mean of 73 days (SD = 96). The three unresponsive patients were those treated without RMP. A switch to TB regimens containing RMP was proposed and successful. In our study, though it was limited by a small sample size, the response to TB regimens without rifampin was poor in immunosupressed patients failing HAART. PMID:12585969

  5. Is Resection of Colorectal Liver Metastases after a Second-Line Chemotherapy Regimen Justified?

    PubMed Central

    Brouquet, Antoine; Overman, Michael J.; Kopetz, Scott; Maru, Dipen M.; Loyer, Evelyne M.; Andreou, Andreas; Cooper, Amanda; Curley, Steven A.; Garrett, Christopher R.; Abdalla, Eddie K.; Vauthey, Jean Nicolas

    2011-01-01

    Background Patients' outcomes following resection of colorectal liver metastases (CLM) after second-line chemotherapy regimen is unknown. Methods From August 1998 to June 2009, data from 1099 patients with CLM were collected prospectively. We retrospectively analyzed outcomes of patients who underwent resection of CLM after second-line (two or more) chemotherapy regimens. Results Sixty patients underwent resection of CLM after 2 or more chemotherapy regimens. Patients had advanced CLM (mean number of CLM ± standard deviation, 4 ± 3.5; mean maximum size of CLM, 5 ± 3.2 cm) and had received 17 ± 8 cycles of preoperative chemotherapy. In 54 patients (90%), the switch from the first regimen to another was motivated by tumor progression or suboptimal radiographic response. All patients received irinotecan or oxaliplatin and the majority (42/60, 70%) received a monoclonal antibody (bevacizumab or cetuximab) as part of the last preoperative regimen. Postoperative morbidity and mortality rates were 33% and 3%, respectively. At a median follow-up of 32 months, 1-year, 3-year, and 5-year overall survival rates were 83%, 41%, and 22%, respectively. Median chemotherapy-free survival following resection or completion of additional chemotherapy administered after resection was 9 months (95% confidence interval (CI) 4–14 months). Synchronous (v metachronous) CLM and minor (v major) pathologic response were independently associated with worse survival. Conclusion Resection of CLM after second-line chemotherapy regimen is safe and associated with a modest hope for definitive cure. This approach represents a viable option in patients with advanced CLM. PMID:21446046

  6. Comparative Effectiveness of First Antiretroviral Regimens in Clinical Practice Using a Causal Approach.

    PubMed

    Cuzin, Lise; Pugliese, Pascal; Allavena, Clotilde; Katlama, Christine; Cotte, Laurent; Cheret, Antoine; Cabié, André; Rey, David; Chirouze, Catherine; Bani-Sadr, Firouze; Flandre, Philippe

    2015-09-01

    The objective of this study was to estimate the cumulative incidences of failure by months 12 (M12) and 24 (M24) for the most prescribed first-line anti-retroviral regimens (ART). It is retrospective analysis of a prospectively collected database. All patients who initiated their first ART with the most prescribed regimens between 1st January 2004 and 30th June 2013 in 12 large HIV reference centers in France were included. The outcome was treatment failure--defined by any treatment modification for virological or tolerability reasons--and comparisons between regimens were carried out at M12 and M24. Adjusted and weighted methods via the propensity score (PS) were used to compare the effectiveness of the first antiretroviral regimens. Potential confounders of the treatment-outcome association were used to estimate PS with multinomial logistic regression. Overall, 3128 and 2690 patients were included in the M12 and M24 analyses, respectively. Patients received 5 different regimens (ABC/3TC with ATV/r or DRV/r, TDF/FTC with ATV/r, DRV/r, or EFV). Failure was reported in 25% and 42% at M12 and M24, respectively. Patients who received TDF/FTC/EFV had a significantly higher proportion of failure at M12 by comparison with TDF/FTC with DRV/r (reference), but not at M24. Patients in the 3 other groups had a trend toward a higher proportion of failure at M12 although not statistically significant. No difference was found at M24. Using data from a large prospective cohort, we found that boosted atazanavir and darunavir had comparable effectiveness, whatever the associated NRTIs, whereas efavirenz-based regimens were relatively less performing on the short term. PMID:26426666

  7. Comparative Effectiveness of First Antiretroviral Regimens in Clinical Practice Using a Causal Approach

    PubMed Central

    Cuzin, Lise; Pugliese, Pascal; Allavena, Clotilde; Katlama, Christine; Cotte, Laurent; Cheret, Antoine; Cabié, André; Rey, David; Chirouze, Catherine; Bani-Sadr, Firouze; Flandre, Philippe

    2015-01-01

    Abstract The objective of this study was to estimate the cumulative incidences of failure by months 12 (M12) and 24 (M24) for the most prescribed first-line anti-retroviral regimens (ART). It is retrospective analysis of a prospectively collected database. All patients who initiated their first ART with the most prescribed regimens between 1st January 2004 and 30th June 2013 in 12 large HIV reference centers in France were included. The outcome was treatment failure—defined by any treatment modification for virological or tolerability reasons—and comparisons between regimens were carried out at M12 and M24. Adjusted and weighted methods via the propensity score (PS) were used to compare the effectiveness of the first antiretroviral regimens. Potential confounders of the treatment-outcome association were used to estimate PS with multinomial logistic regression. Overall, 3128 and 2690 patients were included in the M12 and M24 analyses, respectively. Patients received 5 different regimens (ABC/3TC with ATV/r or DRV/r, TDF/FTC with ATV/r, DRV/r, or EFV). Failure was reported in 25% and 42% at M12 and M24, respectively. Patients who received TDF/FTC/EFV had a significantly higher proportion of failure at M12 by comparison with TDF/FTC with DRV/r (reference), but not at M24. Patients in the 3 other groups had a trend toward a higher proportion of failure at M12 although not statistically significant. No difference was found at M24. Using data from a large prospective cohort, we found that boosted atazanavir and darunavir had comparable effectiveness, whatever the associated NRTIs, whereas efavirenz-based regimens were relatively less performing on the short term. PMID:26426666

  8. Evidence-Based Development and Rationale for Once-Daily Rivaroxaban Dosing Regimens Across Multiple Indications

    PubMed Central

    Berkowitz, Scott D.; Misselwitz, Frank

    2016-01-01

    Background: Rivaroxaban, a direct factor Xa inhibitor, has been developed to meet clinical needs in a broad range of indications in adults: prevention of venous thromboembolism after elective hip or knee replacement surgery, treatment and secondary prevention of venous thromboembolism, prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation having one or more risk factors, and in Europe, prevention of atherothrombotic events after an acute coronary syndrome in patients with elevated cardiac biomarkers. However, the precise dose and regimen vary with the indication, leading to this effort to provide clarity concerning the appropriate use of rivaroxaban. This article reviews the clinical development program for rivaroxaban and summarizes the evidence for each approved, indication-specific dose regimen. Results: Although initially investigated for twice-daily dosing, early observations, including the finding that the pharmacodynamic effects of rivaroxaban last longer than the elimination half-life, suggested that once-daily dosing might be attainable and effective. These observations were evaluated within the extensive phase II program, which, together with pharmacology studies, provides the evidence underpinning the selection of once-daily regimens for most, but not all, of the approved clinical indications for rivaroxaban. Conclusion: The evidence for each dosing regimen demonstrates that although pharmacology studies are of paramount importance, dose regimens must be subjected to careful empirical validation. Once-daily dosing was shown to be clinically appropriate for most rivaroxaban indications. Furthermore, a “one size fits all” approach to dosing frequency is unlikely to result in a regimen that yields optimal patient outcomes across different indications. PMID:26893445

  9. Some Practical Examples of Computer-Adaptive Sequential Testing.

    ERIC Educational Resources Information Center

    Luecht, Richard M.; Nungester, Ronald J.

    1998-01-01

    Describes an integrated approach to test development and administration called computer-adaptive sequential testing (CAST). CAST incorporates adaptive testing methods with automated test assembly. Describes the CAST framework and demonstrates several applications using a medical-licensure example. (SLD)

  10. Optimizing Standard Sequential Extraction Protocol With Lake And Ocean Sediments

    EPA Science Inventory

    The environmental mobility/availability behavior of radionuclides in soils and sediments depends on their speciation. Experiments have been carried out to develop a simple but robust radionuclide sequential extraction method for identification of radionuclide partitioning in sed...

  11. A Sequential Preparation of Organic Compounds for Senior Chemistry Classes

    ERIC Educational Resources Information Center

    Merrigan, Cecilia; Crotty, Patricia

    1971-01-01

    Describes procedures suitable for student preparation of benzaldehyde, benzoic acid, and ethyl benzoate sequentially from benzyl alcohol. Preparation for benzyl chloride also given. All reagents except benzyl alcohol are common inorganic chemicals. (AL)

  12. Ligand Binding to Macromolecules: Allosteric and Sequential Models of Cooperativity.

    ERIC Educational Resources Information Center

    Hess, V. L.; Szabo, Attila

    1979-01-01

    A simple model is described for the binding of ligands to macromolecules. The model is applied to the cooperative binding by hemoglobin and aspartate transcarbamylase. The sequential and allosteric models of cooperative binding are considered. (BB)

  13. Spatial versus sequential correlations for random access coding

    NASA Astrophysics Data System (ADS)

    Tavakoli, Armin; Marques, Breno; Pawłowski, Marcin; Bourennane, Mohamed

    2016-03-01

    Random access codes are important for a wide range of applications in quantum information. However, their implementation with quantum theory can be made in two very different ways: (i) by distributing data with strong spatial correlations violating a Bell inequality or (ii) using quantum communication channels to create stronger-than-classical sequential correlations between state preparation and measurement outcome. Here we study this duality of the quantum realization. We present a family of Bell inequalities tailored to the task at hand and study their quantum violations. Remarkably, we show that the use of spatial and sequential quantum correlations imposes different limitations on the performance of quantum random access codes: Sequential correlations can outperform spatial correlations. We discuss the physics behind the observed discrepancy between spatial and sequential quantum correlations.

  14. DNA Sequential Logic Gate Using Two-Ring DNA.

    PubMed

    Zhang, Cheng; Shen, Linjing; Liang, Chao; Dong, Yafei; Yang, Jing; Xu, Jin

    2016-04-13

    Sequential DNA detection is a fundamental issue for elucidating the interactive relationships among complex gene systems. Here, a sequential logic DNA gate was achieved by utilizing the two-ring DNA structure, with the ability to recognize "before" and "after" triggering sequences of DNA signals. By taking advantage of a "loop-open" mechanism, separations of two-ring DNAs were controlled. Three triggering pathways with different sequential DNA treatments were distinguished by comparing fluorescent outputs. Programmed nanoparticle arrangement guided by "interlocked" two-ring DNA was also constructed to demonstrate the achievement of designed nanostrucutres. Such sequential logic DNA operation may guide future molecular sensors to monitor more complex gene network in biological systems. PMID:26990044

  15. Age-related differences in arithmetic strategy sequential effects.

    PubMed

    Lemaire, Patrick

    2016-03-01

    In this article, I review a series of new findings concerning how age-related changes in strategic variations are modulated by sequential effects. Sequential effects refer to how strategy selection and strategy execution on current problems are influenced by which strategy is used on immediately preceding problems. Two sequential effects during strategy selection (i.e., strategy revisions and strategy perseverations) and during strategy execution (i.e., strategy switch costs and modulations of poorer strategy effects) are presented. I also discuss how these effects change with age during adulthood. These phenomena are important, as they shed light on arithmetic processes and how these processes change with age during adulthood. In particular, they speak to the role of executive control while participants select and execute arithmetic strategies. Finally, I discuss the implications of sequential effects for theories of strategies and of arithmetic. (PsycINFO Database Record PMID:26372058

  16. Esomeprazole regimens for reflux symptoms in Chinese patients with chronic gastritis

    PubMed Central

    Sun, Jing; Yuan, Yao-Zong; Hou, Xiao-Hua; Zou, Duo-Wu; Lu, Bin; Chen, Min-Hu; Liu, Fei; Wu, Kai-Chun; Zou, Xiao-Ping; Li, Yan-Qing; Zhou, Li-Ya

    2015-01-01

    AIM: To compare symptom control with esomeprazole regimens for non-erosive reflux disease and chronic gastritis in patients with a negative endoscopy. METHODS: This randomized, open-label study was designed in line with clinical practice in China. Patients with typical reflux symptoms for ≥ 3 mo and a negative endoscopy who had a Gastroesophageal Reflux Disease Questionnaire score ≥ 8 were randomized to initial treatment with esomeprazole 20 mg once daily either for 8 wk or for 2 wk. Patients with symptom relief could enter another 24 wk of maintenance/on-demand treatment, where further courses of esomeprazole 20 mg once daily were given if symptoms recurred. The primary endpoint was the symptom control rate at week 24 of the maintenance/on-demand treatment period. Secondary endpoints were symptom relief rate, success rate (defined as patients who had symptom relief after initial treatment and after 24 wk of maintenance treatment), time-to-first-relapse and satisfaction rate. RESULTS: Based on the data collected in the modified intention-to-treat population (MITT; patients in the ITT population with symptom relief after initial esomeprazole treatment, n = 262), the symptom control rate showed a small but statistically significant difference in favor of the 8-wk regimen (94.9% vs 87.3%, P = 0.0473). Among the secondary endpoints, based on the data collected in the ITT population (n = 305), the 8-wk group presented marginally better results in symptom relief after initial esomeprazole treatment (88.3% vs 83.4%, P = 0.2513) and success rate over the whole study (83.8% vs 72.8%, P = 0.0258). The 8-wk regimen was found to provide a 46% reduction in risk of relapse vs the 2-wk regimen (HR = 0.543; 95%CI: 0.388-0.761). In addition, fewer unscheduled visits and higher patient satisfaction supported the therapeutic benefits of the 8-wk regimen over the 2-wk regimen. Safety was comparable between the two groups, with both regimens being well tolerated. CONCLUSION

  17. Antiretroviral Therapy and Efficacy After Virologic Failure on First-line Boosted Protease Inhibitor Regimens

    PubMed Central

    Zheng, Yu; Hughes, Michael D.; Lockman, Shahin; Benson, Constance A.; Hosseinipour, Mina C.; Campbell, Thomas B.; Gulick, Roy M.; Daar, Eric S.; Sax, Paul E.; Riddler, Sharon A.; Haubrich, Richard; Salata, Robert A.; Currier, Judith S.

    2014-01-01

    Background. Virologic failure (VF) on a first-line ritonavir-boosted protease inhibitor (PI/r) regimen is associated with low rates of resistance, but optimal management after failure is unknown. Methods. The analysis included participants in randomized trials who experienced VF on a first-line regimen of PI/r plus 2 nucleoside reverse transcriptase inhibitors (NRTIs) and had at least 24 weeks of follow-up after VF. Antiretroviral management and virologic suppression (human immunodeficiency virus type 1 [HIV-1] RNA <400 copies/mL) after VF were assessed. Results. Of 209 participants, only 1 participant had major PI-associated treatment-emergent mutations at first-line VF. The most common treatment approach after VF (66%) was to continue the same regimen. The virologic suppression rate 24 weeks after VF was 64% for these participants, compared with 72% for those who changed regimens (P = .19). Participants remaining on the same regimen had lower NRTI resistance rates (11% vs 30%; P = .003) and higher CD4+ cell counts (median, 275 vs 213 cells/µL; P = .005) at VF than those who changed. Among participants remaining on their first-line regimen, factors at or before VF significantly associated with subsequent virologic suppression were achieving HIV-1 RNA <400 copies/mL before VF (odds ratio [OR], 3.39 [95% confidence interval {CI}, 1.32–8.73]) and lower HIV-1 RNA at VF (OR for <10 000 vs ≥10 000 copies/mL, 3.35 [95% CI, 1.40–8.01]). Better adherence after VF was also associated with subsequent suppression (OR for <100% vs 100%, 0.38 [95% CI, .15–.97]). For participants who changed regimens, achieving HIV-1 RNA <400 copies/mL before VF also predicted subsequent suppression. Conclusions. For participants failing first-line PI/r with no or limited drug resistance, remaining on the same regimen is a reasonable approach. Improving adherence is important to subsequent treatment success. PMID:24842909

  18. Placebo HAART Regimen as a Method for Teaching Medication Adherence Issues to Students

    PubMed Central

    Sutton, Eliza L; Transue, Emily R; Comes E, Susan; Paauw, Douglas S

    2005-01-01

    Placebo medication regimens may help educate students about adherence issues. In this randomized trial, 23 third-year medical students took a 2-week placebo regimen mimicking highly active antiretroviral therapy (HAART) during their medicine clerkship; 15 students served as controls. Although no effect was demonstrated from this intervention on an evaluation instrument examining attitudes and beliefs about medication nonadherence, all 23 student-subjects agreed in postintervention interviews that the experience was useful and had learning value. Representative comments from the 19 subjects who expanded their interview responses portray this intervention as an eye-opening and unique method for teaching students about medication adherence issues. PMID:15987331

  19. Generalized Sequential Probability Ratio Test for Separate Families of Hypotheses

    PubMed Central

    Li, Xiaoou; Liu, Jingchen; Ying, Zhiliang

    2014-01-01

    In this paper, we consider the problem of testing two separate families of hypotheses via a generalization of the sequential probability ratio test. In particular, the generalized likelihood ratio statistic is considered and the stopping rule is the first boundary crossing of the generalized likelihood ratio statistic. We show that this sequential test is asymptotically optimal in the sense that it achieves asymptotically the shortest expected sample size as the maximal type I and type II error probabilities tend to zero.

  20. Asynchronous sequential circuit design using pass transistor iterative logic arrays

    NASA Technical Reports Server (NTRS)

    Liu, M. N.; Maki, G. K.; Whitaker, S. R.

    1991-01-01

    The iterative logic array (ILA) is introduced as a new architecture for asynchronous sequential circuits. This is the first ILA architecture for sequential circuits reported in the literature. The ILA architecture produces a very regular circuit structure. Moreover, it is immune to both 1-1 and 0-0 crossovers and is free of hazards. This paper also presents a new critical race free STT state assignment which produces a simple form of design equations that greatly simplifies the ILA realizations.

