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Sample records for ad patients methods

  1. Twistor methods for AdS5

    NASA Astrophysics Data System (ADS)

    Adamo, Tim; Skinner, David; Williams, Jack

    2016-08-01

    We consider the application of twistor theory to five-dimensional anti-de Sitter space. The twistor space of AdS5 is the same as the ambitwistor space of the four-dimensional conformal boundary; the geometry of this correspondence is reviewed for both the bulk and boundary. A Penrose transform allows us to describe free bulk fields, with or without mass, in terms of data on twistor space. Explicit representatives for the bulk-to-boundary propagators of scalars and spinors are constructed, along with twistor action functionals for the free theories. Evaluating these twistor actions on bulk-to-boundary propagators is shown to produce the correct two-point functions.

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

    PubMed Central

    Yakusheva, Olga; Lindrooth, Richard; Weiss, Marianne

    2014-01-01

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

  3. Efficacy of adding the kinesio taping method to guideline-endorsed conventional physiotherapy in patients with chronic nonspecific low back pain: a randomised controlled trial

    PubMed Central

    2013-01-01

    Background Chronic nonspecific low back pain is a significant health condition with high prevalence worldwide and it is associated with enormous costs to society. Clinical practice guidelines show that many interventions are available to treat patients with chronic low back pain, but the vast majority of these interventions have a modest effect in reducing pain and disability. An intervention that has been widespread in recent years is the use of elastic bandages called Kinesio Taping. Although Kinesio Taping has been used extensively in clinical practice, current evidence does not support the use of this intervention; however these conclusions are based on a small number of underpowered studies. Therefore, questions remain about the effectiveness of the Kinesio Taping method as an additional treatment to interventions, such as conventional physiotherapy, that have already been recommended by the current clinical practice guidelines in robust and high-quality randomised controlled trials. We aim to determine the effectiveness of the addition of the use of Kinesio Taping in patients with chronic nonspecific low back pain who receive guideline-endorsed conventional physiotherapy. Methods/design One hundred and forty-eight patients will be randomly allocated to receive either conventional physiotherapy, which consists of a combination of manual therapy techniques, general exercises, and specific stabilisation exercises (Guideline-Endorsed Conventional Physiotherapy Group) or to receive conventional physiotherapy with the addition of Kinesio Taping to the lumbar spine (Conventional Physiotherapy plus Kinesio Taping Group) over a period of 5 weeks (10 sessions of treatment). Clinical outcomes (pain intensity, disability and global perceived effect) will be collected at baseline and at 5 weeks, 3 months, and 6 months after randomisation. We will also collect satisfaction with care and adverse effects after treatment. Data will be collected by a blinded assessor. All

  4. Value Added Methods: Moving from Univariate to Multivariate Criteria

    ERIC Educational Resources Information Center

    Newman, David; Newman, Isadore; Ridenour, Carolyn; Morales, Jennifer

    2014-01-01

    The authors describe five value-added methods (VAM) used in school assessment as the backdrop to their main thesis. Then they review the assumptions underlying measurement and evaluation, the foundation of all assessment systems, including value-added. They discuss the traditional criterion variable used in VAM: a standardized test score. Next,…

  5. Patient Internet services: creating the value-added paradigm.

    PubMed

    Molfenter, Todd; Johnson, Pauley; Gustafson, David H; DeVries, Kathy; Veeramani, Dharmaraj

    2002-01-01

    An analysis of consumer and organizational perspectives on web design suggests emerging webside functionality, growing patient needs for self-management skills, and mounting corporate accountability will transform web strategies and consumer expectations from the current general health information approach to a value-added paradigm, which is described with a list of eight guiding principles. PMID:12365305

  6. Metadata-driven Ad Hoc Query of Patient Data

    PubMed Central

    Deshpande, Aniruddha M.; Brandt, Cynthia; Nadkarni, Prakash M.

    2002-01-01

    Clinical study data management systems (CSDMSs) have many similarities to clinical patient record systems (CPRSs) in their focus on recording clinical parameters. Requirements for ad hoc query interfaces for both systems would therefore appear to be highly similar. However, a clinical study is concerned primarily with collective responses of groups of subjects to standardized therapeutic interventions for the same underlying clinical condition. The parameters that are recorded in CSDMSs tend to be more diverse than those required for patient management in non-research settings, because of the greater emphasis on questionnaires for which responses to each question are recorded separately. The differences between CSDMSs and CPRSs are reflected in the metadata that support the respective systems' operation, and need to be reflected in the query interfaces. The authors describe major revisions of their previously described CSDMS ad hoc query interface to meet CSDMS needs more fully, as well as its porting to a Web-based platform. PMID:12087118

  7. Reflectance of a vegetation canopy using the Adding method.

    PubMed

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

    1982-11-15

    The Adding method has been used to calculate vegetation canopy bidirectional reflectance. Appropriate reflection and transmission matrices for canopy and underlying soil layers are developed in terms of canopy geometry and basic optical properties. The model is illustrated by comparisons with field reflectance measurements for blue grama (Bouteloua gracilis) and soybeans (Calahan 9250). Calculations using the Suits model are also included for comparison.

  8. Catecholamine-Based Treatment in AD Patients: Expectations and Delusions

    PubMed Central

    Stefani, Alessandro; Olivola, Enrica; Liguori, Claudio; Hainsworth, Atticus H.; Saviozzi, Valentina; Angileri, Giacoma; D’Angelo, Vincenza; Galati, Salvatore; Pierantozzi, Mariangela

    2015-01-01

    In Alzheimer disease, the gap between excellence of diagnostics and efficacy of therapy is wide. Despite sophisticated imaging and biochemical markers, the efficacy of available therapeutic options is limited. Here we examine the possibility that assessment of endogenous catecholamine levels in cerebrospinal fluid (CSF) may fuel new therapeutic strategies. In reviewing the available literature, we consider the effects of levodopa, monoamine oxidase inhibitors, and noradrenaline (NE) modulators, showing disparate results. We present a preliminary assessment of CSF concentrations of dopamine (DA) and NE, determined by HPLC, in a small dementia cohort of either Alzheimer’s disease (AD) or frontotemporal dementia patients, compared to control subjects. Our data reveal detectable levels of DA, NE in CSF, though we found no significant alterations in the dementia population as a whole. AD patients exhibit a small impairment of the DA axis and a larger increase of NE concentration, likely to represent a compensatory mechanism. While waiting for preventive strategies, a pragmatic approach to AD may re-evaluate catecholamine modulation, possibly stratified to dementia subtypes, as part of the therapeutic armamentarium. PMID:25999852

  9. Does Ad Hoc Coronary Intervention Reduce Radiation Exposure? – Analysis of 568 Patients

    PubMed Central

    Truffa, Márcio A. M.; Alves, Gustavo M.P.; Bernardi, Fernando; Esteves Filho, Antonio; Ribeiro, Expedito; Galon, Micheli Z.; Spadaro, André; Kajita, Luiz J.; Arrieta, Raul; Lemos, Pedro A.

    2015-01-01

    Background Advantages and disadvantages of ad hoc percutaneous coronary intervention have been described. However little is known about the radiation exposure of that procedure as compared with the staged intervention. Objective To compare the radiation dose of the ad hoc percutaneous coronary intervention with that of the staged procedure Methods The dose-area product and total Kerma were measured, and the doses of the diagnostic and therapeutic procedures were added. In addition, total fluoroscopic time and number of acquisitions were evaluated. Results A total of 568 consecutive patients were treated with ad hoc percutaneous coronary intervention (n = 320) or staged percutaneous coronary intervention (n = 248). On admission, the ad hoc group had less hypertension (74.1% vs 81.9%; p = 0.035), dyslipidemia (57.8% vs. 67.7%; p = 0.02) and three-vessel disease (38.8% vs. 50.4%; p = 0.015). The ad hoc group was exposed to significantly lower radiation doses, even after baseline characteristic adjustment between both groups. The ad hoc group was exposed to a total dose-area product of 119.7 ± 70.7 Gycm2, while the staged group, to 139.2 ± 75.3 Gycm2 (p < 0.001). Conclusion Ad hoc percutaneous coronary intervention reduced radiation exposure as compared with diagnostic and therapeutic procedures performed at two separate times. PMID:26351982

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

    PubMed

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

    2015-09-01

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

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

    PubMed Central

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

    2015-01-01

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

  12. Citalopram for agitation in Alzheimer’s disease (CitAD): design and methods

    PubMed Central

    Drye, Lea T.; Ismail, Zahinoor; Porsteinsson, Anton P.; Rosenberg, Paul B.; Weintraub, Daniel; Marano, Christopher; Pelton, Gregory; Frangakis, Constantine; Rabins, Peter V.; Munro, Cynthia A.; Meinert, Curtis L.; Devanand, D.P.; Yesavage, Jerome; Mintzer, Jacobo E.; Schneider, Lon S.; Pollock, Bruce G.; Lyketsos, Constantine G.

    2012-01-01

    Background Agitation is one of the most common neuropsychiatric symptoms of Alzheimer’s disease (AD), and is associated with serious adverse consequences for patients and caregivers. Evidence-supported treatment options for agitation are limited. The citalopram for agitation in Alzheimer’s disease (CitAD) study was designed to evaluate the potential of citalopram to ameliorate these symptoms. Methods CitAD is a randomized, double-masked, placebo-controlled multicenter clinical trial with two parallel treatment groups assigned in a 1:1 ratio and randomization stratified by clinical center. The study has eight recruiting clinical centers, a chair’s office and a coordinating center located in university settings in the United States and Canada. 200 people having probable Alzheimer’s disease with clinically significant agitation and without major depression are being recruited. Patients are randomized to receive citalopram (target dose of 30 mg/day) or matching placebo. Caregivers of patients in both treatment groups receive a structured psychosocial therapy. Agitation will be compared between treatment groups using the NeuroBehavioral Rating Scale and the AD Cooperative Study- Clinical Global Impression of Change which are the primary outcomes. Functional performance, cognition, caregiver distress and rates of adverse and serious adverse events will also be measured. Conclusion The authors believe the design elements in CitAD are important features to be included in trials assessing the safety and efficacy of psychotropic medications for clinically significant agitation in Alzheimer’s disease. PMID:22301195

  13. Neurophysiological predictors of long term response to AChE inhibitors in AD patients

    PubMed Central

    Di, L; Oliviero, A; Pilato, F; Saturno, E; Dileone, M; Marra, C; Ghirlanda, S; Ranieri, F; Gainotti, G; Tonali, P

    2005-01-01

    Background: In vivo evaluation of cholinergic circuits of the human brain has recently been introduced using a transcranial magnetic stimulation (TMS) protocol based on coupling peripheral nerve stimulation with motor cortex TMS (short latency afferent inhibition, SAI). SAI is reduced in Alzheimer's disease (AD) and drugs enhancing cholinergic transmission increase SAI. Methods: We evaluated whether SAI testing, together with SAI test-retest, after a single dose of the acetylcholinesterase (AChE) inhibitor rivastigmine, might be useful in predicting the response after 1 year treatment with rivastigmine in 16 AD patients. Results: Fourteen AD patients had pathologically reduced SAI. SAI was increased after administration of a single oral dose of rivastigmine in AD patients with abnormal baseline SAI, but individual responses to rivastigmine varied widely, with SAI change ranging from an increase in inhibition of ∼50% of test size to no change. Baseline SAI and the increase in SAI after a single dose of rivastigmine were correlated with response to long term treatment. A normal SAI in baseline conditions, or an abnormal SAI in baseline conditions that was not greatly increased by a single oral dose of rivastigmine, were invariably associated with poor response to long term treatment, while an abnormal SAI in baseline conditions in conjunction with a large increase in SAI after a single dose of rivastigmine was associated with good response to long term treatment in most of the patients. Conclusions: Evaluation of SAI may be useful for identifying AD patients likely to respond to treatment with AChE inhibitors. PMID:16024879

  14. Secure ADS-B authentication system and method

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

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

  15. Variational methods in AdS/CFT correspondence

    SciTech Connect

    Andrade, Tomas; Banados, Maximo; Rojas, Francisco

    2007-03-15

    We prove that the AdS/CFT calculation of 1-point functions can be drastically simplified by using variational arguments. We give a simple proof, valid for any theory that can be derived from a Lagrangian, that the large radius divergencies in 1-point functions can always be renormalized away (at least in the semiclassical approximation). The renormalized 1-point functions then follow by a simple variational problem involving only finite quantities. Several examples, a massive scalar, gravity, and renormalization flows, are discussed. Our results are general and can thus be used for dualities beyond AdS/CFT.

  16. Bayesian Methods for Scalable Multivariate Value-Added Assessment

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  17. Modifying Repetitive Verbalizations of Community-Dwelling Patients with AD.

    ERIC Educational Resources Information Center

    Bourgeois, Michelle S.; And Others

    1997-01-01

    Reports on behavior management training given to seven caregivers of a home-dwelling spouse with Alzheimer's disease. Results reveal that trained caregivers were successful at decreasing patient repetitions using written cues. Patients of control subjects showed no systematic changes in behavioral disturbances. Intervention effects lasted for 16…

  18. Method for adding nodes to a quantum key distribution system

    DOEpatents

    Grice, Warren P

    2015-02-24

    An improved quantum key distribution (QKD) system and method are provided. The system and method introduce new clients at intermediate points along a quantum channel, where any two clients can establish a secret key without the need for a secret meeting between the clients. The new clients perform operations on photons as they pass through nodes in the quantum channel, and participate in a non-secret protocol that is amended to include the new clients. The system and method significantly increase the number of clients that can be supported by a conventional QKD system, with only a modest increase in cost. The system and method are compatible with a variety of QKD schemes, including polarization, time-bin, continuous variable and entanglement QKD.

  19. Aromatase Expression in the Hippocampus of AD Patients and 5xFAD Mice

    PubMed Central

    Prange-Kiel, Janine; Dudzinski, Danuta A.; Pröls, Felicitas; Glatzel, Markus; Matschke, Jakob; Rune, Gabriele M.

    2016-01-01

    Numerous studies show that 17β-estradiol (E2) protects against Alzheimer's disease (AD) induced neurodegeneration. The E2-synthesizing enzyme aromatase is expressed in healthy hippocampi, but although the hippocampus is severely affected in AD, little is known about the expression of hippocampal aromatase in AD. To better understand the role of hippocampal aromatase in AD, we studied its expression in postmortem material from patients with AD and in a mouse model for AD (5xFAD mice). In human hippocampi, aromatase-immunoreactivity was observed in the vast majority of principal neurons and signal quantification revealed higher expression of aromatase protein in AD patients compared to age- and sex-matched controls. The tissue-specific first exons of aromatase I.f, PII, I.3, and I.6 were detected in hippocampi of controls and AD patients by RT-PCR. In contrast, 3-month-old, female 5xFAD mice showed lower expression of aromatase mRNA and protein (measured by qRT-PCR and semiquantitative immunohistochemistry) than WT controls; no such differences were observed in male mice. Our findings stress the importance of hippocampal aromatase expression in neurodegenerative diseases. PMID:27298742

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

    ERIC Educational Resources Information Center

    Yeh, Stuart S.

    2012-01-01

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

  1. Oxidative DNA damage in peripheral leukocytes of mild cognitive impairment and AD patients.

    PubMed

    Migliore, L; Fontana, I; Trippi, F; Colognato, R; Coppedè, F; Tognoni, G; Nucciarone, B; Siciliano, G

    2005-05-01

    It is well established that oxidative stress plays a key role in the degenerative neuronal death and progression of Alzheimer's disease (AD), although it is not clear if it is the primary triggering event in the pathogenesis of this disorder. Mild cognitive impairment (MCI) is a clinical condition between normal aging and AD, characterized by a memory deficit without loss of general cognitive and functional abilities. We performed this study by a comet assay analysis to evaluate the level of primary and oxidative DNA damage in two groups of MCI and AD patients, compared to healthy controls. Data showed a significantly higher level of primary DNA damage in leukocytes of AD and also of MCI patients compared to control individuals (average: 2.09+/-0.79 and 2.47+/-1.01, respectively for AD and MCI, versus 1.04+/-0.31 in controls). Moreover, the amount of oxidised DNA bases (both purines and pyrimidines) was significatively higher in the two groups of patients (AD and MCI) compared to controls. Our results give a further indication that oxidative stress, at least at the DNA level, is an earlier event in the pathogenesis of AD.

  2. A retrospective comparison of androgen deprivation (AD) vs. no AD among low-risk and intermediate-risk prostate cancer patients treated with brachytherapy, external beam radiotherapy, or radical prostatectomy

    SciTech Connect

    Ciezki, Jay P. . E-mail: ciezkij@ccf.org; Klein, Eric A.; Angermeier, Kenneth; Ulchaker, James; Chehade, Nabil; Altman, Andrew; Mahadevan, Arul; Reddy, Chandana A.

    2004-12-01

    Purpose: To examine the value of androgen deprivation (AD) in the curative treatment of low- and intermediate-risk prostate cancer treated with the three major modalities: radical retropubic prostatectomy (RRP), external beam radiotherapy (EBRT), and permanent prostate implantation (PI). Methods and materials: During 1996-2001, 1668 patients with low- and intermediate-risk prostate cancer were treated at The Cleveland Clinic Foundation. Only patients with a minimum of 2 years of prostate-specific antigen follow-up were included in the analysis, and biochemical relapse-free survival (bRFS) was used as the endpoint. Patients were grouped according to treatment modality and stratified according to the use of AD. Results: The overall 5-year bRFS rate was 87.8%. The 5-year bRFS rate for low-risk patients was 89% and for intermediate-risk patients was 79%. For low-risk patients, the 5-year bRFS rates by treatment modality (without AD vs. with AD, respectively) were PI: 90% vs. 93%; EBRT: 90% vs. 93%; and RRP: 89% vs. 84%. For intermediate-risk patients, the 5-year bRFS rates by treatment modality (without AD vs. with AD, respectively) were PI: 88% vs. 82%; EBRT: 81% vs. 84%; and RRP: 75% vs. 72%. None of the comparisons within risk groups or among modalities supports an increased efficacy with the use of AD. Conclusion: Five-year bRFS rates in low-risk and intermediate-risk patients are not improved by the use of AD.

  3. The bone-added osteotome sinus floor elevation technique: multicenter retrospective report of consecutively treated patients.

    PubMed

    Rosen, P S; Summers, R; Mellado, J R; Salkin, L M; Shanaman, R H; Marks, M H; Fugazzotto, P A

    1999-01-01

    A retrospective clinical evaluation of patients consecutively treated from multiple centers was performed. The treatment of these patients utilized the bone-added osteotome sinus floor elevation (BAOSFE) procedure with immediate implant fixation. The BAOSFE method employs a specific set of osteotome instruments to tent the sinus membrane with bone graft material placed through the osteotomy site. A total of 174 implants was placed in 101 patients. Implants were of both screw and cylinder shapes with machined, titanium plasma-sprayed, and hydroxyapatite surfaces from various manufacturers. The 9 participating clinicians used autografts, allografts, and xenografts alone or in various combinations, and the type of graft was selected by the individual clinicians. The choice of graft material did not appear to influence survival rates. Loading periods varied from 6 to 66 months. The survival rate was 96% or higher when pretreatment bone height was 5 mm or more and dropped to 85.7% when pretreatment bone height was 4 mm or less. The most important factor influencing implant survival with the BAOSFE was the preexisting bone height between the sinus floor and crest. This short-term retrospective investigation suggests that the BAOSFE can be a successful procedure with a wide variety of implant types and grafting procedures. PMID:10612923

  4. Radiographic Parameters in Adult Degenerative Scoliosis and Different Parameters Between Sagittal Balanced and Imbalanced ADS Patients.

    PubMed

    Yang, Changwei; Yang, Mingyuan; Chen, Yuanyuan; Wei, Xianzhao; Ni, Haijian; Chen, Ziqiang; Li, Jingfeng; Bai, Yushu; Zhu, Xiaodong; Li, Ming

    2015-07-01

    A retrospective study. To summarize and describe the radiographic parameters of adult degenerative scoliosis (ADS) and explore the radiological parameters which are significantly different in sagittal balanced and imbalanced ADS patients. ADS is the most common type of adult spinal deformity. However, no comprehensive description of radiographic parameters in ADS patients has been made, and few studies have been performed to explore which radiological parameters are significantly different between sagittal balanced and imbalanced ADS patients. Medical records of ADS patients in our outpatient clinic from January 2012 to January 2014 were reviewed. Demographic data including age and sex, and radiographic data including the coronal Cobb angle, location of apical vertebra/disc, convexity of the curve, degree of apical vertebra rotation, curve segments, thoracic kyphosis (TK), lumbar lordosis (LL), thoracolumbar kyphosis (TL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), sagittal vertical axis (SVA), and PI minus LL (PI-LL) were reviewed to make comprehensive description of radiographic parameters of ADS. Furthermore, patients were divided into 2 groups according to whether the patients' sagittal plane was balanced: Group A (imbalanced, SVA > 5 cm) and Group B (balanced, SVA  ≤ 5 cm). Demographic and radiological parameters were compared between these 2 groups. A total of 99 patients were included in this study (Group A = 33 and Group B = 66; female = 83 and male = 16; sex ratio = 5:1). The median of age were 67 years (range: 41-92 years). The median of coronal Cobb angle and length of curve was 23 (range: 10-75°) and 5 segments (range: 3-7), respectively. The most common location of apical vertebra was at L2 to L3 (81%) and the median of degree of apical vertebra rotation was 2° (range: 1-3). Our study also showed significant correlations between coronal Cobb angle and curve segments (r = 0.23, P < 0.005) and degree of apical vertebra rotation (r

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

    ERIC Educational Resources Information Center

    Hock, Heinrich; Isenberg, Eric

    2012-01-01

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

  6. MR diffusion tensor imaging (DTI) and neuropsychological testing for neuronal connectivity in Alzheimer's disease (AD) patients

    NASA Astrophysics Data System (ADS)

    Zhong, Jianhui; Ni, Hongyan; Zhu, Tong; Ekholm, Sven; Kavcic, Voyko

    2004-04-01

    We have used MR DTI to identify relevant brain structures involved in visuospatial processing, in an attempt to link perceptual and attentional impairments to WM changes in Alzheimer's disease (AD) patients. Correlation of DTI measured parameters with results of several neuropsychological tests will be reported here. Several issues related to quantitation of DTI parameters in ROI analysis are addressed. In spite of only a small number of subjects were studied so far, we found not only that AD patients showed significant decrease of white matter (WM) integrity in corpus callosum (CC), most prominent at the posterior portion, but also found significant correlations between the DTI parameters and scores from several neuropsychological tests. Our preliminary results suggest that DTI help to improve the overall accuracy rate in distinguishing between early AD onset and age-related functional decline, and potentially may improve efficiency in differentiating between different types of dementia.

  7. Influence of Education on the Pattern of Cognitive Deterioration in Ad Patients: The Cognitive Reserve Hypothesis

    ERIC Educational Resources Information Center

    Carret, N.L.; Auriacombe, S.; Letenneur, L.; Bergua, V.; Dartigues, J.F.; Fabrigoule, C.

    2005-01-01

    The cognitive reserve hypothesis proposes that a high educational level could delay the clinical expression of Alzheimer's disease (AD) although neuropathologic changes develop in the brain. Therefore, some studies have reported that when the clinical signs of the disease emerge, high-educated patients may decline more rapidly than low-educated…

  8. Correlation of statin-increased platelet APP ratios and reduced blood lipids in AD patients.

    PubMed

    Baskin, F; Rosenberg, R N; Fang, X; Hynan, L S; Moore, C B; Weiner, M; Vega, G L

    2003-06-24

    Platelets, like neurons, contain 120- to 130- and 110-kd amyloid precursor proteins (APPs). Their ratio is reduced in AD, further reductions correlating with reduced Mini-Mental Status Examination scores [r(11) = 0.69, p < 0.05]. As statins alter APP processing, platelet APPs were analyzed in patients with AD given anticholesterol drugs for 6 weeks. APP ratios increased [t(37) = -3.888, p = 0.0004], proportionally with reduced cholesterol [r(36) = -0.45, p = 0.005]. Longer trials may reveal slowed cognitive loss, validating this index. PMID:12821755

  9. Pegylated IFN-α 2b added to ongoing lamivudine therapy in patients with lamivudine-resistant chronic hepatitis B

    PubMed Central

    Vassiliadis, Themistoklis; Patsiaoura, Kalliopi; Tziomalos, Konstantinos; Gkiourtzis, Theodoros; Giouleme, Olga; Grammatikos, Nikolaos; Rizopoulou, Despoina; Nikolaidis, Nikolaos; Katsinelos, Panagiotis; Orfanou-Koumerkeridou, Eleni; Eugenidis, Nikolaos

    2006-01-01

    AIM: To investigate the role of pegylated-interferon (IFN) α-2b in the management of patients with lamivudine-resistant chronic hepatitis B. METHODS: Twenty consecutive anti-HBe positive patients were treated with pegylated IFN α-2b (100 μg sc once weekly) for 12 mo. There was no interruption in lamivudine therapy. Hematology, liver biochemistry, serum HBV DNA levels were detected by PCR, and vital signs were also assessed. Liver histology was assessed in some patients at entry and at wk 52 for comparison. RESULTS: Nine patients (45%) had a partial virological end-treatment response; seven patients (35%) showed complete virological end-treatment response. Eight patients (40%) showed biochemical end-treatment response. There was a trend for higher virological response rates in patients who had previously responded to IFN and relapsed compared to IFN non-responders (four out of seven patients vs none out of six patients, respectively; P = 0.1). Patients without virological end-treatment response showed significant worsening of fibrosis [median score 2 (range, 1 to 3) vs median score 3 (range, 1 to 4)], in the first and second biopsy respectively (P = 0.014), whereas necroinflammatory activity was not significantly affected. Patients with complete or partial virological end-treatment response did not show any significant changes in histological findings, possibly due to the small number of patients with paired biopsies (n = 5). Nevertheless, after 12 mo of follow-up, only one patient (5%) showed sustained virological response and only 2 patients (10%) showed sustained biochemical response. Two patients (10%) discontinued pegylated IFN both after 6 mo of treatment due to flu-like symptoms. CONCLUSION: Pegylated IFNα-2b, when added to ongoing lamivudine therapy in patients with lamivudine-resistant chronic hepatitis B, induces sustained responses only in a small minority of cases. PMID:16688836

  10. Obesity is linked with lower brain volume in 700 AD and MCI patients

    PubMed Central

    Ho, April J.; Raji, Cyrus A.; Becker, James T.; Lopez, Oscar L.; Kuller, Lewis H.; Hua, Xue; Lee, Suh; Hibar, Derrek; Dinov, Ivo D.; Stein, Jason L.; Jack, Clifford R.; Weiner, Michael W.; Toga, Arthur W.; Thompson, Paul M.

    2011-01-01

    Obesity is associated with lower brain volumes in cognitively normal elderly subjects, but no study has yet investigated the effects of obesity on brain structure in patients with mild cognitive impairment (MCI) or Alzheimer’s disease (AD). To determine if higher body mass index (BMI) is associated with brain volume deficits in cognitively impaired elderly subjects, we analyzed brain magnetic resonance imaging (MRI) scans of 700 MCI or AD patients from two different cohorts: the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and the Cardiovascular Health Study-Cognition Study (CHS-CS). Tensor-based morphometry (TBM) was used to create 3-dimensional maps of regional tissue excess or deficits in subjects with MCI (ADNI, N=399; CHS, N=77) and AD (ADNI, N=188; CHS, N=36). In both AD and MCI groups, higher BMI was associated with brain volume deficits in frontal, temporal, parietal, and occipital lobes; the atrophic pattern was consistent in both ADNI and CHS populations. Cardiovascular risk factors, especially obesity, should be considered as influencing brain structure in those already afflicted by cognitive impairment and dementia. PMID:20570405

  11. Regeneration ad integrum of the condyle head in a patient with temporomandibular disorders.

    PubMed

    Learreta, J A

    1999-07-01

    A 14-year-old who had suffered from a beta-hemolytic streptococcus infection presented with serious temporomandibular disorders, including a reabsorption of the condyle head on the right side, and reabsorption in the cavern of the left side. Her masticatory muscles were electronically deprogramed, achieving a mandibular position supported by a relaxed musculature. The patient's signs and symptoms subsequently disappeared. Study of the magnetic resonance image a year later clearly showed a regeneration ad integrum of the condyle head and a spontaneous reinsertion of the articular disk. The results suggest the need for use of electronic elements in order to treat patients with temporomandibular disorders effectively. PMID:10650410

  12. Adding method of delta-four-stream spherical harmonic expansion approximation for infrared radiative transfer parameterization

    NASA Astrophysics Data System (ADS)

    Wu, Kun; Zhang, Feng; Min, Jinzhong; Yu, Qiu-Run; Wang, Xin-Yue; Ma, Leiming

    2016-09-01

    The adding method, which could calculate the infrared radiative transfer (IRT) in inhomogeneous atmosphere with multiple layers, has been applied to δ -four-stream discrete-ordinates method (DOM). This scheme is referred as δ -4DDA. However, there is a lack of application for adding method of δ -four-stream spherical harmonic expansion approximation (SHM) to solve infrared radiative transfer through multiple layers. In this paper, the adding method for δ -four-stream SHM (δ -4SDA) will be obtained and the accuracy of it will be evaluated as well. The result of δ -4SDA in an idealized medium with homogeneous optical property is significantly more accurate than that of the adding method for δ -two-stream DOM (δ -2DDA). The relative errors of δ -2DDA can be over 15% in thin optical depths for downward emissivity, while errors of δ -4SDA are bounded by 2%. However, the result of δ -4SDA is slightly less accurate than that of δ -4DDA. In a radiation model with realistic atmospheric profile considering gaseous transmission, the accuracy for heating rate of δ -4SDA is significantly superior than that of δ -2DDA, especially for the cloudy sky. The accuracy for heating rate of δ -4SDA is slightly less accurate than that of δ -4DDA under water cloud conditions, while it is superior than that of δ -4DDA in ice cloud cases. Beside, the computational efficiency of δ -4SDA is higher than that of δ -4DDA.

  13. An improved method for the measurement of added vegetable fats in chocolate.

    PubMed

    Macarthur, R; Crews, C; Brereton, P

    2000-08-01

    A method for identifying refined vegetable fats added to chocolate (cocoa butter equivalents, CBEs) was combined with established quantitative methods for determining the level of vegetable fat added to cocoa butter with the aim of providing improved precision. The identification of fats was based on the analysis of sterol and triterpene alcohol degradation products formed during the processing of the fat. The procedure was able to successfully discriminate between 95% of pairs of fats from a set (33) of CBE-type vegetable fats. Subsequent analysis of 80 mixtures of four CBEs with chocolate successfully identified, on cross-validation, 94% of the samples. Combining the qualitative procedure with established quantitative methodology, based on the analysis of triacylglycerols, improved the method precision from +/- 2.1% to +/- 0.3% (5% addition of CBE at 95% confidence). Identifying the fat analytically permits the use of quantitative methods for determining the level of added fat in chocolate that have improved precision in comparison with the measurement of an unidentified fat. This may obviate the need to use factory inspection as a means to identify the ingredients of a product and monitor compliance with proposed legislation.

  14. Autoantibodies Profile in Matching CSF and Serum from AD and aMCI patients: Potential Pathogenic Role and Link to Oxidative Damage.

    PubMed

    Di Domenico, Fabio; Pupo, Gilda; Giraldo, Esther; Lloret, Ana; Badia, Mari-Carmen; Schinina, Maria Eugenia; Giorgi, Alessandra; Butterfield, D Allan; Vina, Jose; Perluigi, Marzia

    2016-01-01

    Alzheimer disease (AD) is the most common form of dementia among the elderly and is characterized by progressive loss of memory and cognition. Amyloid-ß-peptide (Aß) forms senile plaques, which, together with hyperphosphorylated tau-based neurofibrillary tangles, are the hallmarks of AD neuropathology. Evidence support the involvement of immune system in AD progression and current concepts regarding its pathogenesis include the participation of inflammatory and autoimmune components in the neurodegenerative process. Pathologically, immune system components have been detected in the brain, cerebrospinal fluid (CSF) and in serum of AD subjects and their trend of variation correlates with disease progression. However, patients with AD present significantly lower levels of antibody immunoreactivity against Aß in serum and CSF than healthy controls suggesting that a depletion of such patrolling system is involved in the deposition of toxic aggregates in AD. Within this frame, incomplete and often controversial results are reported about CNS immune/ autoimmune responses during AD, and a better comprehension of such processes is needed. Our research will aim to shed light on the nature and potential role of autoantibodies in CSF and serum from AD and amnestic mild cognitive impairment (aMCI) patients compared to healthy subjects by using an immunoproteomics approach. Our method allows recognition of natural occurring antibodies by the identification of brain antigen targeted by human IgGs. Overall our data reveal that the alterations of autoantibodies profile both in CSF and serum follow disease staging and progression. However, we demonstrate a fair overlap between CSF and serum suggesting the existence of different immunogenic events. Interestingly, CSF autoantibodies recognized, among others, key players of energy metabolic pathway, including glycolysis and TCA cycle, found oxidatively modified in AD brain studies. These data suggest a potential casual sequence

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

    DOEpatents

    Zhao, Haibo; Holladay, Johnathan E.