  1. On some classes of sequential spiking neural p systems.

    PubMed

    Zhang, Xingyi; Zeng, Xiangxiang; Luo, Bin; Pan, Linqiang

    2014-05-01

    Spiking neural P systems (SN P systems) are a class of distributed parallel computing devices inspired by the way neurons communicate by means of spikes; neurons work in parallel in the sense that each neuron that can fire should fire, but the work in each neuron is sequential in the sense that at most one rule can be applied at each computation step. In this work, with biological inspiration, we consider SN P systems with the restriction that at each step, one of the neurons (i.e., sequential mode) or all neurons (i.e., pseudo-sequential mode) with the maximum (or minimum) number of spikes among the neurons that are active (can spike) will fire. If an active neuron has more than one enabled rule, it nondeterministically chooses one of the enabled rules to be applied, and the chosen rule is applied in an exhaustive manner (a kind of local parallelism): the rule is used as many times as possible. This strategy makes the system sequential or pseudo-sequential from the global view of the whole network and locally parallel at the level of neurons. We obtain four types of SN P systems: maximum/minimum spike number induced sequential/pseudo-sequential SN P systems with exhaustive use of rules. We prove that SN P systems of these four types are all Turing universal as number-generating computation devices. These results illustrate that the restriction of sequentiality may have little effect on the computation power of SN P systems. PMID:24555456

  2. Robust sequential working memory recall in heterogeneous cognitive networks

    PubMed Central

    Rabinovich, Mikhail I.; Sokolov, Yury; Kozma, Robert

    2014-01-01

    Psychiatric disorders are often caused by partial heterogeneous disinhibition in cognitive networks, controlling sequential and spatial working memory (SWM). Such dynamic connectivity changes suggest that the normal relationship between the neuronal components within the network deteriorates. As a result, competitive network dynamics is qualitatively altered. This dynamics defines the robust recall of the sequential information from memory and, thus, the SWM capacity. To understand pathological and non-pathological bifurcations of the sequential memory dynamics, here we investigate the model of recurrent inhibitory-excitatory networks with heterogeneous inhibition. We consider the ensemble of units with all-to-all inhibitory connections, in which the connection strengths are monotonically distributed at some interval. Based on computer experiments and studying the Lyapunov exponents, we observed and analyzed the new phenomenon—clustered sequential dynamics. The results are interpreted in the context of the winnerless competition principle. Accordingly, clustered sequential dynamics is represented in the phase space of the model by two weakly interacting quasi-attractors. One of them is similar to the sequential heteroclinic chain—the regular image of SWM, while the other is a quasi-chaotic attractor. Coexistence of these quasi-attractors means that the recall of the normal information sequence is intermittently interrupted by episodes with chaotic dynamics. We indicate potential dynamic ways for augmenting damaged working memory and other cognitive functions. PMID:25452717

  3. Administration of a Triple versus a Standard Double Antimicrobial Regimen for Human Brucellosis More Efficiently Eliminates Bacterial DNA Load

    PubMed Central

    Vrioni, Georgia; Bourdakis, Adamantios; Pappas, Georgios; Pitiriga, Vassiliki; Mavrouli, Maria; Tsakris, Athanassios

    2014-01-01

    The effects of doxycycline-streptomycin-rifampin versus a standard doxycycline-streptomycin regimen on residual Brucella DNA were compared in 36 acute brucellosis patients. At admission, all patients given triple (n = 22) and double (n = 14) regimens had detectable Brucella DNA with similar mean loads (P = 0.982). At follow-up, 14 to 20 months postpresentation, significantly more patients receiving triple than double regimens had undetectable Brucella DNA (P = 0.026). The doxycycline-streptomycin-rifampin regimen eliminates Brucella DNA more efficiently than doxycycline-streptomycin, which may result in superior long-term clearance of Brucella. PMID:25246401

  4. Alternating versus continuous drug regimens in combination chemotherapy of human immunodeficiency virus type 1 infection in vitro.

    PubMed Central

    Mazzulli, T; Rusconi, S; Merrill, D P; D'Aquila, R T; Moonis, M; Chou, T C; Hirsch, M S

    1994-01-01

    We compared the in vitro efficacies of two-, three-, and four-drug combinations given continuously or in alternating regimens against a clinical isolate of human immunodeficiency virus type 1. In H9 cells and peripheral blood mononuclear cells, at the drug concentrations used in this study, there was greater suppression of human immunodeficiency virus type 1 infection as the number of drugs in the regimen was increased from one to four simultaneously administered agents. Although alternating drug regimens were effective, they were not better than continuous administration of either single drugs or combinations of agents and were less effective than giving all drugs of an alternating regimen simultaneously. PMID:8031028

  5. Combined chemotherapy plus endostar with sequential stereotactic radiotherapy as salvage treatment for recurrent esophageal cancer with severe dyspnea: A case report and review of the literature

    PubMed Central

    XU, MINGFANG; HUANG, HUAN; XIONG, YANLI; PENG, BO; ZHOU, ZEJUN; WANG, DONG; YANG, XUEQIN

    2014-01-01

    For the majority of inoperable esophageal cancer cases, chemoradiotherapy is the most suitable treatment option. Cetuximab may provide certain benefits, however, this can be an expensive therapy. Additionally, stereotactic body radiation therapy (SBRT) is typically contraindicated for esophageal cancer due to the potential for esophageal perforation and stenosis. The use of combined chemotherapy plus endostar with sequential SBRT for the treatment of esophageal squamous cancer has not been reported. In the current study, the case of a 71-year-old female with esophageal squamous cancer diagnosed 2 years prior is presented. Surgery and four cycles of cisplatin plus 5-fluorouracil chemotherapy had been administered. The patient showed recurrence at the paratracheal lymph node, exhibited severe dyspnea (grade III) and required a semi-liquid diet. Four cycles of the docetaxel, 5-fluorouracil and nedaplatin regimen plus endostar (3 mg; days 1–14; intravenously) with sequential SBRT (3300 cGy in 10 fractions) was administered. Following treatment, the symptoms of the patient completely disappeared, and objective efficacy evaluation indicated complete remission. At the time of writing, the patient is living without discomfort and the progression-free survival is >8 months. In conclusion, the present case indicates that combined treatment of chemotherapy and endostar with sequential stereotactic radiotherapy is a safe and effective option for the management of esophageal cancer. PMID:24959263

  6. Evaluation of antimicrobial activities of sequential spray applications of decontamination treatments on chicken carcasses.

    PubMed

    Benli, Hakan; Sanchez-Plata, Marcos X; Ilhak, Osman Irfan; Núñez De González, Maryuri T; Keeton, Jimmy T

    2015-03-01

    The objective of this study was to evaluate the effects of sequential applications of ɛ-polylysine (EPL) or lauramide arginine ethyl ester (LAE) sprays followed by an acidic calcium sulfate (ACS) spray on inoculated chicken carcasses to reduce Salmonella (Salmonella enterica serovars including Salmonella typhimurium and Salmonella enteritidis) contamination during 6 days of storage (4.4°C). Secondly, reductions of the resident microflora were studied on uninoculated chicken carcasses following the sequential application of the treatments, chilling and 10 days of storage at 4.4°C. The treatment of Salmonella inoculated carcasses with 300 mg/L EPL followed by 30% ACS (EPL300-ACS30) sprays reduced Salmonella counts initially by 1.5 log cfu/mL and then by 1.2 log cfu/mL (p<0.05) following 6 days of storage at 4.4°C. Likewise, 200 mg/L LAE followed by 30% ACS (LAE200-ACS30) treatment reduced initial Salmonella counts on poultry carcasses by 1.8, 1.4 and 1.8 log cfu/mL (p<0.05), respectively, after 0, 3, and 6 days storage. Immediately after the treatments, EPL300-ACS30 and LAE200-ACS30 both reduced Escherichia coli counts significantly by 2.6 and 2.9 log cfu/mL, respectively. EPL300-ACS30 and LAE200-ASC30 were effective in lowering psychrotroph counts by 1 log cfu/mL on day 10 when compared to the control and distilled water treatments. This study demonstrated that EPL300-ACS30 and LAE200-ACS30 were effective in reducing Salmonella on inoculated chicken carcasses both after treatment and during the storage at 4.4°C for up to 6 days. In addition, reductions in psychrotroph counts indicated that these treatments might have the potential to increase the shelf-life of poultry carcasses. PMID:25656180

  7. Evaluation of Antimicrobial Activities of Sequential Spray Applications of Decontamination Treatments on Chicken Carcasses

    PubMed Central

    Benli, Hakan; Sanchez-Plata, Marcos X.; Ilhak, Osman Irfan; Núñez De González, Maryuri T.; Keeton, Jimmy T.

    2015-01-01

    The objective of this study was to evaluate the effects of sequential applications of ɛ-polylysine (EPL) or lauramide arginine ethyl ester (LAE) sprays followed by an acidic calcium sulfate (ACS) spray on inoculated chicken carcasses to reduce Salmonella (Salmonella enterica serovars including Salmonella typhimurium and Salmonella enteritidis) contamination during 6 days of storage (4.4°C). Secondly, reductions of the resident microflora were studied on uninoculated chicken carcasses following the sequential application of the treatments, chilling and 10 days of storage at 4.4°C. The treatment of Salmonella inoculated carcasses with 300 mg/L EPL followed by 30% ACS (EPL300-ACS30) sprays reduced Salmonella counts initially by 1.5 log cfu/mL and then by 1.2 log cfu/mL (p<0.05) following 6 days of storage at 4.4°C. Likewise, 200 mg/L LAE followed by 30% ACS (LAE200-ACS30) treatment reduced initial Salmonella counts on poultry carcasses by 1.8, 1.4 and 1.8 log cfu/mL (p<0.05), respectively, after 0, 3, and 6 days storage. Immediately after the treatments, EPL300-ACS30 and LAE200-ACS30 both reduced Escherichia coli counts significantly by 2.6 and 2.9 log cfu/mL, respectively. EPL300-ACS30 and LAE200-ASC30 were effective in lowering psychrotroph counts by 1 log cfu/mL on day 10 when compared to the control and distilled water treatments. This study demonstrated that EPL300-ACS30 and LAE200-ACS30 were effective in reducing Salmonella on inoculated chicken carcasses both after treatment and during the storage at 4.4°C for up to 6 days. In addition, reductions in psychrotroph counts indicated that these treatments might have the potential to increase the shelf-life of poultry carcasses. PMID:25656180

  8. Syncom 4 deploy, LDEF retrieval highlight 10-day Columbia flight

    NASA Technical Reports Server (NTRS)

    1989-01-01

    The objectives of Space Shuttle Mission STS-32 are described along with major flight activities, prelaunch and launch operations, trajectory sequence of events, and landing and post-landing operations. The primary objectives of STS-32 are the deployment of a Navy synchronous communications satellite (Syncom 4) and the retrieval of the Long Duration Exposure Facility (LDEF) launched from the Challenger in April 1984. Secondary STS-32 payloads include a protein crystal growth experiment, the Fluids Experiment Apparatus (FEA) for the investigation of microgravity materials processing, the Mesoscale Lighting Experiment, the Latitude-Longitude Locator Experiment, the Americal Flight Echocardiograph, and an experiment to investigate neurospora circadian rhythms in a microgravity environment.

  9. Enhancing Resilience in Youth through a 10-Day Developmental Voyage

    ERIC Educational Resources Information Center

    Hayhurst, Jill; Hunter, John A.; Kafka, Sarah; Boyes, Mike

    2015-01-01

    The present study sought to examine the potential for resilience to be enhanced in a group of youth participating in a developmental voyage, and to identify the factors that contribute to increased resilience following the voyage. Two studies are reported. Study 1 revealed that voyage participants experienced increased resilience over the course…

  10. An effective and more convenient drug regimen for prophylaxis against paclitaxel-associated hypersensitivity reactions.

    PubMed

    Markman, M; Kennedy, A; Webster, K; Peterson, G; Kulp, B; Belinson, J

    1999-07-01

    "Standard" prophylaxis for paclitaxel-associated hypersensitivity reactions has included the systemic administration of H1 and H2 histamine antagonists, along with oral dexamethasone taken both the night prior to, and the morning of, each paclitaxel treatment. To improve patient convenience and compliance with steroid delivery, the Gynecologic Cancer Program of the Cleveland Clinic Foundation has treated patients with an all-intravenous prophylaxis regimen (diphenhydramine 50 mg, famotidine 20 mg, dexamethasone 20 mg) given 30 min prior to paclitaxel (without any earlier oral steroid dosing). To date, we have treated more than 200 patients who received all courses of paclitaxel with this simplified prophylactic regimen, of whom approximately 9% developed hypersensitivity reactions (major or minor). This incidence is comparable to our previously reported experience with hypersensitivity reactions in a similar number of patients receiving the standard prophylaxis (including oral dexamethasone) with their initial course of paclitaxel, and subsequent cycles employing this all-intravenous program. We conclude that this "modified" regimen for paclitaxel-associated hypersensitivity reactions (with all drugs administered approximately 30 min prior to the delivery of paclitaxel) is as effective as, and more convenient than, the standard regimen, and avoids delaying chemotherapy as a result of a patient failing to remember to take one or both oral steroid doses. PMID:10394964

  11. Graft failure in children receiving HLA-mismatched marrow transplants with busulfan-containing regimens.

    PubMed

    Schultz, K R; Ratanatharathorn, V; Abella, E; Eisenbrey, A B; Karanes, C; Lum, L G; de Planque, M M; Uberti, J P; Ravindranath, Y; Sensenbrenner, L L

    1994-06-01

    Identifying risk factors that lead to graft failure may reduce morbidity and mortality after bone marrow transplantation (BMT) for hematologic malignancies. We evaluated engraftment of all patients with acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML) and myelodysplastic syndrome (MDS) receiving an unmanipulated marrow allogeneic BMT at the Detroit Medical Center from 1987 to 1992 using a busulfan, cyclophosphamide +/- cytarabine preparative regimen. Three of 118 patients had graft failure (2.5%; (95% confidence interval (CI) 0.7%, 6.4%). Graft failure was high in patients < or = 15 years with 3 of 12 patients with failure (25.0%) compared with 0 of 106 patients > 15 years (p = 0.002). Failure to engraft was not seen in HLA-identical (related or unrelated) donor transplants (0 of 103) whereas 3 of 15 HLA-mismatched donors failed (p = 0.003). Patient diagnosis, locus of HLA-mismatch, cytarabine in the preparative regimen, marrow cell dose and the relative reactive index (RRI) were not significant factors. Altered busulfan kinetics secondary to young age was probably not a major factor since 8 of 8 HLA-identical donor transplants engrafted in children. These findings demonstrate that patients receiving an unmanipulated marrow graft using busulfan-containing regimens were at a high risk for graft failure only if they were < or = 15 years of age and had an HLA-mismatched donor. More immunosuppressive preparative regimens, possibly including total body irradiation, should be considered to prevent potential graft failure in children. PMID:7920320

  12. Effects of Dietary Protein Concentration and Feeding Regimen on Channel Catfish Ictalurus punctatus Production

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A factorial experiment was conducted to examine effects of dietary protein concentration (24, 28, 32, or 36%) and feeding regimen (feeding once daily or every other d) on channel catfish Ictalurus punctatus production in earthen ponds. Compared with fish fed daily, fish fed every other d had lower ...

  13. The effects of a discretionary food allowance during a caloric restriction regimen with provided food

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effects of self-selected discretionary foods in a structured energy restricted diet on adherence to a caloric restriction (CR) regimen, dietary satisfaction, and weight loss were studied in 32 healthy, overweight (BMI 25-30 kg/m2) adults, aged 20-42y participating in the CALERIE trial. Subjects ...

  14. Comparative effects of constant versus fluctuating thermal regimens on yellow perch growth, feed conversion and survival

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effects of fluctuating or constant thermal regimens on growth, mortality, and feed conversion were determined for juvenile yellow perch (Perca flavescens). Yellow perch averaging 156mm total length and 43g body weight were held in replicate 288L circular tanks for 129 days under: 1) a diel therm...

  15. Evidence-Based Nursing of the 3C Therapeutic Regimen for Type 1 Diabetes.

    PubMed

    Wu, Jianya; Zou, Ling

    2015-05-01

    The aim of this study is to explore the efficacy of the 3C therapeutic regimen for type 1 diabetes. Thirty-nine patients with type 1 diabetes, who were hospitalized from January 2013 to April 2014, were included to receive 3C therapeutic regimen. Evidence-based nursing was performed in the treatment period and the efficacy was observed 6 days after therapy. Six days after the administration of the 3C therapeutic regimen, the fasting glucose levels in all 39 patients were controlled to be 4.4-6.0 mmol/L and 2h-postprandial glucose levels to be 4.4-7.8 mmol/L. Three patients had a glucose level <3.9 mmol/L, which was corrected after adjusting the dose of insulin infusion. Evidence-based nursing was provided in the treatment period and no nursing-associated complication occurred. All patients were satisfied with the nursing service. The efficacy of the 3C therapeutic regimen for type 1 diabetes is satisfactory. The evidence-based nursing can help to ensure the efficacy and improve the quality of nursing service. PMID:25424358

  16. Comparison of two intensified conventional insulin regimens with three and four daily injections.

    PubMed

    Faglia, E; Favales, F; Brivio, M; Calia, P; Quarantiello, A

    1993-01-01

    When choosing an intensified conventional insulin therapy, no specific differentiation is made between the three-injection regimen (regular insulin at breakfast and lunch, and regular+intermediate-acting insulin at dinner) and the four-injection regimen (regular insulin at breakfast, lunch and dinner, and intermediate-acting insulin at bedtime). No published studies have evaluated to our knowledge the differences between these two regimens. In 1991, we proposed to 30 stable type 1 diabetic patients without residual insulin secretion a change from three to four daily injections: 7 refused, 4 were later excluded for intercurrent events; 19 followed the four daily injection regimen for 2 years. In these non randomized 19 patients, the Student's test for paired data was used to compare with a self-controlled study the 1989-90 three-daily injection period with the 1991-92 four-daily-injection period in order to evaluate any differences in daytime blood glucose values (bi-monthly out-patient measurements taken at 8 am, 10 am, 3 pm and 5 pm), nocturnal blood glucose levels at 3 am (bi-monthly patient self-monitoring by means of a blood glucose meter, for a total of 188 vs 188 measurements), HbA1c (a total of 203 vs 207 bi-monthly out-patient measurements), the number of nocturnal hypoglycaemic attacks, body weight and mean insulin requirement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8026609

  17. Revisiting Dosing Regimen Using Pharmacokinetic/Pharmacodynamic Mathematical Modeling: Densification and Intensification of Combination Cancer Therapy.

    PubMed

    Meille, Christophe; Barbolosi, Dominique; Ciccolini, Joseph; Freyer, Gilles; Iliadis, Athanassios

    2016-08-01

    Controlling effects of drugs administered in combination is particularly challenging with a densified regimen because of life-threatening hematological toxicities. We have developed a mathematical model to optimize drug dosing regimens and to redesign the dose intensification-dose escalation process, using densified cycles of combined anticancer drugs. A generic mathematical model was developed to describe the main components of the real process, including pharmacokinetics, safety and efficacy pharmacodynamics, and non-hematological toxicity risk. This model allowed for computing the distribution of the total drug amount of each drug in combination, for each escalation dose level, in order to minimize the average tumor mass for each cycle. This was achieved while complying with absolute neutrophil count clinical constraints and without exceeding a fixed risk of non-hematological dose-limiting toxicity. The innovative part of this work was the development of densifying and intensifying designs in a unified procedure. This model enabled us to determine the appropriate regimen in a pilot phase I/II study in metastatic breast patients for a 2-week-cycle treatment of docetaxel plus epirubicin doublet, and to propose a new dose-ranging process. In addition to the present application, this method can be further used to achieve optimization of any combination therapy, thus improving the efficacy versus toxicity balance of such a regimen. PMID:26946136

  18. Non Comparative Study on Various Pulse Regimens (DCP, DAP and DMP) in Pemphigus: Our Experience

    PubMed Central

    Hassan, Iffat; Sameem, Farah; Masood, Qazi Manaan; Majid, Imran; Abdullah, Zubair; Ahmad, Qazi Masood

    2014-01-01

    Background: Pemphigus has been treated with Dexamethasone Cyclophosphamide Pulse (DCP) Therapy since 1981. Various modifications have been suggested in the original regimen. These include Dexamethasone Azathioprine Pulse (DAP) and Dexamethasone Methotrexate Pulse (DMP) therapies. Aims: To report our experience on the noncomparative study of various Pulse regimens DCP, DAP AND DMP therapies in patients with Pemphigus. Materials and Methods: The patients were put on three regimens depending upon the situation-Conventional DCP, DAP in the reproductive age group, DMP in patients who showed prolonged Phase I more than 12 months while on DCP. Results: 30 patients were put on DCP therapy. The duration of phase I was on an average six months. Relapse was seen in 3 patients in phase IV. 12 patients on DAP therapy were considered. In Phase III 5 patients relapsed in phase IV four patients relapsed. Five patients were put on the DMP. Disease activity was poorly controlled and in three DMP was discontinued. Conclusion: DCP remains the most effective regimen with quickest onset of remission and continuance of remission. In DAP therapy fixation of dose of azathioprine at 50 mgs daily may be counterproductive. DMP does not fulfil the promise of a viable treatment option in recalcitrant pemphigus and this lacunae needs to be plugged. PMID:24470657

  19. Effects of body size and nutritional regimen on survival in adult Aedes albopictus (Diptera: Culicidae)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effects of adult body size and nutritional regimen on the mean time to death (LT) for the 50th (LT50) and 90th centiles (LT90) of large and small male and female Aedes albopictus (Skuse) was determined in the laboratory. The estimated LT50 and the LT90 for large/small females was significantly ...