    2011-05-10

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

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

    DOEpatents

    Zhang, Zongchao C.; Brown, Heather M.; Su, Yu

    2012-02-07

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

  17. Statistical Voxel-Based Methods and [18F]FDG PET Brain Imaging: Frontiers for the Diagnosis of AD.

    PubMed

    Gallivanone, Francesca; Della Rosa, Pasquale Anthony; Castiglioni, Isabella

    2016-01-01

    Recommended guidelines for the diagnosis of dementia due to Alzheimer's Disease (AD) were revised in recent years, including Positron Emission Tomography (PET) as an in-vivo diagnostic imaging technique for the diagnosis of neurodegeneration. In particular PET, using 18Ffluorodeoxiglucouse ([18F]FDG), is able to detect very early changes of glucose consumption at the synaptic level, enabling to support both early and differential diagnosis of AD. In standard clinical practice, interpretation of [18F] FDG-PET images is usually achieved through qualitative assessment. Visual inspection although only reveals information visible at human eyes resolution, while information at a higher resolution is missed. Furthermore, qualitative assessment depends on the degree of expertise of the clinician, preventing from the definition of accurate and standardized imaging biomarkers. Automated and computerized image processing methods have been proposed to support the in-vivo assessment of brain PET studies. In particular, objective statistical image analyses, enabling the comparison of one patient's images to a group of control images have been shown to carry important advantages for detecting significant metabolic changes, including the availability of more objective, cross-center reliable metrics and the detectability of brain subtle functional changes, as occurring in prodromal AD. The purpose of the current review is to provide a systematic overview encompassing the frontiers recently reached by quantitative approaches for the statistical analysis of PET brain images in the study of AD, with a particular focus on Statistical Parametric Mapping. Main achievements, e.g. in terms of standardized biomarkers of AD as well as of sensitivity and specificity, will be discussed. PMID:26567733

  18. Application of CBR method for adding the process of cutting tools and parameters selection

    NASA Astrophysics Data System (ADS)

    Ociepka, P.; Herbus, K.

    2015-11-01

    Modem enterprises must face with the dynamically changing market demand what influences the designing process. It is possible by linking computer tools with information gathered by experienced designers teams. The article describes the method basing on engineering knowledge and experience to adding the process of tools selection and cutting parameters determination for a turning operation. The method, proposed by the authors, is based on the CBR (Case Based Reasoning) method. CBR is a method of problem solving that involves searching for an analogy (similarity) between the current task to be solved, and the earlier cases that properly described, are stored in a computer memory. This article presents an algorithm and a formalized description of the developed method. It was discussed the range of its utilization, as well as it was illustrated the method of its functioning on the example of the tools and cutting parameters selection with respect to the turning process.

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

    PubMed

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

    2013-01-01

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

  20. Improving the sensitivity of a vision chip using the software A-D conversion method

    NASA Astrophysics Data System (ADS)

    Takeuchi, Daisuke; Kagami, Shingo; Komuro, Takashi; Ishikawa, Masatoshi

    2004-06-01

    We developed a new method of pixel-level Analog-to-Digital (A-D) conversion for vision chips, removing Fixed Pattern Noise (FPN) at the same time. Vision chips are CMOS image sensors integrating a processing element (PE) and a photodetector (PD) in each pixel. The chip can handle high frame rate images in real time because its processing speed is high due to the parallel processing and also because it does not need high-bandwidth communication. Pixel-level A-D conversion is an essential technology for vision chips because digital operations must be performed in each pixel. The vision chip, which we have developed, contains a programmable PE in each pixel, and it directly controls the behavior of the PD with the use of the software. In our developed method, the chip controls the reference voltage to cancel the FPN by using this feature. We applied this method to our vision chip, and confirmed that the FPN was reduced and the sensitivity improved. We made a test chip including only PDs to solve the problem on the existing vision chip. As a result of applying this method to the test chip, the detectable minimum illuminance improved about 40 times in comparison with applying our existing method.

  1. No Added Value of Novel Biomarkers in the Diagnostic Assessment of Patients Suspected of Acute Coronary Syndrome

    PubMed Central

    Poldervaart, Judith M.; Röttger, Emma; Dekker, Marieke S.; Zuithoff, Nicolaas P. A.; Verheggen, Peter W. H. M.; de Vrey, Evelyn A.; Wildbergh, Thierry X.; van ‘t Hof, Arnoud W. J.; Mosterd, Arend; Hoes, Arno W.

    2015-01-01

    Background Despite the availability of high-sensitive troponin (hs-cTnT), there is still room for improvement in the diagnostic assessment of patients suspected of acute coronary syndrome (ACS). Apart from serial biomarker testing, which is time-consuming, novel biomarkers like copeptin have been proposed to expedite the early diagnosis of suspected ACS in addition to hs-cTnT. We determined whether placenta derived growth factor (PlGF), soluble Fms-like tyrosine kinase 1 (sFlt-1), myoglobin, N-terminal prohormone B-type Natriuretic Peptide (NT-proBNP), growth-differentiation factor 15 (GDF-15) and copeptin improved early assessment of chest pain patients. Methods This prospective, single centre diagnostic FAME-ER study included patients presenting to the ED with symptoms suggestive of ACS. Blood was collected to measure biomarkers, notably, hs-cTnT was retrospectively assessed. Added value of markers was judged by increase in AUC using multivariable logistic regression. Results Of 453 patients enrolled, 149 (33%) received a final diagnosis of ACS. Hs-cTnT had the highest diagnostic value in both univariable and multivariable analysis. PPVs of the biomarkers ranged from 23.5% (PlGF) to 77.9% (hs-cTnT), NPVs from 67.0% (PlGF) to 86.4% (hs-cTnT). Only myoglobin yielded diagnostic value in addition to clinical symptoms and electrocardiography (ECG) (AUC of clinical model 0.80) with AUC of 0.84 (p<0.001). However, addition of hs-cTnT was superior (AUC 0.89, p<0.001). Addition of the biomarkers to our clinical model and hs-cTnT did not or only marginally (GDF-15) improved diagnostic performance. Conclusion When assessing patients suspected of ACS, only myoglobin had added diagnostic value beyond clinical symptoms and ECG. However, when combined with hs-cTnT, it yields no additional diagnostic value. PlGF, sFlt-1, NT-proBNP, GDF-15 and copeptin had no added value to the clinical model or hs-cTnT. PMID:26177390

  2. Efficacy and safety of luseogliflozin added to various oral antidiabetic drugs in Japanese patients with type 2 diabetes mellitus

    PubMed Central

    Seino, Yutaka; Inagaki, Nobuya; Haneda, Masakazu; Kaku, Kohei; Sasaki, Takashi; Fukatsu, Atsushi; Ubukata, Michito; Sakai, Soichi; Samukawa, Yoshishige

    2015-01-01

    Introduction Two studies were carried out to investigate the efficacy and safety of luseogliflozin added to existing oral antidiabetic drugs (OADs) in Japanese type 2 diabetic patients inadequately controlled with OAD monotherapy. Materials and Methods In the trial involving add-on to sulfonylureas (study 03-1), patients were randomly assigned to receive luseogliflozin 2.5 mg or a placebo for a 24-week double-blind period, followed by a 28-week open-label period. In the open-label trial involving add-on to other OADs; that is, biguanides, dipeptidyl peptidase-4 inhibitors, thiazolidinediones, glinides and α-glucosidase inhibitors (study 03-2), patients received luseogliflozin for 52 weeks. Results In study 03-1, luseogliflozin significantly decreased glycated hemoglobin at the end of the 24-week double-blind period compared with the placebo (–0.88%, P < 0.001), and glycated hemoglobin reduction from baseline at week 52 was –0.63%. In study 03-2, luseogliflozin added to other OADs significantly decreased glycated hemoglobin from baseline at week 52 (–0.52 to –0.68%, P < 0.001 for all OADs). Bodyweight reduction was observed in all add-on therapies, even with agents associated with weight gain, such as sulfonylureas and thiazolidinediones. Most adverse events were mild in severity. When added to a sulfonylurea, incidences of hypoglycemia during the double-blind period were 8.7% and 4.2% for luseogliflozin and placebo, respectively, but no major hypoglycemic episodes occurred. The frequency and incidences of adverse events of special interest for sodium glucose cotransporter 2 inhibitors and adverse events associated with combined OADs were acceptable. Conclusions Add-on therapies of luseogliflozin to existing OADs improved glycemic control, reduced bodyweight and were well tolerated in Japanese type 2 diabetic patients. These trials were registered with the Japan Pharmaceutical Information Center (add on to sulfonylurea: JapicCTI-111507; add on to

  3. Development of an impact noise reduction method by the adding of a small thickness elastomeric material

    NASA Astrophysics Data System (ADS)

    Arz, Jean-Pierre

    The starting point of this Ph.D. is the industrial issue submitted to the ETS by the company Bombardier Recreational Products (BRP) of the noise reduction of the tracked drive mechanism of snowmobiles. The overall goal of is to develop a method to predict the impact noise reduction obtained by the adding of an elastomeric layer specimen of small thickness between the impacting body and the impacted structure which is a complex structure (i.e. a structure whose geometry is complex and whose composition involves several materials). To reach this overall goal, three specific goals have been fixed: (1) characterize the behavior under impact of different small thickness elastomeric layers; (2) predict the impact force generated when an elastomeric layer is added on a complex vibrating structure; and (3) validate experimentally the whole method by applying it to the impact noise reduction of a bar of the snowmobile track. To reach the first specific goal (characterize the behavior under impact of different small thickness elastomeric layers), a specific experimental characterization method has been developed. Firstly, an experimental device has been realized to submit the elastomeric layer specimens to the reproducible impact conditions of an impact hammer. The measurement of the penetration depth of the hammer into the elastomeric layer is achieved by recording its motion with a high-speed camera and by detecting its position by further analysis on the individual images. Secondly, the experimental curves obtained are analyzed to point out their main characteristics and choose an appropriate impact model. Thirdly, the contact force parameters are estimated from the experimental results and from the impact model. Using this method, eight impacted elastomeric specimens have been characterized. The results show that a more precise characterization than hardness is obtained. To reach the second specific goal (predict the impact force generated when an elastomeric layer is

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  5. [Is 'attention' important for the results of dementia screening? Relation among Digit Span Test, CST amd ADS in elderly patients].

    PubMed

    Mol, B A; de Jonghe, J F; Lindeboom, J

    2000-02-01

    This study focused on the relationship between attention and dementia screening test performance, using the adapted Wechsler's Digit Span test for elderly patients, the Cognitive Screening Test (CST) and the Amsterdam Dementia Screening Test (ADS6). Participants were dementia patients and psychiatric patients (n = 147). In both groups no floor-effect was found on the Digit Span test. Principal components analysis showed that CST and ADS6-scores had relatively high loadings on one factor, in contrast to digit span scores that loaded on a second factor. On average, psychiatric patients did hardly worse than normal controls. Attention deficits were more apparent in dementia patients. Considering a maximum of r = .41, these more or less subtle deficits were only moderately related to dementia screening test performance. It is concluded that the adapted Digit Span test is suitable for measuring attention deficits in elderly patients. However, Digit Span predicts performance on dementia screening test only to a modest degree.

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

    PubMed

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

    2010-10-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  8. A new method for compensation and rematch of cavity failure in the C-ADS linac

    NASA Astrophysics Data System (ADS)

    Xue, Zhou; Dai, Jian-Ping; Meng, Cai

    2016-06-01

    For proton linear accelerators used in applications such as accelerator-driven systems, due to the nature of the operation, it is essential for the beam failure rate to be several orders of magnitude lower than usual performance of similar accelerators. A fault-tolerant mechanism should be mandatorily imposed in order to maintain short recovery time, high uptime and extremely low frequency of beam loss. This paper proposes an innovative and challenging way for compensation and rematch of cavity failure using fast electronic devices and Field Programmable Gate Arrays (FPGAs) instead of embedded computers to complete the computation of beam dynamics. A method of building an equivalent model for the FPGA, with optimization using a genetic algorithm, is shown. Results based on the model and algorithm are compared with TRACEWIN simulation to show the precision and correctness of the mechanism. Supported by China ADS Project (XDA03020600) and Natural Science Foundation of China (11575216)

  9. Application of the CBR method for adding the technological process designing

    NASA Astrophysics Data System (ADS)

    Ociepka, P.; Herbuś, K.

    2016-08-01

    The manufacturing process is a very important step in the process of new products creating. The market trends cause that the process must be very flexible to facilitate fast and cost-effective adaptation to changing market conditions. Commonly used CNC machine tools, grouped in flexible production systems significantly facilitate fast production adjusting to these dynamic changes. The programs for CNC machine tools could be easily modified or generated in the CAM class programs. It remains, however, the technological process, which should be planned and continuously optimized with respect to new details being produced. In this paper is proposed the method basing on the engineering knowledge and experience for adding the process of production preparation. The method, developed by authors, is based on the CBR (Case Based Reasoning) technique. CBR is a method of problems solving. It bases on seeking an analogy (similarity) between the task currently being solved, and the earlier tasks that had already been solved. The article presents an algorithm and formalized description of the developed method.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

  12. Adding Chemoprophylaxis to Sequential Compression May Not Reduce the Risk of Venous Thromboembolism in Bariatric Surgery Patients

    PubMed Central

    Gagner, Michel; Selzer, Faith; Belle, Steve H.; Bessler, Marc; Courcoulas, Anita P.; Dakin, Gregory; Davis, Dan; Inabnet, William B.; Mitchell, James E.; Pomp, Alfons; Strain, Gladys; Pories, Walter J.; Wolfe, Bruce

    2012-01-01

    Background Anticoagulation, the use of sequential compression devices on lower extremities peri-operatively, and early ambulation are thought to reduce venous thromboembolism (VTE) postoperatively and are recommended to reduce VTE risk. However, the evidence upon which this recommendation is based is not particularly strong. We demonstrate that even a large, multi-center cohort with carefully collected prospective data is inadequate to provide sufficient evidence to support, or refute, this recommendation. Methods The Longitudinal Assessment of Bariatric Surgery (LABS) participants from 10 centers in the United States who underwent their first bariatric surgery between March, 2005 and December, 2007 comprise the study group. We examined the ability to address the question of whether anti-coagulation therapy, in addition to sequential compression, reduces the 30 day incidence of VTE or death sufficiently to recommend the use of prophylactic anticoagulation, a therapy that is not without risk. Results Of 4416 patients, 396 (9.0%) received sequential compression alone, while the others also received anticoagulation therapy. The incidence of VTE within 30 days of surgery was small (0.25% among those receiving sequential compression alone, 0.47% when anticoagulation therapy was added), and the 30 days incidence of death was also small (0.25% vs. 0.34%, p = 0.76, for sequential compression alone vs. sequential compression plus anticoagulation therapy). Estimates of the number of cases required to address the question of whether there is a difference in outcome related to VTE chemoprophylaxis, or whether the outcome rates are equivalent, range from 13,680 to at least 35,760 patients, depending upon whether superiority or equivalence is being analyzed. Conclusion Sufficient evidence from a clinical trial study to determine whether prophylactic anticoagulation added to compression devices further prevents VTEs is not available and such a trial is likely to be impractical

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

    NASA Astrophysics Data System (ADS)

    Hortos, William S.

    2006-05-01

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

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

    PubMed

    Scotter, M J

    2011-05-01

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

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

    PubMed

    Scotter, M J

    2011-05-01

    Coupled to increasing consumer demand, food manufacturers have moved towards increased usage of approved natural colours. There is a legal requirement for governments to monitor the consumption of all food additives in the European Union to ensure the acceptable daily intakes (ADIs) are not exceeded, especially by young children. Validated analytical methods are needed to fulfil this requirement. The aim of this paper is to review the available literature on methods of extraction for approved natural colours in food and drink. Available analytical methods for the determination of European Union-permitted natural food colour additives in foods and beverages have been assessed for their fitness for purpose in terms of their key extraction and analysis procedures, selectivity and sensitivity, especially with regard to maximum permitted levels, and their applicability for use in surveillance and in an enforcement role. The advantages and disadvantages of available analytical methods for each of nine designated chemical classes (groups) of natural colours in different food and beverage matrices are given. Other important factors such as technical requirements, cost, transferability and applicability are given due consideration. Gaps in the knowledge and levels of validation are identified and recommendations made on further research to develop suitable methods. The nine designated natural colour classes covered are: 1. Curcumin (E100), 2. Riboflavins (E101i-ii), 3. Cochineal (E120), 4. Chlorophylls--including chlorophyllins and copper analogues (E140-141), 5. Caramel Classes I-IV (E150a-d), 6. Carotenoids (E160a-f, E161b, E161g), 7. Beetroot red (E162), 8. Anthocyanins (E163), and 9. Other colours--Vegetable carbon (E153), Calcium carbonate (E170), Titanium dioxide (E171) and Iron oxides and hydroxides (E172). PMID:21424961

  16. Determination of optical properties in dental restorative biomaterials using the inverse-adding-doubling method

    NASA Astrophysics Data System (ADS)

    Fernández-Oliveras, Alicia; Rubiño, Manuel; Pérez, María. M.

    2013-11-01

    Light propagation in biological media is characterized by the absorption coefficient, the scattering coefficient, the scattering phase function, the refractive index, and the surface conditions (roughness). By means of the inverse-adding-doubling (IAD) method, transmittance and reflectance measurements lead to the determination of the absorption coefficient and the reduced scattering coefficient. The additional measurement of the phase function performed by goniometry allows the separation of the reduced scattering coefficient into the scattering coefficient and the scattering anisotropy factor. The majority of techniques, such as the one utilized in this work, involve the use of integrating spheres to measure total transmission and reflection. We have employed an integrating sphere setup to measure the total transmittance and reflectance of dental biomaterials used in restorative dentistry. Dental biomaterials are meant to replace dental tissues, such as enamel and dentine, in irreversibly diseased teeth. In previous works we performed goniometric measurements in order to evaluate the scattering anisotropy factor for these kinds of materials. In the present work we have used the IAD method to combine the measurements performed using the integrating sphere setup with the results of the previous goniometric measurements. The aim was to optically characterize the dental biomaterials analyzed, since whole studies to assess the appropriate material properties are required in medical applications. In this context, complete optical characterizations play an important role in achieving the fulfillment of optimal quality and the final success of dental biomaterials used in restorative dentistry.

  17. Eikonal methods in AdS/CFT: BFKL Pomeron at weak coupling

    NASA Astrophysics Data System (ADS)

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

    2008-06-01

    We consider correlators of Script N = 4 super Yang Mills of the form Script A ~ langleScript O1Script O2Script O1starScript O2starrangle, where the operators Script O1 and Script O2 are scalar primaries. In particular, we analyze this correlator in the planar limit and in a Lorentzian regime corresponding to high energy interactions in AdS. The planar amplitude is dominated by a Regge pole whose nature varies as a function of the 't Hooft coupling g2. At large g, the pole corresponds to graviton exchange in AdS, whereas at weak g, the pole is that of the hard perturbative BFKL Pomeron. We concentrate on the weak coupling regime and analyze Pomeron exchange directly in position space. The analysis relies heavily on the conformal symmetry of the transverse space Bbb E2 and of its holographic dual hyperbolic space H3, describing with an unified language, both the weak and strong 't Hooft coupling regimes. In particular, the form of the impact factors is highly constrained in position space by conformal invariance. Finally, the analysis suggests a possible AdS eikonal resummation of multi-Pomeron exchanges implementing AdS unitarity, which differs from the usual 4-dimensional eikonal exponentiation. Relations to violations of 4-dimensional unitarity at high energy and to the onset of nonlinear effects and gluon saturation become immediate questions for future research.

  18. Rapid Acting Insulin Use and Persistence among Elderly Type 2 Diabetes Patients Adding RAI to Oral Antidiabetes Drug Regimens

    PubMed Central

    Zhou, Steve; Fan, Tao

    2016-01-01

    We examined the real-world utilization and persistence of rapid acting insulin (RAI) in elderly patients with type 2 diabetes who added RAI to their drug (OAD) regimen. Insulin-naïve patients aged ≥65 years, with ≥1 OAD prescription during the baseline period, who were continuously enrolled in the US Humana Medicare Advantage insurance plan for 18 months and initiated RAI were included. Among patients with ≥2 RAI prescriptions (RAIp), persistence during the 12-month follow-up was assessed. Multivariate logistic regression analyses identified factors affecting RAI use and persistence. Of 3734 patients adding RAI to their OAD regimen, 2334 (62.5%) had a RAIp during follow-up. Factors associated with RAIp included using ≤2 OADs; cognitive impairment, basal insulin use during follow-up; and higher RAI out-of-pocket costs ($36 to <$56 versus $0 to $6.30). Patients were less likely to persist with RAI when on ≤2 OADs versus ≥3 OADs and when having higher RAI out-of-pocket costs ($36 to <$56 versus $0 to $6.30) and more likely to persist when they had cognitive impairment and basal insulin use during follow-up. Real-world persistence of RAI in insulin-naïve elderly patients with type 2 diabetes was very poor when RAI was added to an OAD regimen. PMID:27761472

  19. Determination of optical property changes by laser treatments using inverse adding-doubling method

    NASA Astrophysics Data System (ADS)

    Honda, Norihiro; Ishii, Katsunori; Kimura, Akinori; Sakai, Makoto; Awazu, Kunio

    2009-02-01

    It is widely recognized for the realization of the pre-estimated treatment effects that the knowledge about the optical properties of the target tissues used to understanding the prediction of propagation and distribution of light within tissues would suffer from the technical problem such as the kinetic changes of the optical properties in laser irradiation. In this study, the optical properties of normal and laser coagulated chicken breast tissues and porcine intervertebral disks, normal and laser ablation have been determined in vitro in the spectral range between 350 and 1000 nm. In addition, the optical properties of the normal and photodynamic therapy (PDT) treated tumor, Lewis lung carcinoma, tissues have been determined. Diffuse reflectance and total transmittance of the samples are measured using an integrating-sphere technique. From these experimental data, the absorption coefficients and the reduced scattering coefficients of the samples are determined employing an inverse adding-doubling method. Laser coagulations and ablations have clearly increased the reduced scattering coefficient and slightly reduced the absorption coefficient. PDT treatment has increased absorption and reduced scattering coefficient. It is our expectation that these data will provide fundamental understandings on laser irradiation interactions behavior with tissues. The changes of the optical properties should be accounted for while planning the therapeutic procedure for the realization of safe laser treatments.

  20. Intrathecal clonidine added to small-dose bupivacaine prolongs postoperative analgesia in patients undergoing transurethral surgery

    PubMed Central

    Gecaj-Gashi, Agreta; Terziqi, Hasime; Pervorfi, Tune; Kryeziu, Arben

    2012-01-01

    Introduction: The aim of this prospective, double-blinded study was to investigate the effects of clonidine in co-administration with bupivacaine during spinal anesthesia, regarding the onset and regression of motor and sensory block, postoperative analgesia and possible side effects. Methods: We randomly selected 66 male patients (age 35 to 70), from the American Society of Anesthesiologists (ASA) class I–II; these patients were scheduled for transurethral surgical procedures. These patients were randomly allocated into two groups of 33 patients each: group B (bupivacaine) only received 0.5% isobaric bupivacaine 7.5 mg intrathecally and group BC (bupivacaine + clonidine) received bupivacaine 7.5 mg and clonidine 25 μg intrathecally. We performed the spinal anesthesia at a level of L3–L4 with a 25-gauge needle. We assessed the sensory block with a pin-prick, the motor block using the Bromage scale, analgesia with the visual analog scale and sedation with the modified Wilson scale. We also recorded the hemodynamic and respiratory parameters. Results: The groups were demographically similar. The mean time of achievement of motor block (Bromage 3) and sensory block at level T9 was significantly shorter in the BC group compared with B group (p = 0.002, p = 0.000, respeectively). The motor block regression time was not significantly different between the two groups (p = 0.237). The postoperative analgesia requirement was significantly longer in group BC compared with group B (p = 0.000). No neurological deficit, sedation or other significant adverse effects were recorded. Conclusion: The intrathecal application of clonidine in combination with bupivacaine improves the duration and quality of spinal anesthesia; it also provides longer duration of postoperative analgesia, without significant side effects. PMID:22396363

  1. How Should Educators Interpret Value-Added Scores? What We Know Series: Value-Added Methods and Applications. Knowledge Brief 1

    ERIC Educational Resources Information Center

    Raudenbush, Stephen W.; Jean, Marshall

    2012-01-01

    A teacher's value-added score is intended to convey how much that teacher has contributed to student learning in a particular subject in a particular year. Different school districts define and compute value-added scores in different ways. A variety of people may see value-added estimates, and each group may use them for different purposes.…

  2. Differential hippocampal shapes in posterior cortical atrophy patients: A comparison with control and typical AD subjects

    PubMed Central

    Macdonald, Kate E.; Leung, Kelvin K.; Young, Jonathan; Pepple, Tracey; Lehmann, Manja; Zuluaga, Maria A.; Cardoso, M. Jorge; Schott, Jonathan M.; Ourselin, Sebastien; Crutch, Sebastian; Fox, Nick C.; Barnes, Josephine

    2015-01-01

    Abstract Posterior cortical atrophy (PCA) is a neurodegenerative syndrome characterized by predominant visual deficits and parieto‐occipital atrophy, and is typically associated with Alzheimer's disease (AD) pathology. In AD, assessment of hippocampal atrophy is widely used in diagnosis, research, and clinical trials; its utility in PCA remains unclear. Given the posterior emphasis of PCA, we hypothesized that hippocampal shape measures may give additional group differentiation information compared with whole‐hippocampal volume assessments. We investigated hippocampal volume and shape in subjects with PCA (n = 47), typical AD (n = 29), and controls (n = 48). Hippocampi were outlined on MRI scans and their 3D meshes were generated. We compared hippocampal volume and shape between disease groups. Mean adjusted hippocampal volumes were ∼8% smaller in PCA subjects (P < 0.001) and ∼22% smaller in tAD subject (P < 0.001) compared with controls. Significant inward deformations in the superior hippocampal tail were observed in PCA compared with controls even after adjustment for hippocampal volume. Inward deformations in large areas of the hippocampus were seen in tAD subjects compared with controls and PCA subjects, but only localized shape differences remained after adjusting for hippocampal volume. The shape differences observed, even allowing for volume differences, suggest that PCA and tAD are each associated with different patterns of hippocampal tissue loss that may contribute to the differential range and extent of episodic memory dysfunction in the two groups. Hum Brain Mapp 36:5123–5136, 2015. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. PMID:26461053

  3. Cerebrospinal fluid biomarkers and memory present distinct associations along the continuum from healthy subjects to AD patients.

    PubMed

    Rami, Lorena; Fortea, Juan; Bosch, Beatriz; Solé-Padullés, Cristina; Lladó, Albert; Iranzo, Alex; Sánchez-Valle, Raquel; Molinuevo, Jose Luis

    2011-01-01

    The objective was to study the association between cerebrospinal fluid (CSF) levels of amyloid-β (Aβ)(1-42), t-tau, and p-tau and cognitive performance along the Alzheimer's disease (AD) continuum from healthy subjects to AD patients and, specifically, among patients in the pre-dementia stage of the disease. A total of 101 subjects were studied: 19 healthy controls (CTR), 17 subjects with subjective memory complaints (SMC), 47 with mild cognitive impairment (MCI), and 18 AD patients. Only memory performance significantly correlated with CSF levels of Aβ(1-42), t-tau, and p-tau along the AD continuum. Subgroup analyses revealed that in SMC patients Aβ(1-42) levels positively correlated with the total recall score of the Free and Cued Selective Reminding Test (FCRST) (r = 0.666; p < 0.005), Digit Span (r = 0.752; p < 0.005), and CERAD world list learning (r = 0.697; p < 0.005). In MCI patients, a significant inverse correlation was found between the word list recall score from the CERAD and t-tau (r = -0.483; p < 0.005) and p-tau levels (r = -0.495; p < 0.005), as well as between the total recall subtest score from the FCRST and both t-tau (r = -0.420; p < 0.005) and p-tau levels (r = -0.422; p < 0.005). No significant correlations were found between other aspects of cognition and CSF levels in CTR or AD patients. These results indicate that memory performance is related to Aβ(1-42) levels in SMC, while it is associated with tau in the prodromal stage of the disease. This suggests that in the continuum from healthy aging to AD, memory performance is first related with Aβ(1-42) levels and then with t-tau or p-tau, before becoming independent of biomarker levels in the dementia stage. PMID:21098971

  4. Adding Memantine to Rivastigmine Therapy in Patients With Mild-to-Moderate Alzheimer's Disease: Results of a 12-Week, Open-Label Pilot Study

    PubMed Central

    Riepe, Matthias W.; Adler, Georg; Ibach, Bernd; Weinkauf, Birgit; Gunay, Ibrahim; Tracik, Ferenc

    2006-01-01

    Objective: At present, inhibition of cholines-terase is the treatment of choice for subjects with mild-to-moderate Alzheimer's disease (AD). Memantine, a noncompetitive antagonist at N-methyl-d-aspartate receptors, is currently used to treat subjects with moderate-to-severe AD. The goal of this multicenter, open-label pilot study was to investigate whether combination therapy with memantine added to rivastigmine is safe and beneficial in subjects with mild-to-moderate AD. Method: Patients with a DSM-IV diagnosis of dementia of the Alzheimer's type (N = 95), who were treated with rivastigmine (6–12 mg/day) for a maximum duration of 24 weeks prior to baseline, received memantine (5–20 mg/day) in combination with rivastigmine for 12 weeks. The primary efficacy variable was the change in the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) total score at the end of 12 weeks compared with baseline. The study was conducted between September 15, 2003, and May 27, 2004. Results: There was a statistically significant difference between baseline and week 12 for the ADAS-cog total score, showing a positive effect of combination therapy. Combination therapy did not evidence any unexpected safety concerns and was well-tolerated by most patients. Conclusion: Memantine in combination with rivastigmine appears to be safe and beneficial in patients with mild-to-moderate AD. Our results need to be confirmed in a large, long-term, randomized, double-blind, placebo-controlled clinical trial. PMID:17235381

  5. An efficient synthesis method targeted to marine alkaloids marinacarbolines A-D and their antitumor activities.

    PubMed

    Li, Jun; Tang, Yang; Jin, Hui-Juan; Cui, Yi-Di; Zhang, Li-Juan; Jiang, Tao

    2015-01-01

    Marinacarbolines A-D are a series of marine β-carboline alkaloids isolated from actinomycete Marinactinospora thermotolerans of the deep South China Sea with antiplasmodial activities. In inhibition assays of in vitro growth of Plasmodium falciparum, marinacarbolines exhibited antiplasmodial activity against drug-sensitive line 3D7 and drug-resistant line Dd2 of P. falciparum. However, approaches for the synthesis of such useful compounds are very limited. In this work, we reported a simple, efficient, and versatile process to synthesize marinacarbolines A-D (1-4). On the basis of that, the antitumor activities of marinacarbolines in a structure-dependent manner were allowed to be unveiled.

  6. Ondansetron and simvastatin added to treatment as usual in patients with schizophrenia: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Negative symptoms and cognitive deficits are two partially-related features of schizophrenia which have a major negative impact on social function and objective quality of life. Standard drug treatments have little impact on either. There is some evidence that anti-inflammatory treatment may have beneficial effects in schizophrenia and major depression. Statins are cholesterol-lowering agents that have been found to be anti-inflammatory agents and are also known to decrease C-reactive protein (CRP). Ondansetron is a serotonin (5-HT3) receptor antagonist widely used to prevent nausea and vomiting in patients receiving chemotherapy for cancer. Small studies have suggested that ondansetron is effective as an adjunct drug in improving the symptoms of schizophrenia. Methods/design This is a two center, six-month, double-blind placebo controlled, factorial design study of ondansetron and/or simvastatin added to treatment as usual for patients suffering from schizophrenia, schizoaffective disorder, psychosis not otherwise specified or schizophreniform disorder. This will be a 2 × 2 design, with 54 patients in each cell, giving a total of 216 patients over three years. There will be a screening, a randomization and seven follow-up visits. Full clinical and neurocognitive assessments will be carried out at baseline (randomization), 14 weeks and at 26 weeks, while the positive and negative syndrome scale (PANSS), pill count and side effects checklist will be carried out at every visit. Simvastatin will be started at 20 mg once daily (OD), this will be increased to 40 mg after four weeks. Ondansetron will be administered in an 8 mg dose. Discussion Anti-inflammatory treatments have been shown to have some beneficial effects in schizophrenia. Both simvastatin and ondansetron provide some evidence of a reduction in symptoms compared to treatment as usual. The aim of this study is to establish the degree of improvement in negative symptoms with the addition of

  7. Value-Added Methods & Their Application to Teachers and District Decisions about Teaching

    ERIC Educational Resources Information Center

    Villar, Anthony G.

    2011-01-01

    This dissertation project in applied research uses value added models to estimate learning effects in classrooms in one district under two conditions, schools piloting a reorganization and schools not yet under reorganization. The project addresses one of the current impasses in deciding how to take advantage of the variance among teachers…

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

    ERIC Educational Resources Information Center

    Harris, Douglas N.; Anderson, Andrew

    2013-01-01

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

  9. Will Teacher Value-Added Scores Change When Accountability Tests Change? What We Know Series: Value-Added Methods and Applications. Knowledge Brief 8

    ERIC Educational Resources Information Center

    McCaffrey, Daniel F.

    2013-01-01

    Value-added evaluations use student test scores to assess teacher effectiveness. How student achievement is judged can depend on which test is used to measure it. Thus it is reasonable to ask whether a teacher's value-added score depends on which test is used to calculate it. Would it change if a different test was used? Specifically, might a…

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

    ERIC Educational Resources Information Center

    Loeb, Susanna

    2013-01-01

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

  11. Unpacking the "Value Added" Impact of Continuing Professional Education: A Multi-Method Case Study Approach.

    ERIC Educational Resources Information Center

    Smith, Jo; Topping, Annie

    2001-01-01

    A study of 14 nurses who completed a children's neuroscience course found evidence of improved knowledge and increased ability to care for neurology patients. Although the direct impact of continuing education on patient care is difficult to assess, participants' assessment of their learning and its potential to affect patient care is a valid…

  12. Methods of Patient Warming during Abdominal Surgery

    PubMed Central

    Shao, Li; Zheng, Hong; Jia, Feng-Ju; Wang, Hui-Qin; Liu, Li; Sun, Qi; An, Meng-Ying; Zhang, Xiu-Hua; Wen, Hao

    2012-01-01

    Background Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. Methods Patients (n = 160) scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients’ nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. Results When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. Discussion The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed. PMID:22808045

  13. Propensity Score Methods as Alternatives to Value-Added Modeling for the Estimation of Teacher Contributions to Student Achievement

    ERIC Educational Resources Information Center

    Davison, Kimberlee Kaye Callister

    2012-01-01

    The purpose of this study was to examine the potential for using propensity score-based matching methods to estimate teacher contributions to student learning. Value-added models are increasingly used in teacher accountability systems in the United States in spite of ongoing qualms about the validity of teacher quality estimates resulting from…

  14. Informal, Incidental and Ad Hoc: The Information-Seeking and Learning Strategies of Health Care Patients

    ERIC Educational Resources Information Center

    Papen, Uta

    2012-01-01

    When people are ill, they want to know what is happening to them and how they can get better. Current health policies support patients' access to health information and encourage them to take part in decisions regarding their health. But little is known about how patients learn and the difficulties they may encounter in the process. This paper…

  15. Structural and optical properties of Ni added ZnO thin films deposited by sol-gel method

    SciTech Connect

    Murugan, R.; Vijayaprasath, G.; Anandhan, N. E-mail: gravicrc@gmail.com; Ravi, G. E-mail: gravicrc@gmail.com; Mahalingam, T.

    2014-04-24

    Pure and Ni added zinc oxide thin films were prepared by sol-gel method using spin-coating technique on glass substrates. The influences of nickel on ZnO thin films are characterized by Powder X-ray diffraction study. Pure and Ni added thin films are hexagonal wurtzite structure without any secondary phase in c-axis orientation. The SEM images of thin films show uniform sphere like particles covered completely on glass substrates. All the films exhibit transmittance of 85-95% in the visible range up to 800nm and cut-off wavelength observed at 394 nm corresponding to the fundamental absorption of ZnO. The photoluminescence property for pure and Ni added ZnO thin films has been studied and results are presented in detail.

  16. Inhibition of acetylcholinesterase in CSF versus brain assessed by 11C-PMP PET in AD patients treated with galantamine.

    PubMed

    Darreh-Shori, T; Kadir, A; Almkvist, O; Grut, M; Wall, A; Blomquist, G; Eriksson, B; Långström, B; Nordberg, A

    2008-02-01

    The relationship between acetylcholinesterase (AChE) activity in the CSF and brain of patients with Alzheimer's disease (AD) was investigated in 18 mild AD patients following galantamine treatment. The first 3 months of the study had a randomized double-blind placebo-controlled design, during which 12 patients received galantamine (16-24 mg/day) and six patients placebo. This was followed by 9 months galantamine treatment in all patients. Activities and protein levels of both the "read-through" AChE (AChE-R) and the synaptic (AChE-S) variants in CSF were assessed in parallel together with the regional brain AChE activity by (11)C-PMP and PET. The AChE-S inhibition was 30-36% in CSF, which correlated well with the in vivo AChE inhibition in the brain. No significant AChE inhibition was observed in the placebo group. The increased level of the AChE-R protein was 16% higher than that of AChE-S. Both the AChE inhibition and the increased level of AChE-R protein positively correlated with the patient's performance in cognitive tests associated with visuospatial ability and attention. In conclusion, AChE levels in CSF closely mirror in vivo brain AChE levels prior to and after treatment with the cholinesterase inhibitors. A positive cognitive response seems to dependent on the AChE inhibition level, which is balanced by an increased protein level of the AChE-R variant in the patients.

  17. PARENT joint action: increasing the added value of patient registries in a cross-border setting.

    PubMed

    Meglič, Matic; Doupi, Persephone; Pristaš, Ivan; Skalkidis, Yannis; Zaletel, Metka; Orel, Andrej

    2013-01-01

    Patient registries are poorly interoperable and as a result data exchange or aggregation across organizations, regions and countries for secondary purposes (i.e. research and public health) is difficult to perform. PARENT Joint Action aims to provide EU Member States with a set of guidelines, recommendations and tools to support setting-up, management and governance of interoperable patient registries, thus helping EU Member States to drive down cost and interoperability risks of patient registries as well as improving secondary us-age of registry data in a cross-border setting. PMID:23920935

  18. Comparison of TIVA and Desflurane Added to a Subanaesthetic Dose of Propofol in Patients Undergoing Coronary Artery Bypass Surgery: Evaluation of Haemodynamic and Stress Hormone Changes

    PubMed Central

    Akarsu Ayazoğlu, Tülin; Onk, Oruç Alper; Aksüt, Mehmet; Günay, Murat; Turkmen, Kultigin; Özensoy, Aynur; Yazıcı Ersoy, Çiğdem; Çoban, Abdulkadir

    2016-01-01

    Introduction. Increased levels of stress hormones are associated with mortality in patients undergoing coronary artery bypass grafting (CABG). Aim. To compare total intravenous anaesthesia (TIVA) and desflurane added to a subanaesthetic dose of propofol. Material and Methods. Fifty patients were enrolled in this study. Fentanyl (3–5 mcg/kg/h) was started in both groups. Patients were divided into two groups. The PD group (n = 25) received 1 minimum alveolar concentration (MAC) desflurane anaesthesia in addition to propofol infusion (2-3 mg/kg/h), while P group (n = 25) received propofol infusion (5-6 mg/kg/h) only. Biochemical data, cortisol, and insulin levels were measured preoperatively (T0), after initiation of CPB but before cross-clamping the aorta (T1), after removal of the cross-clamp (T2), and at the 24th postoperative hour (T3). Results. Systolic, diastolic, and mean arterial pressure levels were significantly higher in PD group than those in P group in T1 and T2 measurements (p ≤ 0.05). CK-MB showed a significant decrease in group P (p ≤ 0.05). When we compared both groups, cortisol levels were significantly higher in PD group than P group (p ≤ 0.05). Conclusion. Stress and haemodynamic responses were better controlled using TIVA than desflurane inhalation added to a subanaesthetic dose of propofol in patients undergoing CABG. PMID:27547757

  19. Comparison of TIVA and Desflurane Added to a Subanaesthetic Dose of Propofol in Patients Undergoing Coronary Artery Bypass Surgery: Evaluation of Haemodynamic and Stress Hormone Changes.

    PubMed

    Onk, Didem; Akarsu Ayazoğlu, Tülin; Onk, Oruç Alper; Aksüt, Mehmet; Günay, Murat; Turkmen, Kultigin; Özensoy, Aynur; Yazıcı Ersoy, Çiğdem; Çoban, Abdulkadir

    2016-01-01

    Introduction. Increased levels of stress hormones are associated with mortality in patients undergoing coronary artery bypass grafting (CABG). Aim. To compare total intravenous anaesthesia (TIVA) and desflurane added to a subanaesthetic dose of propofol. Material and Methods. Fifty patients were enrolled in this study. Fentanyl (3-5 mcg/kg/h) was started in both groups. Patients were divided into two groups. The PD group (n = 25) received 1 minimum alveolar concentration (MAC) desflurane anaesthesia in addition to propofol infusion (2-3 mg/kg/h), while P group (n = 25) received propofol infusion (5-6 mg/kg/h) only. Biochemical data, cortisol, and insulin levels were measured preoperatively (T0), after initiation of CPB but before cross-clamping the aorta (T1), after removal of the cross-clamp (T2), and at the 24th postoperative hour (T3). Results. Systolic, diastolic, and mean arterial pressure levels were significantly higher in PD group than those in P group in T1 and T2 measurements (p ≤ 0.05). CK-MB showed a significant decrease in group P (p ≤ 0.05). When we compared both groups, cortisol levels were significantly higher in PD group than P group (p ≤ 0.05). Conclusion. Stress and haemodynamic responses were better controlled using TIVA than desflurane inhalation added to a subanaesthetic dose of propofol in patients undergoing CABG. PMID:27547757

  20. Adding versatility to the reconstruction of intraoral lining: opened pocket method.

    PubMed

    Cinar, Can; Ogur, Simin; Arslan, Hakan; Kilic, Ali

    2007-01-01

    Reconstruction of a full-thickness cheek defect, especially one associated with a large lip and oral commissure defect, remains a challenge. After tumor excision, replacement of the oral mucosa is often necessary. The oral mucosa is a thin, pliable lining. Because the skin of the forearm is ideally suited for replacement of oral lining, being thin, pliable, and predominantly hairless, the radial forearm flap is the most frequently used soft-tissue flap for this purpose. In addition, the vascularity of the area allows substantial variation in the design of the flap, both in relation to its site and size. On the other hand, the radial forearm flap might be unusable in some occasions, such as in the case presented here. Thus, a search for an alternative free flap is required. We used a prefabricated scapular free flap to reconstruct a large concomitant lip and full-thickness cheek defect resulting from perioral cancer ablation. We introduce a new "opened pocket" method for reconstruction of the intra-oral lining without folding the flap. Resection of the tumor resulted in a defect including 45% of the upper lip, 50% of the lower lip, and a large, full-thickness defect of the cheek. The resultant defect was temporarily closed with a split-thickness skin graft. Meanwhile, the left scapular fasciocutaneous flap was prefabricated for permanent closure of the defect. The left scapular flap was outlined horizontally, and the flap orientation for the defect was estimated. Then, the distal portion of the flap was harvested and incised to create lips and oral commissure. Afterward, the raw surface under the neo-lip regions and the base where the flap was raised was grafted with one piece from a thick, split-thickness skin graft. Fourteen days later, the patient was taken back to the operating room for reconstruction of the defect with free transfer of a prefabricated scapular fascia-cutaneous flap. The grafted distal region of the flap was raised with the deep fascia located

  1. Adding Chemotherapy to Radiation Improves Survival for Some Patients with Rare Brain Cancer

    Cancer.gov

    Long-term results from two clinical trials confirm that certain patients with anaplastic oligodendrogliomas live substantially longer if they are treated with a combination of chemotherapy and radiation therapy rather than radiatiation alone.

  2. Performance Impacts of Lower-Layer Cryptographic Methods in Mobile Wireless Ad Hoc Networks

    SciTech Connect

    VAN LEEUWEN, BRIAN P.; TORGERSON, MARK D.

    2002-10-01

    In high consequence systems, all layers of the protocol stack need security features. If network and data-link layer control messages are not secured, a network may be open to adversarial manipulation. The open nature of the wireless channel makes mobile wireless mobile ad hoc networks (MANETs) especially vulnerable to control plane manipulation. The objective of this research is to investigate MANET performance issues when cryptographic processing delays are applied at the data-link layer. The results of analysis are combined with modeling and simulation experiments to show that network performance in MANETs is highly sensitive to the cryptographic overhead.

  3. A Comprehensive Support Program: Effect on Depression in Spouse-Caregivers of AD Patients.

    ERIC Educational Resources Information Center

    Mittelman, Mary S.; And Others

    1995-01-01

    Describes a psychosocial intervention program that treats the primary caregiver and family members of the Alzheimer's patient over the entire course of the disease. In the first year after intake, the control group became increasingly more depressed, whereas the treatment group remained stable. By the eighth month, treated caregivers were…

  4. Estimation of the effective phase function of bulk diffusing materials with the inverse adding-doubling method.

    PubMed

    Leyre, Sven; Meuret, Youri; Durinck, Guy; Hofkens, Johan; Deconinck, Geert; Hanselaer, Peter

    2014-04-01

    The accuracy of optical simulations including bulk diffusors is heavily dependent on the accuracy of the bulk scattering properties. If no knowledge on the physical scattering effects is available, an iterative procedure is usually used to obtain the scattering properties, such as the inverse Monte Carlo method or the inverse adding-doubling (AD) method. In these methods, a predefined phase function with one free parameter is usually used to limit the number of free parameters. In this work, three predefined phase functions (Henyey-Greenstein, two-term Henyey-Greenstein, and Gegenbauer kernel (GK) phase function) are implemented in the inverse AD method to determine the optical properties of two strongly diffusing materials: low-density polyethylene and TiO₂ particles. Using the presented approach, an estimation of the effective phase function was made. It was found that the use of the GK phase function resulted in the best agreement between calculated and experimental transmittance, reflectance, and scattered radiant intensity distribution for the LDPE sample. For the TiO₂ sample, a good agreement was obtained with both the two-term Henyey-Greenstein and the GK phase function. PMID:24787170

  5. Adding mindfulness to CBT programs for binge eating: a mixed-methods evaluation.

    PubMed

    Woolhouse, Hannah; Knowles, Ann; Crafti, Naomi

    2012-01-01

    The current study investigated the effectiveness of a combined mindfulness-CBT group therapy program for women with binge eating problems. Questionnaires were completed by group participants pre-program (n = 30), post-program (n = 30) and 3 month follow-up (n = 28). Significant reductions between pre- and post-program scores were found on standardised measures assessing binge eating, dieting, and body image dissatisfaction, with all reductions maintained at follow-up. Qualitative interviews with 16 women following completion of the program revealed the value of mindfulness in improving eating behaviour through increased self-awareness. This exploratory study supports the value of adding mindfulness to the more commonly utilised CBT-based programs for binge eating.

  6. Effect of pretreatment and drying methods on quality of value-added dried aonla (Emblica officinalis Gaertn) shreds.

    PubMed

    Prajapati, V K; Nema, Prabhat K; Rathore, S S

    2011-02-01

    Value added dried Indian gooseberry (aonla) shreds were prepared using aonla fruits of cv. 'NA-7'. Two blanching methods (hot water and potassium metabisulphite (KMS) at 0.1%) and two drying methods (solar and hot air oven drying) were tried for the production of aonla shreds. Common salt, black salt and ginger juice were mixed for enhancing sensory quality of the product. The best product was obtained with KMS blanching and drying in solar dryer with added common salt at 3%. The most acceptable product had ascorbic acid content 298.3 mg/100 g, tannin 2.4%, acidity 2.6%, reducing sugar 3.0%, non-reducing sugar 21.0% and total sugar 24.0%. The recovery was 8.0-8.5%.

  7. Effect of pretreatment and drying methods on quality of value-added dried aonla (Emblica officinalis Gaertn) shreds.

    PubMed

    Prajapati, V K; Nema, Prabhat K; Rathore, S S

    2011-02-01

    Value added dried Indian gooseberry (aonla) shreds were prepared using aonla fruits of cv. 'NA-7'. Two blanching methods (hot water and potassium metabisulphite (KMS) at 0.1%) and two drying methods (solar and hot air oven drying) were tried for the production of aonla shreds. Common salt, black salt and ginger juice were mixed for enhancing sensory quality of the product. The best product was obtained with KMS blanching and drying in solar dryer with added common salt at 3%. The most acceptable product had ascorbic acid content 298.3 mg/100 g, tannin 2.4%, acidity 2.6%, reducing sugar 3.0%, non-reducing sugar 21.0% and total sugar 24.0%. The recovery was 8.0-8.5%. PMID:23572715

  8. Pittsburgh compound B-negative dementia: a possibility of misdiagnosis of patients with non-alzheimer disease-type dementia as having AD.

    PubMed

    Shimada, Hiroyuki; Ataka, Suzuka; Takeuchi, Jun; Mori, Hiroshi; Wada, Yasuhiro; Watanabe, Yasuyoshi; Miki, Takami

    2011-09-01

    Amyloid imaging has been used to detect amyloid deposition in the brain. We performed Pittsburgh compound B (PiB)-positron emission tomography on 63 patients with dementia having cognitive decline or memory disturbance. In addition, we measured the patients' apolipoprotein E4 (apo E4) status and cerebrospinal fluid (CSF) levels of amyloid-β (Aβ)1-42, tau, and P-tau. Finally, the patients were diagnosed as having probable Alzheimer disease (AD) on the basis of their neuropsychological findings and because they met the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria. Among the patients diagnosed with probable AD, 10 patients were PiB negative. The CSF levels of P-tau and tau in PiB-negative patients were significantly lower than those in the PiB-positive patients. In addition, the CSF levels of Aβ1-42 in the PiB-negative patients were significantly higher than those in the PiB-positive patients. None of the PiB-negative patients were apo E4 carriers. These results suggest that the PiB-negative patient group included not only AD patients but also non-AD-type dementia patients. However, our finding is based on a relatively small number of patients and therefore should be replicated in a larger cohort. In addition, it will be necessary to categorize these participants by longitudinal follow-up and postmortem pathological examinations.

  9. What Do We Know about the Long-Term Impacts of Teacher Value-Added? What We Know Series: Value-Added Methods and Applications. Knowledge Brief 15

    ERIC Educational Resources Information Center

    Raudenbush, Stephen W.

    2014-01-01

    Proposals to evaluate teachers based on their "value-added" to student test scores generate intense debate. Underlying the debate are concerns about three factors: "bias," "precision," and "relevance." Previous Carnegie Foundation briefs have detailed the reasons why the first two are significant concerns.…

  10. Application of the CBR method for adding the process of cutting tools and parameters selection

    NASA Astrophysics Data System (ADS)

    Ociepka, P.; Herbuś, K.

    2016-08-01

    The paper presents a method, basing on engineering knowledge and experience, designated to aid the selection of tools and machining parameters for the processes of turning. In this method, the informatics system is built basing on a Case Based Reasoning (CBR) method. This is a method of problems solving based on experience. It consists in finding analogies between the currently being solved task, and earlier realized tasks that have been stored in the database of the CBR system. The article presents the structure of the developed software, as well as the functioning of the CBR method. It also presents the possibility of integrating the developed method with the CAM module of the SIEMENS PLM NX program.

  11. Coherence penalty functional: A simple method for adding decoherence in Ehrenfest dynamics

    SciTech Connect

    Akimov, Alexey V. E-mail: oleg.prezhdo@rochester.edu; Long, Run; Prezhdo, Oleg V. E-mail: oleg.prezhdo@rochester.edu

    2014-05-21

    We present a new semiclassical approach for description of decoherence in electronically non-adiabatic molecular dynamics. The method is formulated on the grounds of the Ehrenfest dynamics and the Meyer-Miller-Thoss-Stock mapping of the time-dependent Schrödinger equation onto a fully classical Hamiltonian representation. We introduce a coherence penalty functional (CPF) that accounts for decoherence effects by randomizing the wavefunction phase and penalizing development of coherences in regions of strong non-adiabatic coupling. The performance of the method is demonstrated with several model and realistic systems. Compared to other semiclassical methods tested, the CPF method eliminates artificial interference and improves agreement with the fully quantum calculations on the models. When applied to study electron transfer dynamics in the nanoscale systems, the method shows an improved accuracy of the predicted time scales. The simplicity and high computational efficiency of the CPF approach make it a perfect practical candidate for applications in realistic systems.

  12. Quality specifications: self pleasure for clinical laboratories or added value for patient management?

    PubMed

    Plebani, Mario

    2007-01-01

    Analytical quality specifications play a key role in assuring and continuously improving high-quality laboratory services. However, I believe, that there are two "missing links" in the effective management of quality specifications in the delivery of laboratory services. The first is the evidence that pre-analytical variation and related problems are not taken into great consideration by laboratory professionals. The second missing link is the communication of quality specifications to clinicians and other possible stakeholders. If quality specifications represent "the level of performance required to facilitate clinical decision-making", they cannot be used only for internal quality management procedures but must be communicated to facilitate clinical reasoning, decision-making and patient management. A consensus should be achieved in the scientific community on these issues to assure better utilization of laboratory data and, ultimately, improved clinical outcomes.

  13. Methods to recover value-added coproducts from dry grind processing of grains into fuel ethanol.

    PubMed

    Liu, Keshun; Barrows, Frederic T

    2013-07-31

    Three methods are described to fractionate condensed distillers solubles (CDS) into several new coproducts, including a protein-mineral fraction and a glycerol fraction by a chemical method; a protein fraction, an oil fraction and a glycerol-mineral fraction by a physical method; or a protein fraction, an oil fraction, a mineral fraction, and a glycerol fraction by a physicochemical method. Processing factors (ethanol concentration and centrifuge force) were also investigated. Results show that the three methods separated CDS into different fractions, with each fraction enriched with one or more of the five components (protein, oil, ash, glycerol and other carbohydrates) and thus having different targeted end uses. Furthermore, because glycerol, a hygroscopic substance, was mostly shifted to the glycerol or glycerol-mineral fraction, the other fractions had much faster moisture reduction rates than CDS upon drying in a forced air oven at 60 °C. Thus, these methods could effectively solve the dewatering problem of CDS, allowing elimination of the current industrial practice of blending distiller wet grains with CDS for drying together and production of distiller dried grains as a standalone coproduct in addition to a few new fractions.

  14. Evaluation of microbial diversity in sulfite-added and sulfite-free wine by culture-dependent and -independent methods.

    PubMed

    Takahashi, Masayuki; Ohta, Tami; Masaki, Kazuo; Mizuno, Akihiro; Goto-Yamamoto, Nami

    2014-05-01

    The difference in microbiota including non-lactic acid bacteria, non-acetic acid bacteria, and wild yeast during winemaking and in the end-products between sulfite-added and sulfite-free wine, was investigated using polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) and a culture-dependent method. There were differences between the microorganisms detected by PCR-DGGE and those detected by the culture-dependent method, probably because of the selectivity of culture medium and the characteristics of PCR-based method. In both the red wine and white wine, the microbial diversity of the sulfite-added wine was lower than that of the sulfite-free wine during fermentation. Tatumella terrea was detected from the fermenting must by PCR-DGGE and by the culture-dependent method, even though sulfite inhibited its growth to some extent. We confirmed that the addition of sulfite plays an important role in winemaking by inhibiting the growth of unexpected microorganisms, but on the other hand, it was revealed that some microorganisms can survive and grow in sulfite-added fermenting must. We also analyzed 15 samples of commercial wines by the PCR-DGGE method and detected various microorganisms. Among them, Sphingomonas sp., Pseudozyma sp., Ochromonas sp. and Methylophilus sp. were found for the first time in wine as far as we know. We did not identify a specific microorganism that was detected only from wines without sulfite addition. Thus, the microbiota of end-products seemed to be influenced by other factors, such as filtration before bottling, the production equipment and the storage environment.

  15. Adding Qualitative and Mixed Methods Research to Health Intervention Studies: Interacting With Differences.

    PubMed

    Johnson, R Burke; Schoonenboom, Judith

    2016-04-01

    The purpose of this article is to explain how to improve intervention designs, such as randomized controlled trials (RCTs), in health science research using a process philosophy and theory known as dialectical pluralism (DP). DP views reality as plural and uses dialectical, dialogical, and hermeneutical approaches to knowledge construction. Using DP and its "both/and" logic, and its attempt to produce new creative syntheses, researchers on heterogeneous teams can better dialogue with qualitative and mixed methods approaches, concepts, paradigms, methodologies, and methods to improve their intervention research studies. The concept of reflexivity is utilized but is expanded when it is a component of DP. Examples of strategies for identifying, inviting, and creating divergence and integrative strategies for producing strong mixed methods intervention studies are provided and illustrated using real-life examples.

  16. Adding an Integrated Library Component to an Undergraduate Research Methods Course

    ERIC Educational Resources Information Center

    Gilbert, Julie K.; Knutson, Katherine; Gilbert, Christopher P.

    2012-01-01

    As undergraduate students increasingly rely on the Internet as their primary method for gathering sources, they often overlook the rich and varied resources available to them in library collections. Furthermore, students often lack the sophistication to effectively seek out and use information, an ability generally referred to as information…

  17. Positive impact of adding No.14v lymph node to D2 dissection on survival for distal gastric cancer patients after surgery with curative intent

    PubMed Central

    Liang, Yuexiang; Wu, Liangliang; Wang, Xiaona; Ding, Xuewei; Liu, Hongmin; Li, Bin; Wang, Baogui; Pan, Yuan; Zhang, Rupeng; Liu, Ning

    2015-01-01

    Background D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer (GC), while the necessity of No.14v lymph node (14v) dissection for distal GC is still controversial. Methods A total of 920 distal GC patients receiving at least a D2 lymph node dissection in Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were enrolled in this study, of whom, 243 patients also had the 14v dissected. Other 677 patients without 14v dissection were used for comparison. Results Forty-five (18.5%) patients had 14v metastasis. There was no significant difference in 3-year overall survival (OS) rate between patients with and without 14v dissection. Following stratified analysis, in TNM stages I, II, IIIa and IV, 14v dissection did not affect 3-year OS; in contrast, patients with 14v dissection had a significant higher 3-year OS than those without in TNM stages IIIb and IIIc. In multivariate analysis, 14v dissection was found to be an independent prognostic factor for GC patients with TNM stage IIIb/IIIc disease [hazard ratio (HR), 1.568; 95% confidence interval (CI): 1.186-2.072; P=0.002]. GC patients with 14v dissection had a significant lower locoregional, especially lymph node, recurrence rate than those without 14v dissection (11.7% vs. 21.1%, P=0.035). Conclusions Adding 14v to D2 lymphadenectomy may be associated with improved 3-year OS for distal GC staged TNM IIIb/IIIc. PMID:26752932

  18. Method for adding additional isotopes to actinide-only burnup credit

    SciTech Connect

    Lancaster, D.B.; Fuentes, E.; Kang, C.

    1998-01-01

    The Topical Report on Actinide-Only Burnup Credit for Pressurized Water Reactor Spent Nuclear Fuel Packages requires computer code validation to be performed against a benchmark set of chemical assays for isotopic concentration and against a benchmark set of critical experiments for package criticality. Both sets contain all the isotopes included in the methodology. The chemical assays used include the uranium and plutonium isotopes, while the critical experiments were composed of UO{sub 2} or MOX rods, covering the isotopes in the actinide only approach. Since other isotopes are not included in the validation benchmark sets, it would be necessary to justify both the content and worth of any additional isotope for which burnup credit is to be taken (i.e., both the concentration and criticality effect of each particular isotope must be validated). A method is proposed here that can be used for any number of additional isotopes. As does the actinide-only burnup credit methodology, this method makes use of chemical assay data to establish the conservatism in the prediction of each isotope`s concentration. Criticality validation is also performed using a benchmark set of UO{sub 2} and MOX critical experiments, where the additional isotopes are validated using worth experiments to conservatively account for any uncertainty in their cross sections. The remaining requirements (analysis and modeling parameters, loading criteria generation, and physical implementation and controls) are performed exactly as described in the actinide-only burnup credit methodology. This report provides insight into each particular requirement in the new methodology.

  19. The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis

    PubMed Central

    Shanb, Alsayed A.; Youssef, Enas F.

    2014-01-01

    Background: Osteoporosis is a major public health problem affecting the elderly population, particularly women. The objective of the study was to evaluate the effects of adding weight-bearing exercise as opposed to nonweight-bearing programs to the medical treatment of bone mineral density (BMD) and health-related quality of life (HRQoL) of elderly patients with osteoporosis. Materials and Methods: Participating in the study were 40 elderly osteoporotic patients (27 females and 13 males), with ages ranging from 60 to 67 years, who were receiving medical treatment for osteoporosis. They were assigned randomly into two groups: Group-I: Twenty patients practiced weight-bearing exercises. Group-II: Twenty patients did nonweight-bearing exercises. All patients trained for 45-60 min/session, two sessions/week for 6 months. BMD of the lumbar spine, right neck of femur, and right distal radial head of all patients were measured by dual-energy X-ray absorptiometry before and after both treatment programs. In addition, the QoL was measured by means of the HRQoL “ECOS-16” questionnaire. Results: T-tests proved that mean values of BMD of the lumbar spine, right neck of femur and right distal radial head were significantly increased in both groups with greater improvement in the weight-bearing group. The QoL was significantly improved in both groups, but the difference between them was not significant. Conclusion: Addition of weight-bearing exercise program to medical treatment increases BMD more than nonweight-bearing exercise in elderly subjects with osteoporosis. Furthermore, both weight-bearing and nonweight-bearing exercise programs significantly improved the QoL of patients with osteoporosis. PMID:25374469

  20. FRAGMATIC: A randomised phase III clinical trial investigating the effect of fragmin® added to standard therapy in patients with lung cancer

    PubMed Central

    2009-01-01

    Background Venous thromboembolism (VTE) occurs when blood clots in the leg, pelvic or other deep vein (deep vein thrombosis) with or without transport of the thrombus into the pulmonary arterial circulation (pulmonary embolus). VTE is common in patients with cancer and is increased by surgery, chemotherapy, radiotherapy and disease progression. Low molecular weight heparin (LMWH) is routinely used to treat VTE and some evidence suggests that LMWH may also have an anticancer effect, by reduction in the incidence of metastases. The FRAGMATIC trial will assess the effect of adding dalteparin (FRAGMIN), a type of LMWH, to standard treatment for patients with lung cancer. Methods/Design The study design is a randomised multicentre phase III trial comparing standard treatment and standard treatment plus daily LMWH for 24 weeks in patients with lung cancer. Patients eligible for this study must have histopathological or cytological diagnosis of primary bronchial carcinoma (small cell or non-small cell) within 6 weeks of randomisation, be 18 or older, and must be willing and able to self-administer 5000 IU dalteparin by daily subcutaneous injection or have it administered to themselves or by a carer for 24 weeks. A total of 2200 patients will be recruited from all over the UK over a 3 year period and followed up for a minimum of 1 year after randomisation. Patients will be randomised to one of the two treatment groups in a 1:1 ratio, standard treatment or standard treatment plus dalteparin. The primary outcome measure of the trial is overall survival. The secondary outcome measures include venous thrombotic event (VTE) free survival, serious adverse events (SAEs), metastasis-free survival, toxicity, quality of life (QoL), levels of breathlessness, anxiety and depression, cost effectiveness and cost utility. Trial registration Current Controlled Trials ISRCTN80812769 PMID:19807917

  1. Hairy AdS solitons

    NASA Astrophysics Data System (ADS)

    Anabalón, Andrés; Astefanesei, Dumitru; Choque, David

    2016-11-01

    We construct exact hairy AdS soliton solutions in Einstein-dilaton gravity theory. We examine their thermodynamic properties and discuss the role of these solutions for the existence of first order phase transitions for hairy black holes. The negative energy density associated to hairy AdS solitons can be interpreted as the Casimir energy that is generated in the dual filed theory when the fermions are antiperiodic on the compact coordinate.

  2. Efficacy and safety of ezetimibe added to atorvastatin versus atorvastatin uptitration or switching to rosuvastatin in patients with primary hypercholesterolemia.

    PubMed

    Bays, Harold E; Averna, Maurizio; Majul, Claudio; Muller-Wieland, Dirk; De Pellegrin, Annamaria; Giezek, Hilde; Lee, Raymond; Lowe, Robert S; Brudi, Philippe; Triscari, Joseph; Farnier, Michel

    2013-12-15

    Hypercholesterolemic patients (n = 1,547) at high atherosclerotic cardiovascular disease risk with low-density lipoprotein cholesterol (LDL-C) levels ≥100 and ≤160 mg/dl while treated with atorvastatin 10 mg/day entered a multicenter, randomized, double-blind, active-controlled, clinical trial using two 6-week study periods. Period I compared the efficacy/safety of (1) adding ezetimibe 10 mg (ezetimibe) to stable atorvastatin 10 mg, (2) doubling atorvastatin to 20 mg, or (3) switching to rosuvastatin 10 mg. Subjects in the latter 2 groups who persisted with elevated LDL-C levels (≥100 and ≤160 mg/dl) after period I, entered period II; subjects on atorvastatin 20 mg had ezetimibe added to their atorvastatin 20 mg, or uptitrated their atorvastatin to 40 mg; subjects on rosuvastatin 10 mg switched to atorvastatin 20 mg plus ezetimibe or uptitrated their rosuvastatin to 20 mg. Some subjects on atorvastatin 10 mg plus ezetimibe continued the same treatment into period II. At the end of period I, ezetimibe plus atorvastatin 10 mg reduced LDL-C significantly more than atorvastatin 20 mg or rosuvastatin 10 mg (22.2% vs 9.5% or 13.0%, respectively, p <0.001). At the end of period II, ezetimibe plus atorvastatin 20 mg reduced LDL-C significantly more than atorvastatin 40 mg (17.4% vs 6.9%, p <0.001); switching from rosuvastatin 10 mg to ezetimibe plus atorvastatin 20 mg reduced LDL-C significantly more than uptitrating to rosuvastatin 20 mg (17.1% vs 7.5%, p <0.001). Relative to comparative treatments, ezetimibe added to atorvastatin 10 mg (period I) or atorvastatin 20 mg (period II) produced significantly greater percent attainment of LDL-C targets <100 or <70 mg/dl, and significantly greater percent reductions in total cholesterol, non-high-density lipoprotein cholesterol, most lipid and lipoprotein ratios, and apolipoprotein B (except ezetimibe plus atorvastatin 20 vs atorvastatin 40 mg). Reports of adverse experiences were generally

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

    DOEpatents

    Lapshina, Elena V.; Zhuikov, Boris L.; Srivastava, Suresh C.; Ermolaev, Stanislav V.; Togaeva, Natalia R.

    2012-01-17

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

  4. Budgetary Impact of Adding Riociguat to a US Health Plan for the Treatment of Patients with Pulmonary Arterial Hypertension or Chronic Thromboembolic Pulmonary Hypertension

    PubMed Central

    Burudpakdee, Chakkarin; Shah, Anshul; Joish, Vijay N.; Divers, Christine H.; Yaldo, Avin

    2014-01-01

    Background Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are chronic, debilitating, and life-threatening conditions. Riociguat is the first and only pharmacotherapy approved by the US Food and Drug Administration (FDA) for the treatment of PAH and for CTEPH in patients who are either inoperable or have persistent pulmonary hypertension after surgery. Objective To estimate the budgetary impact of adding riociguat to a US health plan's formulary for the treatment of patients with PAH or CTEPH using a budget impact analytic model. Methods A customizable, Microsoft Excel–based decision analytic tool was developed to estimate the impact of riociguat on per-member per-month (PMPM) and per-member per-year (PMPY) bases in Medicare and non-Medicare health plans. The economic impact was calculated based on 1 million insured lives, published prevalence estimates of PAH and CTEPH, pharmacotherapy-eligible patients with PAH or CTEPH, administration costs, and monitoring costs related to pharmacotherapy. The drug costs were based on wholesale acquisition costs, and the medical costs were derived from Truven Health MarketScan claims data and the Medicare 2013 Clinical Diagnostic Laboratory Fee Schedule and Physician Fee Schedule. The market share for approved treatments was based on a tracking study of physicians treating patients with PAH or CTEPH. A sensitivity analysis was used to test the model's robustness. Results In a hypothetical plan population of 1 million members, the model estimated that 7 patients with PAH and 2 patients with CTEPH would be suitable for pharmacotherapy. Overall, 3 patients (1 with PAH and 2 with CTEPH) were receiving riociguat in a health plan consisting of patients with commercial and with Medicare insurance coverage. The incremental PMPY and PMPM costs for providing insurance coverage for riociguat were $0.27 and $0.02, respectively, for non-Medicare and Medicare health plans. Sensitivity analyses

  5. Combined bio-inspired/evolutionary computational methods in cross-layer protocol optimization for wireless ad hoc sensor networks

    NASA Astrophysics Data System (ADS)

    Hortos, William S.