  20. Effects of an Aerobic Rowing Training Regimen in Young Adults with Down Syndrome.

    ERIC Educational Resources Information Center

    Varela, Ana Maria; Sardinha, Luis Bettencount; Pitetti, Kenneth H.

    2001-01-01

    Eight young adult males with Down syndrome received a 16-week rowing ergometry training regimen. Following training, no changes in cardiovascular fitness were found but participants did achieve significantly higher levels of work performance on both treadmill and rowing ergometer tests than did a control group. (Contains references.) (Author/DB)

  1. Autotransplant conditioning regimens for aggressive lymphoma: are we on the right road?

    PubMed

    Fernandez, H F; Escalón, M P; Pereira, D; Lazarus, H M

    2007-09-01

    High-dose chemotherapy and autologous stem cell transplant (ASCT) is the standard approach for chemosensitive, relapsed aggressive non-Hodgkin's lymphoma (NHL). Various conditioning regimens have been used as treatment before ASCT and disease-free (DFS) and overall survival (OS) rates range from 34 to 60% and 26 to 46%, respectively. To date, few comparative randomized trials have been performed and no regimen has demonstrated superiority to another. Reduction of disease relapse remains the major hurdle for improving patient outcome and in vitro and in vivo purging of lymphoma cells has not necessarily enhanced results. Rituximab pre-mobilization and post-transplant appear to provide better response rates with OS approaching 87-91% at 2-3 years. Newer approaches with radioimmunotherapy may raise DFS to 78% and OS to 93%, albeit with short follow-up. Advances in the conditioning regimens and supportive care have reduced transplant-related mortality to less than 10%. In this review we discuss commonly utilized conditioning regimens, describe their pros and cons and address purging and present conditioning strategies. Owing to the poor outcome with conventional chemotherapy in mantle cell, Burkitt's and T-cell lymphoma, we propose the standard approach of front-line ASCT for these high-risk lymphoma patients. Finally, we will present novel strategies, which can enhance the anti-lymphoma effect, at the same time reducing toxicity, to improve the outcome of ASCT in NHL patients. PMID:17589535

  2. A Patient Education Program to Improve Adherence Rates with Antituberculosis Drug Regimens.

    ERIC Educational Resources Information Center

    Morisky, Donald E.; And Others

    1990-01-01

    An incentive scheme to reward positive health behaviors (adherence to antituberculosis drug regimens) was tested with 88 active and 117 preventive patients randomly assigned to intervention and control groups. Preventive patients who received incentives were significantly more likely to continue care and had higher adherence levels. Actives showed…

  3. PROPOSAL OF ANTI-TUBERCULOSIS REGIMENS BASED ON SUSCEPTIBILITY TO ISONIAZID AND RIFAMPICIN

    PubMed Central

    Mendoza-Ticona, Alberto; Moore, David AJ; Alarcón, Valentina; Samalvides, Frine; Seas, Carlos

    2014-01-01

    Objective To elaborate optimal anti-tuberculosis regimens following drug susceptibility testing (DST) to isoniazid (H) and rifampicin (R). Design 12 311 M. tuberculosis strains (National Health Institute of Peru 2007-2009) were classified in four groups according H and R resistance. In each group the sensitivity to ethambutol (E), pirazinamide (Z), streptomycin (S), kanamycin (Km), capreomycin (Cm), ciprofloxacin (Cfx), ethionamide (Eto), cicloserine (Cs) and p-amino salicilic acid (PAS) was determined. Based on resistance profiles, domestic costs, and following WHO guidelines, we elaborated and selected optimal putative regimens for each group. The potential efficacy (PE) variable was defined as the proportion of strains sensitive to at least three or four drugs for each regimen evaluated. Results Selected regimes with the lowest cost, and highest PE of containing 3 and 4 effective drugs for TB sensitive to H and R were: HRZ (99,5%) and HREZ (99,1%), respectively; RZECfx (PE=98,9%) and RZECfxKm (PE=97,7%) for TB resistant to H; HZECfx (96,8%) and HZECfxKm (95,4%) for TB resistant to R; and EZCfxKmEtoCs (82.9%) for MDR-TB. Conclusion Based on resistance to H and R it was possible to select anti-tuberculosis regimens with high probability of success. This proposal is a feasible alternative to tackle tuberculosis in Peru where the access to rapid DST to H and R is improving progressively. PMID:23949502

  4. The Diabetes Regimen Responsibility Scale: Information on Internal Consistency and Validity in a Pediatric Sample.

    ERIC Educational Resources Information Center

    Carey, Tracy; Reid, Graham; Ruggiero, Laurie; Horner, James; Dubow, Eric

    1997-01-01

    The internal consistency and validity of the Diabetes Regimen Responsibility Scale (DRRS) (L. Ruggiero and others, 1991) were examined in a sample of 49 youths. The DRRS demonstrated adequate internal consistency, and most subscales correlated significantly with diabetes knowledge (health education issue). Only two reports correlated with…

  5. The Role of Feeding Regimens in Regulating Metabolism of Sexually Mature Broiler Breeders

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A trial was conducted to determine the effects of different rearing feed regimens on plasma hormone and metabolite levels and hepatic lipid metabolism and gene expression on sexually mature broiler breeders. Cobb 500 birds were divided into two groups at 4 weeks of age and fed either everyday (ED) ...

  6. Mixed chimerism and permanent specific transplantation tolerance induced by a nonlethal preparative regimen

    SciTech Connect

    Sharabi, Y.; Sachs, D.H.

    1989-02-01

    The use of allogeneic bone marrow transplantation as a means of inducing donor-specific tolerance across MHC barriers could provide an immunologically specific conditioning regimen for organ transplantation. However, a major limitation to this approach is the toxicity of whole body irradiation as currently used to abrogate host resistance and permit marrow engraftment. The present study describes methodology for abrogating host resistance and permitting marrow engraftment without lethal irradiation. Our preparative protocol involves administration of anti-CD4 and anti-CD8 mAbs in vivo, 300-rad WBI, 700-rad thymic irradiation, and unmanipulated fully MHC-disparate bone marrow. B10 mice prepared by this regimen developed stable mixed lymphohematopoetic chimerism without any clinical evidence of graft-vs.-host disease. Engraftment was accompanied by induction of specific tolerance to donor skin grafts (B10.D2), while third-party skin grafts (B10.BR) were promptly rejected. Mice treated with the complete regimen without bone marrow transplantation appeared healthy and enjoyed long-term survival. This study therefore demonstrates that stable mixed chimerism with donor-specific tolerance can be induced across an MHC barrier after a nonlethal preparative regimen, without clinical GVHD and without the risk of aplasia.

  7. Sequential determination of fat- and water-soluble vitamins in green leafy vegetables during storage.

    PubMed

    Santos, J; Mendiola, J A; Oliveira, M B P P; Ibáñez, E; Herrero, M

    2012-10-26

    The simultaneous analysis of fat- and water-soluble vitamins from foods is a difficult task considering the wide range of chemical structures involved. In this work, a new procedure based on a sequential extraction and analysis of both types of vitamins is presented. The procedure couples several simple extraction steps to LC-MS/MS and LC-DAD in order to quantify the free vitamins contents in fresh-cut vegetables before and after a 10-days storage period. The developed method allows the correct quantification of vitamins C, B(1), B(2), B(3), B(5), B(6), B(9), E and provitamin A in ready-to-eat green leafy vegetable products including green lettuce, ruby red lettuce, watercress, swiss chard, lamb's lettuce, spearmint, spinach, wild rocket, pea leaves, mizuna, garden cress and red mustard. Using this optimized methodology, low LOQs were attained for the analyzed vitamins in less than 100 min, including extraction and vitamin analysis using 2 optimized procedures; good repeatability and linearity was achieved for all vitamins studied, while recoveries ranged from 83% to 105%. The most abundant free vitamins found in leafy vegetable products were vitamin C, provitamin A and vitamin E. The richest sample on vitamin C and provitamin A was pea leaves (154 mg/g fresh weight and 14.4 mg/100g fresh weight, respectively), whereas lamb's lettuce was the vegetable with the highest content on vitamin E (3.1 mg/100 g fresh weight). Generally, some losses of vitamins were detected after storage, although the behavior of each vitamin varied strongly among samples. PMID:22608116

  8. Short Communication: Comparative Evaluation of Coformulated Injectable Combination Antiretroviral Therapy Regimens in Simian Immunodeficiency Virus-Infected Rhesus Macaques.

    PubMed

    Del Prete, Gregory Q; Smedley, Jeremy; Macallister, Rhonda; Jones, Gregg S; Li, Bei; Hattersley, Jillian; Zheng, Jim; Piatak, Michael; Keele, Brandon F; Hesselgesser, Joseph; Geleziunas, Romas; Lifson, Jeffrey D

    2016-02-01

    The use of nonhuman primate (NHP) models to study persistent residual virus and viral eradication strategies in combination antiretroviral therapy (cART)-treated individuals requires regimens that effectively suppress SIV replication to clinically relevant levels in macaques. We developed and evaluated two novel cART regimens in SIVmac239-infected rhesus macaques: (1) a "triple regimen" containing the nucleo(s/t)ide reverse transcriptase inhibitors emtricitabine (FTC) and tenofovir disoproxil fumarate [TDF, prodrug of tenofovir (TFV, PMPA)] with the integrase strand transfer inhibitor dolutegravir (DTG) (n = 3), or (2) a "quad regimen" containing the same three drugs plus the protease inhibitor darunavir (DRV) (n = 3), with each regimen coformulated for convenient administration by a single daily subcutaneous injection. Plasma drug concentrations were consistent across animals within the triple and quad regimen-treated groups, although DTG levels were lower in the quad regimen animals. Time to achieve plasma viral loads stably <30 viral RNA copies/ml ranged from 12 to 20 weeks of treatment between animals, and viral loads <30 viral RNA copies/ml plasma were maintained through 40 weeks of follow-up on cART. Notably, although we show virologic suppression and development of viral resistance in a separate cohort of SIV-infected animals treated with oral DRV monotherapy, the addition of DRV in the quad regimen did not confer an apparent virologic benefit during early treatment, hence the quad regimen-treated animals were switched to the triple regimen after 4 weeks. This coformulated triple cART regimen can be safely, conveniently, and sustainably administered to durably suppress SIV replication to clinically relevant levels in rhesus macaques. PMID:26150024

  9. A Bayesian Theory of Sequential Causal Learning and Abstract Transfer.

    PubMed

    Lu, Hongjing; Rojas, Randall R; Beckers, Tom; Yuille, Alan L

    2016-03-01

    Two key research issues in the field of causal learning are how people acquire causal knowledge when observing data that are presented sequentially, and the level of abstraction at which learning takes place. Does sequential causal learning solely involve the acquisition of specific cause-effect links, or do learners also acquire knowledge about abstract causal constraints? Recent empirical studies have revealed that experience with one set of causal cues can dramatically alter subsequent learning and performance with entirely different cues, suggesting that learning involves abstract transfer, and such transfer effects involve sequential presentation of distinct sets of causal cues. It has been demonstrated that pre-training (or even post-training) can modulate classic causal learning phenomena such as forward and backward blocking. To account for these effects, we propose a Bayesian theory of sequential causal learning. The theory assumes that humans are able to consider and use several alternative causal generative models, each instantiating a different causal integration rule. Model selection is used to decide which integration rule to use in a given learning environment in order to infer causal knowledge from sequential data. Detailed computer simulations demonstrate that humans rely on the abstract characteristics of outcome variables (e.g., binary vs. continuous) to select a causal integration rule, which in turn alters causal learning in a variety of blocking and overshadowing paradigms. When the nature of the outcome variable is ambiguous, humans select the model that yields the best fit with the recent environment, and then apply it to subsequent learning tasks. Based on sequential patterns of cue-outcome co-occurrence, the theory can account for a range of phenomena in sequential causal learning, including various blocking effects, primacy effects in some experimental conditions, and apparently abstract transfer of causal knowledge. PMID:25902728

  10. Intermittent Versus Daily Pulmonary Tuberculosis Treatment Regimens: A Meta-Analysis

    PubMed Central

    Kasozi, Samuel; Clark, Justin; Doi, Suhail A. R.

    2015-01-01

    Background Several systematic reviews suggest that intermittent pulmonary tuberculosis (TB) chemotherapy is effective, but intensity (daily versus intermittent) and duration of rifampicin use (intensive phase only versus both phases) have not been distinguished. In addition, the various outcomes (success, failure, relapse, and default) have only selectively been evaluated. Methods We conducted a meta-analysis of proportions using all four outcomes as multi-category proportions to examine the effectiveness of WHO category 1 TB treatment regimens. Database searches of studies reporting treatment outcomes of HIV negative subjects were included and stratified by intensity of therapy and duration of rifampicin therapy. Using a bias-adjusted statistical model, we pooled proportions of the four treatment outcome categories using a method that handles multi-category proportions. Results A total of 27 studies comprising of 48 data sets with 10,624 participants were studied. Overall, treatment success was similar among patients treated with intermittent (I/I) (88%) (95% CI, 81–92) and daily (D/D) (90%) (95% CI, 84–95) regimens. Default was significantly less with I/I (0%) (95% CI, 0–2) compared to D/D regimens (5%) (95% CI, 1–9). Nevertheless, I/I relapse rates (7%) (95% CI, 3–11) were higher than D/D relapse rates (1%) (95% CI, 0–3). Conclusion Treatment regimens that are offered completely intermittently versus completely daily are associated with a trade-off between treatment relapse and treatment default. There is a possibility that I/I regimens can be improved by increasing treatment duration, and this needs to be urgently addressed by future studies. PMID:26056374

  11. A prospective study of the LMB regimen for diffuse large cell non Hodgkin's lymphoma in adults.

    PubMed

    Voog, E; Sebban, C; Biron, P; Philip, T; Blay, J Y

    2000-02-01

    Although the CHOP regimen remains a standard first line chemotherapy for diffuse large cell lymphoma (DLCL) in adults, a majority of these patients will still experience disease progression after the completion of this treatment. The LMB protocol is an intensive chemotherapy regimen which yields high survival rates in Burkitt's lymphoma (BL) and diffuse large cell lymphoma (DLCL) in children, as well as in primary cerebral DLCL (PCL) of adults. Here, we report the long term results of this regimen in a prospective series of 22 adult patients with DLCL excluding PCL. Fifteen male and 7 female patients with a median age of 30 years (range: 20-55) were treated prospectively between 1988 and 1993. 16 (72%) patients had an age adjusted International Pronostic Index (IPI) > or = 1. The median duration of the treatment was 15 weeks (range 13-19). Nineteen of the 22 patients (87%) experienced an objective response (14 complete, and 5 partial responses) at the end of the protocol. The predominant toxicity was myelosuppression: 89% of the COPADEM courses were followed by grade IV neutropenia and 5% with grade IV infection. One patient died (4%) of treatment related toxicity. With a median follow-up of 94 months and a minimum follow-up of 65 months, 8-year overall and progression-free survival are 73% and 67% respectively. The 8 year overall survival were 100%, 78% and 42% in patients with an IPI 0, 1, and 2-3 respectively. This short intensive regimen yields promising long term survival rates in this monocentric prospective study and may deserve to be tested in a larger multicentric prospective study comparing it to the CHOP regimen. PMID:10784397

  12. Possible impact of the standardized Category IV regimen on multidrug-resistant tuberculosis patients in Mumbai

    PubMed Central

    Udwadia, Zarir F; Mullerpattan, Jai Bharat; Shah, Kushal D; Rodrigues, Camilla S

    2016-01-01

    Background: Treatment of multidrug-resistant tuberculosis (MDR-TB) in the Programmatic Management of Drug-resistant TB program involves a standard regimen with a 6-month intensive phase and an 18-month continuation phase. However, the local drug resistance patterns in high MDR regions such as Mumbai may not be adequately reflected in the design of the regimen for that particular area. Setting: The study was carried out at a private Tertiary Level Hospital in Mumbai in a mycobacteriology laboratory equipped to perform the second-line drug susceptibility testing (DST). Objective: We attempted to analyze the impact of prescribing the standardized Category IV regimen to all patients receiving a DST at our mycobacteriology laboratory. Materials and Methods: All samples confirmed to be MDR-TB and tested for the second-line drugs at Hinduja Hospital's Mycobacteriology Laboratory in the year 2012 were analyzed. Results: A total of 1539 samples were analyzed. Of these, 464 (30.14%) were MDR-TB, 867 (56.33%) were MDR with fluoroquinolone resistance, and 198 (12.8%) were extensively drug-resistant TB. The average number of susceptible drugs per sample was 3.07 ± 1.29 (assuming 100% cycloserine susceptibility). Taking 4 effective drugs to be the cut or an effective regimen, the number of patients receiving 4 or more effective drugs from the standardized directly observed treatment, short-course plus regimen would be 516 (33.5%) while 66.5% of cases would receive 3 or less effective drugs. Conclusion: Our study shows that a high proportion of patients will have resistance to a number of the first- and second-line drugs. Local epidemiology must be factored in to avoid amplification of resistance. PMID:27185987

  13. Deterministic sequential isolation of floating cancer cells under continuous flow.

    PubMed

    Tran, Quang D; Kong, Tian Fook; Hu, Dinglong; Marcos; Lam, Raymond H W

    2016-08-01

    Isolation of rare cells, such as circulating tumor cells, has been challenging because of their low abundance and limited timeframes of expressions of relevant cell characteristics. In this work, we devise a novel hydrodynamic mechanism to sequentially trap and isolate floating cells in biosamples. We develop a microfluidic device for the sequential isolation of floating cancer cells through a series of microsieves to obtain up to 100% trapping yield and >95% sequential isolation efficiency. We optimize the trappers' dimensions and locations through both computational and experimental analyses using microbeads and cells. Furthermore, we investigated the functional range of flow rates for effective sequential cell isolation by taking the cell deformability into account. We verify the cell isolation ability using the human breast cancer cell line MDA-MB-231 with perfect agreement with the microbead results. The viability of the isolated cells can be maintained for direct identification of any cell characteristics within the device. We further demonstrate that this device can be applied to isolate the largest particles from a sample containing multiple sizes of particles, revealing its possible applicability in isolation of circulating tumor cells in cancer patients' blood. Our study provides a promising sequential cell isolation strategy with high potential for rapid detection and analysis of general floating cells, including circulating tumor cells and other rare cell types. PMID:27387093

  14. Sequential Treatment of Multiple Actinic Keratoses with Solaraze and Actikerall

    PubMed Central

    Dirschka, Thomas; Lear, John T.