    2011-06-01

    Published studies have focused on the application of one bio-inspired or evolutionary computational method to the functions of a single protocol layer in a wireless ad hoc sensor network (WSN). For example, swarm intelligence in the form of ant colony optimization (ACO), has been repeatedly considered for the routing of data/information among nodes, a network-layer function, while genetic algorithms (GAs) have been used to select transmission frequencies and power levels, physical-layer functions. Similarly, artificial immune systems (AISs) as well as trust models of quantized data reputation have been invoked for detection of network intrusions that cause anomalies in data and information; these act on the application and presentation layers. Most recently, a self-organizing scheduling scheme inspired by frog-calling behavior for reliable data transmission in wireless sensor networks, termed anti-phase synchronization, has been applied to realize collision-free transmissions between neighboring nodes, a function of the MAC layer. In a novel departure from previous work, the cross-layer approach to WSN protocol design suggests applying more than one evolutionary computational method to the functions of the appropriate layers to improve the QoS performance of the cross-layer design beyond that of one method applied to a single layer's functions. A baseline WSN protocol design, embedding GAs, anti-phase synchronization, ACO, and a trust model based on quantized data reputation at the physical, MAC, network, and application layers, respectively, is constructed. Simulation results demonstrate the synergies among the bioinspired/ evolutionary methods of the proposed baseline design improve the overall QoS performance of networks over that of a single computational method.

  6. Value Added?

    ERIC Educational Resources Information Center

    UCLA IDEA, 2012

    2012-01-01

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

  7. Determination of added sulfites in dried garlic with a modified version of the optimized Monier-Williams method.

    PubMed

    Lafeuille, Jean-Louis; Lefevre, Stephane; Achouri, Djamila

    2007-01-01

    The optimized Monier-Williams method is slightly modified so that it could be applied for determining sulfite content in dried garlic. Dried garlic sample is directly acidified in a reactor at a pH below 3. At this pH level, the alliinase enzyme activity is irreversibly blocked, and the sulfur-containing amino acids such as alliin (the most abundant) present in dried garlic cannot be transformed into corresponding thiosulfinates such as allicin, which is absent in dried garlic. This prevents allicin from reacting with added sulfites and being probably converted to S-allyl thiosulfate, which is not volatile and has no taste. It is found that at a pH below 2.4 and at boiling water temperature, allicin produces sulfur dioxide in adequate quantity to explain the false-positive results when utilizing the optimized Monier-Williams method with allicin suppression for unsulfited dried garlic samples. Finally, when garlic samples are stabilized in a phosphoric acid buffer at a final pH around 2.4, no sulfite is produced during the Monier-Williams distillation, which is further proof there are no naturally occurring sulfites in unsulfited dried garlic under these mild conditions.

  8. Effectiveness of an intercultural module added to the treatment guidelines for Moroccan and Turkish patients with depressive and anxiety disorders

    PubMed Central

    2011-01-01

    Background Since the sixties of the last century, many people from Morocco and Turkey have migrated into the Netherlands. In the last decade, Moroccan and Turkish patients have found their way to organizations for mental health care. However, they often drop out of treatment. Problems in the communication with therapists and different expectations regarding treatment seem to be causal factors for the early drop-out of therapy. In the Netherlands as in other countries courses have been developed for training cultural competence of therapists. Yet, up to now, the effectiveness of increased cultural competence of therapists in reducing drop-out of treatment has not been studied. Methods/Design A randomized clinical trial was started in January 2010. Moroccan and Turkish adult patients who are referred to our outpatient clinics for mood and anxiety disorders are randomly assigned to mental health workers who are trained in a cultural module and to those who are not. The therapists have been trained in the Cultural Formulation and in techniques bridging the (cultural) gap between them and their Moroccan and Turkish patients. The target number of participants is 150 patients, 75 for each group. Drop-out of treatment is the primary outcome measure. Secondary outcome measures are no-show and patients' perspective of care. Discussion The study will give an answer to the question whether increasing cultural competence of therapists reduces drop-out of treatment in Moroccan and Turkish outpatients with depressive and anxiety disorders. Trial Registration The Dutch Cochrane Centre, NTR1989 PMID:21247455

  9. The effectiveness of adding cognitive behavioural therapy aimed at changing lifestyle to managed diabetes care for patients with type 2 diabetes: design of a randomised controlled trial

    PubMed Central

    Welschen, Laura MC; van Oppen, Patricia; Dekker, Jacqueline M; Bouter, Lex M; Stalman, Wim AB; Nijpels, Giel

    2007-01-01

    Background In patients with type 2 diabetes, the risk for cardiovascular disease is substantial. To achieve a more favourable risk profile, lifestyle changes on diet, physical activity and smoking status are needed. This will involve changes in behaviour, which is difficult to achieve. Cognitive behavioural therapies focussing on self-management have been shown to be effective. We have developed an intervention combining techniques of Motivational Interviewing (MI) and Problem Solving Treatment (PST). The aim of our study is to investigate if adding a combined behavioural intervention to managed care, is effective in achieving changes in lifestyle and cardiovascular risk profile. Methods Patients with type 2 diabetes will be selected from general practices (n = 13), who are participating in a managed diabetes care system. Patients will be randomised into an intervention group receiving cognitive behaviour therapy (CBT) in addition to managed care, and a control group that will receive managed care only. The CBT consists of three to six individual sessions of 30 minutes to increase the patient's motivation, by using principles of MI, and ability to change their lifestyle, by using PST. The first session will start with a risk assessment of diabetes complications that will be used to focus the intervention. The primary outcome measure is the difference between intervention and control group in change in cardiovascular risk score. For this purpose blood pressure, HbA1c, total and HDL-cholesterol and smoking status will be assessed. Secondary outcome measures are quality of life, patient satisfaction, physical activity, eating behaviour, smoking status, depression and determinants of behaviour change. Differences between changes in the two groups will be analysed according to the intention-to-treat principle, with 95% confidence intervals. The power calculation is based on the risk for cardiovascular disease and we calculated that 97 patients should be included in

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

    ERIC Educational Resources Information Center

    Croft, Michelle; Buddin, Richard

    2014-01-01

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

  11. Adherence to and appropriateness of anti-osteoporotic treatments in patients aged 50 and over in the Valencia Region (Spain). The ESOSVAL-AD Study

    PubMed Central

    2011-01-01

    Summary Background A study to evaluate the adherence to and appropriateness of anti-osteoporotic treatments in a cohort of men and women aged 50 and over participating in the ESOSVAL-R study. Methods/Design Design: An observational, longitudinal, prospective cohort study; Study subjects: Men and women aged 50 and over living in the Valencia Region (Spain) who initiated treatment between June 15, 2009, and June 15, 2011, in primary healthcare centers with electronic medical records; Data sources: The main data source will be electronic medical records. Measurement of results: Degree of compliance with and persistence of anti-osteoporotic treatments, and the proportion of patients with appropriate anti-osteoporotic treatment in accordance with the most relevant and high impact recommendations with clearly defined treatment algorithms in Spain (the Spanish National Health System guide (2010), the General Practitioners' Society (2007) and the General Directorate for Pharmacy and Medical Products of Madrid (2007)), and with the National Osteoporosis Foundation (NOF, 2010), and the International Osteoporosis Foundation guidelines (IOF, 2008); Analysis: 1.) Descriptive analysis of patients undergoing treatment and the treatments prescribed; 2.) Descriptive analysis of compliance with and persistence of anti-osteoporotic treatments; 3.) Analysis of factors associated with compliance with and persistence of treatments by Cox proportional hazard regression models, 4.) Descriptive analysis of appropriateness of treatment; 5.) Analysis of factors associated with the appropriateness of treatment by multilevel models (4 levels: patient, doctor, Basic Healthcare Zone/Primary Healthcare Center, and Health Area variables). Discussion ESOSVAL-AD will provide information regarding adherence to osteoporosis treatments and the factors associated with a higher or lower adherence (including the appropriateness of the treatment) in the Spanish context. A better understanding of this

  12. Safety and Efficacy of Adding Ribavirin to Interferon or Peginterferon in Treatment of Hepatitis C Infection in Patients With Thalassemia: A Systematic Review on Randomized Controlled Trials

    PubMed Central

    Aminizadeh, Ehsan; Alavian, Seyed Moayyed; Akbari Sari, Ali; Ebrahimi Daryani, Nasser; Behnava, Bita

    2016-01-01

    Context Hepatitis C virus (HCV) infection is a major cause of liver-morbidity and mortality among patients with thalassemia. Peginterferon plus ribavirin is currently the recommended therapy for hepatitis C infection in patients do not have thalassemia, but using ribavirin in patients with thalassemia is restricted due to its hemolytic effect. To evaluate the efficacy and safety of adding ribavirin to peginterferon or interferon, authors performed a systematic review on the available literatures. Evidence Acquisition Trials were identified through electronic database, manual searches of journals and bibliographies and approaching authors of trials. Randomized trials that enrolled patients with a diagnosis of thalassemia and chronic hepatitis C infection treated with interferon or peginterferon with or without ribavirin were included. Two investigators independently evaluated the trials for inclusion criteria, risk of bias and data extraction. The primary outcomes were sustained virological response (SVR), liver-related morbidity, mortality and adverse events. The odds ratios from each trial were calculated individually and in the subgroup analysis of trials. Data were analyzed with fixed-effect model. Results Three randomized clinical trials with 92 patients were included. All three trials had unclear risk of bias. Compared with peginterferon monotherapy, adding ribavirin to peginterferon had significant beneficial effect on sustained virological response (OR = 3.44, 95% CI: 1.18 - 10.06). There was no significant difference between combination therapy and monotherapy in the end of treatment achievement response. Other than about 30% increase in blood transfusion due to anemia that returned to normal level 2 - 3 months after treatment, there was no significant increase in side effects followed by adding ribavirin to pegylated interferon (Peg-IFN). Data were insufficient to determine the impact of genotype, viral load and age on the response to treatment

  13. Sex Differences in Grey Matter Atrophy Patterns Among AD and aMCI Patients: Results from ADNI

    PubMed Central

    Skup, Martha; Zhu, Hongtu; Wang, Yaping; Giovanello, Kelly S.; Lin, Ja-an; Shen, Dinggang; Shi, Feng; Gao, Wei; Lin, Weili; Fan, Yong; Zhang, Heping

    2011-01-01

    We used longitudinal magnetic resonance imaging (MRI) data to determine whether there are any gender differences in grey matter atrophy patterns over time in 197 individuals with probable Alzheimer’s disease (AD) and 266 with amnestic mild cognitive impairment (aMCI), compared with 224 healthy controls participating in the Alzheimer’s Disease Neuroimaging Initiative (ADNI). While previous research has differentiated probable AD and aMCI groups from controls in brain atrophy, it is unclear whether and how sex plays a role in patterns of change over time. Using regional volumetric maps, we fit longitudinal models to the grey matter data collected at repeated occasions, seeking differences in patterns of volume change over time by sex and diagnostic group in a voxel-wise analysis. Additionally, using a region-of-interest approach, we fit longitudinal models to the global volumetric data of predetermined brain regions to determine whether this more conventional approach is sufficient for determining sex and group differences in atrophy. Our longitudinal analyses revealed that, of the various grey matter regions investigated, males and females in the AD group and the aMCI group showed different patterns of decline over time compared to controls in the bilateral precuneus, bilateral caudate nucleus, right entorhinal gyrus, bilateral thalamus, bilateral middle temporal gyrus, left insula, and right amygdala. As one of the first investigation to model more than two time points of structural MRI data over time, our findings add insight into how AD and aMCI males and females differ from controls and from each other over time. PMID:21356315

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

    ERIC Educational Resources Information Center

    National Center on Performance Incentives, 2008

    2008-01-01

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

  15. Comparative Efficacy and Safety of Antidiabetic Drug Regimens Added to Metformin Monotherapy in Patients with Type 2 Diabetes: A Network Meta-Analysis

    PubMed Central

    Sobieraj, Diana M.; White, C. Michael; Saulsberry, Whitney J.; Kohn, Christine G.; Doleh, Yunes; Zaccaro, Eric

    2015-01-01

    Introduction When first line therapy with metformin is insufficient for patients with type 2 diabetes (T2D), the optimal adjunctive therapy is unclear. We assessed the efficacy and safety of adjunctive antidiabetic agents in patients with inadequately controlled T2D on metformin alone. Materials and Methods A search of MEDLINE and CENTRAL, clinicaltrials.gov, regulatory websites was performed. We included randomized controlled trials of 3–12 months duration, evaluating Food and Drug Administration or European Union approved agents (noninsulin and long acting, once daily basal insulins) in patients experiencing inadequate glycemic control with metformin monotherapy (≥1500 mg daily or maximally tolerated dose for ≥4 weeks). Random-effects network meta-analyses were used to compare the weighted mean difference for changes from baseline in HbA1c, body weight (BW) and systolic blood pressure (SBP), and the risk of developing hypoglycemia, urinary (UTI) and genital tract infection (GTI). Results Sixty-two trials evaluating 25 agents were included. All agents significantly reduced HbA1c vs. placebo; albeit not to the same extent (range, 0.43% for miglitol to 1.29% for glibenclamide). Glargine, sulfonylureas (SUs) and nateglinide were associated with increased hypoglycemia risk vs. placebo (range, 4.00–11.67). Sodium glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 analogs, miglitol and empagliflozin/linagliptin significantly reduced BW (range, 1.15–2.26kg) whereas SUs, thiazolindinediones, glargine and alogliptin/pioglitazone caused weight gain (range, 1.19–2.44kg). SGLT2 inhibitors, empagliflozin/linagliptin, liraglutide and sitagliptin decreased SBP (range, 1.88–5.43mmHg). No therapy increased UTI risk vs. placebo; however, SGLT2 inhibitors were associated with an increased risk of GTI (range, 2.16–8.03). Conclusions Adding different AHAs to metformin was associated with varying effects on HbA1c, BW, SBP, hypoglycemia, UTI and GTI

  16. Immunization coverage among splenectomized patients: Results of an ad hoc survey in Puglia Region (South of Italy).

    PubMed

    Martino, Carmen; Gallone, Maria Serena; Quarto, Michele; Germinario, Cinzia; Tafuri, Silvio

    2016-05-01

    Patients with anatomic or functional asplenia have a 10-50 times higher risk than general population to develop Overwhelming Post-Splenectomy Infection. Evidences are unanimous in recommending splenectomised patients to receive meningococcal, antipneumococcal and Haemophilus influenzae type B vaccinations according to a specific timing. In Italy there are no current data on the immunisation coverage in these patients. This study aims to investigate immunisation coverage in patients undergoing elective or urgent splenectomy for 2012-2013 in the 3 Apulian hospitals. The patients discharged with the code ICD-9-CM 41.5 - "Total splenectomy" were enrolled. The administration of vaccines was verified through consultation of medical records, archives of general practitioners and vaccination offices. In the study period, 166 subjects underwent splenectomy and none of them received vaccinations during hospitalization. 25 splenectomised patients (15.1%) received at least one of the recommended vaccinations. 21 patients (12.6%) received vaccine against Streptococcus pneumonia, 13 (7.8%) meningococcal vaccine, 10 patients (6%) Haemophilus influenzae type B vaccine. The low vaccination coverage could be due both to poor perception of the risk of infection and to a lack of knowledge on vaccinations by surgeons. For this reason it is necessary to draw up and share operational protocols that establish the administration of vaccines. PMID:26890256

  17. Immunization coverage among splenectomized patients: Results of an ad hoc survey in Puglia Region (South of Italy).

    PubMed

    Martino, Carmen; Gallone, Maria Serena; Quarto, Michele; Germinario, Cinzia; Tafuri, Silvio

    2016-05-01

    Patients with anatomic or functional asplenia have a 10-50 times higher risk than general population to develop Overwhelming Post-Splenectomy Infection. Evidences are unanimous in recommending splenectomised patients to receive meningococcal, antipneumococcal and Haemophilus influenzae type B vaccinations according to a specific timing. In Italy there are no current data on the immunisation coverage in these patients. This study aims to investigate immunisation coverage in patients undergoing elective or urgent splenectomy for 2012-2013 in the 3 Apulian hospitals. The patients discharged with the code ICD-9-CM 41.5 - "Total splenectomy" were enrolled. The administration of vaccines was verified through consultation of medical records, archives of general practitioners and vaccination offices. In the study period, 166 subjects underwent splenectomy and none of them received vaccinations during hospitalization. 25 splenectomised patients (15.1%) received at least one of the recommended vaccinations. 21 patients (12.6%) received vaccine against Streptococcus pneumonia, 13 (7.8%) meningococcal vaccine, 10 patients (6%) Haemophilus influenzae type B vaccine. The low vaccination coverage could be due both to poor perception of the risk of infection and to a lack of knowledge on vaccinations by surgeons. For this reason it is necessary to draw up and share operational protocols that establish the administration of vaccines.

  18. Design and implementation of a framework for monitoring patients in hospitals using wireless sensors in ad hoc configuration.

    PubMed

    O'Donoughue, Nicholas; Kulkarni, Sarvesh; Marzella, Douglas

    2006-01-01

    Patients in hospital intensive care units (ICUs) have to be monitored constantly. Typically, unless the attending physician is at the bedside, he or she has no information of the patient's progress, and must be paged manually in case of emergencies. A far better system would be one that keeps the patient's information available to the doctor or nurse at all times, possibly through the use of a handheld device. The doctor would then be able to check on the patient's progress in real time. Should an emergency arise, the doctor would be notified directly by the monitoring system itself, saving valuable response time. This paper aims to set up an infrastructure for monitoring patients in hospital ICUs. An architectural framework and related protocols to support communication between the various components of such a system are presented. The prototyped product was successfully demonstrated to industry representatives, in November 2005, at Villanova University, PA.

  19. [Research of the EEMD method to pulse analysis of traditional Chinese medicine based on different amplitudes of the added white noise].

    PubMed

    Yan, Haixia; Qin, Kairong; Wang, Yiqin; Li, Fufeng; Run, Fengying; Hong, Yujian; Hao, Jiming

    2011-02-01

    The ensemble empirical mode decomposition (EEMD) can be used to overcome the mode mixing problem of empirical mode decomposition (EMD) effectively. The EEMD method and Hilbert-Huang Transform (HHT) can be used to analyze pulse signals of Traditional Chinese Medicine (TCM). The amplitudes of the added white noise were about 0.1 and 0.2 time standard deviation of the investigated signal respectively. The difference of average frequency and average energy of every mode between normal pulse, slippery pulse, wiry pulse and wiry-slippery pulse were demonstrated based on different amplitudes of the added white noise. The results showed that it is more in line with clinical practice when the amplitude of the added white noise is about 0.2 time standard deviation of the investigated signal.

  20. A high resolution method for 14C analysis of a coral from South China Sea: Implication for "AD 775" 14C event

    NASA Astrophysics Data System (ADS)

    Ding, Ping; Shen, Chengde; Yi, Weixi; Wang, Ning; Ding, Xingfang; Liu, Kexin; Fu, Dongpo; Liu, Weiguo; Liu, Yi

    2015-10-01

    A pre-heating method that improves the background and precision of 14C dating significantly was applied for fossil coral dating with high resolution in our lab in Guangzhou Institute of Geochemistry, Chinese Academy of Sciences (GIGCAS). The reaction tube is heated under 300 °C in a vacuum line before it is used for graphitization. The method can reduce the contamination absorbed in TiH2, Zn and Fe power placed in the graphitization tube. With the pre-heating and average drilling method, bi-weekly resolution 14C dating in a fossil coral is carried out to investigate the "AD 775 14C spike event". Different from the tree ring 14C archives with the 14C spike of ∼15‰ (Δ14C), the 14C spike in the coral shows an abrupt peak of 45‰ and two smaller spikes of Δ14C > 20‰ in half a year in AD 776. And then, the 14C content in coral decreases gradually in AD 777. The peak time of the 14C spike event likely occurs in the summer of AD 776 according to the δ18O variation in coral. High-resolution dating of 14C in coral provides not only a more detail process of the event than that from tree rings, but also the first report of the event from sea ecosystem. Both of them suggest an extraterrestrial origin of the event cause.

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

    PubMed

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

    2016-09-01

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

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

    PubMed

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

    2016-09-01

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

  3. The effect of umeclidinium added to inhaled corticosteroid/long-acting β2-agonist in patients with symptomatic COPD: a randomised, double-blind, parallel-group study.

    PubMed

    Sousa, Ana R; Riley, John H; Church, Alison; Zhu, Chang-Qing; Punekar, Yogesh S; Fahy, William A

    2016-01-01

    Benefits of triple therapy with a long-acting muscarinic antagonist (LAMA), added to inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA), have been demonstrated. Limited data assessing the efficacy of the LAMA umeclidinium (UMEC) added to ICS/LABA are available. The aim of this study is to evaluate the efficacy and safety of UMEC added to ICS/LABAs in patients with moderate-to-very-severe COPD. This is a multicentre, randomised, double-blind, parallel-group study. Patients were symptomatic (modified Medical Research Council Dyspnoea Scale score ⩾2), despite receiving ICS/LABA (fluticasone propionate/salmeterol (FP/SAL, branded) 500/50 mcg, budesonide/formoterol (BD/FOR, branded) 200/6 mcg or 400/12 mcg, or other ICS/LABAs) ⩾30 days before the run-in (7±2 days). Patients were randomised 1:1 to once-daily UMEC 62.5 mcg or placebo (PBO), added to twice-daily open-label ICS/LABA for 12 weeks. Primary end point was trough forced expiratory volume in 1 s (FEV1) at Day 85; secondary end point was weighted mean (WM) 0-6 h FEV1 at Day 84; other end points included COPD Assessment Test (CAT) score and Transition Dyspnoea Index (TDI) score. Adverse events (AEs) were investigated. In the UMEC+ICS/LABA and PBO+ICS/LABA groups, 119 and 117 patients were randomised, respectively. Patients received FP/SAL (40%), BD/FOR (43%) and other ICS/LABAs (17%). UMEC+ICS/LABA resulted in significant improvements in trough FEV1 (Day 85) and in WM 0-6 h FEV1 (Day 84) versus PBO+ICS/LABA (difference: 123 and 148 ml, respectively, both P<0.001). Change from baseline for UMEC+ICS/LABA versus PBO+ICS/LABA was significantly different for CAT score at Day 84 (-1.31, P<0.05), but not for TDI score (0.40, P=0.152). AE incidence was similar with UMEC+ICS/LABA (38%) and PBO+ICS/LABA (42%). UMEC+ICS/LABA improved lung function and CAT score in patients with symptomatic COPD versus PBO+ICS/LABA (ClinicalTrials.gov NCT02257372). PMID:27334739

  4. Effects on transthyretin in plasma and cerebrospinal fluid by DHA-rich n - 3 fatty acid supplementation in patients with Alzheimer's disease: the OmegAD study.

    PubMed

    Faxén-Irving, Gerd; Freund-Levi, Yvonne; Eriksdotter-Jönhagen, Maria; Basun, Hans; Hjorth, Erik; Palmblad, Jan; Vedin, Inger; Cederholm, Tommy; Wahlund, Lars-Olof

    2013-01-01

    Transthyretin (TTR) binds amyloid-β (Aβ) and may reduce brain Aβ, a pathological feature in Alzheimer's disease (AD). N - 3 fatty acids (FA), docosahexaenoic (DHA), and eicosapentaenoic acid (EPA) may increase TTR transcription in rat hippocampus. We studied effects of n - 3 FA supplementation on TTR-levels in patients with AD. Outpatients were randomized to receive 1.7 g DHA and 0.6 g EPA (n - 3/n - 3 group) or placebo (placebo/n - 3 group) during 6 months. After 6 months, all patients received n - 3 FA for another 6 months. TTR and FA were measured in plasma in all subjects, whereas TTR in cerebrospinal fluid (CSF) was measured in a subgroup. The study was completed by 89 patients in the n - 3/n - 3 group (75 y, 57% w) and 85 in the placebo/n - 3 group (75 y, 46% w). Baseline plasma-TTR was within normal range in both groups. After 6 months, plasma-TTR decreased in the placebo/n - 3 group (p < 0.001 within and p < 0.015 between the groups). No changes were observed in CSF TTR. From 6 to 12 months when both groups were supplemented, plasma-TTR increased significantly in both groups. Repeated measures ANOVA indicated an increase in TTR over time (p = 0.04) in those receiving n - 3 FA for 12 months. By linear regression analyses, n - 3 FA treatment was independently associated with increased plasma-TTR at 6 months (β = -0.172, p = 0.028). Thus, n - 3 FA treatment appeared to increase plasma-TTR in patients with AD. Since TTR may influence Aβ deposition in the brain, the results warrant further exploration. PMID:23563245

  5. DIS in AdS

    SciTech Connect

    Albacete, Javier L.; Kovchegov, Yuri V.; Taliotis, Anastasios

    2009-03-23

    We calculate the total cross section for the scattering of a quark-anti-quark dipole on a large nucleus at high energy for a strongly coupled N = 4 super Yang-Mills theory using AdS/CFT correspondence. We model the nucleus by a metric of a shock wave in AdS{sub 5}. We then calculate the expectation value of the Wilson loop (the dipole) by finding the extrema of the Nambu-Goto action for an open string attached to the quark and antiquark lines of the loop in the background of an AdS{sub 5} shock wave. We find two physically meaningful extremal string configurations. For both solutions we obtain the forward scattering amplitude N for the quark dipole-nucleus scattering. We study the onset of unitarity with increasing center-of-mass energy and transverse size of the dipole: we observe that for both solutions the saturation scale Q{sub s} is independent of energy/Bjorken-x and depends on the atomic number of the nucleus as Q{sub s}{approx}A{sup 1/3}. Finally we observe that while one of the solutions we found corresponds to the pomeron intercept of {alpha}{sub P} = 2 found earlier in the literature, when extended to higher energy or larger dipole sizes it violates the black disk limit. The other solution we found respects the black disk limit and yields the pomeron intercept of {alpha}{sub P} = 1.5. We thus conjecture that the right pomeron intercept in gauge theories at strong coupling may be {alpha}{sub P} = 1.5.

  6. A stacking method to study the gamma-ray emission of source samples based on the co-adding of Fermi-LAT count maps

    NASA Astrophysics Data System (ADS)

    Huber, B.; Farnier, C.; Manalaysay, A.; Straumann, U.; Walter, R.

    2012-11-01

    Aims: We present a stacking method that makes use of co-added maps of gamma-ray counts produced from data taken with the Fermi Large Area Telescope. Sources with low integrated gamma-ray fluxes that are not detected individually may become detectable when their corresponding count maps are added. Methods: The combined data set is analyzed with a maximum likelihood method taking into account the contribution from point-like and diffuse background sources. For both simulated and real data, detection significance and integrated gamma-ray flux are investigated for different numbers of stacked sources using the public Fermi Science Tools for analysis and data preparation. Results: The co-adding is done such that potential source signals add constructively, in contrast to the signals from background sources, which allows the stacked data to be described with simply structured models. We show, for different scenarios, that the stacking method can be used to increase the cumulative significance of a sample of sources and to characterize the corresponding gamma-ray emission. The method can, for instance, help to search for gamma-ray emission from galaxy clusters.

  7. Nonlinear realization of local symmetries of AdS space

    SciTech Connect

    Clark, T.E.; Love, S.T.; Nitta, Muneto; Veldhuis, T. ter

    2005-10-15

    Coset methods are used to construct the action describing the dynamics associated with the spontaneous breaking of the local symmetries of AdS{sub d+1} space due to the embedding of an AdS{sub d} brane. The resulting action is an SO(2,d) invariant AdS form of the Einstein-Hilbert action, which in addition to the AdS{sub d} gravitational vielbein, also includes a massive vector field localized on the brane. Its long wavelength dynamics is the same as a massive Abelian vector field coupled to gravity in AdS{sub d} space.

  8. The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used.

    PubMed

    Jögi, Jonas; Markstad, Hanna; Tufvesson, Ellen; Bjermer, Leif; Bajc, Marika

    2015-01-01

    Ventilation/perfusion (V/P) single-photon emission computed tomography (SPECT) is recognized as a diagnostic method with potential beyond the diagnosis of pulmonary embolism. V/P SPECT identifies functional impairment in diseases such as heart failure (HF), pneumonia, and chronic obstructive pulmonary disease (COPD). The development of hybrid SPECT/computed tomography (CT) systems, combining functional with morphological imaging through the addition of low-dose CT (LDCT), may be useful in COPD, as these patients are prone to lung cancer and other comorbidities. The aim of this study was to investigate the added value of LDCT among healthy smokers and patients with stable COPD, when examined with V/P SPECT/CT hybrid imaging. Sixty-nine subjects, 55 with COPD (GOLD I-IV) and 14 apparently healthy smokers, were examined with V/P SPECT and LDCT hybrid imaging. Spirometry was used to verify COPD grade. Only one apparently healthy smoker and three COPD patients had a normal or nearly normal V/P SPECT. All other patients showed various degrees of airway obstruction, even when spirometry was normal. The same interpretation was reached on both modalities in 39% of the patients. LDCT made V/P SPECT interpretation more certain in 9% of the patients and, in 52%, LDCT provided additional diagnoses. LDCT better characterized the type of emphysema in 12 patients. In 19 cases, tumor-suspected changes were reported. Three of these 19 patients (ie, 4.3% of all subjects) were in the end confirmed to have lung cancer. The majority of LDCT findings were not regarded as clinically significant. V/P SPECT identified perfusion patterns consistent with decompensated left ventricular HF in 14 COPD patients. In 16 patients (23%), perfusion defects were observed. HF and perfusion defects were not recognized with LDCT. In COPD patients and long-time smokers, hybrid imaging had added value compared to V/P SPECT alone, by identifying patients with lung malignancy and more clearly identifying

  9. The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used.

    PubMed

    Jögi, Jonas; Markstad, Hanna; Tufvesson, Ellen; Bjermer, Leif; Bajc, Marika

    2015-01-01

    Ventilation/perfusion (V/P) single-photon emission computed tomography (SPECT) is recognized as a diagnostic method with potential beyond the diagnosis of pulmonary embolism. V/P SPECT identifies functional impairment in diseases such as heart failure (HF), pneumonia, and chronic obstructive pulmonary disease (COPD). The development of hybrid SPECT/computed tomography (CT) systems, combining functional with morphological imaging through the addition of low-dose CT (LDCT), may be useful in COPD, as these patients are prone to lung cancer and other comorbidities. The aim of this study was to investigate the added value of LDCT among healthy smokers and patients with stable COPD, when examined with V/P SPECT/CT hybrid imaging. Sixty-nine subjects, 55 with COPD (GOLD I-IV) and 14 apparently healthy smokers, were examined with V/P SPECT and LDCT hybrid imaging. Spirometry was used to verify COPD grade. Only one apparently healthy smoker and three COPD patients had a normal or nearly normal V/P SPECT. All other patients showed various degrees of airway obstruction, even when spirometry was normal. The same interpretation was reached on both modalities in 39% of the patients. LDCT made V/P SPECT interpretation more certain in 9% of the patients and, in 52%, LDCT provided additional diagnoses. LDCT better characterized the type of emphysema in 12 patients. In 19 cases, tumor-suspected changes were reported. Three of these 19 patients (ie, 4.3% of all subjects) were in the end confirmed to have lung cancer. The majority of LDCT findings were not regarded as clinically significant. V/P SPECT identified perfusion patterns consistent with decompensated left ventricular HF in 14 COPD patients. In 16 patients (23%), perfusion defects were observed. HF and perfusion defects were not recognized with LDCT. In COPD patients and long-time smokers, hybrid imaging had added value compared to V/P SPECT alone, by identifying patients with lung malignancy and more clearly identifying

  10. An effective method for enhancing metal-ions' selectivity of ionic liquid-based extraction system: Adding water-soluble complexing agent.

    PubMed

    Sun, Xiao Qi; Peng, Bo; Chen, Ji; Li, De Qian; Luo, Fang

    2008-01-15

    Selective extraction-separation of yttrium(III) from heavy lanthanides into 1-octyl-3-methylimidazolium hexafluorophosphate ([C(8)mim][PF(6)]) containing Cyanex 923 was achieved by adding a water-soluble complexing agent (EDTA) to aqueous phase. The simple and environmentally benign complexing method was proved to be an effective strategy for enhancing the selectivity of [C(n)mim][PF(6)]/[Tf(2)N]-based extraction system without increasing the loss of [C(n)mim](+).

  11. Comparison of ketanserin and slow-release nifedipine added to the treatment of hypertensive patients uncontrolled by a thiazide diuretic plus beta-adrenoceptor blocker.

    PubMed

    Waller, P C; Solomon, S A; Ramsay, L E

    1987-11-01

    1. Ketanserin or slow-release nifedipine were added to the treatment of 24 patients with hypertension uncontrolled by a thiazide diuretic plus beta-adrenoceptor antagonist in an observer-blind, randomised parallel-group study of 6 months duration. 2. At 6 months the mean falls in supine blood pressure were for ketanserin (mean daily dose 77 mg) 7/5 mm Hg and for nifedipine (mean daily dose 62 mg) 27/10 mm Hg. The difference between the treatments was significant for systolic blood pressure (P less than 0.02) and mean arterial pressure (P less than 0.05). Six nifedipine-treated patients reached target blood pressure, compared with one patient with ketanserin (P less than 0.02). 3. One patient taking nifedipine, and none taking ketanserin withdrew because of side-effects. The tolerability of the two drugs was broadly similar. 4. Ketanserin treatment was associated with significant changes in supine pulse rate (-8 beats min-1, P less than 0.05) and corrected QT interval (+27 ms, P less than 0.05). Nifedipine treatment had no effect on these variables. The change in pulse rate was significantly different between the groups. 5. In patients treated with a diuretic and beta-adrenoceptor blocker who required additional treatment ketanserin was significantly inferior to nifedipine. PMID:2893636

  12. [Behavioral, stress and immunological evaluation methods of music therapy in elderly patients with senile dementia].

    PubMed

    Suzuki, Mizue; Kanamori, Masao; Nagasawa, Shingo; Saruhara, Takayuki

    2005-01-01

    The purpose of this study was to clarify the efficacy of behavioral, stress and immunological evaluation methods in music therapy (MT) with elderly patients with senile dementia. The MT group consisted of 8 elderly patients with dementia and the control group included 8 similarly matched patients. A total of 25 sessions of music therapy were conducted for one hour, twice each week for three months. The Mini-Mental State Exam (MMSE), Gottfries-Brane-Steen Scale (GBS), and Behavioral Pathology in Alzheimer's Disease Rating Scale (Behave-AD) were used to evaluate behavioral changes. Saliva Chromogranin A (Cg A) and Immunoglobulin A (Ig A) were used to assess changes in stress and immunological status, respectively. The results of the study were as follows: 1. In GBS, the mean score of "different symptoms common in dementia" improved significantly after MT. 2. The mean Behave-AD score of "paranoid and delusional ideation" was also significantly improved (p<0.05) after the intervention. 3. In the 25th session, mean saliva Cg A was significantly decreased after MT (p<0.05). IgA was slightly increased prior to intervention. Our results suggest that a combination of behavioral, stress and immunological evaluation methods were valuable for assessing changes that occurred during MT for elderly patients with dementia.

  13. Glucose Variability and β- Cell Response by GLP-1 Analogue added-on CSII for Patients with Poorly Controlled Type 2 Diabetes

    PubMed Central

    Lin, Chia-Hung; Hsieh, Sheng-Hwu; Sun, Jui-Hung; Tsai, Jir-Shiong; Huang, Yu-Yao

    2015-01-01

    The effects of twice-daily GLP-1 analogue injections added on continuous subcutaneous insulin infusion (CSII) in patients with poorly controlled type 2 diabetes (T2DM) were unknown. After optimization of blood glucose in the first 3 days by CSII during hospitalization, patients with poorly controlled T2DM were randomized to receive CSII combined with injections of exenatide or placebo for another 3 days. A total of 51 patients (30 in exenatide and 21 in placebo groups) with mean A1C 11% were studied. There was no difference in mean glucose but a significant higher standard deviation of plasma glucose (SDPG) was found in the exenatide group (50.51 ± 2.43 vs. 41.49 ± 3.00 mg/dl, p = 0.027). The improvement of incremental area under the curve (AUC) of glucose and insulinogenic index (Insulin0–peak/ Glucose0–peak) in 75 g oral glucose tolerance test was prominent in the exenatide group (p < 0.01). The adiponectin level was significantly increased with exenatide added on (0.39 ± 0.32 vs. −1.62 ± 0.97 μg/mL, in exenatide and placebo groups, respectively, p = 0.045). In conclusion, the add-on of GLP-1 analogue to CSII increased glucose variability and the β - cell response in patients with poorly controlled T2DM. PMID:26607841

  14. Cytarabine added to interferon improves the cost-effectiveness of initial therapy for patients with early chronic phase chronic myelogenous leukemia.

    PubMed

    Beck, J R; Guilhot, J; Giles, F J; Aoki, N; Wirt, D P; Guilhot, F

    2001-03-01

    The French Chronic Myeloid Leukemia Study Group prospective randomized study results indicate that the addition of cytarabine to alpha interferon (IFN-alpha) increases the rate of major cytogenetic response and prolongs survival in patients with early chronic phase chronic myelogenous leukemia (CML). The French group study design permitted a single crossover to include or discontinue cytarabine or interferon. Endpoints were overall survival, complete hematologic remission (CHR) at six months, and major cytogenetic response at 12 months. We modified a published Markov model that compared IFN-alpha alone to IFN-alpha plus cytarabine and included the possibility of crossover as in the French study. The model permits allogeneic and autologous stem cell transplantation (SCT), and follows cytogenetic response and acceleration of CML through death. Treatment response, toxicity, and survival are drawn from the French Chronic Myeloid Leukemia Study Group population of 810 patients on an intention-to-treat model. Survivals are extended to 62 months based on currently available follow-up. Costs from a United States oncology specialty institution, and state utilities from previous research and a quality-adjusted Time Without Symptoms or Toxicity analysis of the subject study were discounted at 3% per annum. At the median cohort age of 50, cytarabine offers 21 months of added median survival to IFN-alpha, which itself is superior to conventional chemotherapy by 21 months. Cost-effectiveness estimates for cytarabine added to IFN-alpha range from $7,000 per quality-adjusted life year (QALY) to $35,000 per QALY, under all plausible assumptions superior to IFN-alpha alone. The model is sensitive to the quality of life on therapy, as well as to remission rate with additive cytarabine, although the cost-effectiveness calculations are robust over the entire range of clinical assumptions. Based on data from the French study, cytarabine added to IFN-alpha substantially improves the cost

  15. Development of an automatic evaluation method for patient positioning error.

    PubMed

    Kubota, Yoshiki; Tashiro, Mutsumi; Shinohara, Ayaka; Abe, Satoshi; Souda, Saki; Okada, Ryosuke; Ishii, Takayoshi; Kanai, Tatsuaki; Ohno, Tatsuya; Nakano, Takashi

    2015-07-08

    Highly accurate radiotherapy needs highly accurate patient positioning. At our facility, patient positioning is manually performed by radiology technicians. After the positioning, positioning error is measured by manually comparing some positions on a digital radiography image (DR) to the corresponding positions on a digitally reconstructed radiography image (DRR). This method is prone to error and can be time-consuming because of its manual nature. Therefore, we propose an automated measuring method for positioning error to improve patient throughput and achieve higher reliability. The error between a position on the DR and a position on the DRR was calculated to determine the best matched position using the block-matching method. The zero-mean normalized cross correlation was used as our evaluation function, and the Gaussian weight function was used to increase importance as the pixel position approached the isocenter. The accuracy of the calculation method was evaluated using pelvic phantom images, and the method's effectiveness was evaluated on images of prostate cancer patients before the positioning, comparing them with the results of radiology technicians' measurements. The root mean square error (RMSE) of the calculation method for the pelvic phantom was 0.23 ± 0.05 mm. The coefficients between the calculation method and the measurement results of the technicians were 0.989 for the phantom images and 0.980 for the patient images. The RMSE of the total evaluation results of positioning for prostate cancer patients using the calculation method was 0.32 ± 0.18 mm. Using the proposed method, we successfully measured residual positioning errors. The accuracy and effectiveness of the method was evaluated for pelvic phantom images and images of prostate cancer patients. In the future, positioning for cancer patients at other sites will be evaluated using the calculation method. Consequently, we expect an improvement in treatment throughput for these other sites.

  16. A double-blind placebo controlled trial of piracetam added to risperidone in patients with autistic disorder.

    PubMed

    Akhondzadeh, Shahin; Tajdar, Hamid; Mohammadi, Mohammad-Reza; Mohammadi, Mohammad; Nouroozinejad, Gholam-Hossein; Shabstari, Omid L; Ghelichnia, Hossein-Ali

    2008-09-01

    It has been reported that autism is a hypoglutamatergic disorder. Therefore, it was of interest to assess the efficacy of piracetam, a positive modulator of AMPA-sensitive glutamate receptors in autistic disorder. About 40 children between the ages three and 11 years (inclusive) with a DSM IV clinical diagnosis of autism and who were outpatients from a specialty clinic for children were recruited. The children presented with a chief complaint of severely disruptive symptoms related to autistic disorder. Patients were randomly allocated to piracetam + risperidone (Group A) or placebo + risperidone (Group B) for a 10-week, double-blind, placebo-controlled study. The dose of risperidone was titrated up to 2 mg/day for children between 10 and 40 kg and 3 mg/day for children weighting above 40 kg. The dose of piracetam was titrated up to 800 mg/day. Patients were assessed at baseline and after 2, 4, 6, 8 and 10 weeks of starting medication. The measure of the outcome was the Aberrant Behavior Checklist-Community (ABC-C) Rating Scale (total score). The ABC-C Rating Scale scores improved with piracetam. The difference between the two protocols was significant as indicated by the effect of group, the between subjects factor (F = 5.85, d.f. = 1, P = 0.02). The changes at the endpoint compared with baseline were: -11.90 +/- 3.79 (mean +/- SD) and -5.15 +/- 3.04 for group A and B respectively. A significant difference was observed on the change in scores in the ABC-C Rating Scale in week 10 compared with baseline in the two groups (t = 6.017, d.f. = 38, P < 0.0001). The results suggest that a combination of atypical antipsychotic medications and a glutamate agent such as piracetam, might have increase synergistic effects in the treatment of autism.

  17. The efficacy and safety of liraglutide added to metformin in patients with diabetes: a meta-analysis of randomized controlled trials

    NASA Astrophysics Data System (ADS)

    Gu, Jianqiu; Meng, Xin; Guo, Yan; Wang, Lei; Zheng, Hongzhi; Liu, Yixuan; Wu, Bingshu; Wang, Difei

    2016-09-01

    Liraglutide, a glucagon-like peptide (GLP-1) receptor agonist, has showed favorable effects in the glycaemic control and weight reduction in patients with type 2 diabetes mellitus (T2DM). The meta-analysis was to compare the efficacy and safety of liraglutide added to metformin with other treatments in patients with T2DM. A systematic literature search on PubMed, Embase, Web of Science and the Cochrane library databases were performed. Eligible studies were randomized controlled trials (RCTs) of patients with T2DM who received the combination treatment of liraglutide and metformin. Pooled estimates were performed using a fixed-effects model or random-effects model. A total of nine RCTs met the inclusion criteria. Compared with control (placebo, sitagliptin, glimepiride, dulaglutide, insulin glargine, and NPH), liraglutide in combination with metformin resulted in significant reductions in HbA1c, bodyweight, FPG, and PPG, and similar reductions in SBP, and DBP. Moreover, liraglutide combined with metformin did not increase the risk of hypoglycemia, but induced a higher incidence of gastrointestinal disorders. In conclusion, this meta-analysis confirmed the use of liraglutide as add-on to metformin appeared to be effective and safe for patients with T2DM. However, considering the potential limitations in this study, more large-scale, well-conducted RCTs are needed to identify our findings.

  18. The efficacy and safety of liraglutide added to metformin in patients with diabetes: a meta-analysis of randomized controlled trials.

    PubMed

    Gu, Jianqiu; Meng, Xin; Guo, Yan; Wang, Lei; Zheng, Hongzhi; Liu, Yixuan; Wu, Bingshu; Wang, Difei

    2016-01-01

    Liraglutide, a glucagon-like peptide (GLP-1) receptor agonist, has showed favorable effects in the glycaemic control and weight reduction in patients with type 2 diabetes mellitus (T2DM). The meta-analysis was to compare the efficacy and safety of liraglutide added to metformin with other treatments in patients with T2DM. A systematic literature search on PubMed, Embase, Web of Science and the Cochrane library databases were performed. Eligible studies were randomized controlled trials (RCTs) of patients with T2DM who received the combination treatment of liraglutide and metformin. Pooled estimates were performed using a fixed-effects model or random-effects model. A total of nine RCTs met the inclusion criteria. Compared with control (placebo, sitagliptin, glimepiride, dulaglutide, insulin glargine, and NPH), liraglutide in combination with metformin resulted in significant reductions in HbA1c, bodyweight, FPG, and PPG, and similar reductions in SBP, and DBP. Moreover, liraglutide combined with metformin did not increase the risk of hypoglycemia, but induced a higher incidence of gastrointestinal disorders. In conclusion, this meta-analysis confirmed the use of liraglutide as add-on to metformin appeared to be effective and safe for patients with T2DM. However, considering the potential limitations in this study, more large-scale, well-conducted RCTs are needed to identify our findings. PMID:27600499

  19. The efficacy and safety of liraglutide added to metformin in patients with diabetes: a meta-analysis of randomized controlled trials

    PubMed Central

    Gu, Jianqiu; Meng, Xin; Guo, Yan; Wang, Lei; Zheng, Hongzhi; Liu, Yixuan; Wu, Bingshu; Wang, Difei

    2016-01-01

    Liraglutide, a glucagon-like peptide (GLP-1) receptor agonist, has showed favorable effects in the glycaemic control and weight reduction in patients with type 2 diabetes mellitus (T2DM). The meta-analysis was to compare the efficacy and safety of liraglutide added to metformin with other treatments in patients with T2DM. A systematic literature search on PubMed, Embase, Web of Science and the Cochrane library databases were performed. Eligible studies were randomized controlled trials (RCTs) of patients with T2DM who received the combination treatment of liraglutide and metformin. Pooled estimates were performed using a fixed-effects model or random-effects model. A total of nine RCTs met the inclusion criteria. Compared with control (placebo, sitagliptin, glimepiride, dulaglutide, insulin glargine, and NPH), liraglutide in combination with metformin resulted in significant reductions in HbA1c, bodyweight, FPG, and PPG, and similar reductions in SBP, and DBP. Moreover, liraglutide combined with metformin did not increase the risk of hypoglycemia, but induced a higher incidence of gastrointestinal disorders. In conclusion, this meta-analysis confirmed the use of liraglutide as add-on to metformin appeared to be effective and safe for patients with T2DM. However, considering the potential limitations in this study, more large-scale, well-conducted RCTs are needed to identify our findings. PMID:27600499

  20. AdS3: the NHEK generation

    NASA Astrophysics Data System (ADS)

    Bena, Iosif; Heurtier, Lucien; Puhm, Andrea

    2016-05-01

    It was argued in [1] that the five-dimensional near-horizon extremal Kerr (NHEK) geometry can be embedded in String Theory as the infrared region of an infinite family of non-supersymmetric geometries that have D1, D5, momentum and KK monopole charges. We show that there exists a method to embed these geometries into asymptotically- {AdS}_3× {S}^3/{{Z}}_N solutions, and hence to obtain infinite families of flows whose infrared is NHEK. This indicates that the CFT dual to the NHEK geometry is the IR fixed point of a Renormalization Group flow from a known local UV CFT and opens the door to its explicit construction.

  1. A Randomized Controlled Trial of Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in Patients With Uncontrolled Type 2 Diabetes

    PubMed Central

    Safren, Steven A.; Gonzalez, Jeffrey S.; Wexler, Deborah J.; Psaros, Christina; Delahanty, Linda M.; Blashill, Aaron J.; Margolina, Aleksandra I.; Cagliero, Enrico

    2014-01-01

    OBJECTIVE To test cognitive behavioral therapy for adherence and depression (CBT-AD) in type 2 diabetes. We hypothesized that CBT-AD would improve adherence; depression; and, secondarily, hemoglobin A1c (A1C). RESEARCH DESIGN AND METHODS Eighty-seven adults with unipolar depression and uncontrolled type 2 diabetes received enhanced treatment as usual (ETAU), including medication adherence, self-monitoring of blood glucose (SMBG), and lifestyle counseling; a provider letter documented psychiatric diagnoses. Those randomized to the intervention arm also received 9–11 sessions of CBT-AD. RESULTS Immediately after acute treatment (4 months), adjusting for baseline, CBT-AD had 20.7 percentage points greater oral medication adherence on electronic pill cap (95% CI −31.14 to −10.22, P = 0.000); 30.2 percentage points greater SMBG adherence through glucometer downloads (95% CI −42.95 to −17.37, P = 0.000); 6.44 points lower depression scores on the Montgomery-Asberg Depression Rating Scale (95% CI 2.33–10.56, P = 0.002); 0.74 points lower on the Clinical Global Impression (95% CI 0.16–1.32, P = 0.01); and 0.72 units lower A1C (95% CI 0.29–1.15, P = 0.001) relative to ETAU. Analyses of 4-, 8-, and 12-month follow-up time points indicated that CBT-AD maintained 24.3 percentage points higher medication adherence (95% CI −38.2 to −10.3, P = 0.001); 16.9 percentage points greater SMBG adherence (95% CI −33.3 to −0.5, P = 0.043); and 0.63 units lower A1C (95% CI 0.06–1.2, P = 0.03) after acute treatment ended. For depression, there was some evidence of continued improvement posttreatment, but no between-group differences. CONCLUSIONS CBT-AD is an effective intervention for adherence, depression, and glycemic control, with enduring and clinically meaningful benefits for diabetes self-management and glycemic control in adults with type 2 diabetes and depression. PMID:24170758

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

    PubMed

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

    2012-07-01

    A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods. PMID:22919767

  3. Added value of interpreter experience in occult and suspect hip fractures: a retrospective analysis of 254 patients.

    PubMed

    Collin, David; Göthlin, Jan H; Nilsson, Martin; Hellström, Mikael; Geijer, Mats

    2016-06-01

    The influence of experience in categorizing suspect and occult fractures on radiography compared to MRI and clinical outcome has not been studied. The aim of this study is to evaluate the importance of experience in diagnosing normal or suspect hip radiographs compared to MRI. Primarily reported normal or suspect radiography in 254 patients with low-energy hip trauma and subsequent MRI was re-evaluated by two experienced reviewers. Primary readings and review were compared. The prevalence of fractures among normal and suspect radiographic studies was assessed. Clinical outcome was used as reference. At review of radiography, 44 fractures (17 %) were found. Significantly more fractures were found among suspect cases than among normal cases. At MRI, all 44 fractures were confirmed, and further 64 fractures were detected (25 %). MRI detected all fractures with no missed fractures revealed at follow-up. There were a significantly higher proportion of fractures at MRI among the suspect radiographic diagnoses for both the primary report and at review than among occult cases. The more experienced reviewers classified radiography examinations with higher accuracy than primary reporting general radiologists. There was almost complete agreement on MRI diagnoses.

  4. Effects of potent antiretroviral therapy on the immune activation marker soluble CD27 in patients infected with HIV-1 subtypes A-D.

    PubMed

    Atlas, Ann; Thanh Ha, Tran Thi; Lindström, Anna; Nilsson, Anna; Alaeus, Annette; Chiodi, Francesca; De Milito, Angelo

    2004-03-01

    HIV-1 genetic subtypes might have a different impact on disease progression and response to antiretroviral therapy (ART). Few data are available on the immune activation profile in patients with different HIV-1 subtypes. We have tested by ELISA the plasma levels of an immune activation marker, soluble CD27 (sCD27), in a cohort of 64 patients infected with HIV-1 subtypes A-D, at baseline and after 1 year of virologically successful ART. Plasma sCD27 was significantly higher in the whole HIV-1-infected population as compared to healthy subjects [522 U/ml (188-1,307) vs. 285 U/ml (174-397), P < 0.001]. Among the four different HIV-1 subtypes, patients with subtype C virus had significantly higher plasma sCD27 [684 U/ml, (188-1228)] as compared to patients with subtype A [428 U/ml (247-1307), P < 0.05] and B [454 (211-925), P < 0.05]. After 1 year of ART, plasma sCD27 significantly decreased in all groups but patients with subtype C viruses had the largest reduction of sCD27 from baseline. The data indicate that a similar immune activation profile is present in patients infected with HIV-1 subtypes A, B, and D and that in presence of successful ART these subtypes respond similarly in terms of immune activation. Intriguingly, subtype C infection seems to be associated with higher levels of plasma sCD27, suggesting that HIV-1 genetic subtype C may have a different impact on disease outcome and response to therapy.

  5. Using Personal Ads and Online Self-Help Groups to Teach Content Analysis in a Research Methods Course

    ERIC Educational Resources Information Center

    Finn, Jerry; Dillon, Caroline

    2007-01-01

    This paper describes methods for teaching content analysis as part of the Research sequence in social work education. Teaching content analysis is used to develop research skills as well as to promote students' knowledge and critical thinking and about new information technology resources that are being increasingly used by the general public. The…

  6. The Incremental Diagnostic Performance of Coronary Computed Tomography Angiography Added to Myocardial Perfusion Imaging in Patients with Intermediate-to-High Cardiovascular Risk

    PubMed Central

    Hsu, Pei-Ying; Lee, Wen-Jeng; Cheng, Mei-Fang; Yen, Ruoh-Fang; Tzen, Kai-Yuan; Wu, Yen-Wen

    2016-01-01

    Purpose Several studies have suggested that a combined approach of stress myocardial perfusion imaging (MPI) and coronary computed tomography angiography (CCTA) can provide diagnostic results with excellent accuracy. We aimed to explore whether the addition of CCTA to stress MPI provides incremental diagnostic value in intermediate-to-high cardiovascular risk patients. Methods A total of 106 consecutive patients (93 male, 65 ± 10.4 years) underwent coronary artery calcium scoring (CACS), CCTA and 201Thallium stress MPI before coronary angiography was reviewed. Thirty-seven patients (34.9%) had a history of proven coronary artery disease (CAD) or revascularization procedures, and four had documented non-significant CAD (3.8%). The remaining patients consisted of 17 (16.0%) classified as intermediate, and 48 (45.3%) as the high-risk groups. Results Obstructive CAD was diagnosed by invasive coronary angiography in 88 patients with 161 vessels. The sensitivity and specificity in a patient-based analysis for obstructive CAD were 99% and 17% for CCTA, 80% and 50% for MPI and 91% and 67% for the combined method, respectively. The per-vessel diagnostic sensitivity and specificity were 95% and 54% for CCTA, 59% and 75% for MPI and 84% and 76% for the combined method. There were significant differences (p < 0.05) when comparing the combined method with MPI or CCTA by areas under the curve in a patient- or vessel-based analysis. However, CACS of 400 or more could not further stratify the patients with obstructive CAD. Conclusions CCTA, not CACS, provided additional diagnostic values to stress MPI in patients with intermediate-to-high cardiovascular risk. PMID:27122945

  7. Engaging patients through open notes: an evaluation using mixed methods

    PubMed Central

    Esch, Tobias; Mejilla, Roanne; Anselmo, Melissa; Podtschaske, Beatrice; Delbanco, Tom; Walker, Jan

    2016-01-01

    Objectives (A) To gain insights into the experiences of patients invited to view their doctors’ visit notes, with a focus on those who review multiple notes; (B) to examine the relationships among fully transparent electronic medical records and quality of care, the patient-doctor relationship, patient engagement, self-care, self-management skills and clinical outcomes. Design Mixed methods qualitative study: analyses of survey data, including content analysis of free-text answers, and quantitative-descriptive measures combined with semistructured individual interviews, patient activation measures, and member checks. Setting Greater Boston, USA. Participants Patients cared for by primary care physicians (PCPs) at the Beth Israel Deaconess Medical Center who had electronic access to their PCP visit notes. Among those submitting surveys, 576 free-text answers were identified and analysed (414 from female patients, 162 from male patients; 23–88 years). In addition, 13 patients (9 female, 4 male; 58–87 years) were interviewed. Results Patient experiences indicate improved understanding (of health information), better relationships (with doctors), better quality (adherence and compliance; keeping track) and improved self-care (patient-centredness, empowerment). Patients want more doctors to offer access to their notes, and some wish to contribute to their generation. Those patients with repeated experience reviewing notes express fewer concerns and more perceived benefits. Conclusions As the use of fully transparent medical records spreads, it is important to gain a deeper understanding of possible benefits or harms, and to characterise target populations that may require varying modes of delivery. Patient desires for expansion of this practice extend to specialty care and settings beyond the physician's office. Patients are also interested in becoming involved actively in the generation of their medical records. The OpenNotes movement may increase patient

  8. Methods for assessing nutritional status of patients with renal failure.

    PubMed

    Blumenkrantz, M J; Kopple, J D; Gutman, R A; Chan, Y K; Barbour, G L; Roberts, C; Shen, F H; Gandhi, V C; Tucker, C T; Curtis, F K; Coburn, J W

    1980-07-01

    Since wasting and malnutrition are common problems in patients with renal failure, it is important to develop techniques for the longitudinal assessment of nutritional status. This paper reviews available methods for assessing the nutritional status; their possible limitations when applied to uremic patients are discussed. If carefully done, dietary intake can be estimated by recall interviews augmented with dietary diaries. Also, in a stable patient with chronic renal failure, the serum urea nitrogen (N)/creatinine ratio and the rate of urea N appearance reflect dietary protein intake. A comparison of N intake and urea N appearance will give an estimate of N balance. Anthropometric parameters such as the relationship between height and weight, thickness of subcutaneous skinfolds, and midarm muscle circumference are simple methods for evaluating body composition. Other methods for assessing body composition, such as densitometry and total body potassium, may not be readily applicable in patients with renal failure. More traditional biochemical estimates of nutritional status such as serum protein, albumin, transferrin, and selected serum complement determinations show that abnormalities are common among uremic patients. Certain anthropometric and biochemical measurements of nutritional status are abnormal in chronically uremic patients who appear to be particularly robust; thus, factors other than altered nutritional intake may lead to abnormal parameters in such patients. Serial monitoring of selected nutritional parameters in the same individual may improve the sensitivity of these measurements to detect changes. Standards for measuring nutritional status are needed for patients with renal failure so that realistic goals can be established optimal body nutriture.

  9. Perceiving patient assignment methods through a conceptual framework.

    PubMed

    Sandhu, B K; Duquette, A; Kérouac, S

    1991-01-01

    For several decades, the nursing process has been the central issue for numerous nursing discussions. Definitions, meanings, sequences and steps as well as their significance have been presented within the context of given clinically oriented conceptual frameworks. On the other hand, the nursing process could be largely influenced by the organizational context in which it is exercised. This article shows how analyzing patient assignment methods through a conceptual framework permits a better understanding of the ways organizational factors impact upon nursing process quality. Nursing care is the central issue of nursing modalities which characterize the organization and provision of its delivery. In this analysis, these modalities are renamed patient assignment methods. They refer to the tasks, roles, policy and structure for allocating nursing personnel to patients for the provision of nursing care in a hospital unit (Kérouac, Duquette & Sandhu, 1990; Nunson, Beckman, Clinton, Kever & Simms, 1980). The synonyms for patient assignment method found in the literature are: nursing assignment patterns, nursing assignment systems, and organization mode of nursing care (McLennan, 1983). Whatever its name, a given modality does not occur by chance but, rather is a product of specific characteristics. Some of these characteristics pertain to the nursing process. These characteristics can be identified and better understood through a conceptual framework. Historically, patient assignment methods have been extensively described in the literature. The descriptions usually focus on their merits and limitations or their comparisons with one and another. To the best of our knowledge, they have not been analysed using a conceptual framework. This article demonstrates how patient assignment methods could be better understood through an analysis using a conceptual framework. This analysis aims to systematically examine the commonly used patient assignment methods: case, functional

  10. Detection of adulteration in honey samples added various sugar syrups with 13C/12C isotope ratio analysis method.

    PubMed

    Tosun, Murat

    2013-06-01

    Honey can be adulterated in various ways. One of the adulteration methods is the addition of different sugar syrups during or after honey production. Starch-based sugar syrups, high fructose corn syrup (HFCS), glucose syrup (GS) and saccharose syrups (SS), which are produced from beet or canes, can be used for adulterating honey. In this study, adulterated honey samples were prepared with the addition of HFCS, GS and SS (beet sugar) at a ratio of 0%, 10%, 20%, 40% and 50% by weight. (13)C/(12)C analysis was conducted on these adulterated honey samples using an isotope ratio mass spectrometer in combination with an elemental analyser (EA-IRMS). As a result, adulteration using C(4) sugar syrups (HFCS and GS) could be detected to a certain extent while adulteration of honey using C(3) sugar syrups (beet sugar) could not be detected. Adulteration by using SS (beet sugar) still has a serious detection problem, especially in countries in which beet is used in manufacturing sugar. For this reason, practice and analysis methods are needed to meet this deficit and to detect the adulterations precisely in the studies that will be conducted. PMID:23411291

  11. Adding flavor to AdS4/CFT3

    NASA Astrophysics Data System (ADS)

    Ammon, Martin; Erdmenger, Johanna; Meyer, René; O'Bannon, Andy; Wrase, Timm

    2009-11-01

    Aharony, Bergman, Jafferis, and Maldacena have proposed that the low-energy description of multiple M2-branes at a Bbb C4/Bbb Zk singularity is a (2+1)-dimensional Script N = 6 supersymmetric U(Nc) × U(Nc) Chern-Simons matter theory, the ABJM theory. In the large-Nc limit, its holographic dual is supergravity in AdS4 × S7/Bbb Zk. We study various ways to add fields that transform in the fundamental representation of the gauge groups, i.e. flavor fields, to the ABJM theory. We work in a probe limit and perform analyses in both the supergravity and field theory descriptions. In the supergravity description we find a large class of supersymmetric embeddings of probe flavor branes. In the field theory description, we present a general method to determine the couplings of the flavor fields to the fields of the ABJM theory. We then study four examples in detail: codimension-zero Script N = 3 supersymmetric flavor, described in supergravity by Kaluza-Klein monopoles or D6-branes; codimension-one Script N = (0,6) supersymmetric chiral flavor, described by D8-branes; codimension-one Script N = (3,3) supersymmetric non-chiral flavor, described by M5/D4-branes; codimension-two Script N = 4 supersymmetric flavor, described by M2/D2-branes. Finally we discuss special physical equivalences between brane embeddings in M-theory, and their interpretation in the field theory description.

  12. A new patient registration method for intensive care department management.

    PubMed

    Van Aken, P; Bossaert, L; Gilot, C; Tielemans, L

    1987-01-01

    A new method to describe intensive care department performance is presented. The method is a complication of available administrative and medical data, completed with a severity of illness measure (Acute Physiology And Chronic Health Evaluation, APACHE) and the registration of nursing care intensity. The development of this latter patient stratification system (Intensive Care Activity Score, INCAS) is described. The performance of the method is demonstrated by a study of 200 consecutive admissions.

  13. Immunological data from cancer patients treated with Ad5/3-E2F-Δ24-GMCSF suggests utility for tumor immunotherapy.

    PubMed

    Hemminki, Otto; Parviainen, Suvi; Juhila, Juuso; Turkki, Riku; Linder, Nina; Lundin, Johan; Kankainen, Matti; Ristimäki, Ari; Koski, Anniina; Liikanen, Ilkka; Oksanen, Minna; Nettelbeck, Dirk M; Kairemo, Kalevi; Partanen, Kaarina; Joensuu, Timo; Kanerva, Anna; Hemminki, Akseli

    2015-02-28

    Oncolytic viruses that selectively replicate in tumor cells can be used for treatment of cancer. Accumulating data suggests that virus induced oncolysis can enhance anti-tumor immunity and break immune tolerance. To capitalize on the immunogenic nature of oncolysis, we generated a quadruple modified oncolytic adenovirus expressing granulocyte-macrophage colony-stimulating factor (GMCSF). Ad5/3-E2F-Δ24-GMCSF (CGTG-602) was engineered to contain a tumor specific E2F1 promoter driving an E1 gene deleted at the retinoblastoma protein binding site ("Δ24"). The fiber features a knob from serotype 3 for enhanced gene delivery to tumor cells. The virus was tested preclinically in vitro and in vivo and then 13 patients with solid tumors refractory to standard therapies were treated. Treatments were well tolerated and frequent tumor- and adenovirus-specific T-cell immune responses were seen. Overall, with regard to tumor marker or radiological responses, signs of antitumor efficacy were seen in 9/12 evaluable patients (75%). The radiological disease control rate with positron emission tomography was 83% while the response rate (including minor responses) was 50%. Tumor biopsies indicated accumulation of immunological cells, especially T-cells, to tumors after treatment. RNA expression analyses of tumors indicated immunological activation and metabolic changes secondary to virus replication.

  14. Immunological data from cancer patients treated with Ad5/3-E2F-Δ24-GMCSF suggests utility for tumor immunotherapy

    PubMed Central

    Hemminki, Otto; Parviainen, Suvi; Juhila, Juuso; Turkki, Riku; Linder, Nina; Lundin, Johan; Kankainen, Matti; Ristimäki, Ari; Koski, Anniina; Liikanen, Ilkka; Oksanen, Minna; Nettelbeck, Dirk M.; Kairemo, Kalevi; Partanen, Kaarina; Joensuu, Timo; Kanerva, Anna; Hemminki, Akseli

    2015-01-01

    Oncolytic viruses that selectively replicate in tumor cells can be used for treatment of cancer. Accumulating data suggests that virus induced oncolysis can enhance anti-tumor immunity and break immune tolerance. To capitalize on the immunogenic nature of oncolysis, we generated a quadruple modified oncolytic adenovirus expressing granulocyte-macrophage colony-stimulating factor (GMCSF). Ad5/3-E2F-Δ24-GMCSF (CGTG-602) was engineered to contain a tumor specific E2F1 promoter driving an E1 gene deleted at the retinoblastoma protein binding site (“Δ24”). The fiber features a knob from serotype 3 for enhanced gene delivery to tumor cells. The virus was tested preclinically in vitro and in vivo and then 13 patients with solid tumors refractory to standard therapies were treated. Treatments were well tolerated and frequent tumor- and adenovirus-specific T-cell immune responses were seen. Overall, with regard to tumor marker or radiological responses, signs of antitumor efficacy were seen in 9/12 evaluable patients (75%). The radiological disease control rate with positron emission tomography was 83% while the response rate (including minor responses) was 50%. Tumor biopsies indicated accumulation of immunological cells, especially T-cells, to tumors after treatment. RNA expression analyses of tumors indicated immunological activation and metabolic changes secondary to virus replication. PMID:25714011

  15. [A new method for treating patients with chronic prostatitis].

    PubMed

    Boĭko, M I

    1995-01-01

    A new preparation is reported for treatment of chronic inflammation of the prostate, which substantially lowers rates of patients' complaints and depresses the secretion leucocyte reaction. Prostatilen was shown to be capable of normalization of immunity status of the chronic prostatitis patients thus lowering the microbial index of the cultured prostate secretion microorganisms. The following new nonantibacterial strategy of treatment of chronic prostatitis patients is proposed: prostatilen given as a single agent or in combination with immunomodulators and physiotherapeutic methods. Antibacterial therapy is to be instituted on a short-term basis only during the period of exacerbation of the inflammatory process.