    2014-01-01

    Interest is increasing in the use of sequential or combined therapeutic modalities for spot or area treatment of actinic keratoses (AKs) to achieve complete sustained remission. For multiple lesions in a contained area, topical treatment offers less discomfort, better cosmesis and greater patient convenience than destructive/ablative techniques. Twelve patients with multiple grade I and II AK lesions of the scalp (cases 1–10) or the dorsum of the hand (cases 11 and 12), most with a history of recurrence, were treated with Solaraze gel (3% diclofenac sodium in 2.5% hyaluronic acid) twice daily for 12 weeks, followed by a 2-week treatment-free interval, then Actikerall cutaneous solution (5-fluorouracil 5 mg/g and salicylic acid 100 mg/g) once daily for up to 6 weeks as required. Sequential treatment provided complete (clinical and histological) clearance in 8/10 male patients. Two patients with numerous lesions had partial clearance (significant improvement) and the remaining few lesions were treated with erbium laser. Both female patients achieved complete clinical clearance with sequential treatment. Solaraze/Actikerall were well tolerated. A case of contact dermatitis with Solaraze resolved after discontinuation and the patient progressed to treatment with Actikerall. Local application site reactions resolved upon treatment completion. Topical lesion-directed sequential treatment with Solaraze/Actikerall is a rational approach to treat patients with multiple AKs. Sequential treatment produces excellent clearance rates which are accompanied by relevant improvement in patients’ quality of life. PMID:25120467

  15. Reduction of delayed renal allograft function using sequential immunosuppression.

    PubMed

    Müller, T; Ruffingshofer, D; Bidmon, B; Arbeiter, K; Balzar, E; Aufricht, C

    2001-08-01

    Previous data suggested that outcome in small children with cadaveric renal transplantation might be improved with sequential therapy. This protocol combines augmented immunosuppression [by including antibody induction (ATG)] with avoidance of nephrotoxic medication in the immediate postoperative phase (by delayed start of cyclosporin therapy). In this report, we describe effects of this approach in 12 consecutively transplanted small children of less than 5 years of age (mean 3.2 years) who received a cadaveric renal graft at our institution between 1991 and 1998. Up to 1996 triple therapy (prednisolone, azathioprine, cyclosporin) and since 1997 sequential therapy (prednisolone, azathioprine, ATG until serum creatinine <2 mg/dl, then cyclosporin) was used for immunosuppression. Five children had delayed graft function (45.4%), all of whom were treated with triple therapy including cyclosporin from the very beginning, whereas children treated by the sequential protocol gained immediate graft function (P<0.05). There was no statistical difference between the two protocols concerning frequency or severity of rejections (67% vs. 60%, all steroid responsive), difference in the incidence of either bacterial or viral infections, or between the incidence of hypertension. Although not reaching statistical significance, 1-year graft survival rates also increased from 60% for triple therapy to 80% for sequential therapy. In conclusion, our findings confirm previous studies showing that outcome in small children undergoing renal transplantation may be improved by specially tailored treatment protocols such as sequential therapy. PMID:11519888

  16. The Role of Health Beliefs in the Regimen Adherence and Metabolic Control of Adolescents and Adults with Diabetes Mellitus.

    ERIC Educational Resources Information Center

    Brownlee-Duffeck, Martha; And Others

    1987-01-01

    Examined the role of health beliefs in diabetic regimen adherence and metabolic control. Health beliefs accounted for a statistically significant portion of the variance in both. For older patients perceived benefits of adhering to the diabetic regimen was most significant. For younger patients costs figured prominently in adherence and perceived…

  17. Adherence to Medical Regimens: Understanding the Effects of Cognitive Appraisal, Quality of Life, and Perceived Family Resiliency

    ERIC Educational Resources Information Center

    Frain, Michael P.; Bishop, Malachy; Tschopp, Molly K.; Ferrin, Micheal J.; Frain, Judy

    2009-01-01

    Adherence studies have taken center stage due to the life-threatening risks associated with nonadherence to highly active antiretroviral therapy (HAART) regimens for people with HIV/AIDS. This study examines adherence through self-report of individuals on HAART regimens in a manner to account for demand characteristic bias, while still attempting…

  18. Sequential changes in the metabolic response in severely septic patients during the first 23 days after the onset of peritonitis.

    PubMed Central

    Plank, L D; Connolly, A B; Hill, G L

    1998-01-01

    OBJECTIVE: To quantify the sequential changes in metabolic response occurring in patients with severe sepsis after the onset of peritonitis. SUMMARY BACKGROUND DATA: Understanding the changes in energy expenditure and body composition is essential for the optimal management of severely septic patients; however, they have not been quantified in the context of modern surgical care. METHODS: Twelve patients with severe sepsis secondary to peritonitis (median APACHE II score = 21.5) had measurements of energy expenditure and body composition as soon as they were hemodynamically stable and 5, 10, and 21 days later. Sequential measurements of acute-phase proteins and cytokine responses were also made. RESULTS: Resting energy expenditure rose to 49% above predicted and remained elevated throughout the study period. Total energy expenditure was 1.25 x resting energy expenditure. Body fat was oxidized when energy intake was insufficient to achieve energy balance. There was a positive fluid balance of 12.5 1 over the first 2 days after onset of sepsis; thereafter, body water changes closely paralleled body weight changes and were largely accounted for by changes in extracellular water. During the 21 -day study period, there was a loss of 1.21 kg (13%) of total body protein. During the first 10 days, 67% of the protein lost came from skeletal muscle, but after this time it was predominantly from viscera. Intracellular potassium levels were low but did not deteriorate further after hemodynamic stability had been reached. There was a reprioritization of hepatic protein synthesis that was obligatory and independent of changes in total body protein. The cytokine responses demonstrated the complexity, redundancy, and overlap of mediators. CONCLUSIONS: The period of hypermetabolism in severely septic patients is similar to that previously described, but the fluid changes are larger and the protein loss is greater. Protein loss early on is predominantly from muscle, thereafter from

  19. A Bayesian sequential processor approach to spectroscopic portal system decisions

    SciTech Connect

    Sale, K; Candy, J; Breitfeller, E; Guidry, B; Manatt, D; Gosnell, T; Chambers, D

    2007-07-31

    The development of faster more reliable techniques to detect radioactive contraband in a portal type scenario is an extremely important problem especially in this era of constant terrorist threats. Towards this goal the development of a model-based, Bayesian sequential data processor for the detection problem is discussed. In the sequential processor each datum (detector energy deposit and pulse arrival time) is used to update the posterior probability distribution over the space of model parameters. The nature of the sequential processor approach is that a detection is produced as soon as it is statistically justified by the data rather than waiting for a fixed counting interval before any analysis is performed. In this paper the Bayesian model-based approach, physics and signal processing models and decision functions are discussed along with the first results of our research.

  20. Finding a Path for Segmentation Through Sequential Learning.

    PubMed

    Wang, Hongzhi; Cao, Yu; Syed-Mahmood, Tanveer F

    2015-01-01

    Sequential learning techniques, such as auto-context, that applies the output of an intermediate classifier as contextual features for its subsequent classifier has shown impressive performance for semantic segmentation. We show that these methods can be interpreted as an approximation technique derived from a Bayesian formulation. To improve the effectiveness of applying this approximation technique, we propose a new sequential learning approach for semantic segmentation that solves a segmentation problem by breaking it into a series of simplified segmentation problems. Sequentially solving each of the simplified problems along the path leads to a more effective way for solving the original segmentation problem. To achieve this goal, we also propose a learning-based method to generate simplified segmentation problems by explicitly controlling the complexities of the modeling classifiers. We report promising results on the 2013 SATA canine leg muscle segmentation dataset. PMID:26221697

  1. Sequential and combined acceleration tests for crystalline Si photovoltaic modules

    NASA Astrophysics Data System (ADS)

    Masuda, Atsushi; Yamamoto, Chizuko; Uchiyama, Naomi; Ueno, Kiyoshi; Yamazaki, Toshiharu; Mitsuhashi, Kazunari; Tsutsumida, Akihiro; Watanabe, Jyunichi; Shirataki, Jyunko; Matsuda, Keiko

    2016-04-01

    The sequential combination test for photovoltaic modules is effective for accelerating degradation to shorten the test time and for reproducing degradation phenomena observed in modules exposed outdoors for a long time. The damp-heat (DH) test, thermal-cycle (TC) test, humidity-freeze (HF) test or dynamic mechanical load (DML) test is combined for the test modules. It was confirmed that chemical corrosion degradation or physical mechanical degradation is reproduced by the combination of the above tests. Cracks on the back sheet and delamination, often observed upon outdoor exposure, were well reproduced by the combination of DH and TC tests and TC and HF tests, respectively. Sequential DH and TC tests and DML and TC tests accelerated the degradation. These sequential tests are expected to be effective in reducing the required time of indoor testing for ensuring long-term reliability.

  2. Sequential extrusion-microwave pretreatment of switchgrass and big bluestem.

    PubMed

    Karunanithy, C; Muthukumarappan, K; Gibbons, W R

    2014-02-01

    Developing an effective and economical biomass pretreatment method is a significant roadblock to meeting the ever growing demand for transportation fuels. Earlier studies with different feedstocks revealed that in the absence of chemicals, neither extrusion nor microwave could be standalone pretreatments. However, there is potential that the advantages of these individual methods can be harnessed in a sequential pretreatment process. Accordingly, switchgrass and big bluestem were extruded and then subject to microwave pretreatment, under optimal conditions that had been separately determined in prior studies. Pretreated biomass was then subject to enzymatic hydrolysis to understand the effectiveness of the sequential pretreatment on sugar recovery and generation of fermentation inhibitors. Statistical analysis confirmed that moisture content, microwave power level, and exposure time (and their interactions) had significant influence on sugar recovery. Sequential pretreatment of switchgrass (25% moisture, 450W and 2.5min) resulted in a maximum glucose, xylose, and total sugar recovery of 52.6%, 75.5%, and 59.2%, respectively. This was higher by 1.27 and 2.71, 1.21 and 4.60, and 1.25 and 2.87 times compared to extrusion alone and the unpretreated control, respectively. The same sequential pretreatment conditions achieved maximum glucose, xylose, and total sugar recovery of 83.2%, 92.1%, and 68.1%, respectively, for big bluestem. This was 1.14 and 4.1, 1.18 and 2.7, and 1.20 and 3.0 times higher than extrusion alone and the unpretreated control, respectively. This sequential pretreatment process did not aggravate acetic acid formation over levels observed with the individual pretreatments. Furthermore, furfural, HMF, and formic acid were not detected in any of the treatments. Although the sequential pretreatment process enhanced sugar recovery without increasing the levels of potential fermentation inhibitors, the increased energy input for the microwave treatment may

  3. Fluorescence sensor for sequential detection of zinc and phosphate ions.

    PubMed

    An, Miran; Kim, Bo-Yeon; Seo, Hansol; Helal, Aasif; Kim, Hong-Seok

    2016-12-01

    A new, highly selective turn-on fluorescent chemosensor based on 2-(2'-tosylamidophenyl)thiazole (1) for the detection of zinc and phosphate ions in ethanol was synthesized and characterized. Sensor 1 showed a high selectivity for zinc compared to other cations and sequentially detected hydrogen pyrophosphate and hydrogen phosphate. The fluorescence mechanism can be explained by two different mechanisms: (i) the inhibition of excited-state intramolecular proton transfer (ESIPT) and (ii) chelation-induced enhanced fluorescence by binding with Zn(2+). The sequential detection of phosphate anions was achieved by the quenching and subsequent revival of ESIPT. PMID:27343439

  4. Sequential behavior and its inherent tolerance to memory faults.

    NASA Technical Reports Server (NTRS)

    Meyer, J. F.

    1972-01-01

    Representation of a memory fault of a sequential machine M by a function mu on the states of M and the result of the fault by an appropriately determined machine M(mu). Given some sequential behavior B, its inherent tolerance to memory faults can then be measured in terms of the minimum memory redundancy required to realize B with a state-assigned machine having fault tolerance type tau and fault tolerance level t. A behavior having maximum inherent tolerance is exhibited, and it is shown that behaviors of the same size can have different inherent tolerance.

  5. Not each sequential effect algebra is sharply dominating

    NASA Astrophysics Data System (ADS)

    Shen, Jun; Wu, Junde

    2009-04-01

    Let E be an effect algebra and E be the set of all sharp elements of E. E is said to be sharply dominating if for each a∈E there exists a smallest element aˆ∈E such that a⩽aˆ. In 2002, Professors Gudder and Greechie proved that each σ-sequential effect algebra is sharply dominating. In 2005, Professor Gudder presented 25 open problems in [S. Gudder, Int. J. Theory Phys. 44 (2005) 2219], the 3rd problem asked: Is each sequential effect algebra sharply dominating? Now, we construct an example to answer the problem negatively.

  6. Structural Drift: The Population Dynamics of Sequential Learning

    PubMed Central

    Crutchfield, James P.; Whalen, Sean

    2012-01-01

    We introduce a theory of sequential causal inference in which learners in a chain estimate a structural model from their upstream “teacher” and then pass samples from the model to their downstream “student”. It extends the population dynamics of genetic drift, recasting Kimura's selectively neutral theory as a special case of a generalized drift process using structured populations with memory. We examine the diffusion and fixation properties of several drift processes and propose applications to learning, inference, and evolution. We also demonstrate how the organization of drift process space controls fidelity, facilitates innovations, and leads to information loss in sequential learning with and without memory. PMID:22685387

  7. Fluorescence sensor for sequential detection of zinc and phosphate ions

    NASA Astrophysics Data System (ADS)

    An, Miran; Kim, Bo-Yeon; Seo, Hansol; Helal, Aasif; Kim, Hong-Seok

    2016-12-01

    A new, highly selective turn-on fluorescent chemosensor based on 2-(2‧-tosylamidophenyl)thiazole (1) for the detection of zinc and phosphate ions in ethanol was synthesized and characterized. Sensor 1 showed a high selectivity for zinc compared to other cations and sequentially detected hydrogen pyrophosphate and hydrogen phosphate. The fluorescence mechanism can be explained by two different mechanisms: (i) the inhibition of excited-state intramolecular proton transfer (ESIPT) and (ii) chelation-induced enhanced fluorescence by binding with Zn2 +. The sequential detection of phosphate anions was achieved by the quenching and subsequent revival of ESIPT.

  8. Analysis of filter tuning techniques for sequential orbit determination

    NASA Technical Reports Server (NTRS)

    Lee, T.; Yee, C.; Oza, D.

    1995-01-01

    This paper examines filter tuning techniques for a sequential orbit determination (OD) covariance analysis. Recently, there has been a renewed interest in sequential OD, primarily due to the successful flight qualification of the Tracking and Data Relay Satellite System (TDRSS) Onboard Navigation System (TONS) using Doppler data extracted onboard the Extreme Ultraviolet Explorer (EUVE) spacecraft. TONS computes highly accurate orbit solutions onboard the spacecraft in realtime using a sequential filter. As the result of the successful TONS-EUVE flight qualification experiment, the Earth Observing System (EOS) AM-1 Project has selected TONS as the prime navigation system. In addition, sequential OD methods can be used successfully for ground OD. Whether data are processed onboard or on the ground, a sequential OD procedure is generally favored over a batch technique when a realtime automated OD system is desired. Recently, OD covariance analyses were performed for the TONS-EUVE and TONS-EOS missions using the sequential processing options of the Orbit Determination Error Analysis System (ODEAS). ODEAS is the primary covariance analysis system used by the Goddard Space Flight Center (GSFC) Flight Dynamics Division (FDD). The results of these analyses revealed a high sensitivity of the OD solutions to the state process noise filter tuning parameters. The covariance analysis results show that the state estimate error contributions from measurement-related error sources, especially those due to the random noise and satellite-to-satellite ionospheric refraction correction errors, increase rapidly as the state process noise increases. These results prompted an in-depth investigation of the role of the filter tuning parameters in sequential OD covariance analysis. This paper analyzes how the spacecraft state estimate errors due to dynamic and measurement-related error sources are affected by the process noise level used. This information is then used to establish

  9. Case Report: Stevens-Johnson syndrome following a single double dosing of nevirapine-containing regimen once in an HIV-infected woman on long-term antiretroviral therapy.

    PubMed Central

    Kakande, Betty; Isaacs, Thuraya; Muloiwa, Rudzani; Dlamini, Sipho; Lehloenya, Rannakoe

    2015-01-01

    A 31-year old HIV-infected African woman on nevirapine, tenofovir and lamivudine for more than 4 years presented with an 8-day history of symptoms and signs of Stevens-Johnson syndrome. She was on no other medication. Her viral load was undetectable and she had maintained a CD4 count of between 356 and 387cells/mm 3 in the preceding 2½ years. She missed her antiretrovirals 10 days before the onset of her symptoms and subsequently doubled her daily dose the following day. She had been on no other medication in the preceding 8 weeks. Her ARVs were stopped and she fully re-epithelialized with the exception of the lips, over the following 10 days. She was started on a daily single tablet of Odimune® (a fixed drug combination antiretroviral containing tenofovir, emtricitabine and efavirenz). Nevirapine is the most common offender in cases of antiretroviral-associated SJS in published literature. Lamivudine is very rarely implicated while there are no similar reports with tenofovir.  We concluded that nevirapine was by far the most likely offender in this case. Nevirapine toxicity is associated with high CD4 counts, undetectable viral load and high drug plasma level. We postulate that the sudden increase of the plasma levels of nevirapine in a patient with a high CD4 count and undetectable viral load created a perfect storm for the development of SJS in our patient, who had been on the NVP-containing regimen for many years. Clinicians should be aware that severe adverse drug reactions are dynamic and can occur even when the drug has been in use for a long time. PMID:26629333

  10. Comparative Cost Analysis of Sequential, Adaptive, Behavioral, Pharmacological, and Combined Treatments for Childhood ADHD.

    PubMed

    Page, Timothy F; Pelham, William E; Fabiano, Gregory A; Greiner, Andrew R; Gnagy, Elizabeth M; Hart, Katie C; Coxe, Stefany; Waxmonsky, James G; Foster, E Michael; Pelham, William E

    2016-01-01

    We conducted a cost analysis of the behavioral, pharmacological, and combined interventions employed in a sequential, multiple assignment, randomized, and adaptive trial investigating the sequencing and enhancement of treatment for children with attention deficit hyperactivity disorder (ADHD; Pelham et al., 201X; N = 146, 76% male, 80% Caucasian). The quantity of resources expended on each child's treatment was determined from records that listed the type, date, location, persons present, and duration of all services provided. The inputs considered were the amount of physician time, clinician time, paraprofessional time, teacher time, parent time, medication, and gasoline. Quantities of these inputs were converted into costs in 2013 USD using national wage estimates from the Bureau of Labor Statistics, the prices of 30-day supplies of prescription drugs from the national Express Scripts service, and mean fuel prices from the Energy Information Administration. Beginning treatment with a low-dose/intensity regimen of behavior modification (large-group parent training) was less costly for a school year of treatment ($961) than beginning treatment with a low dose of stimulant medication ($1,669), regardless of whether the initial treatment was intensified with a higher "dose" or if the other modality was added. Outcome data from the parent study (Pelham et al., 201X) found equivalent or superior outcomes for treatments beginning with low-intensity behavior modification compared to intervention beginning with medication. Combined with the present analyses, these findings suggest that initiating treatment with behavior modification rather than medication is the more cost-effective option for children with ADHD. PMID:26808137

  11. Modelling and Analysis of the Feeding Regimen Induced Entrainment of Hepatocyte Circadian Oscillators Using Petri Nets

    PubMed Central

    Tareen, Samar Hayat Khan; Ahmad, Jamil

    2015-01-01

    Circadian rhythms are certain periodic behaviours exhibited by living organism at different levels, including cellular and system-wide scales. Recent studies have found that the circadian rhythms of several peripheral organs in mammals, such as the liver, are able to entrain their clocks to received signals independent of other system level clocks, in particular when responding to signals generated during feeding. These studies have found SIRT1, PARP1, and HSF1 proteins to be the major influencers of the core CLOCKBMAL1:PER-CRY circadian clock. These entities, along with abstracted feeding induced signals were modelled collectively in this study using Petri Nets. The properties of the model show that the circadian system itself is strongly robust, and is able to continually evolve. The modelled feeding regimens suggest that the usual 3 meals/day and 2 meals/day feeding regimens are beneficial with any more or less meals/day negatively affecting the system. PMID:25789928

  12. Irinotecan-based regimens for recurrent glioblastoma multiforme: [corrected] a systematic review.

    PubMed

    Abdel-Rahman, Omar; Fouad, Mona

    2015-01-01

    This systematic review aims to assess irinotecan-based salvage regimens for patients with recurrent glioblastoma multiforme (GBM) beyond first line treatment. Eligible trials were identified using databases search and 25 studies were included in the final analysis. Among the 25 studies, PFS-6 rate was reported in 15 studies and it ranged from 16% to 63%. Median PFS was reported in 18 studies and it ranged from 1 to 7.6 months. While for median OS, it was reported in 17 studies and it ranged from 5.8 months to 17.9 months. The available data suggests that routine use of irinotecan-based salvage regimens cannot be recommended outside the setting of well-controlled prospective randomized studies investigating novel combinations of irinotecan. PMID:26469869

  13. Combination of everolimus and tacrolimus: a potentially effective regimen for recalcitrant psoriasis.

    PubMed

    Wei, Kai-Che; Lai, Ping-Chin

    2015-01-01

    Severe forms of psoriasis that are refractory to conventional therapies are often difficult to manage. The mammalian target of rapamycin (mTOR) inhibitors potentially have versatile effects toward putative psoriatic pathologic pathways. Therefore, mTOR inhibitors may offer a range of new therapeutic options for patients with psoriasis. We describe a 55-year-old male renal transplant patient with refractory psoriasis. We adjusted his antirejection regimen and put him on everolimus (Certican(®); Novartis, Basel, Switzerland; a semisynthetic macrolide, belonging to the mTOR inhibitors family) with low-dose tacrolimus. This combination regimen maintained his graft function and successfully controlled his psoriasis. His skin lesions never recurred in the next 18 months. To our knowledge, this is the first report showing that the combination of everolimus and tacrolimus could be used to treat recalcitrant psoriasis. The relative benefit-risk profiles of such therapies worth further investigation. PMID:25285355

  14. Medication regimens of frail older adults after discharge from home health care

    PubMed Central

    Lancaster, Rachelle; Marek, Karen Dorman; Bub, Linda Denison; Stetzer, Frank

    2015-01-01

    The purpose of this study was to examine the number and types of discrepancy errors present after discharge from home health care in older adults at risk for medication management problems following an episode of home healthcare. More than half of the 414 participants had at least one medication discrepancy error (53.2%, n=219) with the participant’s omission of a prescribed medication (n=118, 30.17%) occurring most frequently. The results of this study support the need for home health clinicians to perform frequent assessments of medication regimens to ensure that the older adults are aware of the regimen they are prescribed, and have systems in place to support them in managing their medications. PMID:25268528

  15. Standardised nomenclature for glucocorticoid dosages and glucocorticoid treatment regimens: current questions and tentative answers in rheumatology.

    PubMed

    Buttgereit, F; da Silva, J A P; Boers, M; Burmester, G-R; Cutolo, M; Jacobs, J; Kirwan, J; Köhler, L; Van Riel, P; Vischer, T; Bijlsma, J W J

    2002-08-01

    In rheumatology and other medical specialties there is a discrepancy between the widespread use and the imprecise designation of glucocorticoid treatment regimens. Verbal descriptions of glucocorticoid treatment regimens used in various phases of diseases vary between countries and institutions. Given this background, a workshop under the auspices of the EULAR Standing Committee on International Clinical Studies including Therapeutic Trials was held to discuss this issue and to seek a consensus on nomenclature for glucocorticoid treatment. This report summarises the panel's discussion and recognises that answers derived from consensus conferences are not definitive. Nevertheless, recommendations on glucocorticoid treatment are presented that (1) reflect current and best knowledge available and (2) take into account current clinical practice. A question-answer rationale presentation style has been chosen to convey the messages, to summarise the meeting in a readable format, and to avoid dogmatism. PMID:12117678

  16. Sequential organ failure assessment scoring and prediction of patient's outcome in Intensive Care Unit of a tertiary care hospital

    PubMed Central

    Jain, Aditi; Palta, Sanjeev; Saroa, Richa; Palta, Anshu; Sama, Sonu; Gombar, Satinder

    2016-01-01

    Background and Aims: The objective was to determine the accuracy of sequential organ failure assessment (SOFA) score in predicting outcome of patients in Intensive Care Unit (ICU). Material and Methods: Forty-four consecutive patients between 15 and 80 years admitted to ICU over 8 weeks period were studied prospectively. Three patients were excluded. SOFA score was determined 24 h postadmission to ICU and subsequently every 48 h for the first 10 days. Patients were followed till discharge/death/transfer from the ICU. Initial SOFA score, highest and mean SOFA scores were calculated and correlated with mortality and duration of stay in ICU. Results: The mortality rate was 39% and the mean duration of stay in the ICU was 9 days. The maximum score in survivors (3.92 ± 2.17) was significantly lower than nonsurvivors (8.9 ± 3.45). The initial SOFA score had a strong statistical correlation with mortality. Cardiovascular score on day 1 and 3, respiratory score on day 7, and coagulation profile on day 3 correlated significantly with the outcome. Duration of the stay did not correlate with the survival (P = 0.461). Conclusion: SOFA score is a simple, but effective prognostic indicator and evaluator for patient progress in ICU. Day 1 SOFA can triage the patients into risk categories. For further management, mean and maximum score help determine the severity of illness and can act as a guide for the intensity of therapy required for each patient.

  17. Frozen shoulder: prospective clinical study with an evaluation of three treatment regimens.

    PubMed Central

    Bulgen, D Y; Binder, A I; Hazleman, B L; Dutton, J; Roberts, S

    1984-01-01

    Forty-two patients with frozen shoulder were followed up closely for eight months. They were all taught pendular exercises and randomly allocated to one of four treatment groups: (a) intraarticular steroids, (b) mobilisations , (c) ice therapy, (d) no treatment. This study has shown that there is little long-term advantage in any of the treatment regimens but that steroid injections may benefit pain and range of movement in the early stages of the condition. PMID:6742895

  18. Do Glioma Patients Derive Any Therapeutic Benefit From Taking a Higher Cumulative Dose of Temozolomide Regimens?

    PubMed Central

    Sun, Hao; Du, Shasha; Liao, Guixiang; Xie, Xiao; Ren, Chen; Yuan, Ya Wei

    2015-01-01

    Abstract Temozolomide (TMZ) is an oral alkylating agent with established effects on the central nervous system of glioblastoma (GBM) patients. Clinical trials have demonstrated a significant impact on overall survival (OS) with TMZ. Ever since, several TMZ regimens have been designed to improve treatment efficacy by increasing the cumulative dose per cycle. We report a meta-analysis to systematically evaluate different treatment schedules of TMZ in GBM patients. All searches that were conducted in the Cochrane library, Science Direct, and PubMed Databases, and 3 randomized controlled trials (1141 patients) were included. OS and progression-free survival (PFS) were the primary outcomes to be pooled. Unexpectedly, this analysis did not reveal any OS or PFS advantage for the high cumulative dose (HCD) regimen compared with the normal cumulative dose regimen (1141 total patients; hazard ratio [HR] 1.07, 95% CI 0.94–1.22, P = 0.31). Then after analyzing the characteristics of the results from each trial, we found that the regimen with a higher peak concentration during a short-term period (daily doses ≥150 mg/m2/d within ≤7 days/cycle) always had a more superior clinical benefit. So we generated a new pooled HR of 1.10 with a 95% CI of 0.96–1.25 (P = 0.17), which prefers the high peak concentration schedule even without a significant difference. The adverse outcome also indicates a significant increased risk of leukopenia (risk ratio 1.59, 95% CI 1.03–2.46, P = 0.04) among the HCD group. Our study suggests that increasing the cumulative dose per cycle is not an ideal way to improve the efficacy of TMZ, and it will lead to increased risk for leukopenia. Future trials should be designed to examine schedules of higher peak concentration rather than the cumulative dose per cycle. PMID:25997057

  19. Cellular HIV-1 DNA quantitation in patients during simplification therapy with protease inhibitor-sparing regimens.

    PubMed

    Sarmati, Loredana; Parisi, Saverio Giuseppe; Nicastri, Emanuele; d'Ettorre, Gabriella; Andreoni, Carolina; Dori, Luca; Gatti, Francesca; Montano, Marco; Buonomini, Anna Rita; Boldrin, Caterina; Palù, Giorgio; Vullo, Vincenzo; Andreoni, Massimo

    2007-07-01

    Simplified regimens containing protease-inhibitors (PI)-sparing combinations were used in patients with virological suppression after prolonged highly active antiretroviral therapy. This study evaluated the total HIV-1 DNA quantitation as a predictor of long-term success for PI-sparing simplified therapy. Sixty-two patients were enrolled in a prospective non-randomized cohort. All patients have been receiving a triple-therapy regimen, two nucleoside reverse transcriptase inhibitors (NRTIs) plus one PI, for at least 9 months and were characterized by undetectable plasma HIV-1 RNA levels (<50 cp/ml) for at least 6 months. Patients were changed to a simplified PI-sparing regimen to overcome PI-associated adverse effects. HIV-DNA levels in peripheral blood mononuclear cells (PBMCs) were evaluated at baseline and at the end of follow-up. Patients with proviral DNA levels below the median value (226 copies/10(6) PBMCs) had a significant higher CD4 cell count at nadir (P = 0.003) and at enrolment (P = 0.001) with respect to patients with HIV-DNA levels above the median value. At month 18, 53 out of 62 (85%) patients on simplified regimen showed virological success, 4 (6.4%) patients experienced virological failure and 5 (8%) patients showed viral blip. At logistic regression analysis, HIV-DNA levels below 226 copies/10(6) PBMCs at baseline were associated independently to a reduced risk of virological failure or viral blip during simplified therapy (OR 0.002, 95% CI 0.001-0.46, P = 0.025). The substitution of PI with NRTI or non-NRTIs may represent an effective treatment option. Indeed, treatment failure or viral blip were experienced by 6% and 8% of the patients on simplified therapy, respectively. In addition, sustained suppression of the plasma viral load was significantly correlated with low levels of proviral DNA before treatment simplification. PMID:17516532

  20. Nanoparticulate delivery of novel drug combination regimens for the chemoprevention of colon cancer

    PubMed Central

    KANTHAMNENI, NAVEEN; CHAUDHARY, ABHISHEK; WANG, JEFFREY; PRABHU, SUNIL

    2010-01-01

    The purpose of this work was to assess synergistic inhibitory responses of a novel chemopreventive combination regimen of drugs namely, aspirin in combination with calcium and folic acid on two human colon cancer cell lines, HT-29 and SW-480. Subsequently, based on positive responses, nanotechnology-based formulations were developed for the targeted delivery of these combinatorial regimens to the colon for the chemoprevention of colon cancer. Additionally, conventional drug formulations using controlled release polymers chitosan, pectin and hydroxypropyl methylcellulose (HPMC) were tested for release of the drugs, for comparison purposes. Chemopreventive combination regimens demonstrated significant synergistic efficacy in both cell lines from XTT assay studies, when compared to the effects of individual agents. Approximately 45% decrease in cell viability for aspirin (15 mM) and calcium (30 mM) mixtures was observed in HT-29 cell lines, compared to ~55% decrease by the same combination in SW-480 cell lines. With combinations of aspirin (5 mM) and folic acid (1.5 mM), HT-29 cells demonstrated a 30% decrease in cell viability compared to ~38% decrease in the SW-480 cell line. Overall, all drug combinations demonstrated significant synergistic responses in the cell lines tested with the SW-480 cell line being more significantly affected by the drug regimens than the HT-29 cell line. Drug encapsulated nanoparticles demonstrated a spherical morphology, <125 nm average particle size (aspirin and folic acid) of nanoparticles and encapsulation efficiencies in the range of 80–91%. Drug release from nanoparticles was controlled with ~60% of the original amount released over a 96 h period. Conventional formulations exhibited faster kinetics of drug release when compared to the PLGA nanoparticles. Overall, the cell line studies demonstrate, for the first time, the ability of novel chemopreventive combinations to inhibit the growth of colon cancer cells whereas the

  1. Vildagliptin with metformin once-daily regimen-insights from a single-center analysis.

    PubMed

    Chatterjee, Sanjay; Chatterjee, Saurav

    2015-01-01

    Dipeptidyl peptidase-4 (DPP-4) inhibitors have been well established as an adjunctive treatment to metformin. Most guidelines recommend treatment with a DPP-4 inhibitor, vildagliptin, in addition to metformin in a twice-daily regimen. However, the twice-daily regimen has difficulty with medication adherence, increased cost of therapy, and possibility of more side effects. Our objective was to evaluate, by means of retrospective analysis, the efficacy of once-daily metformin and vildagliptin (a DPP-4 inhibitor) in reducing blood glucose for patients on combination therapy. We analyzed data from our database of outpatients attending the diabetic clinic at a tertiary care center in Kolkata, India. We had data on once-daily combination of metformin and vildagliptin for 154 patients between September 2008 and May 2012. We followed up these patients for a median of 17.6 months and evaluated posttherapy glucose levels and hemoglobin A1c. Continuous variables were compared with t tests. Once-daily metformin-vildagliptin combination was found to be associated with a mean reduction of 27.52 mg/dL of fasting plasma glucose, 71.70 mg/dL of postprandial plasma glucose, and 1.41% reduction of HbA1c (P < 0.05 for all). Metformin-vildagliptin combination in a once-daily regimen seems to be associated with significant reductions in plasma glucose and HbA1c and may be a viable and cost-effective alternative to a twice-daily regimen as starting therapy. PMID:23665884

  2. Daclatasvir-containing all-oral regimens for the treatment of hepatitis C virus infection.

    PubMed

    Yang, Sheng-Shun; Kao, Jia-Horng

    2016-03-01

    The treatment of chronic hepatitis C is revolutionizing rapidly. The aim of this study is to review the efficacy and safety of daclatasvir (DCV)-containing all-oral regimens in clinical studies for chronic hepatitis C treatment. Using PubMed and search terms of 'DCV,' 'hepatitis C virus (HCV) treatment,' and 'HCV NS5A inhibitors,' literature on the clinical development of DCV, as well as abstracts presented at the April 2015 annual meeting of the European Association for the Study of the Liver (EASL) and November 2014 annual meeting of the American Association for the Study of Liver Diseases were reviewed. The final search was undertaken on 14 July 2015. With its potent antiviral activity to all HCV genotypes (GT) demonstrated in preclinical, phases 1-3 studies, DCV has been acting as a very competent team player in clinical trials of all-oral regimens. It is generally safe and well tolerated with a low genetic barrier to resistance and low potential for drug-drug interaction. Administered with a non-structural protein 3 (NS3) protease inhibitor (asunaprevir, ASV) with or without a non-nucleoside NS5B polymerase inhibitor (beclabuvir, BCV), or a nucleotide NS5B polymerase inhibitor (sofosbuvir, SOF), DCV is able to achieve greater than a 90-% HCV eradication rate in both treatment-naïve and treatment-experienced patients with GT 1. A triple combination regimen with DCV/ASV/BCV results in 100% sustained virologic response (SVR) rates in HCV GT 4 treatment-naïve subjects. DCV/SOF combination also had demonstrated up to 90-% SVR rates in GT 3-infected non-cirrhotic patients. The efficacy and safety of DCV-containing all-oral regimens highlight a new era of interferon-free therapy for chronic hepatitis C. PMID:26542068

  3. Risk of Cardiovascular Events Among Patients Initiating Efavirenz-Containing Versus Efavirenz-Free Antiretroviral Regimens

    PubMed Central

    Rosenblatt, Lisa; Farr, Amanda M.; Johnston, Stephen S.; Nkhoma, Ella T.

    2016-01-01

    Background. Efavirenz (EFV), an antiretroviral medication used to treat human immunodeficiency virus (HIV) infection, can increase lipid levels. Because hyperlipidemia is associated with increased risk for cardiovascular (CV) events, this study compared the risk of CV events in patients initiating EFV-containing vs EFV-free antiretroviral regimens. Methods. Antiretroviral-naive HIV-positive (HIV+) patients ages 18–64 were selected from commercial and Medicaid insurance claims databases. Patients with ≥1 claim for antiretroviral medications between January 1, 2007 and December 31, 2013 were classified into 2 cohorts: EFV-containing or EFV-free regimens. Patients were required to have 6 months of continuous enrollment before initiation, with no evidence of a CV event during this time. Patients were observed from initiation until the occurrence of a CV event, disenrollment, or study end. Cardiovascular events were identified through diagnosis or procedure codes for myocardial infarction, stroke, percutaneous coronary intervention, or coronary artery bypass graft. We calculated unadjusted incidence rates (IRs) and fit propensity-score-weighted Cox proportional hazards models. Results. There were 22 212 patients (11 978 EFV-containing and 10 234 EFV-free) identified in the commercial database and 7400 patients identified (2943 EFV-containing and 4457 EFV-free) in the Medicaid database. Cardiovascular events were rare (commercial IR = 396 per 100 000 person-years; Medicaid IR = 973 per 100 000 person-years). In propensity-score-weighted models, hazards of CV events were significantly lower for EFV-containing regimens in the commercial database (hazard ratio [HR] = 0.68; 95% confidence interval [CI], .49–.93) No significant difference was found in the Medicaid database (HR = 0.83; 95% CI, .58–1.19). Conclusions. This analysis found no evidence of increased risk of CV events among HIV+ patients initiating EFV-containing regimens. PMID:27186585

  4. Efficacy and Safety of a Steroid-Free Immunosuppressive Regimen after Liver Transplantation for Hepatocellular Carcinoma

    PubMed Central

    Wei, Qiang; Xu, Xiao; Wang, Chao; Zhuang, Runzhou; Zhuang, Li; Zhou, Lin; Xie, Haiyang; Wu, Jian; Zhang, Min; Shen, Yan; Wang, Weilin; Zheng, Shusen

    2016-01-01

    Background/Aims We aimed to evaluate the efficacy and safety of an immunosuppressive regimen without steroids after liver transplantation (LT) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Methods Sixty-six HCC patients who underwent an immunosuppressive regimen without steroids after LT were enrolled in the steroid-free group. The preoperative characteristics and postoperative outcomes of these patients were compared with those of 132 HCC recipients who were placed on an immunosuppressive regimen using steroids (steroid group). The incidence of acute rejection, HBV recurrence, infection, and new-onset diabetes mellitus and the overall and tumor-free survival rates were compared between the two groups. Results Differences were not observed in the 1-year (83.3% vs 97.0%, p=0.067), 3-year (65.4% vs 75.8%, p=0.067) or 5-year (56.3% vs 70.7%, p=0.067) patient survival rates or in the 1-year (62.1% vs 72.7%, p=0.067), 3-year (49.8% vs 63.6%, p=0.067) or 5-year (48.6% vs 63.6%, p=0.067) tumor-free survival rates between the two groups, respectively. In the steroid-free group, the patients who fulfilled the Milan criteria had higher overall and tumor-free survival rates than those in the steroid group (p<0.001). The prevalence of HBV recurrence (3.0% vs 13.6%, p=0.02) was significantly lower in the steroid-free group compared with the steroid group. Conclusions After LT, an immunosuppressive regimen without steroids could be a safe and feasible treatment for HBV-related HCC patients, thus resulting in the reduction of HBV recurrence. Based on the observed survival rates, patients who fulfill the Milan criteria may derive benefits from steroid-free immunosuppression. PMID:27074818

  5. Risk of Cardiovascular Events Among Patients Initiating Efavirenz-Containing Versus Efavirenz-Free Antiretroviral Regimens.