  16. A Test of a Method of Increasing Patient Question Asking in Physician-Patient Interactions.

    ERIC Educational Resources Information Center

    Feeser, Teresa; Thompson, Teresa L.

    A study examined the effectiveness of a method designed to increase active patient involvement in the health care context. Subjects, 38 patients visiting a three-physician dermatology practice one randomly selected morning, were asked to fill out a survey at the end of their visit. Half of the subjects were asked to read a "communication memo"…

  17. A phase II study of bortezomib added to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone in patients with previously untreated indolent non-Hodgkin's lymphoma.

    PubMed

    Cohen, Jonathon B; Switchenko, Jeffrey M; Koff, Jean L; Sinha, Rajni; Kaufman, Jonathan L; Khoury, H Jean; Bumpers, Nassoma; Colbert, Amanda; Hutchison-Rzepka, Amanda; Nastoupil, Loretta J; Heffner, Leonard T; Langston, Amelia A; Lechowicz, Mary Jo; Lonial, Sagar; Flowers, Christopher R

    2015-11-01

    Bortezomib-containing combinations are active in non-Hodgkin lymphoma (NHL) although peripheral neuropathy can limit their dose intensity. Based on our phase I findings, we conducted a phase II trial of bortezomib in combination with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) with a modified dose of vincristine. Patients with untreated indolent NHL received bortezomib (1·6 mg/m(2) ) on days 1 and 8 of a 21-day cycle for up to 8 cycles and R-CHOP with a 1·5 mg cap of vincristine. Patients achieving a complete response (CR) received maintenance rituximab, and remaining patients received maintenance rituximab and bortezomib. The primary endpoint was CR rate; secondary survival analyses were evaluated using the Kaplan-Meier method. Among 29 eligible patients, NHL morphologies included follicular (n = 20), marginal zone (n = 5) and small lymphocytic lymphoma (n = 4). Nineteen patients had CR (66%) and 10 had partial response (34%), yielding a 100% overall response rate. With a median follow-up of 48·7 months, the 4-year progression-free and overall survivals were 83% and 93%. Twenty-two patients experienced peripheral neuropathy of any grade, and two had grade 3 neuropathy. The combination of bortezomib with R-CHOP is effective for indolent NHL, and we plan to evaluate therapies incorporating novel proteasome inhibitors in future studies in NHL.

  18. Methods to evaluate the nutrition risk in hospitalized patients

    PubMed Central

    Erkan, Tülay

    2014-01-01

    The rate of malnutrition is substantially high both in the population and in chronic patients hospitalized because of different reasons. The rate of patients with no marked malnutrition at the time of hospitalization who develop malnutrition during hospitalization is also substantially high. Therefore, there are currently different screening methods with different targets to prevent malnutrition and its overlook. These methods should be simple and reliable and should not be time-consuming in order to be used in daily practice. Seven nutrition risk screening methods used in children have been established until the present time. However, no consensus has been made on any method as in adults. It should be accepted that interrogation of nutrition is a part of normal examination to increase awareness on this issue and to draw attention to this issue. PMID:26078678

  19. AdS box graphs, unitarity and operator product expansions

    NASA Astrophysics Data System (ADS)

    Hoffmann, L.; Mesref, L.; Rühl, W.

    2000-11-01

    We develop a method of singularity analysis for conformal graphs which, in particular, is applicable to the holographic image of AdS supergravity theory. It can be used to determine the critical exponents for any such graph in a given channel. These exponents determine the towers of conformal blocks that are exchanged in this channel. We analyze the scalar AdS box graph and show that it has the same critical exponents as the corresponding CFT box graph. Thus pairs of external fields couple to the same exchanged conformal blocks in both theories. This is looked upon as a general structural argument supporting the Maldacena hypothesis.

  20. X-ray scatter correction method for dedicated breast computed tomography: improvements and initial patient testing

    NASA Astrophysics Data System (ADS)

    Ramamurthy, Senthil; D'Orsi, Carl J.; Sechopoulos, Ioannis

    2016-02-01

    A previously proposed x-ray scatter correction method for dedicated breast computed tomography was further developed and implemented so as to allow for initial patient testing. The method involves the acquisition of a complete second set of breast CT projections covering 360° with a perforated tungsten plate in the path of the x-ray beam. To make patient testing feasible, a wirelessly controlled electronic positioner for the tungsten plate was designed and added to a breast CT system. Other improvements to the algorithm were implemented, including automated exclusion of non-valid primary estimate points and the use of a different approximation method to estimate the full scatter signal. To evaluate the effectiveness of the algorithm, evaluation of the resulting image quality was performed with a breast phantom and with nine patient images. The improvements in the algorithm resulted in the avoidance of introduction of artifacts, especially at the object borders, which was an issue in the previous implementation in some cases. Both contrast, in terms of signal difference and signal difference-to-noise ratio were improved with the proposed method, as opposed to with the correction algorithm incorporated in the system, which does not recover contrast. Patient image evaluation also showed enhanced contrast, better cupping correction, and more consistent voxel values for the different tissues. The algorithm also reduces artifacts present in reconstructions of non-regularly shaped breasts. With the implemented hardware and software improvements, the proposed method can be reliably used during patient breast CT imaging, resulting in improvement of image quality, no introduction of artifacts, and in some cases reduction of artifacts already present. The impact of the algorithm on actual clinical performance for detection, diagnosis and other clinical tasks in breast imaging remains to be evaluated.

  1. X-ray scatter correction method for dedicated breast computed tomography: improvements and initial patient testing.

    PubMed

    Ramamurthy, Senthil; D'Orsi, Carl J; Sechopoulos, Ioannis

    2016-02-01

    A previously proposed x-ray scatter correction method for dedicated breast computed tomography was further developed and implemented so as to allow for initial patient testing. The method involves the acquisition of a complete second set of breast CT projections covering 360° with a perforated tungsten plate in the path of the x-ray beam. To make patient testing feasible, a wirelessly controlled electronic positioner for the tungsten plate was designed and added to a breast CT system. Other improvements to the algorithm were implemented, including automated exclusion of non-valid primary estimate points and the use of a different approximation method to estimate the full scatter signal. To evaluate the effectiveness of the algorithm, evaluation of the resulting image quality was performed with a breast phantom and with nine patient images. The improvements in the algorithm resulted in the avoidance of introduction of artifacts, especially at the object borders, which was an issue in the previous implementation in some cases. Both contrast, in terms of signal difference and signal difference-to-noise ratio were improved with the proposed method, as opposed to with the correction algorithm incorporated in the system, which does not recover contrast. Patient image evaluation also showed enhanced contrast, better cupping correction, and more consistent voxel values for the different tissues. The algorithm also reduces artifacts present in reconstructions of non-regularly shaped breasts. With the implemented hardware and software improvements, the proposed method can be reliably used during patient breast CT imaging, resulting in improvement of image quality, no introduction of artifacts, and in some cases reduction of artifacts already present. The impact of the algorithm on actual clinical performance for detection, diagnosis and other clinical tasks in breast imaging remains to be evaluated. PMID:26760295

  2. Segmented strings in AdS 3

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

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

  3. Polarised black holes in AdS

    NASA Astrophysics Data System (ADS)

    Costa, Miguel S.; Greenspan, Lauren; Oliveira, Miguel; Penedones, João; Santos, Jorge E.

    2016-06-01

    We consider solutions in Einstein-Maxwell theory with a negative cosmological constant that asymptote to global AdS 4 with conformal boundary {S}2× {{{R}}}t. At the sphere at infinity we turn on a space-dependent electrostatic potential, which does not destroy the asymptotic AdS behaviour. For simplicity we focus on the case of a dipolar electrostatic potential. We find two new geometries: (i) an AdS soliton that includes the full backreaction of the electric field on the AdS geometry; (ii) a polarised neutral black hole that is deformed by the electric field, accumulating opposite charges in each hemisphere. For both geometries we study boundary data such as the charge density and the stress tensor. For the black hole we also study the horizon charge density and area, and further verify a Smarr formula. Then we consider this system at finite temperature and compute the Gibbs free energy for both AdS soliton and black hole phases. The corresponding phase diagram generalizes the Hawking-Page phase transition. The AdS soliton dominates the low temperature phase and the black hole the high temperature phase, with a critical temperature that decreases as the external electric field increases. Finally, we consider the simple case of a free charged scalar field on {S}2× {{{R}}}t with conformal coupling. For a field in the SU(N ) adjoint representation we compare the phase diagram with the above gravitational system.

  4. Modeling patient safety incidents knowledge with the Categorial Structure method.

    PubMed

    Souvignet, Julien; Bousquet, Cédric; Lewalle, Pierre; Trombert-Paviot, Béatrice; Rodrigues, Jean Marie

    2011-01-01

    Following the WHO initiative named World Alliance for Patient Safety (PS) launched in 2004 a conceptual framework developed by PS national reporting experts has summarized the knowledge available. As a second step, the Department of Public Health of the University of Saint Etienne team elaborated a Categorial Structure (a semi formal structure not related to an upper level ontology) identifying the elements of the semantic structure underpinning the broad concepts contained in the framework for patient safety. This knowledge engineering method has been developed to enable modeling patient safety information as a prerequisite for subsequent full ontology development. The present article describes the semantic dissection of the concepts, the elicitation of the ontology requirements and the domain constraints of the conceptual framework. This ontology includes 134 concepts and 25 distinct relations and will serve as basis for an Information Model for Patient Safety.

  5. Entanglement entropy for free scalar fields in AdS

    NASA Astrophysics Data System (ADS)

    Sugishita, Sotaro

    2016-09-01

    We compute entanglement entropy for free massive scalar fields in anti-de Sitter (AdS) space. The entangling surface is a minimal surface whose boundary is a sphere at the boundary of AdS. The entropy can be evaluated from the thermal free energy of the fields on a topological black hole by using the replica method. In odd-dimensional AdS, exact expressions of the Rényi entropy S n are obtained for arbitrary n. We also evaluate 1-loop corrections coming from the scalar fields to holographic entanglement entropy. Applying the results, we compute the leading difference of entanglement entropy between two holographic CFTs related by a renormalization group flow triggered by a double trace deformation. The difference is proportional to the shift of a central charge under the flow.

  6. Detailed ultraviolet asymptotics for AdS scalar field perturbations

    NASA Astrophysics Data System (ADS)

    Evnin, Oleg; Jai-akson, Puttarak

    2016-04-01

    We present a range of methods suitable for accurate evaluation of the leading asymptotics for integrals of products of Jacobi polynomials in limits when the degrees of some or all polynomials inside the integral become large. The structures in question have recently emerged in the context of effective descriptions of small amplitude perturbations in anti-de Sitter (AdS) spacetime. The limit of high degree polynomials corresponds in this situation to effective interactions involving extreme short-wavelength modes, whose dynamics is crucial for the turbulent instabilities that determine the ultimate fate of small AdS perturbations. We explicitly apply the relevant asymptotic techniques to the case of a self-interacting probe scalar field in AdS and extract a detailed form of the leading large degree behavior, including closed form analytic expressions for the numerical coefficients appearing in the asymptotics.

  7. Bioimpedance spectroscopy method to determine hypervolemia in maintenance hemodialysis patients

    PubMed Central

    Merhametsiz, O; Oguz, EG; Yayar, O; Bektan, B; Canbakan, B; Ayli, D

    2015-01-01

    Background: Hypervolemia is a major risk factor for hypertension leading to cardiovascular diseases and also a frequent problem in maintenance hemodialysis (MHD) patients. Fluid overload (FO) can be determined by bioimpedance spectroscopy (BIS) which is a new, practical, and non-invasive method. We tried to determine FO by BIS in MHD patients and find out the relationship between FO and clinical features. Material and Methods: We studied 100 MHD patients aged between 20 and 85 years and undergoing hemodialysis three times weekly for minimum one year. By using BIS, we estimated FO and extracellular water (ECW). The patients who exhibited a FO/ECW ratio >15% were considered as FO. Results: Twenty-nine (29.0%) patients had a FO/ECW ratio >15%. In the overhydrated group, the mean pre-hemodialysis systolic blood pressure was 153.3 ± 20.0 mmHg and the mean diastolic blood pressure was 89.1 ± 8.5 mmHg. These were significantly higher than in the non-overhydrated group (113.5 ± 14.5 and 71.0 ± 8.8, p <0.001). FO was significantly correlated with systolic and diastolic blood pressures (r =0.63, p <0.001 and r =0.59, p <0.001). The patients were divided into two groups, i.e. those with cardiothoracic index (CTI) of  >0.5 and those with CTI of ≤0.5. The median FO/ECW ratio was 0.11 L in the former group and 0.08 L in the latter group with a significant difference (p =0.006). Conclusions: Hypervolemia is associated with high blood pressure and left ventricular hypertrophy that should be treated effectively to prevent cardiovascular diseases in MHD patients. BIS is useful to assess hydration status in MHD patients. Hippokratia 2015; 19 (4): 324-331.

  8. Nested culture method improves detection of Fusobacterium from stool in patients with ulcerative colitis.

    PubMed

    Yukawa, Toyokazu; Ohkusa, Toshifumi; Shibuya, Tomoyoshi; Tsukinaga, Shintaro; Mitobe, Jimi; Takakura, Kazuki; Takahara, Akitaka; Odahara, Shunichi; Matsudaira, Hiroshi; Nagatsuma, Keisuke; Kitahara, Takuya; Kajihara, Mikio; Uchiyama, Kan; Arakawa, Hiroshi; Koido, Shigeo; Tajiri, Hisao

    2013-01-01

    Fusobacterium varium is an elusive pathogenic factor in ulcerative colitis (UC); conventional methods of fecal culture rarely recover F. varium. We have developed a nested culture method to recover Fusobacterium and we used it to investigate whether F. varium could be isolated from UC patients. We enrolled 50 consecutive patients in this study; 26 received combination antibiotic therapy that included amoxicillin, tetracycline, and metronidazole (ATM) for 2 weeks and were thus assigned to the ATM group, and the remaining 24 were assigned to the non-ATM group and did not receive any antibiotics. Stool samples were added to 10 ml of GAM broth that contained neomycin and crystal violet. The samples were vortexed and incubated under anaerobic conditions. The preincubated broth was streaked onto a Fusobacterium-selective agar plate and then incubated under anaerobic conditions. The species of the colonies isolated were identified using the Vitek Automated system and PCR analysis. We recoverd F. varium from 7 of the 24 non-ATM patients (29.2%) and none from the ATM patients (0%) (P = 0.0035). All of the F. varium isolates were susceptible to ATM. This study suggests that the recovery of F. varium is related to UC, which aligns with results from previous studies that used mucosal culture, immunostaining, real-time PCR, and serological studies.

  9. Does adding noradrenaline reuptake inhibition to selective serotonin reuptake inhibition improve efficacy in patients with depression? A systematic review of meta-analyses and large randomised pragmatic trials.

    PubMed

    Bradley, Andrew J; Lenox-Smith, Alan J

    2013-08-01

    Selective serotonin reuptake inhibitors (SSRIs) are recommended as first-line pharmacological treatment for depression and are the most commonly prescribed class of antidepressants. However, there is substantial evidence that noradrenaline has a role in the pathogenesis and treatment of depression. This review aims to examine the evidence of including noradrenaline reuptake inhibition with serotonin reuptake inhibition with respect to increasing efficacy in the treatment of depression. Evidence from meta-analysis of randomised controlled trials (RCTs) and randomised pragmatic trials was found in support of greater efficacy of the serotonin noradrenaline reuptake inhibitors (SNRIs), venlafaxine and duloxetine, in moderate to severe depression compared to SSRIs but no evidence was found for superiority of milnacipran. There is sufficient current evidence that demonstrates an increase in efficacy, when noradrenaline reuptake is added to serotonin (5-HT) reuptake, to suggest that patients with severe depression or those who have failed to reach remission with a SSRI may benefit from treatment with a SNRI. However, as these conclusions are drawn from the evidence derived from meta-analyses and pragmatic trials, large adequately powered RCTs using optimal dosing regimens and clinically relevant outcome measures in severe depression and SSRI treatment failures are still required to confirm these findings. PMID:23832963

  10. Effectiveness of Recruitment in Clinical Trials: An Analysis of Methods Used in a Trial for Irritable Bowel Syndrome Patients

    PubMed Central

    Feman, Siu Ping Chin; Nguyen, Long T; Quilty, Mary T.; Kerr, Catherine E.; Nam, Bong Hyun; Conboy, Lisa A; Singer, Joyce P.; Park, Min; Lembo, Anthony; Kaptchuk, Ted J.; Davis, Roger B.

    2008-01-01

    A successful clinical trial is dependent on recruitment. Between December 2003 and February 2006, our team successfully enrolled 289 participants in a large, single-center, randomized placebo-controlled trial (RCT) studying the impact of the patient-doctor relationship and acupuncture on irritable bowel syndrome (IBS) patients. This paper reports on the effectiveness of standard recruitment methods such as physician referral, newspaper advertisements, fliers, audio and video media ( radio and television commercials) as well as relatively new methods not previously extensively reported on such as internet ads, ads in mass transit vehicles and movie theater previews. We also report the fraction of cost each method consumed and fraction of recruitment each method generated. Our cost per call from potential participants varied from $3–$103 and cost per enrollment participant varied from $12–$584. Using a novel metric, the efficacy index, we found that physician referrals and flyers were the most effective recruitment method in our trial. Despite some methods being more efficient than others, all methods contributed to the successful recruitment. The iterative use of the efficacy index during a recruitment campaign may be helpful to calibrate and focus on the most effective recruitment methods. PMID:17919993

  11. Entanglement temperature and perturbed AdS3 geometry

    NASA Astrophysics Data System (ADS)

    Levine, G. C.; Caravan, B.

    2016-06-01

    Generalizing the first law of thermodynamics, the increase in entropy density δ S (x ) of a conformal field theory (CFT) is proportional to the increase in energy density, δ E (x ) , of a subsystem divided by a spatially dependent entanglement temperature, TE(x ) , a fixed parameter determined by the geometry of the subsystem, crossing over to thermodynamic temperature at high temperatures. In this paper we derive a generalization of the thermodynamic Clausius relation, showing that deformations of the CFT by marginal operators are associated with spatial temperature variations, δ TE(x ) , and spatial energy correlations play the role of specific heat. Using AdS/CFT duality we develop a relationship between a perturbation in the local entanglement temperature of the CFT and the perturbation of the bulk AdS metric. In two dimensions, we demonstrate a method through which direct diagonalizations of the boundary quantum theory may be used to construct geometric perturbations of AdS3 .

  12. Adding point of care ultrasound to assess volume status in heart failure patients in a nurse-led outpatient clinic. A randomised study

    PubMed Central

    Gundersen, Guri Holmen; Norekval, Tone M; Haug, Hilde Haugberg; Skjetne, Kyrre; Kleinau, Jens Olaf; Graven, Torbjorn; Dalen, Havard

    2016-01-01

    Objectives Medical history, physical examination and laboratory testing are not optimal for the assessment of volume status in heart failure (HF) patients. We aimed to study the clinical influence of focused ultrasound of the pleural cavities and inferior vena cava (IVC) performed by specialised nurses to assess volume status in HF patients at an outpatient clinic. Methods HF outpatients were prospectively included and underwent laboratory testing, history recording and clinical examination by two nurses with and without an ultrasound examination of the pleural cavities and IVC using a pocket-size imaging device, in random order. Each nurse worked in a team with a cardiologist. The influence of the different diagnostic tests on diuretic dosing was assessed descriptively and in linear regression analyses. Results Sixty-two patients were included and 119 examinations were performed. Mean±SD age was 74±12 years, EF was 34±14%, and N-terminal pro-brain natriuretic peptide (NT-proBNP) value was 3761±3072 ng/L. Dosing of diuretics differed between the teams in 31 out of 119 consultations. Weight change and volume status assessed clinically with and without ultrasound predicted dose adjustment of diuretics at follow-up (p<0.05). Change of oedema, NT-proBNP, creatinine, and symptoms did not (p≥0.10). In adjusted analyses, only volume status based on ultrasound predicted dose adjustments of diuretics at first visit and follow-up (all ultrasound p≤0.01, all other p≥0.2). Conclusions Ultrasound examinations of the pleural cavities and IVC by nurses may improve diagnostics and patient care in HF patients at an outpatient clinic, but more studies are needed to determine whether these examinations have an impact on clinical outcomes. Trial registration number NCT01794715. PMID:26438785

  13. Efficacy and Safety of Umeclidinium Added to Fluticasone Propionate/Salmeterol in Patients with COPD: Results of Two Randomized, Double-Blind Studies.

    PubMed

    Siler, Thomas M; Kerwin, Edward; Singletary, Karen; Brooks, Jean; Church, Alison

    2016-01-01

    Combinations of drugs with distinct and complementary mechanisms of action may offer improved efficacy in the treatment of chronic obstructive pulmonary disease (COPD). In two 12-week, double-blind, parallel-group studies, patients with COPD were randomized 1:1:1 to once-daily umeclidinium (UMEC; 62.5 μg and 125 μg) or placebo (PBO), added to twice-daily fluticasone propionate/salmeterol (FP/SAL; 250/50 μg). In both studies, the primary efficacy measure was trough forced expiratory volume in 1 second (FEV1) at Day 85. Secondary endpoints were weighted-mean (WM) FEV1 over 0-6 hours post-dose (Day 84) and rescue albuterol use. Health-related quality of life outcomes (St. George's Respiratory Questionnaire [SGRQ] and COPD assessment test [CAT]) were also examined. Safety was assessed throughout. Both UMEC+FP/SAL doses provided statistically significant improvements in trough FEV1 (Day 85: 0.127-0.148 L) versus PBO+FP/SAL. Similarly, both UMEC+FP/SAL doses provided statistically-significant improvements in 0-6 hours post-dose WM FEV1 versus PBO+FP/SAL (Day 84: 0.144-0.165 L). Rescue use over Weeks 1-12 decreased with UMEC+FP/SAL in both studies versus PBO+FP/SAL (Study 1, 0.3 puffs/day [both doses]; Study 2, 0.5 puffs/day [UMEC 125+FP/SAL]). Decreases from baseline in CAT score were generally larger for both doses of UMEC+FP/SAL versus PBO+FP/SAL (except for Day 84 Study 2). In Study 1, no differences in SGRQ score were observed between UMEC+FP/SAL and PBO+FP/SAL; however, in Study 2, statistically significant improvements were observed with UMEC 62.5+FP/SAL (Day 28) and UMEC 125+FP/SAL (Days 28 and 84) versus PBO+FP/SAL. The incidence of on-treatment adverse events across all treatment groups was 37-41% in Study 1 and 36-38% in Study 2. Overall, these data indicate that the combination of UMEC+FP/SAL can provide additional benefits over FP/SAL alone in patients with COPD. PMID:26451734

  14. An Analysis of Inhalation Injury Diagnostic Methods and Patient Outcomes.

    PubMed

    Ching, Jessica A; Ching, Yiu-Hei; Shivers, Steven C; Karlnoski, Rachel A; Payne, Wyatt G; Smith, David J

    2016-01-01

    The purpose of this study was to compare patient outcomes according to the method of diagnosing burn inhalation injury. After approval from the American Burn Association, the National Burn Repository Dataset Version 8.0 was queried for patients with a diagnosis of burn inhalation injury. Subgroups were analyzed by diagnostic method as defined by the National Burn Repository. All diagnostic methods listed for each patient were included, comparing mortality, hospital days, intensive care unit (ICU) days, and ventilator days (VDs). Z-tests, t-tests, and linear regression were used with a statistical significance of P value of less than .05. The database query yielded 9775 patients diagnosed with inhalation injury. The greatest increase in mortality was associated with diagnosis by bronchoscopy or carbon monoxide poisoning. A relative increase in hospital days was noted with diagnosis by bronchoscopy (9 days) or history (2 days). A relative increase in ICU days was associated with diagnosis according to bronchoscopy (8 days), clinical findings (2 days), or history (2 days). A relative increase in VDs was associated with diagnosis by bronchoscopy (6 days) or carbon monoxide poisoning (3 days). The combination of diagnosis by bronchoscopy and clinical findings increased the relative difference across all comparison measures. The combination of diagnosis by bronchoscopy and carbon monoxide poisoning exhibited decreased relative differences when compared with bronchoscopy alone. Diagnosis by laryngoscopy showed no mortality or association with poor outcomes. Bronchoscopic evidence of inhalation injury proved most useful, predicting increased mortality, hospital, ICU, and VDs. A combined diagnosis determined by clinical findings and bronchoscopy should be considered for clinical practice. PMID:26594867

  15. Comparison of elastography methods in patients with pancreatic masses

    PubMed Central

    Rustemovic, N.; Opacic, D.; Ostojic, Z.; Opacic, M.; Ledinsky, I.; Višijić, A.; Ravić, K. Grubelić; Iveković, H.; Markoš, P.

    2014-01-01

    Introduction: Endoscopic ultrasonography (EUS) quantitative elastography methods are developed for non-invasive differentiation of pancreatic masses. Aims: First: To evaluate the diagnostic value of strain ratio (SR) and hue histogram (HH) in patients with pancreatic masses and to determine the cut-off value between pancreatic cancer and focal pancreatitis using a pancreatic tissue close to the mass as a reference area. Second: To calculate new variable HH ratio (HHR) in an attempt to improve sensitivity, specificity and accuracy of the method. Methods: In a prospective single center study, 149 patients were examined: 105 with the pancreatic masses and 44 controls using Pentax EUS linear probes in combination with Hitachi platforms. SR and HH were automatically calculated by machine software. Finally, two groups were formed: Pancreatic cancer group (58 patients) and focal pancreatitis group (47 patients). All statistical analysis has been made in SPSS 14.0 (SPSS Inc., Chicago, USA). Conclusion: Statistical analysis in our study showed that SR with a cut-off value of 7.59 reaches 100% sensitivity and 95% specificity with overall accuracy of 97% (confidence intervals [CI]: 92-97%) in detection of pancreatic cancer. Statistical analysis also showed that HH with a cut-off value of ≥86 reaches 100% sensitivity and just 45% specificity with overall accuracy of 66% (CI: 61-66%) in detection of pancreatic cancer. New variable HHR with cut-off ≥1.153 was slightly better with 98% sensitivity and 50% specificity, with overall accuracy of 69% (CI: 63-70%). SR showed significantly higher specificity compared with HH and HHR. More HH studies on Hitachi platforms are needed. PMID:26425528

  16. AdS duals of matrix strings

    NASA Astrophysics Data System (ADS)

    Morales, Jose F.; Samtleben, Henning

    2003-06-01

    We review recent work on the holographic duals of type II and heterotic matrix string theories described by warped AdS3 supergravities. In particular, we compute the spectra of Kaluza-Klein primaries for type I, II supergravities on warped AdS3 × S7 and match them with the primary operators in the dual two-dimensional gauge theories. The presence of non-trivial warp factors and dilaton profiles requires a modification of the familiar dictionary between masses and 'scaling' dimensions of fields and operators. We present these modifications for the general case of domain wall/QFT correspondences between supergravities on warped AdSd+1 × Sq geometries and super Yang-Mills theories with 16 supercharges.

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

    PubMed

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

    2011-03-01

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

  18. Effects of adding alumina to the nickel-zirconia anode materials for solid oxide fuel cells and a two-step sintering method for half-cells

    NASA Astrophysics Data System (ADS)

    Song, Xiao; Dong, Xiaolei; Li, Ming; Wang, Haiqian

    2016-03-01

    The co-sintering process of half-cells has an important effect on the flatness and performance of solid oxide fuel cells. In this study, we report a two-step sintering method to fabricate flat three-layer half-cells. The first sintering step is a freestanding sintering process at a low temperature (1280 °C). The second sintering step is a constrained sintering process at 1400 °C. The shrinkage of the anode support layer (ASL) and the curvature of the half-cell can be adjusted by adding Al2O3 into the ASL in the first sintering step. Effects of Al2O3 addition on the NiO-YSZ anode material are also studied. We find that NiO reacts with Al2O3 to form NiAl2O4 spinel at the early sintering stage. This reaction transiently promotes the grain growth of NiO. Once the reaction terminates and the NiAl2O4 spinel is formed, the grain growth of NiO will be suppressed, even at higher sintering temperatures. Our results indicate that by a proper amount (approximately 0.2 wt%) of Al2O3 addition, smaller NiO grains can be obtained while the side effects of NiAl2O4 are negligible, which is favorable to increase the conductivity and stability of the ASL, and can enhance the performance of SOFC.

  19. Efficacy and safety of adding an agent to bevacizumab/taxane regimens for the first-line treatment of Her2-negative patients with locally recurrent or metastatic breast cancer: results from seven randomized controlled trials

    PubMed Central

    Liu, Xiaoqun; Liu, Xiangdong; Qiao, Tiankui; Chen, Wei; Yuan, Sujuan

    2016-01-01

    Background The combined therapy of bevacizumab (BEV) with taxane (paclitaxel or docetaxel) has shown an improvement on progression-free survival (PFS) and objective remission in Her2-negative patients with locally recurrent or metastatic breast cancer (LR/MBC). However, there was no benefit in overall survival (OS). The aim of this study was to evaluate the efficacy and safety of adding an agent to the BEV/taxane regimens for the treatment of Her2-negative patients with LR/MBC in a first-line setting. Materials and methods We searched PubMed, Web of Science, EMBASE, EBSCO, and the Cochrane Library databases for eligible trials. A meta-analysis was performed using Review Manager 5.0 freeware package. We calculated the hazard ratio (HR) for PFS and OS. The odds ratio (OR) was used to calculate objective response rate (ORR) and grade 3/4 drug-related adverse events. The heterogeneity of study outcomes was calculated by the χ2 test or I2 statistics. Results A total of 1,124 patients from seven randomized controlled trials were analyzed. Our meta-analysis showed that the ORR was significantly improved in the BEV/taxane-based triplet group when compared with the BEV/taxane-based doublet group (OR =1.31, 95% confidence interval [CI]: 1.03–1.67, P=0.03). A subset analysis showed that a similar result was achieved in the triplet group in which a cytotoxic agent was added (OR =1.46, 95% CI: 1.09–1.95, P=0.01). However, the PFS and OS had no statistically significant differences between the two groups (HR =0.87, 95% CI: 0.68–1.13, P=0.31; HR =0.98, 95% CI: 0.82–1.16, P=0.78, respectively). Regarding safety, thromboembolic events, fatigue, and diarrhea (all $grade 3) were more frequently observed in the BEV/taxane-based triplet group (OR =3.8, 95% CI: 1.86–7.79, P=0.0003; OR =1.55, 95% CI: 1.05–2.27, P=0.03; OR =2.1, 95% CI: 1.29–3.41, P=0.003, respectively). Other toxic effects had no statistically significant differences between the two groups. Conclusion Our

  20. Maggot therapy: a literature review of methods and patient experience.

    PubMed

    Menon, Jane

    Used in wound-bed preparation, larval therapy can be effective both clinically and financially, if used appropriately. In this article,the author reviews contemporary literature and key research on the benefits and challenges of using this therapy for wound care. The article focuses on debridement, as well as associated antimicrobial effects and psychological issues. Considerations and cautions that may affect clinical practice, such as pain management, peri-wound skin care, different methods of application and preparing the patient both physically and psychologically are also explored.

  1. Adding Sarcosine to Antipsychotic Treatment in Patients with Stable Schizophrenia Changes the Concentrations of Neuronal and Glial Metabolites in the Left Dorsolateral Prefrontal Cortex

    PubMed Central

    Strzelecki, Dominik; Podgórski, Michał; Kałużyńska, Olga; Stefańczyk, Ludomir; Kotlicka-Antczak, Magdalena; Gmitrowicz, Agnieszka; Grzelak, Piotr

    2015-01-01

    The glutamatergic system is a key point in pathogenesis of schizophrenia. Sarcosine (N-methylglycine) is an exogenous amino acid that acts as a glycine transporter inhibitor. It modulates glutamatergic transmission by increasing glycine concentration around NMDA (N-methyl-d-aspartate) receptors. In patients with schizophrenia, the function of the glutamatergic system in the prefrontal cortex is impaired, which may promote negative and cognitive symptoms. Proton nuclear magnetic resonance (1H-NMR) spectroscopy is a non-invasive imaging method enabling the evaluation of brain metabolite concentration, which can be applied to assess pharmacologically induced changes. The aim of the study was to evaluate the influence of a six-month course of sarcosine therapy on the concentration of metabolites (NAA, N-acetylaspartate; Glx, complex of glutamate, glutamine and γ-aminobutyric acid (GABA); mI, myo-inositol; Cr, creatine; Cho, choline) in the left dorso-lateral prefrontal cortex (DLPFC) in patients with stable schizophrenia. Fifty patients with schizophrenia, treated with constant antipsychotics doses, in stable clinical condition were randomly assigned to administration of sarcosine (25 patients) or placebo (25 patients) for six months. Metabolite concentrations in DLPFC were assessed with 1.5 Tesla 1H-NMR spectroscopy. Clinical symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS). The first spectroscopy revealed no differences in metabolite concentrations between groups. After six months, NAA/Cho, mI/Cr and mI/Cho ratios in the left DLPFC were significantly higher in the sarcosine than the placebo group. In the sarcosine group, NAA/Cr, NAA/Cho, mI/Cr, mI/Cho ratios also significantly increased compared to baseline values. In the placebo group, only the NAA/Cr ratio increased. The addition of sarcosine to antipsychotic therapy for six months increased markers of neurons viability (NAA) and neurogilal activity (mI) with simultaneous improvement

  2. One-loop diagrams in AdS space

    SciTech Connect

    Hung Lingyan; Shang Yanwen

    2011-01-15

    We study the complex scalar loop corrections to the boundary-boundary gauge two-point function in pure AdS space in Poincare coordinates, in the presence of boundary quadratic perturbations to the scalar. These perturbations correspond to double-trace perturbations in the dual CFT and modify the boundary conditions of the bulk scalars in AdS. We find that, in addition to the usual UV divergences, the one-loop calculation suffers from a divergence originating in the limit as the loop vertices approach the AdS horizon. We show that this type of divergence is independent of the boundary coupling; making use of this we extract the finite relative variation of the imaginary part of the loop via Cutkosky rules as the boundary perturbation varies. Applying our methods to compute the effects of a time-dependent impurity to the conductivities using the replica trick in AdS/CFT, we find that generally an IR-relevant disorder reduces the conductivity and that in the extreme low frequency limit the correction due to the impurities overwhelms the planar CFT result even though it is supposedly 1/N{sup 2} suppressed. We also comment on the more physical scenario of a time-independent impurity.