    PubMed

    Rosenblatt, Lisa; Farr, Amanda M; Johnston, Stephen S; Nkhoma, Ella T

    2016-03-01

    Background.  Efavirenz (EFV), an antiretroviral medication used to treat human immunodeficiency virus (HIV) infection, can increase lipid levels. Because hyperlipidemia is associated with increased risk for cardiovascular (CV) events, this study compared the risk of CV events in patients initiating EFV-containing vs EFV-free antiretroviral regimens. Methods.  Antiretroviral-naive HIV-positive (HIV+) patients ages 18-64 were selected from commercial and Medicaid insurance claims databases. Patients with ≥1 claim for antiretroviral medications between January 1, 2007 and December 31, 2013 were classified into 2 cohorts: EFV-containing or EFV-free regimens. Patients were required to have 6 months of continuous enrollment before initiation, with no evidence of a CV event during this time. Patients were observed from initiation until the occurrence of a CV event, disenrollment, or study end. Cardiovascular events were identified through diagnosis or procedure codes for myocardial infarction, stroke, percutaneous coronary intervention, or coronary artery bypass graft. We calculated unadjusted incidence rates (IRs) and fit propensity-score-weighted Cox proportional hazards models. Results.  There were 22 212 patients (11 978 EFV-containing and 10 234 EFV-free) identified in the commercial database and 7400 patients identified (2943 EFV-containing and 4457 EFV-free) in the Medicaid database. Cardiovascular events were rare (commercial IR = 396 per 100 000 person-years; Medicaid IR = 973 per 100 000 person-years). In propensity-score-weighted models, hazards of CV events were significantly lower for EFV-containing regimens in the commercial database (hazard ratio [HR] = 0.68; 95% confidence interval [CI], .49-.93) No significant difference was found in the Medicaid database (HR = 0.83; 95% CI, .58-1.19). Conclusions.  This analysis found no evidence of increased risk of CV events among HIV+ patients initiating EFV-containing regimens. PMID:27186585

  6. Comparison of the Control of Nausea and Vomiting among Several Moderately Emetic-Risk Chemotherapy Regimens

    PubMed Central

    Iihara, Hirotoshi; Ishihara, Masashi; Fujii, Hironori; Yoshimi, Chiaki; Yamada, Maya; Suzuki, Akio; Yamaguchi, Kazuya; Futamura, Manabu; Yoshida, Kazuhiro; Itoh, Yoshinori

    2016-01-01

    Background: Different antiemetic medications with or without aprepitant are recommended for moderately emetic-risk chemotherapy (MEC) depending on the emetic potential of chemotherapy agents, although the criterion for the use of aprepitant is still unclear. The present study was designed to compare the control of chemotherapy-induced nausea and vomiting (CINV) among several MEC regimens used in the outpatient chemotherapy setting. Materials and Methods: A single center prospective observational study was carried out in 326 patients who received 2,061 chemotherapy cycles from January 2013 to December 2014. Antiemetic medication consisting of two-drug combination of granisetron (day 1) and dexamethasone (days 1-3) was carried out in 87.6% of patients receiving the first chemotherapy cycle. The checklist for CINV was provided to all patients, and the control of CINV was evaluated on the next visit based on the checklist. Complete inhibition of nausea and vomiting during acute and delayed periods were compared among MEC regimens. Results: Two hundred and one patients received the first cycle of chemotherapy, in which the rates of complete inhibition of nausea and vomiting were 87.6% and 95.5%, respectively, during acute period, and 68.2% and 92.0%, respectively, during delayed period. There were no significant differences in the control of CINV among oxaliplatin, carboplatin and irinotecan, except for the cyclophosphamide-base regimen. Conclusions: Two-drug antiemetic medication of 5-HT3 receptor antagonist and dexamethasone was sufficiently effective for prevention of CINV in most MEC regimens. PMID:27053955

  7. Sequential Treatments with Tongsai and Bufei Yishen Granules Reduce Inflammation and Improve Pulmonary Function in Acute Exacerbation-Risk Window of Chronic Obstructive Pulmonary Disease in Rats.

    PubMed

    Lu, Xiaofan; Li, Ya; Li, Jiansheng; Wang, Haifeng; Wu, Zhaohuan; Li, Hangjie; Wang, Yang

    2016-01-01

    Background. Sequential treatments of Chinese medicines for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) risk window (RW) have benefits for preventing reoccurrences of AEs; however, the effects on pulmonary function, pulmonary, and systemic inflammatory biomarkers remain unclear. Methods. Cigarette-smoke/bacterial infections induced rats were randomized into Control, COPD, AECOPD, Tongsai Granule/normal saline (TSG/NS), moxifloxacin + salbutamol/NS (MXF+STL/NS), TSG/Bufei Yishen Granule (BYG), MXF+STL/STL, and TSG+MXF+STL/BYG+STL groups and given corresponding medicine(s) in AE- and/or RW phase. Body temperature, pulmonary function, blood cytology, serum amyloid A (SAA) and C-reactive protein (CRP), pulmonary histomorphology and myeloperoxidase (MPO), polymorphonuclear (PMN) elastase, interleukins IL-1β, IL-6, and IL-10, and tumor necrosis factor- (TNF-) α expressions were determined. Results. Body temperature, inflammatory cells and cytokines, SAA, CRP, and pulmonary impairment were higher in AECOPD rats than stable COPD, while pulmonary function declined and recovered to COPD level in 14-18 days. All biomarkers were improved in treated groups with shorter recovery times of 4-10 days, especially in TSG+MXF+STL/BYG+STL group. Conclusion. Sequential treatments with Tongsai and Bufei Yishen Granules, during AECOPD-RW periods, can reduce inflammatory response and improve pulmonary function and shorten the recovery courses of AEs, especially the integrated Chinese and Western medicines. PMID:27563333

  8. Sequential Treatments with Tongsai and Bufei Yishen Granules Reduce Inflammation and Improve Pulmonary Function in Acute Exacerbation-Risk Window of Chronic Obstructive Pulmonary Disease in Rats

    PubMed Central

    Lu, Xiaofan; Li, Ya; Wang, Haifeng; Wu, Zhaohuan; Li, Hangjie; Wang, Yang

    2016-01-01

    Background. Sequential treatments of Chinese medicines for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) risk window (RW) have benefits for preventing reoccurrences of AEs; however, the effects on pulmonary function, pulmonary, and systemic inflammatory biomarkers remain unclear. Methods. Cigarette-smoke/bacterial infections induced rats were randomized into Control, COPD, AECOPD, Tongsai Granule/normal saline (TSG/NS), moxifloxacin + salbutamol/NS (MXF+STL/NS), TSG/Bufei Yishen Granule (BYG), MXF+STL/STL, and TSG+MXF+STL/BYG+STL groups and given corresponding medicine(s) in AE- and/or RW phase. Body temperature, pulmonary function, blood cytology, serum amyloid A (SAA) and C-reactive protein (CRP), pulmonary histomorphology and myeloperoxidase (MPO), polymorphonuclear (PMN) elastase, interleukins IL-1β, IL-6, and IL-10, and tumor necrosis factor- (TNF-) α expressions were determined. Results. Body temperature, inflammatory cells and cytokines, SAA, CRP, and pulmonary impairment were higher in AECOPD rats than stable COPD, while pulmonary function declined and recovered to COPD level in 14–18 days. All biomarkers were improved in treated groups with shorter recovery times of 4–10 days, especially in TSG+MXF+STL/BYG+STL group. Conclusion. Sequential treatments with Tongsai and Bufei Yishen Granules, during AECOPD-RW periods, can reduce inflammatory response and improve pulmonary function and shorten the recovery courses of AEs, especially the integrated Chinese and Western medicines. PMID:27563333

  9. Intensified ChlVPP/ABVVP chemotherapy regimen and pegfilgrastim support in advanced Hodgkin lymphoma

    PubMed Central

    Cocorocchio, E; Vanazzi, A; Bassi, S; Peccatori, F; Antoniotti, P; Gigli, F; Travaini, L; Piperno, G; Pruneri, G; Preda, L; Biffi, R; Botteri, E; Negri, M; Martinelli, G

    2010-01-01

    We present feasibility, toxicity and efficacy results of an intensified six-cycle ChlVPP/ABVVP regimen in advanced Hodgkin lymphoma (HL). From February 2004 to August 2007, 82 consecutive eligible patients were enrolled. According to the Hasenclever index, 64 patients (78%) were considered at low risk, 15 (18%) at intermediate and 3 (4%) at high risk. The most relevant toxicity was haematological: grade 3–4 neutropenia occurred in 32% of patients, grade 3–4 anaemia in 26% of patients. Severe infections and febrile neutropenia were observed in 8% of patients. With a median follow-up of 35 months (range 12–55), the three-year freedom from treatment failure (FFTF) and overall survival (OS) were 75% (95% CI 65%–86%) and 94% (95% CI 87%–99%), respectively. The intensified ChlVPP/ABVVP regimen in advanced HL is effective, does not seem to differ from standard regimens in terms of FFTF and OS and showed a favourable toxicity profile. PMID:22276036

  10. Intensified ChlVPP/ABVVP chemotherapy regimen and pegfilgrastim support in advanced Hodgkin lymphoma.

    PubMed

    Cocorocchio, E; Vanazzi, A; Bassi, S; Peccatori, F; Antoniotti, P; Gigli, F; Travaini, L; Piperno, G; Pruneri, G; Preda, L; Biffi, R; Botteri, E; Negri, M; Martinelli, G

    2010-01-01

    We present feasibility, toxicity and efficacy results of an intensified six-cycle ChlVPP/ABVVP regimen in advanced Hodgkin lymphoma (HL). From February 2004 to August 2007, 82 consecutive eligible patients were enrolled. According to the Hasenclever index, 64 patients (78%) were considered at low risk, 15 (18%) at intermediate and 3 (4%) at high risk. The most relevant toxicity was haematological: grade 3-4 neutropenia occurred in 32% of patients, grade 3-4 anaemia in 26% of patients. Severe infections and febrile neutropenia were observed in 8% of patients. With a median follow-up of 35 months (range 12-55), the three-year freedom from treatment failure (FFTF) and overall survival (OS) were 75% (95% CI 65%-86%) and 94% (95% CI 87%-99%), respectively. The intensified ChlVPP/ABVVP regimen in advanced HL is effective, does not seem to differ from standard regimens in terms of FFTF and OS and showed a favourable toxicity profile. PMID:22276036

  11. Evaluating the effect of zingiber officinalis on nausea and vomiting in patients receiving Cisplatin based regimens.

    PubMed

    Fahimi, Fanak; Khodadad, Kian; Amini, Somayeh; Naghibi, Farzaneh; Salamzadeh, Jamshid; Baniasadi, Shadi

    2011-01-01

    Ginger, the rhizome of Zingiber officinalis, has long been used as herbal medicine for its antiemetic effect. For evaluating the effect of zingiber officinalis on nausea and vomiting (N and V) in patients receiving cisplatin based regimens, a randomized double-blind placebo-controlled cross-over clinical trial was carried out in patients receiving cisplatin in combination with other chemotherapeutic agents. The patients were randomly assigned to receive ginger capsules (rhizome of zingiber officinalis) or placebo in their first cycle of the study. All patients received standard antiemetics for chemotherapy induced nausea and vomiting (CINV). The patients were crossed-over to receive ginger or placebo in their next cycle of chemotherapy. Among 36 eligible patients who received both cycles of treatment, there were no difference in prevalence, severity, and duration of both acute and delayed N and V. Addition of ginger to the standard antiemetic regimen has shown no advantage in reducing acute and delayed N and V in patients with cisplatin-based regimen in this study. PMID:24250368

  12. A comparison of linaclotide and lubiprostone dosing regimens on ion transport responses in human colonic mucosa.

    PubMed

    Kang, Sang Bum; Marchelletta, Ronald R; Penrose, Harrison; Docherty, Michael J; McCole, Declan F

    2015-03-01

    Linaclotide, a synthetic guanylyl cyclase C (GC-C) agonist, and the prostone analog, Lubiprostone, are approved to manage chronic idiopathic constipation and constipation-predominant irritable bowel syndrome. Lubiprostone also protects intestinal mucosal barrier function in ischemia. GC-C signaling regulates local fluid balance and other components of intestinal mucosal homeostasis including epithelial barrier function. The aim of this study was to compare if select dosing regimens differentially affect linaclotide and lubiprostone modulation of ion transport and barrier properties of normal human colonic mucosa. Normal sigmoid colon biopsies from healthy subjects were mounted in Ussing chambers. Tissues were treated with linaclotide, lubiprostone, or vehicle to determine effects on short-circuit current (I sc). Subsequent I sc responses to the cAMP agonist, forskolin, and the calcium agonist, carbachol, were also measured to assess if either drug caused desensitization. Barrier properties were assessed by measuring transepithelial electrical resistance. I sc responses to linaclotide and lubiprostone were significantly higher than vehicle control when administered bilaterally or to the mucosal side only. Single versus cumulative concentrations of linaclotide showed differences in efficacy while cumulative but not single dosing caused desensitization to forskolin. Lubiprostone reduced forskolin responses under all conditions. Linaclotide and lubiprostone exerted a positive effect on TER that was dependent on the dosing regimen. Linaclotide and lubiprostone increase ion transport responses across normal human colon but linaclotide displays increased sensitivity to the dosing regimen used. These findings may have implications for dosing protocols of these agents in patients with constipation. PMID:26038704

  13. Food allergen selective thermal processing regimens may change oral tolerance in infancy.

    PubMed

    Kosti, R I; Triga, M; Tsabouri, S; Priftis, K N

    2013-01-01

    Food allergy can be considered a failure in the induction of oral tolerance. Recently, great interest has been focused on understanding the mechanisms and the contributing factors of oral tolerance development, hoping for new definitive interventions in the prevention and treatment of food allergy. Given that food processing may modify the properties and the nature of dietary proteins, several food processing methods could affect the allergenicity of these proteins and consequently may favour oral tolerance induction to food allergic children. Indeed, effective thermal food processing regimens of altering food proteins to reduce allergenicity have been recently reported in the literature. This article is mainly focused on the effect of selective thermal processing regimens on the main infant allergenic foods, with a potential clinical relevance on their allergenicity and therefore on oral tolerance induction. In the light of recent findings, the acquisition of tolerance in younger age and consequently the ability of young children to "outgrow" food allergy could be achieved through the application of selective thermal processing regimens on certain allergenic foods. Therefore, the ability of processed foods to circumvent clinical disease and at the same time to have an impact on the immune system and facilitate tolerance induction could be invaluable as a component of a successful therapeutic strategy. The opening in the new avenues of research in the use of processed foods in clinical practice for the amelioration of the impact on the quality of life of patients and possibly in food allergy prevention is warranted. PMID:23253679

  14. A Reduced-Intensity Conditioning Regimen for Patients with Dyskeratosis Congenita Undergoing Hematopoietic Stem Cell Transplantation.

    PubMed

    Nelson, Adam S; Marsh, Rebecca A; Myers, Kasiani C; Davies, Stella M; Jodele, Sonata; O'Brien, Tracey A; Mehta, Parinda A

    2016-05-01

    Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative option for progressive marrow failure, myelodysplastic syndrome, or leukemia associated with dyskeratosis congenita (DC). HSCT for DC is limited by a high incidence of treatment-related mortality, thought to be related to underlying chromosomal instability and sensitivity to chemotherapy and radiation. We report our experience in 7 patients with DC who underwent allogeneic transplantation using a reduced-intensity conditioning (RIC) preparative regimen that contained chemotherapy only (no radiation). This RIC regimen, designed specifically for patients with DC, contained alemtuzumab, fludarabine, and melphalan (with melphalan at 50% reduced dosing), with the goal of decreasing toxicity and improving outcome. All 7 patients engrafted, with none developing mixed chimerism or rejection. Two patients experienced acute graft-versus-host disease (GVHD) and 1 went on to develop limited chronic GVHD of the skin. Five patients remain alive and well at a median follow-up of 44 months (range, 14 to 57 months). We conclude that a radiation-free RIC regimen results in durable engraftment, acceptable toxicity, and improved overall survival in patients with DC undergoing allogeneic HSCT. PMID:26845033

  15. [Comparison of salvage chemotherapy regimen ACES with ESHAP for refractory or relapsed malignant lymphoma].

    PubMed

    Imataki, Osamu; Tamai, Yotaro; Kawakami, Kimihiro

    2007-10-01

    Standard salvage chemotherapy for refractory or relapsed malignant lymphoma has not been defined. The efficacy and feasibility of the ACES regimen, consisting of carboplatin at 100 mg/m(2) on day 1 to 4, etoposide at 80 mg/m(2) on day 1 to 4, high-dose Ara-C at 2 g/m(2) on day 5 and methylprednisolone at 500 mg/day for 5 days, for refractory or relapsed lymphoma were retrospectively reviewed in comparison with the ESHAP regimen. The subjects were 29 patients, including 7 aggressive follicular lymphomas, 16 large B cell lymphomas and 6 Hodgkin lymphomas. Characteristics of patients with ESHAP (19 cases) and the ACES (10 cases) group were as follows: male/female ratio, 10/9 and 3/7; median age, 49 (range, 31-72) and 54 (22-65); and initial clinical stage (I and II / III / IV), 5/8/6 and 1/1/8, respectively. Among the 29 patients, complete response was achieved in 68% (13/19) in ESHAP and 40% (4/10) in ACES.Progression-free survival and overall survival were 31.3% and 34.3%, respectively. Hematological toxicity was not significantly different between the two groups, and renal toxicity was significantly higher in ESHAP (52%) than ACES (0%). We concluded that the ACES regimen had a possibility of effective consolidation therapy for the elderly aiming to undergo autologous stem cell transplantation. PMID:17940378

  16. [IDA-FLAG regimen in treatment of patients with refractory or relapsed acute leukemia].

    PubMed

    Qian, Si-Xuan; Li, Jian-Yong; Wu, Han-Xin; Zhang, Run; Hong, Ming; Xu, Wei; Qiu, Hong-Xia

    2009-04-01

    The objective of this study was to evaluate the efficacy and toxicity of the fludarabine combination with high-dose cytarabine (Ara C), idarubicin and granulocyte colony-stimulating factor (G-CSF) (IDA-FLAG regimen) in treatment of refractory/relapsed acute leukemia (AL) patients. 4 patients were male aged from 32 to 44 years, consisted of 3 cases of acute myeloid leukaemia (AML) and 1 cases of acute lymphocytic leukaemia (ALL). All the patients were treated with idarubicin (10 - 12 mg/m(2)/d, days 1 to 3), fludarabine (50 mg/d, days 1 to 5), cytarabine (2 g/m(2)/d, days 1 to 5) and granulocyte colony-stimulating factor (G-CSF, 300 microg/d, days 0 to 5). The results showed that after one course of induction therapy, 4 patients all achieved complete remission (CR), in which 2 patients were in continuous CR after a follow-up of 3 and 4 months; 1 patient relapsed after 10 months and another one patient died of thrombotic thrombocytopenic purpura at 4 months after allogeneic peripheral blood stem cell transplantation. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicity and the early death were not observed in these patients. In conclusion, the IDA-FLAG regimen is effective in treatment of patients with refractory and relapsed AL, the adverse effects from this regimen were well tolerated by patients, which gains time for further treatment. PMID:19379589

  17. Defining the diversity of phenotypic respecification using multiple cell lines and reprogramming regimens.

    PubMed

    Alicea, Bradly; Murthy, Shashanka; Keaton, Sarah A; Cobbett, Peter; Cibelli, Jose B; Suhr, Steven T

    2013-10-01

    To better understand the basis of variation in cellular reprogramming, we performed experiments with two primary objectives: first, to determine the degree of difference, if any, in reprogramming efficiency among cells lines of a similar type after accounting for technical variables, and second, to compare the efficiency of conversion of multiple similar cell lines to two separate reprogramming regimens-induced neurons and induced skeletal muscle. Using two reprogramming regimens, it could be determined whether converted cells are likely derived from a distinct subpopulation that is generally susceptible to reprogramming or are derived from cells with an independent capacity for respecification to a given phenotype. Our results indicated that when technical components of the reprogramming regimen were accounted for, reprogramming efficiency was reproducible within a given primary fibroblast line but varied dramatically between lines. The disparity in reprogramming efficiency between lines was of sufficient magnitude to account for some discrepancies in published results. We also found that the efficiency of conversion to one phenotype was not predictive of reprogramming to the alternate phenotype, suggesting that the capacity for reprogramming does not arise from a specific subpopulation with a generally "weak grip" on cellular identity. Our findings suggest that parallel testing of multiple cell lines from several sources may be needed to accurately assess the efficiency of direct reprogramming procedures, and that testing a larger number of fibroblast lines--even lines with similar origins--is likely the most direct means of improving reprogramming efficiency. PMID:23672680

  18. [Effect of a vascular event on drug regimen compliance in patients with coronary atherosclerosis].

    PubMed

    Bunova, S S; Usacheva, E V; Ivanov, A Yu

    2015-01-01

    In order to assess the effect of a vascular event on adherence to treatment we examined a total of 68 patients presenting with coronary atherosclerosis. The patients' age varied from 31 to 84 years (mean 57.1±8.7). There were 55 (81.1%) men and 13 (18.9%) women. Drug regimen compliance was evaluated by means of the Morisky-Green Medication Adherence Questionnaire before and after the vascular event. Of the 68 examined patients, 15 (22.1%) had not taken any therapeutic agents before the vascular event occurred, despite existing arterial hypertension. Drug regimen compliance prior to the vascular event was low in 82.4% of cases. The number of patients with coronary atherosclerosis and low compliance to treatment before the vascular event decreased significantly thereafter (p=0.0012). After the vascular event, the number of patients adhering to the doctor's recommendations on medicamentous therapy increases considerably. At the same time, a sufficiently great number of patients [about 30% of patients after endured myocardial infarction (MI) and 18% after transcutaneous coronary intervention (TCI)] still remain in the category of those "having low drug regimen compliance" and, accordingly, have high risk for the development of recurrent vascular events. Endured TCI increases patient compliance more significantly than MI, which requires additional study of a psychological component of the given fact. PMID:26035560

  19. Efficacy of traditional treatment regimen on Kati Shoola with special reference to lumbar spondylolisthesis

    PubMed Central

    Ediriweera, E. R. H. S. S.; Gunathilka, H. D. P.; Weerasinghe, K. D. C. M.; Kalawana, O. T. M. R. K. S. B.

    2013-01-01

    According to Ayurveda, Kati Shoola is a disease with pain in lumbar region. Lumbar spondylolisthesis, anterior displacement of a vertebra or the vertebral column in relation to the vertebrae below, is one of the common causes. Current case study was carried out at Ayurveda Teaching hospital, Borella, to evaluate the efficacy of a treatment regimen used by Sri Lankan traditional physician family “Weerasinghe.” A 59-year-old female with a 9-month history of lumbar spondylolisthesis was treated with this regimen. The patient had progressive pain in left lower back, right and left buttocks, and difficulty in bending forward over 5°. X-ray of lumbo sacral region indicated that patient was suffering from Grade 3 lumbar spondylolisthesis. She was treated for 65 days with four treatment packages consisting of 13 prepared medicines. The response to the treatment was recorded and therapeutic effects were evaluated through symptomatic relief. Clinical symptoms were significantly reduced and degree of anterior flexion increased from 5° to 90°. However, X-rays indicated that the patient was still suffering from Grade 3 lumbar spondylolisthesis. This regimen is effective in successfully treating Kati Shoola (lumbar spondylolisthesis) by helping to reduce the symptoms and improving the degree of anterior flexion. PMID:24049411

  20. [Dosing regimen rationalization of biapenem in pediatric patients: use of Monte Carlo simulation].

    PubMed

    Kameda, Keiko; Miki, Mizuka; Ikawa, Kazuro; Morikawa, Norifumi; Kobayashi, Masao

    2009-02-01

    Biapenem has been used in pediatric patients as well as adult patients; however, little information is available on dosing regimens for pediatric patients. This study examined biapenem pharmacokinetics in pediatric population and performed pharmacokinetic-pharmacodynamic analysis. Biapenem plasma concentrations from 10 pediatric patients were pharmacokinetically analyzed. A multi-regression analysis showed the pharmacokinetic parameters were affected by body weight and creatinine clearance of the patients. Using the pharmacokinetic parameters, a Monte Carlo simulation predicted the probabilities of attaining the pharmacodynamic target (40% of the time above the minimum inhibitory concentration for the bacterium). In the case of about 20 kg, biapenem regimens of 5 mg/kg b.i.d. and 10 mg/kg b.i.d. provided sufficient target attainment probabilities against Streptococcus pneumoniae and Pseudomonas aeruginosa isolates, respectively. Our results should provide a PK-PD-based guidance for rationalizing biapenem regimen according to the body weight and renal function of a pediatric patient and the specific bacterium suspected. PMID:19378765

  1. Comparative Study of Three Regimens of Bowel Preparation Before Transabdominal Ultrasonography of the Colon.

    PubMed

    Fan, Xiu-Ping; Zhu, Qiang; Zhou, Ya-Jing; Ma, Teng; Xia, Chun-Xia; Huang, Hui-Lian

    2016-09-01

    The objective of the study was to compare the efficacy of three bowel preparation regimens for transabdominal colon ultrasonography. A total of 192 consecutive patients were given one of three regimens (senna, magnesium sulfate or polyethylene glycol electrolyte powder) before ultrasonographic examinations. The cleaning grade (I = emptying; II = filled or filled + empty; III = I or II with some retention; and IV = retention [grades I and II were termed "qualified"]) and cleaning range (A = all seven colon sections were qualified; B = four to six sections were qualified; C = three or less sections were qualified) were evaluated retrospectively. Senna was found more effective than polyethylene glycol in terms of cleaning grade (p < 0.001), qualified rate (p < 0.001) and cleaning range (p = 0.003). Senna was better than magnesium sulfate in cleaning grade (p < 0.001). Our results suggest that senna seems to be the preferred regimen for bowel preparation before transabdominal colonic ultrasonography. PMID:27181688

  2. Efficacy of cisplatin, 5-fluorouracil, and paclitaxel regimen for carcinoma of the esophagus.

    PubMed

    Belani, C P; Luketich, J D; Landreaneau, R J; Kim, R; Ramanathan, R K; Day, R; Ferson, P F; Keenan, R J; Posner, M; Seeger, J; Lembersky, B

    1997-12-01

    Eighteen patients with esophageal carcinoma (16 adenocarcinoma, two squamous cell carcinoma) were treated with two cycles of induction chemotherapy consisting of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) 175 mg/m2 (3-hour infusion), cisplatin 20 mg/m2/d x 4 days, and 5-fluorouracil 1 g/m2/d (continuous infusion x 4 days) separated by a 28-day interval before surgical resection. After resection, patients received two more cycles of the same regimen. A thorough staging evaluation was performed before patients were enrolled in the study. The salient chemotherapy toxicities included grade 3 nausea (two patients), grade 3 vomiting (two patients), grades 3 and 4 diarrhea (one patient each), and grades 3 and 4 neutropenia (two and 10 patients, respectively). No deaths occurred due to toxicity. Surgical resection was attempted in all 18 patients (100%) after two cycles of induction chemotherapy. Esophageal resection was successfully completed in 17 patients. Liver metastases were noted at laparotomy in the one patient who subsequently did not undergo esophageal resection. Surgical complications were minor, and no postoperative deaths occurred. Fifteen patients received two additional cycles of the paclitaxel/5-fluorouracil/cisplatin regimen postoperatively, two received only one cycle, and one refused further therapy. Of 15 patients alive, 14 show no evidence of disease. The 1-year actuarial survival rate of this group of patients is 82%. In conclusion, the paclitaxel/5-fluorouracil/cisplatin combination is well tolerated and is an active regimen in esophageal carcinoma. PMID:9427275

  3. A comparison of linaclotide and lubiprostone dosing regimens on ion transport responses in human colonic mucosa

    PubMed Central

    Kang, Sang Bum; Marchelletta, Ronald R; Penrose, Harrison; Docherty, Michael J; McCole, Declan F

    2015-01-01

    Linaclotide, a synthetic guanylyl cyclase C (GC-C) agonist, and the prostone analog, Lubiprostone, are approved to manage chronic idiopathic constipation and constipation-predominant irritable bowel syndrome. Lubiprostone also protects intestinal mucosal barrier function in ischemia. GC-C signaling regulates local fluid balance and other components of intestinal mucosal homeostasis including epithelial barrier function. The aim of this study was to compare if select dosing regimens differentially affect linaclotide and lubiprostone modulation of ion transport and barrier properties of normal human colonic mucosa. Normal sigmoid colon biopsies from healthy subjects were mounted in Ussing chambers. Tissues were treated with linaclotide, lubiprostone, or vehicle to determine effects on short-circuit current (Isc). Subsequent Isc responses to the cAMP agonist, forskolin, and the calcium agonist, carbachol, were also measured to assess if either drug caused desensitization. Barrier properties were assessed by measuring transepithelial electrical resistance. Isc responses to linaclotide and lubiprostone were significantly higher than vehicle control when administered bilaterally or to the mucosal side only. Single versus cumulative concentrations of linaclotide showed differences in efficacy while cumulative but not single dosing caused desensitization to forskolin. Lubiprostone reduced forskolin responses under all conditions. Linaclotide and lubiprostone exerted a positive effect on TER that was dependent on the dosing regimen. Linaclotide and lubiprostone increase ion transport responses across normal human colon but linaclotide displays increased sensitivity to the dosing regimen used. These findings may have implications for dosing protocols of these agents in patients with constipation. PMID:26038704

  4. In vivo prostacyclin biosynthesis and effects of different aspirin regimens in patients with essential thrombocythaemia.

    PubMed

    Cavalca, V; Rocca, B; Squellerio, I; Dragani, A; Veglia, F; Pagliaccia, F; Porro, B; Barbieri, S S; Tremoli, E; Patrono, C

    2014-07-01

    Essential thrombocythaemia (ET) is characterised by enhanced platelet generation and thrombosis. Once daily (od) aspirin incompletely inhibits platelet thromboxane (TX)A2 production in ET. A twice daily (bid) dosing is necessary to fully inhibit TXA2. Whether this dosing regimen affects in vivo prostacyclin (PGI2) biosynthesis is unknown. PGI2 biosynthesis was characterised in 50 ET patients on enteric-coated (EC) aspirin 100 mg od, by measuring its urinary metabolite, 2,3-dinor-6-keto-PGF1α (PGI-M). Moreover, in a crossover study 22 patients poorly responsive to standard aspirin based on serum TXB2 levels (≥4 ng/ml) were randomised to different seven-day aspirin regimens: EC aspirin 100 mg od, 100 mg bid, 200 mg od, or plain aspirin 100 mg od. PGI-M measured 24 hours after the last aspirin intake (EC, 100 mg od) was similar in patients and healthy subjects both on (n=10) and off (n=30) aspirin. PGI-M was unrelated to in vivo TXA2 biosynthesis, and not affected by EC aspirin 100 mg bid or 200 mg od as compared to EC 100 mg od. PGI2 biosynthesis in aspirin-treated ET patients appears unrelated to TXA2 biosynthesis, and not affected by an improved aspirin regimen, demonstrating its vascular safety for future trials. PMID:24671522

  5. Effects of an overfeeding regimen--the affective component of the sweet sensation.

    PubMed

    Fantino, M; Baigts, F; Cabanac, M; Apfelbaum, M

    1983-09-01

    In some isolated parts of North Africa, there persists an ancient Berber custom of imposing an overfeeding regimen on young girls before marriage, to achieve an obesity which is regarded as aesthetically pleasing. We have studied the effect of such a regimen, lasting 12--16 weeks, on blood lipids and on the affective reactions to sweet tastes in nine subjects. It is known that the pleasantness of alimentary cues i.e., the feeding behaviour, depends on the subject's nutritional state. Only three subjects gained weight (by 3,5 and 8 kg), in spite of the strong pressure to overeat. No change in plasma lipid concentrations were observed. Nevertheless, at the end of the regimen every subject showed a highly significant decrease in the rated pleasantness of sweet stimuli when they were tested fasting. However, the reduction in sweet pleasantness induced by ingestion of a 200 ml load of 1.4 M glucose solution was not changed by the overfeeding. Thus, pressure to overfeed can reduce hunger, as seen in the attractiveness of sweet foods in fasted subjects, without modifying glucose-induced satiety. PMID:6582799

  6. Evolving concepts in the selection of immunosuppression regimen for liver transplant recipients

    PubMed Central

    Locke, Jayme E; Singer, Andrew L

    2011-01-01

    The introduction of calcineurin inhibitor (CNI) based immunosuppression has revolutionized the field of liver transplantation by dramatically reducing the incidence of acute cellular rejection and prolonging patient and allograft survival. However, the introduction of CNIs has also come at the price of increased patient morbidity, particularly with regard to the well-known nephrotoxic effects of the medications. In an effort to minimize the adverse effects, immunosuppression regimen have evolved to include the use of various induction agents and purine synthesis inhibitors to limit the dose of CNI necessary to achieve low acute cellular rejection rates. Careful assessments of risks and benefits are needed as these newer agents have their own side effect profiles. In addition, the impact of newer immunosuppression regimen on hepatitis C (HCV) recurrence has not been completely elucidated. This review will provide an overview of the most common immunosuppression regimen used in liver transplantation and discuss their impact on acute cellular rejection, patient and allograft survival, and HCV recurrence. PMID:24367221

  7. Influence of feeding regimens on rat gut fluids and colonic metabolism of diclofenac-β-cyclodextrin.

    PubMed

    Vieira, Amélia C F; Murdan, Sudaxshina; Serra, Arménio C; Veiga, Francisco J; Gonsalves, António M d'A Rocha; Basit, Abdul W

    2014-11-01

    Feeding states may affect the performance of colonic prodrugs. The aim is to investigate the influence of feeding regimen in Wistar rats on: (i) distribution and pH contents along the gut and (ii) metabolism of two colonic prodrugs, diclofenac-β-cyclodextrin and a commercially available control, sulfasalazine, within the caecal and colonic contents. Male Wistar rats were subject to four different feeding regimens, the gut contents characterized (mass and pH) and the metabolism of prodrugs investigated. The feeding regimen affects gut contents (mass and pH), more specifically in the stomach and lower intestine, and affects the rate of metabolism of diclofenac-β-cyclodextrin, but not that of sulfasalazine. The latter's degradation is much faster than that of diclofenac-β-cyclodextrin while the metabolism of both prodrugs is faster in colonic (versus caecal) contents. Fasting results in most rapid degradation of diclofenac-β-cyclodextrin, possibly due to lack of competition (absence of food) for microbial enzymatic activity. PMID:25129806

  8. Evaluating the Effect of Zingiber Officinalis on Nausea and Vomiting in Patients Receiving Cisplatin Based Regimens

    PubMed Central

    Fahimi, Fanak; Khodadad, Kian; Amini, Somayeh; Naghibi, Farzaneh; Salamzadeh, Jamshid; Baniasadi, Shadi

    2011-01-01

    Ginger, the rhizome of Zingiber officinalis, has long been used as herbal medicine for its antiemetic effect. For evaluating the effect of zingiber officinalis on nausea and vomiting (N and V) in patients receiving cisplatin based regimens, a randomized double-blind placebo-controlled cross-over clinical trial was carried out in patients receiving cisplatin in combination with other chemotherapeutic agents. The patients were randomly assigned to receive ginger capsules (rhizome of zingiber officinalis) or placebo in their first cycle of the study. All patients received standard antiemetics for chemotherapy induced nausea and vomiting (CINV). The patients were crossed-over to receive ginger or placebo in their next cycle of chemotherapy. Among 36 eligible patients who received both cycles of treatment, there were no difference in prevalence, severity, and duration of both acute and delayed N and V. Addition of ginger to the standard antiemetic regimen has shown no advantage in reducing acute and delayed N and V in patients with cisplatin-based regimen in this study. PMID:24250368

  9. Antiretroviral therapy for children in resource-limited settings: current regimens and the role of newer agents.

    PubMed

    Eley, Brian S; Meyers, Tammy

    2011-10-01

    WHO antiretroviral treatment guidelines for HIV-infected children have influenced the design of treatment programmes in resource-limited settings. This review analyses the latest WHO first- and second-line regimen recommendations. The recommendation to use lopinavir/ritonavir-containing first-line regimens in young children with prior non-nucleoside reverse transcriptase inhibitor (NNRTI) exposure is based on good quality evidence. Recent research suggests that lopinavir/ritonavir-containing first-line regimens should be extended to all young children, irrespective of prior NNRTI exposure. Strategies for overcoming the adverse metabolic effects of rifampicin-containing anti-tuberculosis therapy on antiretroviral therapy regimens have been under-researched in HIV-infected children, creating uncertainty about global recommendations. Preferred second-line recommendations are largely predictable. The exception is that NNRTI-containing second-line regimens are recommended for children previously exposed to NNRTIs and who subsequently did not respond to lopinavir/ritonavir-containing first-line therapy. In these patients, second-line regimens containing newer protease inhibitors (PIs) such as darunavir and tipranavir, or integrase inhibitors such as raltegravir, should be evaluated. Newer antiretroviral agents including second-generation NNRTIs and PIs, C-C chemokine receptor type 5 inhibitors, and integrase inhibitors may assist in further refinement of existing regimen options. PMID:21888444

  10. Contribution of Oxazolidinones to the Efficacy of Novel Regimens Containing Bedaquiline and Pretomanid in a Mouse Model of Tuberculosis

    PubMed Central

    Tasneen, Rokeya; Betoudji, Fabrice; Tyagi, Sandeep; Li, Si-Yang; Williams, Kathy; Converse, Paul J.; Dartois, Véronique; Yang, Tian; Mendel, Carl M.; Mdluli, Khisimuzi E.