  3. A patient-specific scatter artifacts correction method

    NASA Astrophysics Data System (ADS)

    Zhao, Wei; Brunner, Stephen; Niu, Kai; Schafer, Sebastian; Royalty, Kevin; Chen, Guang-Hong

    2014-03-01

    This paper provides a fast and patient-specific scatter artifact correction method for cone-beam computed tomography (CBCT) used in image-guided interventional procedures. Due to increased irradiated volume of interest in CBCT imaging, scatter radiation has increased dramatically compared to 2D imaging, leading to a degradation of image quality. In this study, we propose a scatter artifact correction strategy using an analytical convolution-based model whose free parameters are estimated using a rough estimation of scatter profiles from the acquired cone-beam projections. It was evaluated using Monte Carlo simulations with both monochromatic and polychromatic X-ray sources. The results demonstrated that the proposed method significantly reduced the scatter-induced shading artifacts and recovered CT numbers.

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

    PubMed Central

    Motsch, Christiane

    2005-01-01

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

  5. Synthesis of a Potent Aminopyridine-Based nNOS-Inhibitor by Two Recent No-Carrier-Added (18)F-Labelling Methods.

    PubMed

    Drerup, Christian; Ermert, Johannes; Coenen, Heinz H

    2016-01-01

    Nitric oxide (NO), an important multifunctional signaling molecule, is produced by three isoforms of NO-synthase (NOS) and has been associated with neurodegenerative disorders. Selective inhibitors of the subtypes iNOS (inducible) or nNOS (neuronal) are of great interest for decoding neurodestructive key factors, and (18)F-labelled analogues would allow investigating the NOS-function by molecular imaging with positron emission tomography. Especially, the highly selective nNOS inhibitor 6-((3-((3-fluorophenethylamino)methyl)phenoxy)methyl)-4-methylpyridin-2-amine (10) lends itself as suitable compound to be (18)F-labelled in no-carrier-added (n.c.a.) form. For preparation of the (18)F-labelled nNOS-Inhibitor [(18)F]10 a "build-up" radiosynthesis was developed based on a corresponding iodonium ylide as labelling precursor. The such activated phenethyl group of the compound was efficiently and regioselectively labelled with n.c.a. [(18)F]fluoride in 79% radiochemical yield (RCY). After conversion by reductive amination and microwave assisted displacement of the protecting groups, the desired nNOS-inhibitor was obtained in about 15% total RCY. Alternatively, for a simplified "late-stage" (18)F-labelling procedure a corresponding boronic ester precursor was synthesized and successfully used in a newer, copper(II) mediated n.c.a. (18)F-fluoro-deboroniation reaction, achieving the same total RCY. Thus, both methods proved comparatively suited to provide the highly selective NOS-inhibitor [(18)F]10 as probe for preclinical in vivo studies. PMID:27598109

  6. Synthesis of a Potent Aminopyridine-Based nNOS-Inhibitor by Two Recent No-Carrier-Added (18)F-Labelling Methods.

    PubMed

    Drerup, Christian; Ermert, Johannes; Coenen, Heinz H

    2016-09-01

    Nitric oxide (NO), an important multifunctional signaling molecule, is produced by three isoforms of NO-synthase (NOS) and has been associated with neurodegenerative disorders. Selective inhibitors of the subtypes iNOS (inducible) or nNOS (neuronal) are of great interest for decoding neurodestructive key factors, and (18)F-labelled analogues would allow investigating the NOS-function by molecular imaging with positron emission tomography. Especially, the highly selective nNOS inhibitor 6-((3-((3-fluorophenethylamino)methyl)phenoxy)methyl)-4-methylpyridin-2-amine (10) lends itself as suitable compound to be (18)F-labelled in no-carrier-added (n.c.a.) form. For preparation of the (18)F-labelled nNOS-Inhibitor [(18)F]10 a "build-up" radiosynthesis was developed based on a corresponding iodonium ylide as labelling precursor. The such activated phenethyl group of the compound was efficiently and regioselectively labelled with n.c.a. [(18)F]fluoride in 79% radiochemical yield (RCY). After conversion by reductive amination and microwave assisted displacement of the protecting groups, the desired nNOS-inhibitor was obtained in about 15% total RCY. Alternatively, for a simplified "late-stage" (18)F-labelling procedure a corresponding boronic ester precursor was synthesized and successfully used in a newer, copper(II) mediated n.c.a. (18)F-fluoro-deboroniation reaction, achieving the same total RCY. Thus, both methods proved comparatively suited to provide the highly selective NOS-inhibitor [(18)F]10 as probe for preclinical in vivo studies.

  7. No-carrier-added carbon-11-labeled sn-1,2- and sn-1,3-diacylglycerols by (11C)propyl ketene method

    SciTech Connect

    Imahori, Y.; Fujii, R.; Ueda, S.; Ido, T.; Nishino, H.; Moriyama, Y.; Yamamoto, Y.L.; Nakahashi, H. )

    1991-08-01

    This article describes the preparation of sn-1,2-(11C)diacylglycerols and sn-1,3-(11C)diacylglycerols by a no-carrier-added reaction based on a labeling method using (1-11C)propyl ketene, which is one of the most potent acylating agents. (1-11C)Propyl ketene was produced by pyrolytic decomposition of (1-11C)butyric acid and was trapped in pyridine containing L-alpha-palmitoyl-lysophosphatidylcholine, producing L-alpha-palmitoyl-2-(1-11C)butyryl-sn-glycero-3-phosphorylcholine. The authors adopted an enzymatic reaction to remove the phosphorylcholine, in which L-alpha-palmitoyl-2-(1-11C)butyryl-sn-glycero-3-phosphorylcholine was incubated with phospholipase C, hydrolyzing to produce 1-palmitoyl-sn-2-(1-11C)butyrylglycerol. Total synthesis time was about 50 minutes and the specific activity was estimated at 93 GBq/mumol (2.5 Ci/mumol) at end of synthesis. Radiochemical yield was 3.8% based on the trapped 11CO2. sn-1,3-(11C)Diacylglycerol was also synthesized by (1-11C)propyl ketene reaction with 1-palmitoyl-sn-glycerol in a single procedure. The regional brain tissue radioactivities obtained in sn-1,2-(11C)diacylglycerol were higher than those of sn-1,3-(11C)diacylglycerol, and the regional values varied widely. In autoradiography of brain slices from conscious rats, sn-1,2-(11C)diacylglycerol incorporation sites were discretely localized, especially in the amygdala, cerebral cortex, and hippocampus, suggesting that intensive neuronal processing occurred in these areas on the basis of phosphatidylinositol turnover.

  8. Adding liraglutide to the backbone therapy of biguanide in patients with coronary artery disease and newly diagnosed type-2 diabetes (the AddHope2 study): a randomised controlled study protocol

    PubMed Central

    Anholm, Christian; Kumarathurai, Preman; Klit, Malene S; Kristiansen, Ole P; Nielsen, Olav W; Ladelund, Steen; Madsbad, Sten; Sajadieh, Ahmad; Haugaard, Steen B

    2014-01-01

    Introduction Newly diagnosed type 2 diabetes mellitus (T2DM) in patients with coronary artery disease (CAD) more than doubles the risk of death compared with otherwise matched glucose tolerant patients. The biguanide metformin is the drug of choice in treatment of T2DM and has shown to ameliorate cardiovascular morbidity in patients with T2DM and myocardial infarction (MI). The incretin hormone, glucagon-like peptide-1 (GLP-1) improves β-cell function, insulin sensitivity and causes weight loss and has been suggested to have beneficial effects on cardiac function. The GLP-1 receptor agonist (GLP-1RA), liraglutide, is currently used for treatment of T2DM but its potential effect on cardiac function has not been investigated in detail. We hypothesised that liraglutide added to metformin backbone therapy in patients with CAD and newly diagnosed T2DM will improve β-cell function and left ventricular systolic function during dobutamine stress. Methods and analyses 40 patients with CAD and newly diagnosed T2DM will receive the intervention liraglutide+metformin and placebo+metformin in this investigator-initiated, double blind, randomised, placebo-controlled, cross-over 12 plus 12 weeks intervention study with a 2-week washout period. The primary cardiovascular end point is changes in left ventricular ejection fraction during stress echocardiography. The primary endocrine end point is β-cell function evaluated during a frequently sampled intravenous glucose tolerance test. Secondary end points include heart rate variability, diurnal blood pressure, glucagon suppression and inflammatory response (urine, blood and adipose tissue). Ethics and dissemination This study is approved by the Danish Medicines Agency, the Danish Dataprotection Agency and the Regional Committee on Biomedical Research Ethics of the Capital Region of Denmark. The trial will be carried out under the guidance from the GCP unit at Copenhagen University Hospital of Bispebjerg and in accordance with

  9. Agricultural Education: Value Adding.

    ERIC Educational Resources Information Center

    Riesenberg, Lou E.; And Others

    1989-01-01

    This issue develops the theme of "Agricultural Education--Value Adding." The concept value adding has been a staple in the world of agricultural business for describing adding value to a commodity that would profit the producer and the local community. Agricultural education should add value to individuals and society to justify agricultural…

  10. [Systematization of types and methods of radiotherapy, methods and methodology of irradiating patients].

    PubMed

    Vaĭnberg, M Sh

    1991-01-01

    The paper is concerned with the principles of systematization and classification of radiation therapy, approaches to the regulation of its terminology. They are based on the distinction of the concepts of radiation therapy and irradiation of patients. The author gives a concise historical review of improvement of the methodology of radiation therapy in the course of developing of its methods and facilities. Problems of terminology are under discussion. There is a table of types and methods of radiation therapy, methods and techniques of irradiation. In the appendices one can find a table of typical legends and examples of graphic signs to denote methods of irradiation. Potentialities of a practical use of the system are described.

  11. Efficacy and tolerability of adding coenzyme A 400 U/d capsule to stable statin therapy for the treatment of patients with mixed dyslipidemia: an 8-week, multicenter, double-Blind, randomized, placebo-controlled study

    PubMed Central

    2014-01-01

    Background Patients with mixed hyperlipidemia usually are in need of combination therapy to achieve low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) target values for reduction of cardiovascular risk. This study investigated the efficacy and safety of adding a new hypolipidemic agent, coenzyme A (CoA) to stable statin therapy in patients with mixed hyperlipidemia. Methods In this multi-center, 8-week, double-blind study, adults who had received ≥8 weeks of stable statin therapy and had hypertriglyceridemia (TG level at 2.3-6.5 mmol/L) were randomized to receive CoA 400 U/d or placebo plus stable dosage of statin. Efficacy was assessed by the changes in the levels and patterns of lipoproteins. Tolerability was assessed by the incidence and severity of adverse events (AEs). Results A total of 304 patients with mixed hyperlipidemia were randomized to receive CoA 400 U/d plus statin or placebo plus statin (n = 152, each group). After treatment for 8 weeks, the mean percent change in TG was significantly greater with CoA plus statin compared with placebo plus statin (-25.9% vs -4.9%, respectively; p = 0.0003). CoA plus statin was associated with significant reductions in TC (-9.1% vs -3.1%; p = 0.0033), LDL-C (-9.9% vs 0.1%; p = 0.003), and non- high-density lipoprotein cholesterol (-13.5% vs -5.7%; p = 0.0039). There was no significant difference in the frequency of AEs between groups. No serious AEs were considered treatment related. Conclusions In these adult patients with persistent hypertriglyceridemia, CoA plus statin therapy improved TG and other lipoprotein parameters to a greater extent than statin alone and has no obviously adverse effect. Trial registration Current Controlled Trials ClinicalTrials.gov ID NCT01928342. PMID:24382338

  12. 27 CFR 19.456 - Adding denaturants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Adding denaturants. 19.456... Denaturation § 19.456 Adding denaturants. Denaturants and spirits shall be mixed in packages, tanks, or bulk... proprietor shall submit a flow diagram of the intended process or method of adding denaturants. (Sec....

  13. The phenanthridine biguanides efficiently differentiate between dGdC, dAdT and rArU sequences by two independent, sensitive spectroscopic methods.

    PubMed

    Radić Stojković, Marijana; Miljanić, Snežana; Mišković, Katarina; Glavaš-Obrovac, Ljubica; Piantanida, Ivo

    2011-05-01

    At submicromolar concentrations two novel phenanthridine biguanides exhibit distinctly different spectroscopic signals for dGdC and dAdT sequences, respectively, by opposite fluorimetric changes (quenching for dGdC and increase for dAdT) and especially the bis-biguanide derivative gives an opposite ICD response (negative ICD for dGC and strong positive for dAdT). This specific signalling was explained by the ability of compounds to switch the binding mode from intercalation into dGdC to minor groove binding into dAdT sequences. Both compounds bind to rArU by intercalation, yielding different fluorimetric and CD response in comparison to any of aforementioned ds-DNA. Moreover, both compounds revealed significantly higher affinity toward ds-polynucleotides in comparison to previously studied alkylamine- and urea-analogues. Furthermore, DNA/RNA binding properties of novel compounds could be controlled by pH, due to the protonation of heterocyclic nitrogen. Low in vitro cytotoxicity of both compounds against human cell lines makes them interesting spectrophotometric probes.

  14. How Teacher Evaluation Methods Matter for Accountability: A Comparative Analysis of Teacher Effectiveness Ratings by Principals and Teacher Value-Added Measures

    ERIC Educational Resources Information Center

    Harris, Douglas N.; Ingle, William K.; Rutledge, Stacey A.

    2014-01-01

    Policymakers are revolutionizing teacher evaluation by attaching greater stakes to student test scores and observation-based teacher effectiveness measures, but relatively little is known about why they often differ so much. Quantitative analysis of thirty schools suggests that teacher value-added measures and informal principal evaluations are…

  15. Physical methods for evaluating the nutrition status of hemodialysis patients.

    PubMed

    Marcelli, Daniele; Wabel, Peter; Wieskotten, Sebastian; Ciotola, Annalisa; Grassmann, Aileen; Di Benedetto, Attilio; Canaud, Bernard

    2015-10-01

    This article aims to provide an overview of the different nutritional markers and the available methodologies for the physical assessment of nutrition status in hemodialysis patients, with special emphasis on early detection of protein energy wasting (PEW). Nutrition status assessment is made on the basis of anamnesis, physical examination, evaluation of nutrient intake, and on a selection of various screening/diagnostic methodologies. These methodologies can be subjective, e.g. the Subjective Global Assessment score (SGA), or objective in nature (e.g. bioimpedance analysis). In addition, certain biochemical tests may be employed (e.g. albumin, pre-albumin). The various subjective-based and objective methodologies provide different insights for the assessment of PEW, particularly regarding their propensity to differentiate between the important body composition compartments-fluid overload, fat mass and muscle mass. This review of currently available methods showed that no single approach and no single marker is able to detect alterations in nutrition status in a timely fashion and to follow such changes over time. The most clinically relevant approach presently appears to be the combination of the SGA method with the bioimpedance spectroscopy technique with physiological model and, additionally, laboratory tests for the detection of micro-nutrient deficiency.

  16. Segmentation and quantification for Alzheimer's disease (AD): a preliminary study

    NASA Astrophysics Data System (ADS)

    Lei, Tianhu; Udupa, Jayaram K.; Zhuge, Ying; Moonis, Gul; Clark, Christopher

    2003-05-01

    Alzheimer's is a progressive brain disease and is clinically characterized by cognitive symptoms that, in combination with behavioral disturbances, significantly interfere with activities of daily living. The purpose of this study is to investigate the possibility of developing volumetric measures of the structural damage and atrophy of brain derived from multiprotocol MR imaging. Our approach first applies intensity inhomogeneity correction and intensity standardization to PD and T2 weighted MR images to create base images for quantitative image analysis. Then, vectorial scale-based fuzzy connectedness segmentation (VSFCS) and morphological operations are applied to the base images to extract masks of cerebrospinal fluid (CSF), grey matter (GM), and white matter (WM), and further to create a clean and accurate intracranial (IC) mask. After separating CSF from brain parenchyma (BP), VSFCS is applied to BP (PD and T2) images to generate pure GM and WM masks, and then subtracting these pure from the BP mask to detect AD lesions. This method was applied to a set of conventional PD and T2 weighted MR images that were obtained from 5 patients with probable AD and 5 healthy normal control subjects. The segmented images of individual brain tissue regions (CSF, GM, WM, and AD lesion) are consistent with a Neuroradiologist's examination. The quantitative analysis shows that patients with AD have more atrophy. The mean value of the volume of brain parenchyma of patients with AD is about 10% less than that of healthy controls.

  17. Patients' Opinions on Display Methods to Protect Privacy.

    PubMed

    Niimi, Yukari; Ota, Katsumasa

    2016-01-01

    The purpose of this study is to ascertain if patients will accept an electronic patient record system that temporarily conceals their private information. We interviewed 11 outpatients at a core hospital in Shizuoka prefecture of Japan. Most patients agree with our idea using temporary mosaic on the screen to protect their privacy. PMID:27332435

  18. Shadows, currents, and AdS fields

    SciTech Connect

    Metsaev, R. R.

    2008-11-15

    Conformal totally symmetric arbitrary spin currents and shadow fields in flat space-time of dimension greater than or equal to four are studied. A gauge invariant formulation for such currents and shadow fields is developed. Gauge symmetries are realized by involving the Stueckelberg fields. A realization of global conformal boost symmetries is obtained. Gauge invariant differential constraints for currents and shadow fields are obtained. AdS/CFT correspondence for currents and shadow fields and the respective normalizable and non-normalizable solutions of massless totally symmetric arbitrary spin AdS fields are studied. The bulk fields are considered in a modified de Donder gauge that leads to decoupled equations of motion. We demonstrate that leftover on shell gauge symmetries of bulk fields correspond to gauge symmetries of boundary currents and shadow fields, while the modified de Donder gauge conditions for bulk fields correspond to differential constraints for boundary conformal currents and shadow fields. Breaking conformal symmetries, we find interrelations between the gauge invariant formulation of the currents and shadow fields, and the gauge invariant formulation of massive fields.

  19. Switching Lopinavir/Ritonavir to Atazanavir/Ritonavir vs Adding Atorvastatin in HIV-Infected Patients Receiving Second-Line Antiretroviral Therapy With Hypercholesterolemia: A Randomized Controlled Trial.

    PubMed

    Wangpatharawanit, Phanthaboon; Sungkanuparph, Somnuek

    2016-09-15

    A randomized controlled trial was conducted among human immunodeficiency virus-infected patients receiving lopinavir/ritonavir-based regimens with hypercholesterolemia. Reduction of total cholesterol and low-density lipoprotein was significantly greater in patients who were randomized to the addition of atorvastatin compared with those who were switched from lopinavir/ritonavir to atazanavir/ritonavir. PMID:27402817

  20. LWR (Light Water Reactor) power plant simulations using the AD10 and AD100 systems

    SciTech Connect

    Wulff, W.; Cheng, H.S.; Chien, C.J.; Jang, J.Y.; Lin, H.C.; Mallen, A.N.; Wang, S.J.; Institute of Nuclear Energy Research, Lung-Tan; Tawian Power Co., Taipei; Brookhaven National Lab., Upton, NY; Institute of Nuclear Energy Research, Lung-Tan )

    1989-01-01

    Boiling (BWR) and Pressurized (PWR) Water Reactor Power Plants are being simulated at BNL with the AD10 and AD100 Peripheral Processor Systems. The AD10 system has been used for BWR simulations since 1984 for safety analyses, emergency training and optimization studies. BWR simulation capabilities have been implemented recently on the AD100 system and PWR simulation capabilities are currently being developed under the auspices of international cooperation. Modeling and simulation methods are presented with emphasis on the simulation of the Nuclear Steam Supply System. Results are presented for BWR simulation and performance characteristics are compared of the AD10 and AD100 systems. It will be shown that the AD100 simulates two times faster than two AD10 processors operating in parallel and that the computing capacity of one AD100 (with FMU processor) is twice as large as that of two AD10 processors. 9 refs., 5 figs., 1 tab.

  1. Efficacy and safety of ezetimibe added on to atorvastatin (20 mg) versus uptitration of atorvastatin (to 40 mg) in hypercholesterolemic patients at moderately high risk for coronary heart disease.

    PubMed

    Conard, Scott E; Bays, Harold E; Leiter, Lawrence A; Bird, Steven R; Rubino, Joseph; Lowe, Robert S; Tomassini, Joanne E; Tershakovec, Andrew M

    2008-12-01

    The aim of this study was to evaluate the efficacy and safety of ezetimibe 10 mg added to atorvastatin 20 mg compared with doubling atorvastatin to 40 mg in patients with hypercholesterolemia at moderately high risk for coronary heart disease who did not reach low-density lipoprotein (LDL) cholesterol levels <100 mg/dl with atorvastatin 20 mg. In this 6-week, multicenter, double-blind, randomized, parallel-group study, 196 patients treated with atorvastatin 20 mg received atorvastatin 20 mg plus ezetimibe 10 mg or atorvastatin 40 mg for 6 weeks. Adding ezetimibe 10 mg to atorvastatin 20 mg produced significantly greater reductions in LDL cholesterol than increasing atorvastatin to 40 mg (-31% vs -11%, p <0.001). Significantly greater reductions were also seen in non-high-density lipoprotein cholesterol, total cholesterol, and apolipoprotein B (p <0.001). Significantly more patients reached LDL cholesterol levels <100 mg/dl with atorvastatin 20 mg plus ezetimibe compared with atorvastatin 40 mg (84% vs 49%, p <0.001). The 2 treatment groups had comparable results for high-density lipoprotein cholesterol, triglycerides, apolipoprotein A-I, and high-sensitivity C-reactive protein. The incidences of clinical and laboratory adverse experiences were generally similar between groups. In conclusion, the addition of ezetimibe 10 mg to atorvastatin 20 mg was generally well tolerated and resulted in significantly greater lipid-lowering efficacy compared with doubling atorvastatin to 40 mg in patients with hypercholesterolemia at moderately high risk for coronary heart disease.

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

    PubMed

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

    2016-01-01

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

  3. A CORBA-based object framework with patient identification translation and dynamic linking. Methods for exchanging patient data.

    PubMed

    Wang, C; Ohe, K

    1999-03-01

    Exchanging and integration of patient data across heterogeneous databases and institutional boundaries offers many problems. We focused on two issues: (1) how to identify identical patients between different systems and institutions while lacking universal patient identifiers; and (2) how to link patient data across heterogeneous databases and institutional boundaries. To solve these problems, we created a patient identification (ID) translation model and a dynamic linking method in the Common Object Request Broker Architecture (CORBA) environment. The algorithm for the patient ID translation is based on patient attribute matching plus computer-based human checking; the method for dynamic linking is temporal mapping. By implementing these methods into computer systems with help of the distributed object computing technology, we built a prototype of a CORBA-based object framework in which the patient ID translation and dynamic linking methods were embedded. Our experiments with a Web-based user interface using the object framework and dynamic linking-through the object framework were successful. These methods are important for exchanging and integrating patient data across heterogeneous databases and institutional boundaries.

  4. ADS pilot program Plan

    NASA Technical Reports Server (NTRS)

    Clauson, J.; Heuser, J.

    1981-01-01

    The Applications Data Service (ADS) is a system based on an electronic data communications network which will permit scientists to share the data stored in data bases at universities and at government and private installations. It is designed to allow users to readily locate and access high quality, timely data from multiple sources. The ADS Pilot program objectives and the current plans for accomplishing those objectives are described.

  5. Rehabilitation of a Total Maxillectomy Patient by Three Different Methods

    PubMed Central

    Ramesh; Kumar, C.Dinesh; Sharma, Neeraj; S, Yogesh

    2014-01-01

    Rehabilitation of a patient with orbital defect is highly a challenging task, requiring an individualized design of the technique for each patient. The disfigurement associated with the loss of facial structures causes significant emotional stress and physical burdens.Various treatment modalities are available, one of which is the use of implants. Although implant-supported orbital prosthesis has a superior outcome, it may not be advisable in all the patients due to economic factors. The treatment of choice includes the silicone orbital prosthesis due to its life-like appearance. This article describes three different techniques, it’s advantages and limitations of fabricating a silicone orbital prosthesis for the same patient to achieve ideal fit and aesthetics. PMID:25478462

  6. [Ultrasonic methods and semiotics in patients with vasculogenic erectile dysfunction].

    PubMed

    Zhukov, O B; Zubarev, A R

    2001-01-01

    The authors have developed criteria for ultrasonic assessment of cavernous bodies, arterial and venous circulation in normal penile vessels and in erectile dysfunction in 125 patients; describe modern ultrasound modalities in differential diagnosis of various forms of vasculogenic erectile dysfunction basing on the experience with 92 patients; validate hydrodynamic role of the tunica albuginea in pathogenesis of venocorporal dysfunction and pathological venous drainage. Early ischemic signs of arterial insufficiency were revealed.

  7. Is there an added clinical value of "true"whole body(18)F-FDG PET/CT imaging in patients with malignant melanoma?

    PubMed

    Tan, Julie C; Chatterton, Barry E

    2012-01-01

    Accurate and reliable staging of disease extent in patients with malignant MM is essential to ensure appropriate treatment planning. The detection of recurrent or residual malignancy after primary treatment is important to allow for early intervention and to optimise patient survival. 2-deoxy-2-[(18)F]fluoro-D-glucose ((18)F-FDG) PET or PET computed tomography (PET/CT) is indicated for surveillance of malignant MM due to its high sensitivity and specificity for soft-tissue or nodal recurrences and metastases. It has been claimed that including lower extremities and skull in addition to 'eyes to thigh' images in PET/CT evaluation of metastatic MM routinely is warranted. We have studied retrospectively the reports of whole-body PET/CT scans in all patients with MM scanned in our Department from April 2005 to December 2010. All PET abnormalities in the brain/scalp and lower extremities were tabulated by location and whether they were 'expected' or 'unexpected'. Findings were correlated with pathology, other imaging studies, and clinical follow-up. In this study, 398 PET/CT examinations in 361 patients with MM were included. Results showed that twelve of the 398 (3%) scans had brain/scalp abnormalities, with only 4 (1.0%) showing unexpected abnormalities. Twenty nine of the 398 (7.2%) scans showed lower extremity abnormalities, with only 5 (1.2%) showing unexpected abnormalities. In no case was an isolated unexpected malignant lesion identified in the brain/scalp or lower extremities. In conclusion, whole body PET/CT scan showed about 1% unexpected primary or metastatic MM lesions involving the head or lower extremities, which seldom offered significant additional clinical benefit and were unlikely to change clinical management. No clinically significant change in staging would have occurred. Routine 'eyes to thighs' images were adequate for this subset of patients. PMID:23106051

  8. Safety and efficacy of ezetimibe added to atorvastatin versus up titration of atorvastatin to 40 mg in Patients > or = 65 years of age (from the ZETia in the ELDerly [ZETELD] study).

    PubMed

    Zieve, Franklin; Wenger, Nanette K; Ben-Yehuda, Ori; Constance, Christian; Bird, Steven; Lee, Raymond; Hanson, Mary E; Jones-Burton, Charlotte; Tershakovec, Andrew M

    2010-03-01

    Few clinical studies have focused on the efficacy of lipid-lowering therapies in patients > or = 65 years of age. The percentage of change from baseline in low-density lipoprotein (LDL) cholesterol and the percentage of patients achieving prespecified LDL cholesterol levels after 12 weeks of ezetimibe 10 mg plus atorvastatin versus up titration of atorvastatin were assessed in subjects > or = 65 years old with hyperlipidemia and at high risk of coronary heart disease. After stabilization of atorvastatin 10-mg therapy, 1,053 patients, > or = 65 years old, at high risk of coronary heart disease, with and without atherosclerotic vascular disease and a LDL cholesterol level that was not <70 or <100 mg/dl, respectively, were randomized to receive ezetimibe added to atorvastatin 10 mg for 12 weeks versus up titration to atorvastatin 20 mg for 6 weeks followed by up titration to atorvastatin 40 mg for an additional 6 weeks. Ezetimibe added to atorvastatin 10 mg resulted in significantly greater changes at week 6 in LDL cholesterol (p <0.001), significantly more patients with atherosclerotic vascular disease achieving a LDL cholesterol level of <70 mg/dl (p <0.001), and significantly more patients without atherosclerotic vascular disease achieving a LDL cholesterol level of <100 mg/dl (p <0.001) at weeks 6 and 12 compared to atorvastatin 20 mg or atorvastatin 40 mg. In addition, ezetimibe plus atorvastatin 10 mg resulted in significantly greater changes at week 6 in total cholesterol, triglycerides, non-high-density lipoprotein (HDL) cholesterol, apolipoprotein B (all p <0.001), and HDL cholesterol (p = 0.021) compared with atorvastatin 20 mg and significantly greater changes at week 12 in LDL cholesterol, non-HDL cholesterol, apolipoprotein A-I (p = 0.001), total cholesterol, apolipoprotein B (p <0.030), and HDL cholesterol (p <0.001) compared with atorvastatin 40 mg. Both treatments were generally well tolerated, with comparable safety profiles. In conclusion, adding

  9. Caring for LGBTQ patients: Methods for improving physician cultural competence.

    PubMed

    Klein, Elizabeth W; Nakhai, Maliheh

    2016-05-01

    This article summarizes the components of a curriculum used to teach family medicine residents and faculty about LGBTQ patients' needs in a family medicine residency program in the Pacific Northwest region of the United States. This curriculum was developed to provide primary care physicians and physicians-in-training with skills to provide better health care for LGBTQ-identified patients. The curriculum covers topics that range from implicit and explicit bias and appropriate terminology to techniques for crafting patient-centered treatment plans. Additionally, focus is placed on improving the understanding of specific and unique barriers to competent health care encountered by LGBTQ patients. Through facilitated discussion, learners explore the health disparities that disproportionately affect LGBTQ individuals and develop skills that will improve their ability to care for LGBTQ patients. The goal of the curriculum is to teach family medicine faculty and physicians in training how to more effectively communicate with and treat LGBTQ patients in a safe, non-judgmental, and welcoming primary care environment. PMID:27497452

  10. Thermodynamics of charged Lovelock: AdS black holes

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  11. Efficacy and safety of pioglitazone added to alogliptin in Japanese patients with type 2 diabetes mellitus: a multicentre, randomized, double-blind, parallel-group, comparative study.

    PubMed

    Kaku, K; Katou, M; Igeta, M; Ohira, T; Sano, H

    2015-12-01

    A phase IV, multicentre, randomized, double-blind, parallel-group, comparative study was conducted in Japanese subjects with type 2 diabetes mellitus (T2DM) who had inadequate glycaemic control, despite treatment with alogliptin in addition to diet and/or exercise therapy. Subjects with glycated haemoglobin (HbA1c) concentrations of 6.9-10.5% were randomized to receive 16 weeks' double-blind treatment with pioglitazone 15 mg, 30 mg once daily or placebo added to alogliptin 25 mg once daily. The primary endpoint was the change in HbA1c from baseline at the end of treatment period (week 16). Both pioglitazone 15 and 30 mg combination therapy resulted in a significantly greater reduction in HbA1c than alogliptin monotherapy [-0.80 and -0.90% vs 0.00% (the least squares mean using analysis of covariance model); p < 0.0001, respectively]. The overall incidence rates of treatment-emergent adverse events were similar among the treatment groups. Pioglitazone/alogliptin combination therapy was effective and generally well tolerated in Japanese subjects with T2DM and is considered to be useful in clinical settings.

  12. Conserved charges in timelike warped AdS3 spaces

    NASA Astrophysics Data System (ADS)

    Donnay, L.; Fernández-Melgarejo, J. J.; Giribet, G.; Goya, A.; Lavia, E.

    2015-06-01

    We consider the timelike version of warped anti-de Sitter space (WAdS), which corresponds to the three-dimensional section of the Gödel solution of four-dimensional cosmological Einstein equations. This geometry presents closed timelike curves (CTCs), which are inherited from its four-dimensional embedding. In three dimensions, this type of solution can be supported without matter provided the graviton acquires mass. Here, among the different ways to consistently give mass to the graviton in three dimensions, we consider the parity-even model known as new massive gravity (NMG). In the bulk of timelike WAdS3 space, we introduce defects that, from the three-dimensional point of view, represent spinning massive particlelike objects. For this type of source, we investigate the definition of quasilocal gravitational energy as seen from infinity, far beyond the region where the CTCs appear. We also consider the covariant formalism applied to NMG to compute the mass and the angular momentum of spinning particlelike defects and compare the result with the one obtained by means of the quasilocal stress tensor. We apply these methods to special limits in which the WAdS3 solutions coincide with locally AdS3 and locally AdS2×R spaces. Finally, we make some comments about the asymptotic symmetry algebra of asymptotically WAdS3 spaces in NMG.

  13. The Safety and Immunological Effects of rAd5-EBV-LMP2 Vaccine in Nasopharyngeal Carcinoma Patients: A Phase I Clinical Trial and Two-Year Follow-Up.