    2015-01-01

    New regimens based on two or more novel agents are sought to shorten or simplify treatment of tuberculosis (TB). Pretomanid (PMD) is a nitroimidazole in phase 3 trials that has significant bactericidal activity alone and in combination with bedaquiline (BDQ) and/or pyrazinamide (PZA). We previously showed that the novel combination of BDQ+PMD plus the oxazolidinone sutezolid (SZD) had sterilizing activity superior to that of the first-line regimen in a murine model of TB. The present experiments compared the activity of different oxazolidinones in combination with BDQ+PMD with or without PZA in the same model. The 3-drug regimen of BDQ+PMD plus linezolid (LZD) had sterilizing activity approaching that of BDQ+PMD+SZD and superior to that of the first-line regimen. The addition of PZA further enhanced activity. Reducing the duration of LZD to 1 month did not significantly affect the activity of the regimen. Halving the LZD dose or replacing LZD with RWJ-416457 modestly reduced activity over the first month but not after 2 months. AZD5847 and tedizolid also increased the bactericidal activity of BDQ+PMD, but they were less effective than the other oxazolidinones. These results provide optimism for safe, short-course oral regimens for drug-resistant TB that may also be superior to the current first-line regimen for drug-susceptible TB. PMID:26503656

  11. Contribution of Oxazolidinones to the Efficacy of Novel Regimens Containing Bedaquiline and Pretomanid in a Mouse Model of Tuberculosis.

    PubMed

    Tasneen, Rokeya; Betoudji, Fabrice; Tyagi, Sandeep; Li, Si-Yang; Williams, Kathy; Converse, Paul J; Dartois, Véronique; Yang, Tian; Mendel, Carl M; Mdluli, Khisimuzi E; Nuermberger, Eric L

    2016-01-01

    New regimens based on two or more novel agents are sought to shorten or simplify treatment of tuberculosis (TB). Pretomanid (PMD) is a nitroimidazole in phase 3 trials that has significant bactericidal activity alone and in combination with bedaquiline (BDQ) and/or pyrazinamide (PZA). We previously showed that the novel combination of BDQ+PMD plus the oxazolidinone sutezolid (SZD) had sterilizing activity superior to that of the first-line regimen in a murine model of TB. The present experiments compared the activity of different oxazolidinones in combination with BDQ+PMD with or without PZA in the same model. The 3-drug regimen of BDQ+PMD plus linezolid (LZD) had sterilizing activity approaching that of BDQ+PMD+SZD and superior to that of the first-line regimen. The addition of PZA further enhanced activity. Reducing the duration of LZD to 1 month did not significantly affect the activity of the regimen. Halving the LZD dose or replacing LZD with RWJ-416457 modestly reduced activity over the first month but not after 2 months. AZD5847 and tedizolid also increased the bactericidal activity of BDQ+PMD, but they were less effective than the other oxazolidinones. These results provide optimism for safe, short-course oral regimens for drug-resistant TB that may also be superior to the current first-line regimen for drug-susceptible TB. PMID:26503656

  12. Ecological niches in sequential generations of eastern North American monarch butterflies (Lepidoptera: Danaidae): the ecology of migration and likely climate change implications.

    PubMed

    Batalden, Rebecca V; Oberhauser, Karen; Peterson, A Townsend

    2007-12-01

    Eastern North American monarch butterflies (Danaus plexippus L.) show a series of range shifts during their breeding season. Using ecological niche modeling, we studied the environmental context of these shifts by identifying the ecological conditions that monarchs use in successive summer months. Monarchs use a consistent ecological regimen through the summer, but these conditions contrast strikingly with those used during the winter. Hence, monarchs exhibit niche-following among sequential breeding generations but niche-switching between the breeding and overwintering stages of their annual cycle. We projected their breeding ecological niche onto monthly future climate scenarios, which indicated northward shifts, particularly at the northern extreme of their summer movements, over the next 50 yrs; if both monarchs and their milkweed host plants cannot track these changing climates, monarchs could lose distributional area during critical breeding months. PMID:18284764

  13. Variations on Stochastic Curtailment in Sequential Mastery Testing

    ERIC Educational Resources Information Center

    Finkelman, Matthew David

    2010-01-01

    In sequential mastery testing (SMT), assessment via computer is used to classify examinees into one of two mutually exclusive categories. Unlike paper-and-pencil tests, SMT has the capability to use variable-length stopping rules. One approach to shortening variable-length tests is stochastic curtailment, which halts examination if the probability…

  14. Episodic Contributions to Sequential Control: Learning from a Typist's Touch

    ERIC Educational Resources Information Center

    Crump, Matthew J. C.; Logan, Gordon D.

    2010-01-01

    Sequential control over routine action is widely assumed to be controlled by stable, highly practiced representations. Our findings demonstrate that the processes controlling routine actions in the domain of skilled typing can be flexibly manipulated by memory processes coding recent experience with typing particular words and letters. In two…

  15. The sequential structure of brain activation predicts skill.

    PubMed

    Anderson, John R; Bothell, Daniel; Fincham, Jon M; Moon, Jungaa

    2016-01-29

    In an fMRI study, participants were trained to play a complex video game. They were scanned early and then again after substantial practice. While better players showed greater activation in one region (right dorsal striatum) their relative skill was better diagnosed by considering the sequential structure of whole brain activation. Using a cognitive model that played this game, we extracted a characterization of the mental states that are involved in playing a game and the statistical structure of the transitions among these states. There was a strong correspondence between this measure of sequential structure and the skill of different players. Using multi-voxel pattern analysis, it was possible to recognize, with relatively high accuracy, the cognitive states participants were in during particular scans. We used the sequential structure of these activation-recognized states to predict the skill of individual players. These findings indicate that important features about information-processing strategies can be identified from a model-based analysis of the sequential structure of brain activation. PMID:26707716

  16. The Sequential Probability Ratio Test and Binary Item Response Models

    ERIC Educational Resources Information Center

    Nydick, Steven W.

    2014-01-01

    The sequential probability ratio test (SPRT) is a common method for terminating item response theory (IRT)-based adaptive classification tests. To decide whether a classification test should stop, the SPRT compares a simple log-likelihood ratio, based on the classification bound separating two categories, to prespecified critical values. As has…

  17. Multiple-Category Classification Using a Sequential Probability Ratio Test.

    ERIC Educational Resources Information Center

    Spray, Judith A.

    Sequential probability ratio testing (PRT), which usually is applied in situations requiring a decision between two simple hypotheses or a single decision point, is extended to include situations involving k decision points and [(k + 1)-choose-2] sets of simultaneous, simple hypotheses, where k>1. The multiple-decision point or multiple-category…

  18. Alternating and Sequential Motion Rates in Older Adults

    ERIC Educational Resources Information Center

    Pierce, John E.; Cotton, Susan; Perry, Alison

    2013-01-01

    Background: Alternating motion rate (AMR) and sequential motion rate (SMR) are tests of articulatory diadochokinesis that are widely used in the evaluation of motor speech. However, there are no quality normative data available for adults aged 65 years and older. Aims: There were two aims: (1) to obtain a representative, normative dataset of…

  19. Sequential growth for lifetime extension in biomimetic polypyrrole actuator systems

    NASA Astrophysics Data System (ADS)

    Sarrazin, J. C.; Mascaro, Stephen A.

    2015-04-01

    Electroactive polymers (EAPs) present prospective use in actuation and manipulation devices due to their low electrical activation requirements, biocompatibility, and mechanical performance. One of the main drawbacks with EAP actuators is a decrease in performance over extended periods of operation caused by over-oxidation of the polymer and general polymer degradation. Synthesis of the EAP material, polypyrrole with an embedded metal helix allows for sequential growth of the polymer during operation. The helical metal electrode acts as a scaffolding to support the polymer, and direct the 3-dimensional change in volume of the polymer along the axis of the helix during oxidative and reductive cycling. The metal helix also provides a working metal electrode through the entire length of the polymer actuator to distribute charge for actuation, as well as for sequential growth steps during the lifetime of operation of the polymer. This work demonstrates the method of sequential growth can be utilized after extended periods of use to partially restore electrical and mechanical performance of polypyrrole actuators. Since the actuation must be temporarily stopped to allow for a sequential growth cycle to be performed and reverse some of the polymer degradation, these actuator systems more closely mimic natural muscle in their analogous maintenance and repair.

  20. Sequential quantum cloning under real-life conditions

    NASA Astrophysics Data System (ADS)

    Saberi, Hamed; Mardoukhi, Yousof

    2012-05-01

    We consider a sequential implementation of the optimal quantum cloning machine of Gisin and Massar and propose optimization protocols for experimental realization of such a quantum cloner subject to the real-life restrictions. We demonstrate how exploiting the matrix-product state (MPS) formalism and the ensuing variational optimization techniques reveals the intriguing algebraic structure of the Gisin-Massar output of the cloning procedure and brings about significant improvements to the optimality of the sequential cloning prescription of Delgado [Phys. Rev. Lett.PRLTAO0031-900710.1103/PhysRevLett.98.150502 98, 150502 (2007)]. Our numerical results show that the orthodox paradigm of optimal quantum cloning can in practice be realized in a much more economical manner by utilizing a considerably lesser amount of informational and numerical resources than hitherto estimated. Instead of the previously predicted linear scaling of the required ancilla dimension D with the number of qubits n, our recipe allows a realization of such a sequential cloning setup with an experimentally manageable ancilla of dimension at most D=3 up to n=15 qubits. We also address satisfactorily the possibility of providing an optimal range of sequential ancilla-qubit interactions for optimal cloning of arbitrary states under realistic experimental circumstances when only a restricted class of such bipartite interactions can be engineered in practice.

  1. A Sequential and Comprehensive Method for Effective Substitute Teaching

    ERIC Educational Resources Information Center

    Byer, John L.

    2008-01-01

    This article dealt with methods for making substitute teaching more effective. The purpose was to articulate a sequential method for maximizing the effectiveness of substitute teaching while providing substitutes with a comprehensive method for diligently and flexibly earning respect and using reflection to continually improve substitute teaching.…

  2. SEQUENTIAL INOCULATION AS AN ADJUNCT IN ENTERIC VIRUS PLAQUE ENUMERATION

    EPA Science Inventory

    The potential utility of sequentially inoculating a virus sample onto two different cultures of similar dissimilar cell lines was evaluated in conjunction with IDU (5-iodo-2'-deoxyuridine) treatment of the cells as a potential adjunct in viral plaque formation assays. his evaluat...

  3. Application of Sequential Interval Estimation to Adaptive Mastery Testing

    ERIC Educational Resources Information Center

    Chang, Yuan-chin Ivan

    2005-01-01

    In this paper, we apply sequential one-sided confidence interval estimation procedures with beta-protection to adaptive mastery testing. The procedures of fixed-width and fixed proportional accuracy confidence interval estimation can be viewed as extensions of one-sided confidence interval procedures. It can be shown that the adaptive mastery…

  4. Lexical and Grammatical Associations in Sequential Bilingual Preschoolers

    ERIC Educational Resources Information Center

    Kohnert, Kathryn; Kan, Pui Fong; Conboy, Barbara T.

    2010-01-01

    Purpose: The authors investigated potential relationships between traditional linguistic domains (words, grammar) in the first (L1) and second (L2) languages of young sequential bilingual preschool children. Method: Participants were 19 children, ages 2;11 (years;months) to 5;2 (M = 4;3) who began learning Hmong as the L1 from birth and English as…

  5. Harmonizing and Improvising in the Choral Rehearsal: A Sequential Approach

    ERIC Educational Resources Information Center

    Bell, Cindy L.

    2004-01-01

    This article challenges choral teachers to motivate their choirs to a new level of choral singing and harmonic creativity and outlines a sequential process for introducing improvisation into the daily warm-up. It argues that students can learn to harmonize and improvise by ear as part of each day's warm-up period. Sections include: (1) Chord…

  6. Functionalized sorbent for chemical separations and sequential forming process

    DOEpatents

    Fryxell, Glen E.; Zemanian, Thomas S.

    2012-03-20

    A highly functionalized sorbent and sequential process for making are disclosed. The sorbent includes organic short-length amino silanes and organic oligomeric polyfunctional amino silanes that are dispersed within pores of a porous support that form a 3-dimensional structure containing highly functionalized active binding sites for sorption of analytes.

  7. Atrioventricular Sequential Pacing for Hypertrophic Cardiomyopathy During Liver Transplantation.

    PubMed

    Ramos, Juan; Pai, Sher-Lu; Perry, Dana K; Blackshear, Joseph L; Aniskevich, Stephen

    2015-10-15

    Hypertrophic cardiomyopathy is a myocardial disorder that carries an increased risk of morbidity and mortality during liver transplantation. We describe the use of atrioventricular sequential pacing, placed preoperatively, to assist with intraoperative management of a patient with severe refractory hypertrophic cardiomyopathy undergoing orthotopic piggyback liver transplantation. We discuss the pathogenesis and treatment of this infrequent but serious comorbidity. PMID:26466305

  8. Sequential decision plans, benthic macroinvertebrates, and biological monitoring programs

    NASA Astrophysics Data System (ADS)

    Jackson, John K.; Resh, Vincent H.

    1989-07-01

    A common obstacle to the inclusion of benthic macroinvertebrates in water quality monitoring programs is that numerous sample units must be examined in order to distinguish between impacted and unimpacted conditions, which can add significantly to the total cost of a monitoring program. Sequential decision plans can be used to reduce this cost because the number of sample units needed to classify a site as impacted or unimpacted is reduced by an average of 50%. A plan is created using definitions of unimpacted and impacted conditions, a description of the mathematical distribution of the data, and definitions of acceptable risks of type I and II errors. The applicability of using sequential decision plans and benthic macroinvertebrates in water quality monitoring programs is illustrated with several examples (e.g., identifying moderate and extreme changes in species richness in response to acid mine drainage; assessing the impact of a crude oil contamination on the density of two benthic populations; monitoring the effect of geothermal effluents on species diversity). These examples use data conforming to the negative binomial, Poisson, and normal distributions and define impact as changes in population density, species richness, or species diversity based on empirical data or the economic feasibility of the sequential decision plan. All mathematical formulae and intermediate values are provided for the step-by-step calculation of each sequential decision plan.

  9. Infiltration characteristics of bare soil under sequential water application events

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The marked reduction in infiltration rate caused by formation of a soil surface seal is a well known phenomenon but often ignored in infiltration models. The effect sequential water application events have on infiltration rate and soil surface seal formation has rarely been investigated. The objecti...

  10. Analyzing Sequential Categorical Data: Individual Variation in Markov Chains.

    ERIC Educational Resources Information Center

    Gardner, William

    1990-01-01

    This paper provides a method for analyzing data consisting of event sequences and covariate observations associated with Markov chains. The objective is to use the covariate data to explain differences between individuals in the transition probability matrices characterizing their sequential data. (TJH)

  11. Sequential Patterns of Music Instruction and Learning to Use Them.

    ERIC Educational Resources Information Center

    Price, Harry E.

    1992-01-01

    Presents experiments on effects of music instruction, teaching practica, feedback from the instructor, and videotaped self-observation on undergraduates' use of complete sequential patterns and components. Focuses on two levels: examination of effects of systematic instructional structures on acquisition of skills and refinement of constructs for…

  12. Proportion Congruent Effects in the Absence of Sequential Congruent Effects

    ERIC Educational Resources Information Center

    Torres-Quesada, Maryem; Milliken, Bruce; Lupiáñez, Juan; Funes, María Jesús

    2014-01-01

    A debated question in the cognitive control field is whether cognitive control is best conceptualized as a collection of distinct control mechanisms or a single general purpose mechanism. In an attempt to answer this question, previous studies have dissociated two well-known effects related to cognitive control: sequential congruence and…

  13. Making Career Decisions--A Sequential Elimination Approach.

    ERIC Educational Resources Information Center

    Gati, Itamar

    1986-01-01

    Presents a model for career decision making based on the sequential elimination of occupational alternatives, an adaptation for career decisions of Tversky's (1972) elimination-by-aspects theory of choice. The expected utility approach is reviewed as a representative compensatory model for career decisions. Advantages, disadvantages, and…

  14. Item Overexposure in Computerized Classification Tests Using Sequential Item Selection

    ERIC Educational Resources Information Center

    Huebner, Alan

    2012-01-01

    Computerized classification tests (CCTs) often use sequential item selection which administers items according to maximizing psychometric information at a cut point demarcating passing and failing scores. This paper illustrates why this method of item selection leads to the overexposure of a significant number of items, and the performances of…

  15. Orthographic Processing and Visual Sequential Memory in Unexpectedly Poor Spellers

    ERIC Educational Resources Information Center

    Holmes, Virginia M.; Malone, Aisling M.; Redenbach, Holly

    2008-01-01

    Does unexpectedly poor spelling in adults result from inferior visual sequential memory? In one experiment, unexpectedly poor spellers performed significantly worse than better spellers in the immediate reproduction of sequences of visual symbols, but in a second experiment, the effect was not replicated. Poor spellers were also no worse at the…

  16. Decomposition of Copper (II) Sulfate Pentahydrate: A Sequential Gravimetric Analysis.

    ERIC Educational Resources Information Center

    Harris, Arlo D.; Kalbus, Lee H.

    1979-01-01

    Describes an improved experiment of the thermal dehydration of copper (II) sulfate pentahydrate. The improvements described here are control of the temperature environment and a quantitative study of the decomposition reaction to a thermally stable oxide. Data will suffice to show sequential gravimetric analysis. (Author/SA)

  17. The Motivating Language of Principals: A Sequential Transformative Strategy

    ERIC Educational Resources Information Center

    Holmes, William Tobias

    2012-01-01

    This study implemented a Sequential Transformative Mixed Methods design with teachers (as recipients) and principals (to give voice) in the examination of principal talk in two different school accountability contexts (Continuously Improving and Continuously Zigzag) using the conceptual framework of Motivating Language Theory. In phase one,…

  18. Sequential color video to parallel color video converter

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The engineering design, development, breadboard fabrication, test, and delivery of a breadboard field sequential color video to parallel color video converter is described. The converter was designed for use onboard a manned space vehicle to eliminate a flickering TV display picture and to reduce the weight and bulk of previous ground conversion systems.

  19. Contextual view of Warner's Ranch. Third of three sequential views ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Contextual view of Warner's Ranch. Third of three sequential views (from west to east) of the buildings in relation to the surrounding geography. Note approximate location of Overland Trail crossing left to right. Camera facing northeast - Warner Ranch, Ranch House, San Felipe Road (State Highway S2), Warner Springs, San Diego County, CA

  20. Contextual view of Warner's Ranch. Second of three sequential views ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Contextual view of Warner's Ranch. Second of three sequential views (from west to east) of the buildings in relation to the surrounding geography. Ranch house and trading post/barn on left. Note approximate location of Overland Trail crossing left to right. Camera facing north. - Warner Ranch, Ranch House, San Felipe Road (State Highway S2), Warner Springs, San Diego County, CA