    PubMed

    Si, Yongfeng; Deng, Zhuoxia; Lan, Guiping; Du, Haijun; Wang, Yongli; Si, Jinyuan; Wei, Jiazhang; Weng, Jingjin; Qin, Yangda; Huang, Bo; Yang, Yong; Qin, Ying

    2016-01-01

    Epstein-Barr virus (EBV)-encoded latent membrane protein 2 (LMP2) promotes nasopharyngeal carcinoma (NPC) progression. Previously, we reported that the dendritic cells (DCs) transfected with EBV-LMP2 recombinant serotype 5 adenoviruses (rAd5) induced anti-tumor effect by eliciting cytotoxic T lymphocytes (CTLs)-mediated immune response in vitro and the adenoviral vaccine of EBV-LMP2 (rAd5-EBV-LMP2) stimulated antigen-specific cellular immunity in mice. However, the safety and immunological effect of rAd5-EBV-LMP2 vaccine in human still remained unknown. Here we conducted a single-center, non-randomized, open-label, single-arm phase I clinical trial to clarify this unsolved issue. A total of 24 patients with regional advanced NPC were sequentially enrolled into three dose level groups (2×10(9), 2×10(10), 2×10(11) vp). The rAd5-EBV-LMP2 vaccines were intramuscularly injected for four times within 28 d (D0, D7, D14, D28). Blood samples were harvested immediately before every vaccination, one week and one month after the last vaccination (D0, D7, D14, D28, D35, D58). All the vaccine inoculation-related toxicities presented as grade I/II adverse events. The most frequent systemic adverse reactions were fatigue (33.0%, 8/24), myalgia (29.2%, 7/24) and cough (29.2%, 7/24), while the most common regional adverse reaction was tenderness in the inoculation site (54.2%, 13/24). In addition, proportion of CD(3+)CD(4+) cells in peripheral blood was significantly increased in the high dose group (2×10(11) vp). The rAd5-EBV-LMP2 vaccine was generally well-tolerated and the high dose (2×10(11) vp) is recommended to be adopted in phase II studies. The long-term outcome of rAd5-EBV-LMP2 vaccine inoculation is required to be determined in following placebo-controlled trials. PMID:27477649

  14. Efficacy of Biofeedback and Cognitive-behavioural Therapy in Psoriatic PatientsA Single-blind, Randomized and Controlled Study with Added Narrow-band Ultraviolet B Therapy.

    PubMed

    Piaserico, Stefano; Marinello, Elena; Dessi, Andrea; Linder, Michael Dennis; Coccarielli, Debora; Peserico, Andrea

    2016-08-23

    Increasing data suggests that there is a connection between stress and the appearance of psoriasis symptoms. We therefore performed a clinical trial enrolling 40 participants who were randomly allocated to either an 8-week cognitive-behavioural therapy (CBT) (treatment group) plus narrow-band UVB phototherapy or to an 8-week course of only narrow-band UVB phototherapy (control group). We evaluated the clinical severity of psoriasis (PASI), General Health Questionnaire (GHQ)-12, Skindex-29 and State-Trait Anxiety Inventory (STAI) at baseline and by the end of the study. Sixty-five percent of patients in the treatment group achieved PASI75 compared with 15% of standard UVB patients (p = 0.007). GHQ-12 cases were reduced from 45% to 10% in the treatment group and from 30% to 20% in the control group (p = 0.05). The Skindex-29 emotional domain showed a significant improvement in the CBT/biofeedback group compared with control patients (-2.8 points, p = 0.04). This study shows that an adjunctive 8-week intervention with CBT combined with biofeedback increases the beneficial effect of UVB therapy in the overall management of psoriasis, reduces the clinical severity of psoriasis, improving quality of life and decreases the number of minor psychiatric disorders. PMID:27283367

  15. Distribution and density of Antarctic krill ( Euphausia superba) and ice krill ( E. crystallorophias) off Adélie Land in austral summer 2008 estimated by acoustical methods

    NASA Astrophysics Data System (ADS)

    Amakasu, Kazuo; Ono, Atsushi; Hirano, Daisuke; Moteki, Masato; Ishimaru, Takashi

    2011-08-01

    From January to February 2008 the training research vessel TRV Umitaka Maru conducted a comprehensive oceanographic survey of the waters around the 140°E meridian off Adélie Land as part of the Collaborative East Antarctic Marine Census (CEAMARC) project. The acoustic component of this survey was conducted using a scientific echosounder operating at 38 and 70 kHz to estimate the distribution and density of Antarctic krill ( Euphausia superba) and ice krill ( E. crystallorophias). In addition, the relationship between the vertical distribution of Antarctic krill and the water temperature structure along the 140°E meridian was investigated. Antarctic krill were distributed in the waters of the continental slope at 65-66°S and the maximum value of the mean areal density ρ in 1 nautical mile (nmi) intervals was 4344 inds. m -2. Ice krill were distributed in the neritic waters of the continental shelf to the south of the 66°S and the maximum ρ in 1 nmi intervals was 23,669 inds. m -2. Along the 140°E meridian, Antarctic krill were mainly distributed at the water temperatures below 0.5 °C. Although they were mostly distributed shallower than approximately 100 m, dense aggregations at approximately 180-200 m were also observed, which coincided with a depression of the water temperature structure.

  16. Detection of adulteration in mulberry pekmez samples added various sugar syrups with ¹³C/¹²C isotope ratio analysis method.

    PubMed

    Tosun, Murat

    2014-12-15

    Mulberry pekmez can be adulterated in different ways either during the production process or after production is completed. To identify these adulterations, stable carbon isotope ratio analysis (SCIRA) was performed on the model examples prepared by adding saccharose syrup (SS), glucose syrup (GS) and high fructose corn syrup (HFCS) into two different pure mulberry pekmez samples in the ratios of 0%, 10%, 30% and 50%. The δ(13)C ratio of the pure mulberry pekmez was determined as -26.60‰ on average, the saccharose syrup as -24.80‰, the glucose syrup as -11.20‰ and the high-fructose corn syrup as -11.40‰. In identifying the adulteration made to pekmez, especially with the high-fructose corn syrup, which is obtained from corn starch, and with the glucose syrup, the δ(13)C ratio comes into prominence. However it remains impossible identify the adulterations made with the saccharose, which is obtained from beet sugar, or invert sugar syrups. PMID:25038711

  17. Effect of adding non-volatile oil as a core material for the floating microspheres prepared by emulsion solvent diffusion method.

    PubMed

    Lee, J H; Park, T G; Lee, Y B; Shin, S C; Choi, H K

    2001-01-01

    Eudragit microspheres, to float in the gastrointestinal tract, were prepared to prolong a gastrointestinal transit time. To enhance their buoyancy, non-volatile oil was added to the dispersed phase. When an oil component was not miscible with water, over 90% was entrapped within the microspheres and prolonged the floating time of the microspheres. Depending on the solvent ratio, the morphologies of the microspheres were different and the best result was obtained when the ratio of dichloromethane:ethanol:isopropanol was 5:6:4. As the isopropanol portion increased, the time to form microspheres was delayed and the amount of fibre-like substance produced was decreased, due to the slow diffusion rate of the solvent. Compared with microspheres prepared without non-volatile oil, the release rate of the drug from microspheres was faster in all cases tested, except the microspheres containing mineral oil. The solubility of the drug in the non-volatile oil affected the release profiles of the drugs. The non-volatile oil tends to decrease the glass transition temperature of prepared microspheres and change the release profile. The internal morphology of the microspheres was slightly different depending on the entrapped oil phase used. Tiny spherical objects were present at the inner surface of microspheres and the inside of the shell.

  18. Detection of adulteration in mulberry pekmez samples added various sugar syrups with ¹³C/¹²C isotope ratio analysis method.

    PubMed

    Tosun, Murat

    2014-12-15

    Mulberry pekmez can be adulterated in different ways either during the production process or after production is completed. To identify these adulterations, stable carbon isotope ratio analysis (SCIRA) was performed on the model examples prepared by adding saccharose syrup (SS), glucose syrup (GS) and high fructose corn syrup (HFCS) into two different pure mulberry pekmez samples in the ratios of 0%, 10%, 30% and 50%. The δ(13)C ratio of the pure mulberry pekmez was determined as -26.60‰ on average, the saccharose syrup as -24.80‰, the glucose syrup as -11.20‰ and the high-fructose corn syrup as -11.40‰. In identifying the adulteration made to pekmez, especially with the high-fructose corn syrup, which is obtained from corn starch, and with the glucose syrup, the δ(13)C ratio comes into prominence. However it remains impossible identify the adulterations made with the saccharose, which is obtained from beet sugar, or invert sugar syrups.

  19. Methods of imparting information to patients in dental practice.

    PubMed

    Hein, W

    1984-03-01

    Changes are taking place in dentistry now that we know much more about the causes of caries, periodontal disease and most jaw malformations and that, through education and motivation, our patients can substantially protect themselves from these disorders. In our specialty in particular, it is true that 'prevention is better than cure'! This approach will be successful only if our patients are monitored on a regular recall basis. Attention is drawn to the existence of specific target groups. Successful results can only be achieved if individual efforts are backed by group and population prophylactic measures on the part of national or local authorities using the expertise of the dental profession. A preventively orientated practice must offer much more patient education than one which concentrates on the provision of curative services. Details of the approach to be followed should be thoroughly planned and the members of the dental team to be responsible for the tasks concerned should be identified. Appropriate equipment and working facilities are essential for the effective conduct of preventive measures. It must be emphasized that these measures in dental practice involve high costs. In attending to our patients, we should not forget that not only practical intervention but also the provision of advice is a vitally important health service.

  20. Development and Content Validation of the Information Assessment Method for Patients and Consumers

    PubMed Central

    Bartlett, Gillian; Grad, Roland M; Tang, David L; Johnson-Lafleur, Janique; Shulha, Michael; Barbosa Galvão, Maria Cristiane; Ricarte, Ivan LM; Stephenson, Randolph; Shohet, Linda; Hutsul, Jo-Anne; Repchinsky, Carol A; Rosenberg, Ellen; Burnand, Bernard; Légaré, France; Dunikowski, Lynn; Murray, Susan; Boruff, Jill; Frati, Francesca; Kloda, Lorie; Macaulay, Ann; Lagarde, François; Doray, Geneviève

    2014-01-01

    Background Online consumer health information addresses health problems, self-care, disease prevention, and health care services and is intended for the general public. Using this information, people can improve their knowledge, participation in health decision-making, and health. However, there are no comprehensive instruments to evaluate the value of health information from a consumer perspective. Objective We collaborated with information providers to develop and validate the Information Assessment Method for all (IAM4all) that can be used to collect feedback from information consumers (including patients), and to enable a two-way knowledge translation between information providers and consumers. Methods Content validation steps were followed to develop the IAM4all questionnaire. The first version was based on a theoretical framework from information science, a critical literature review and prior work. Then, 16 laypersons were interviewed on their experience with online health information and specifically their impression of the IAM4all questionnaire. Based on the summaries and interpretations of interviews, questionnaire items were revised, added, and excluded, thus creating the second version of the questionnaire. Subsequently, a panel of 12 information specialists and 8 health researchers participated in an online survey to rate each questionnaire item for relevance, clarity, representativeness, and specificity. The result of this expert panel contributed to the third, current, version of the questionnaire. Results The current version of the IAM4all questionnaire is structured by four levels of outcomes of information seeking/receiving: situational relevance, cognitive impact, information use, and health benefits. Following the interviews and the expert panel survey, 9 questionnaire items were confirmed as relevant, clear, representative, and specific. To improve readability and accessibility for users with a lower level of literacy, 19 items were reworded

  1. EXTENSION OF THE INVERSE ADDING-DOUBLING METHOD TO THE MEASUREMENT OF WAVELENGTH-DEPENDENT ABSORPTION AND SCATTERING COEFFICIENTS OF BIOLOGICAL SAMPLES

    SciTech Connect

    Allegood, M.S.; Baba, J.S.

    2008-01-01

    Light interaction with biological tissue can be described using three parameters: the scattering and absorption coeffi cients (μs and μa), as well as the anisotropy (g) which describes the directional dependence of the scattered photons. Accurately determining these optical properties for different tissue types at specifi c wavelengths simultaneously would be benefi cial for a variety of different biomedical applications. The goal of this project was to take a user defi ned g-value and determine the remaining two parameters for a specifi ed wavelength range. A fully automated computer program and process was developed to collect data for all wavelengths in a timely and accurate manner. LabVIEW® was used to write programs to automate raw intensity data collection from a spectrometer equipped integrating sphere, conversion of the data into a format for analysis via Scott Prahl’s Inverse Adding-Doubling (IAD) C code execution, and fi nally computation of the optical properties based on the output from the IAD code. To allow data to be passed effi ciently between LabVIEW® and C code program modules, the two were combined into a single program (OPT 3.1). OPT 3.1 was tested using tissue mimicking phantoms. Determination of the absorption and scattering coeffi cients showed excellent agreement with theory for wavelengths where the user inputted single g-value was suffi ciently precise. Future improvements entail providing for multi-wavelength g-value entry to extend the accuracy of results to encompass the complete multispectral range. Ultimately, the data collection process and algorithms developed through this effort will be used to examine actual biological tissues for the purpose of building and refi ning models for light-tissue interactions.

  2. Evaluation of dysphagia in early stroke patients by bedside, endoscopic, and electrophysiological methods.

    PubMed

    Umay, Ebru Karaca; Unlu, Ece; Saylam, Guleser Kılıc; Cakci, Aytul; Korkmaz, Hakan

    2013-09-01

    We aimed in this study to evaluate dysphagia in early stroke patients using a bedside screening test and flexible fiberoptic endoscopic evaluation of swallowing (FFEES) and electrophysiological evaluation (EE) methods and to compare the effectiveness of these methods. Twenty-four patients who were hospitalized in our clinic within the first 3 months after stroke were included in this study. Patients were evaluated using a bedside screening test [including bedside dysphagia score (BDS), neurological examination dysphagia score (NEDS), and total dysphagia score (TDS)] and FFEES and EE methods. Patients were divided into normal-swallowing and dysphagia groups according to the results of the evaluation methods. Patients with dysphagia as determined by any of these methods were compared to the patients with normal swallowing based on the results of the other two methods. Based on the results of our study, a high BDS was positively correlated with dysphagia identified by FFEES and EE methods. Moreover, the FFEES and EE methods were positively correlated. There was no significant correlation between NEDS and TDS levels and either EE or FFEES method. Bedside screening tests should be used mainly as an initial screening test; then FFEES and EE methods should be combined in patients who show risks. This diagnostic algorithm may provide a practical and fast solution for selected stroke patients.

  3. An efficient steganography method for hiding patient confidential information.

    PubMed

    Al-Dmour, Hayat; Al-Ani, Ahmed; Nguyen, Hung

    2014-01-01

    This paper deals with the important issue of security and confidentiality of patient information when exchanging or storing medical images. Steganography has recently been viewed as an alternative or complement to cryptography, as existing cryptographic systems are not perfect due to their vulnerability to certain types of attack. We propose in this paper a new steganography algorithm for hiding patient confidential information. It utilizes Pixel Value Differencing (PVD) to identify contrast regions in the image and a Hamming code that embeds 3 secret message bits into 4 bits of the cover image. In order to preserve the content of the region of interest (ROI), the embedding is only performed using the Region of Non-Interest (RONI).

  4. An efficient steganography method for hiding patient confidential information.

    PubMed

    Al-Dmour, Hayat; Al-Ani, Ahmed; Nguyen, Hung

    2014-01-01

    This paper deals with the important issue of security and confidentiality of patient information when exchanging or storing medical images. Steganography has recently been viewed as an alternative or complement to cryptography, as existing cryptographic systems are not perfect due to their vulnerability to certain types of attack. We propose in this paper a new steganography algorithm for hiding patient confidential information. It utilizes Pixel Value Differencing (PVD) to identify contrast regions in the image and a Hamming code that embeds 3 secret message bits into 4 bits of the cover image. In order to preserve the content of the region of interest (ROI), the embedding is only performed using the Region of Non-Interest (RONI). PMID:25569937

  5. Feasibility and Acceptability of the Informant AD8 for Cognitive Screening in Primary Healthcare: A Pilot Study

    PubMed Central

    Dong, YanHong; Tsou, Keith Yu Kei; Chen, Christopher Li-Hsian

    2014-01-01

    Objectives. The utility of informant AD8 for case finding of cognitive impairment at primary healthcare settings is unknown and therefore its feasibility and acceptability for targeted screening at a primary healthcare clinic should be investigated. Methods. The informants of older adult patients attending a primary healthcare clinic in Singapore were administered the AD8. Positive screening findings were provided to patients' primary care physicians for referrals to specialist memory clinics. The acceptability of AD8 was evaluated by collecting feedbacks from the informants and primary care physicians. Results. 205 patients and their informants were recruited. However, 6 (2.9%) informants were uncontactable, while the majority of the remaining 199 patients with completed AD8 (96.5%, n = 192) found it acceptable where 59 (29.6%) patients were deemed cognitively impaired (AD8 ≥ 2). Clinicians (100%, n = 5) found the AD8 helpful in facilitating referrals to memory clinics. However, most referral recommendations (81.4%, n = 48) were declined by patients and/or informant due to limited insight of implications of cognitive impairment. Conclusions. The AD8 can be easily administered and is well tolerated. It detected cognitive impairment in one-third of older adult patients and therefore may be useful for case finding of cognitive impairment in the primary healthcare. PMID:25548780

  6. Superradiance instability of small rotating AdS black holes in arbitrary dimensions

    NASA Astrophysics Data System (ADS)

    Delice, Ã.-zgür; Durǧut, Türküler

    2015-07-01

    We investigate the stability of D dimensional singly rotating Myers-Perry-AdS black holes under superradiance against scalar field perturbations. It is well known that small four dimensional rotating or charged Anti-de Sitter (AdS) black holes are unstable against superradiance instability of a scalar field. Recent works extended the existence of this instability to five dimensional rotating charged AdS black holes or static charged AdS black holes in arbitrary dimensions. In this paper we analytically prove that rotating small AdS black holes in arbitrary dimensions also shows superradiance instability irrespective of the value of the (positive) angular momentum quantum number. To do this we solve the Klein-Gordon equation in the slow rotation, low frequency limit. By using the asymptotic matching technique, we are able to calculate the real and imaginary parts of the correction terms to the frequency of the scalar field due to the presence of the black hole, confirming the presence of superradiance instability. We see that, unlike in the case of static AdS black holes, the analytical method is valid for rotating AdS black holes for any value of angular momentum number and spacetime dimensions. For comparison we derive the corresponding correction terms for Myers-Perry black holes in the black hole bomb formalism in the Appendix and see that the results are in agreement.

  7. Psychological Evaluations of Patients Operated for Idiopathic Scoliosis by the Harrington Method.

    ERIC Educational Resources Information Center

    Orvomaa, E.

    1998-01-01

    A study of 204 patients operated on for idiopathic scoliosis by the Harrington method between 1970 and 1975 found that patients were content with their lives, tended to form families later in life, and had fewer sexual relationships. The patients felt their illness had mostly influenced their participation in work and in physical activities.…

  8. Comparison of Two Educational Methods on Nurses' Adoption of Safe Patient Handling Techniques

    ERIC Educational Resources Information Center

    Folami, Florence

    2010-01-01

    Musculoskeletal injuries caused by patient lifting and transfers are a concern to health care workers. The Safe Patient Handling Act calls for all health care organizations to move to mechanical assistance from previous manual methods of transfers. This research analyzed two different educational programs that addressed safe patient handling for…

  9. What Value "Value Added"?

    ERIC Educational Resources Information Center

    Richards, Andrew

    2015-01-01

    Two quantitative measures of school performance are currently used, the average points score (APS) at Key Stage 2 and value-added (VA), which measures the rate of academic improvement between Key Stage 1 and 2. These figures are used by parents and the Office for Standards in Education to make judgements and comparisons. However, simple…

  10. Fibers comprised of epitaxially grown single-wall carbon nanotubes, and a method for added catalyst and continuous growth at the tip

    DOEpatents

    Kittrell, W. Carter; Wang, Yuhuang; Kim, Myung Jong; Hauge, Robert H.; Smalley, Richard E.; Marek leg, Irene Morin

    2010-06-01

    The present invention is directed to fibers of epitaxially grown single-wall carbon nanotubes (SWNTs) and methods of making same. Such methods generally comprise the steps of: (a) providing a spun SWNT fiber; (b) cutting the fiber substantially perpendicular to the fiber axis to yield a cut fiber; (c) etching the cut fiber at its end with a plasma to yield an etched cut fiber; (d) depositing metal catalyst on the etched cut fiber end to form a continuous SWNT fiber precursor; and (e) introducing feedstock gases under SWNT growth conditions to grow the continuous SWNT fiber precursor into a continuous SWNT fiber.

  11. Introducing ADS Labs

    NASA Astrophysics Data System (ADS)

    Accomazzi, Alberto; Henneken, E.; Grant, C. S.; Kurtz, M. J.; Di Milia, G.; Luker, J.; Thompson, D. M.; Bohlen, E.; Murray, S. S.

    2011-05-01

    ADS Labs is a platform that ADS is introducing in order to test and receive feedback from the community on new technologies and prototype services. Currently, ADS Labs features a new interface for abstract searches, faceted filtering of results, visualization of co-authorship networks, article-level recommendations, and a full-text search service. The streamlined abstract search interface provides a simple, one-box search with options for ranking results based on a paper relevancy, freshness, number of citations, and downloads. In addition, it provides advanced rankings based on collaborative filtering techniques. The faceted filtering interface allows users to narrow search results based on a particular property or set of properties ("facets"), allowing users to manage large lists and explore the relationship between them. For any set or sub-set of records, the co-authorship network can be visualized in an interactive way, offering a view of the distribution of contributors and their inter-relationships. This provides an immediate way to detect groups and collaborations involved in a particular research field. For a majority of papers in Astronomy, our new interface will provide a list of related articles of potential interest. The recommendations are based on a number of factors, including text similarity, citations, and co-readership information. The new full-text search interface allows users to find all instances of particular words or phrases in the body of the articles in our full-text archive. This includes all of the scanned literature in ADS as well as a select portion of the current astronomical literature, including ApJ, ApJS, AJ, MNRAS, PASP, A&A, and soon additional content from Springer journals. Fulltext search results include a list of the matching papers as well as a list of "snippets" of text highlighting the context in which the search terms were found. ADS Labs is available at http://adslabs.org

  12. [Patients on the move: validated methods to quantify physical activity].

    PubMed

    Bakker, Esmée A; Eijsvogels, Thijs M H; de Vegt, Femmie; Busser, Guus S F; Hopman, Maria T E; Verbeek, André L M

    2015-01-01

    Physical activity is an important component in the maintenance and improvement of general health; physical inactivity is, however, an increasing problem in the Netherlands. Requests for advice on physical activity are increasing within the healthcare. Assessment of an individual's physical activity pattern is required to provide tailored advice. There are a number of methods for measuring physical activity; these are divided into subjective and objective methods. Subjective measures include physical activity questionnaires and diaries. Objective measures include indirect calorimetry, measurement with doubly labelled water, heart-rate monitoring and the use of an accelerometer or pedometer. The choice of method depends predominantly on the aim of the measurement, and the availability of personnel, time and financial resources. In clinical practice a validated questionnaire is usually the preferred method, but when measuring effects this should be combined with an objective measurement instrument.

  13. A noninflammatory immune response in aged DNA Aβ42-immunized mice supports its safety for possible use as immunotherapy in AD patients.

    PubMed

    Lambracht-Washington, Doris; Rosenberg, Roger N

    2015-03-01

    Aging in the immune system results in tendency to proinflammatory responses. Intradermal DNA immunization showed Th2 polarized noninflammatory immune responses. We tested here 18-month-old mice which were immunized with Aβ42 peptide, DNA Aβ42 trimer, or 2 different prime boost protocols identical to previous experiments. High Aβ42 antibody levels were found in aged mice which had received peptide immunizations (900 μg/mL plasma), and in mice which had received peptide prime and DNA boost immunizations (500 μg/mL), compared with antibodies in DNA Aβ42 immunized mice with 50 μg/mL. Although we found T-cell proliferation and inflammatory cytokines in mice which had received peptide or prime boost immunization, these were not found in DNA-immunized mice. The results are concordant with proinflammatory responses because of immunosenescence and contraindicate the use of Aβ42 peptide immunizations or prime boost immunization protocols for the use in elderly Alzheimer's disease patients. DNA Aβ42 immunization only on the other hand does lead to effective levels of antibodies without inflammatory cytokine or T-cell responses in the aged animal model tested. PMID:25725942

  14. A noninflammatory immune response in aged DNA Aβ42-immunized mice supports its safety for possible use as immunotherapy in AD patients.

    PubMed

    Lambracht-Washington, Doris; Rosenberg, Roger N

    2015-03-01

    Aging in the immune system results in tendency to proinflammatory responses. Intradermal DNA immunization showed Th2 polarized noninflammatory immune responses. We tested here 18-month-old mice which were immunized with Aβ42 peptide, DNA Aβ42 trimer, or 2 different prime boost protocols identical to previous experiments. High Aβ42 antibody levels were found in aged mice which had received peptide immunizations (900 μg/mL plasma), and in mice which had received peptide prime and DNA boost immunizations (500 μg/mL), compared with antibodies in DNA Aβ42 immunized mice with 50 μg/mL. Although we found T-cell proliferation and inflammatory cytokines in mice which had received peptide or prime boost immunization, these were not found in DNA-immunized mice. The results are concordant with proinflammatory responses because of immunosenescence and contraindicate the use of Aβ42 peptide immunizations or prime boost immunization protocols for the use in elderly Alzheimer's disease patients. DNA Aβ42 immunization only on the other hand does lead to effective levels of antibodies without inflammatory cytokine or T-cell responses in the aged animal model tested.

  15. Simple methods to reduce patient exposure during scoliosis radiography

    SciTech Connect

    Butler, P.F.; Thomas, A.W.; Thompson, W.E.; Wollerton, M.A.; Rachlin, J.A.

    1986-05-01

    Radiation exposure to the breasts of adolescent females can be reduced significantly through the use of one or all of the following methods: fast, rare-earth screen-film combinations; specially designed compensating filters; and breast shielding. The importance of exposure reduction during scoliosis radiography as well as further details on the above described methods are discussed. In addition, the early results of a Center for Devices and Radiological Health study, which recorded exposure and technique data for scoliosis radiography, is presented.

  16. “A Baby Was an Added Burden”: Predictors and Consequences of Unintended Pregnancies for Female Sex Workers in Mombasa, Kenya: A Mixed-Methods Study

    PubMed Central

    Luchters, Stanley; Bosire, Wilkister; Feng, Amy; Richter, Marlise L.; King’ola, Nzioki; Ampt, Frances; Temmerman, Marleen; Chersich, Matthew F.

    2016-01-01

    Introduction Female sex workers (FSW) have high rates of unintended pregnancy, sexually transmitted infections including HIV, and other adverse sexual and reproductive health outcomes. Few services for FSWs include contraception. This mixed-methods study aimed to determine the rate, predictors and consequences of unintended pregnancy among FSWs in Mombasa, Kenya. Methods A prospective cohort study of non-pregnant FSWs was conducted. Quantitative data were collected quarterly, including a structured questionnaire and testing for pregnancy and HIV. Predictors of unintended pregnancy were investigated using multivariate logistic regression. Qualitative data were gathered through focus group discussions and in-depth interviews with FSWs who became pregnant during the study, and interviews with five key informants. These data were transcribed, translated and analysed thematically. Results Four hundred women were enrolled, with 92% remaining in the cohort after one year. Fifty-seven percent reported using a modern contraceptive method (including condoms when used consistently). Over one-third (36%) of women were using condoms inconsistently without another method. Twenty-four percent had an unintended pregnancy during the study. Younger age, having an emotional partner and using traditional or no contraception, or condoms only, were independent predictors of unintended pregnancy. Women attributed pregnancy to forgetting to use contraception and being pressured not to by clients and emotional partners, as well as “bad luck”. They described numerous negative consequences of unintended pregnancy. Conclusion Modern contraceptive uptake is surprisingly low in this at-risk population, which in turn has a high rate of unintended pregnancy. The latter may result in financial hardship, social stigma, risk of abandonment, or dangerous abortion practices. FSWs face considerable barriers to the adoption of dual method contraceptive use, including low levels of control in their

  17. Physical therapy methods in the treatment and rehabilitation of cancer patients

    NASA Astrophysics Data System (ADS)

    Kucherova, T. Ya.; Velikaya, V. V.; Gribova, O. V.; Startseva, Zh. A.; Choinzonov, E. L.; Tuzikov, S. A.; Vusik, M. V.; Doroshenko, A. V.

    2016-08-01

    The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.

  18. Relative efficacy for radiation reducing methods in scoliotic patients

    SciTech Connect

    Aikenhead, J.; Triano, J.; Baker, J. )

    1989-08-01

    Radiation dosages to sensitive organs in full spine radiography have in recent years been a concern of physicians as well as the general public. The spine is the prime target for exposure in scoliosis radiography, though the exposure usually necessitates irradiation of several radio-sensitive organs. In recent studies, various protection techniques have been used including various lead and aluminum filtration systems, altered patient positioning and varied tube-film distances. The purpose of this study was to evaluate the efficiency for radiation dosage reduction of three filtration systems used frequently in the chiropractic profession. The systems tested were the Nolan Multiple X-ray Filters, the Clear-Pb system and the Sportelli Wedge system. These systems were tested in seven configurations varying breast shielding, distance and patient positioning. All systems tested demonstrated significant radiation reductions to organs, especially breast tissue. The Clear-Pb system appeared to be the most effective for all organs except the breast, and the Sportelli Wedge system demonstrated the greatest reduction to breast tissue.

  19. The forecaster's added value

    NASA Astrophysics Data System (ADS)

    Turco, M.; Milelli, M.

    2009-09-01

    To the authors' knowledge there are relatively few studies that try to answer this topic: "Are humans able to add value to computer-generated forecasts and warnings ?". Moreover, the answers are not always positive. In particular some postprocessing method is competitive or superior to human forecast (see for instance Baars et al., 2005, Charba et al., 2002, Doswell C., 2003, Roebber et al., 1996, Sanders F., 1986). Within the alert system of ARPA Piemonte it is possible to study in an objective manner if the human forecaster is able to add value with respect to computer-generated forecasts. Every day the meteorology group of the Centro Funzionale of Regione Piemonte produces the HQPF (Human QPF) in terms of an areal average for each of the 13 regional warning areas, which have been created according to meteo-hydrological criteria. This allows the decision makers to produce an evaluation of the expected effects by comparing these HQPFs with predefined rainfall thresholds. Another important ingredient in this study is the very dense non-GTS network of rain gauges available that makes possible a high resolution verification. In this context the most useful verification approach is the measure of the QPF and HQPF skills by first converting precipitation expressed as continuous amounts into ‘‘exceedance'' categories (yes-no statements indicating whether precipitation equals or exceeds selected thresholds) and then computing the performances for each threshold. In particular in this work we compare the performances of the latest three years of QPF derived from two meteorological models COSMO-I7 (the Italian version of the COSMO Model, a mesoscale model developed in the framework of the COSMO Consortium) and IFS (the ECMWF global model) with the HQPF. In this analysis it is possible to introduce the hypothesis test developed by Hamill (1999), in which a confidence interval is calculated with the bootstrap method in order to establish the real difference between the

  20. Holography beyond conformal invariance and AdS isometry?

    SciTech Connect

    Barvinsky, A. O.

    2015-03-15

    We suggest that the principle of holographic duality be extended beyond conformal invariance and AdS isometry. Such an extension is based on a special relation between functional determinants of the operators acting in the bulk and on its boundary, provided that the boundary operator represents the inverse propagators of the theory induced on the boundary by the Dirichlet boundary value problem in the bulk spacetime. This relation holds for operators of a general spin-tensor structure on generic manifolds with boundaries irrespective of their background geometry and conformal invariance, and it apparently underlies numerous O(N{sup 0}) tests of the AdS/CFT correspondence, based on direct calculation of the bulk and boundary partition functions, Casimir energies, and conformal anomalies. The generalized holographic duality is discussed within the concept of the “double-trace” deformation of the boundary theory, which is responsible in the case of large-N CFT coupled to the tower of higher-spin gauge fields for the renormalization group flow between infrared and ultraviolet fixed points. Potential extension of this method beyond the one-loop order is also briefly discussed.

  1. Methods to reduce prescribing errors in elderly patients with multimorbidity.

    PubMed

    Lavan, Amanda H; Gallagher, Paul F; O'Mahony, Denis

    2016-01-01

    The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribing errors in this patient population are multifaceted and complex, including prescribers' lack of knowledge of aging physiology, geriatric medicine, and geriatric pharmacotherapy, overprescribing that frequently leads to major polypharmacy, inappropriate prescribing, and inappropriate drug omission. This review examines the various ways of minimizing prescribing errors in multimorbid older people. The role of education in physician prescribers and clinical pharmacists, the use of implicit and explicit prescribing criteria designed to improve medication appropriateness in older people, and the application of information and communication-technology systems to minimize errors are discussed in detail. Although evidence to support any single intervention to prevent prescribing errors in multimorbid elderly people is inconclusive or lacking, published data support focused prescriber education in geriatric pharmacotherapy, routine application of STOPP/START (screening tool of older people's prescriptions/screening tool to alert to right treatment) criteria for potentially inappropriate prescribing, electronic prescribing, and close liaison between clinical pharmacists and physicians in relation to structured medication review and reconciliation. Carrying out a structured medication review aimed at optimizing pharmacotherapy in this vulnerable patient population presents a major challenge. Another challenge is to design, build, validate, and test by clinical trials suitably versatile and efficient software engines that can reliably and swiftly perform complex medication reviews in

  2. Methods to reduce prescribing errors in elderly patients with multimorbidity.

    PubMed

    Lavan, Amanda H; Gallagher, Paul F; O'Mahony, Denis

    2016-01-01

    The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribing errors in this patient population are multifaceted and complex, including prescribers' lack of knowledge of aging physiology, geriatric medicine, and geriatric pharmacotherapy, overprescribing that frequently leads to major polypharmacy, inappropriate prescribing, and inappropriate drug omission. This review examines the various ways of minimizing prescribing errors in multimorbid older people. The role of education in physician prescribers and clinical pharmacists, the use of implicit and explicit prescribing criteria designed to improve medication appropriateness in older people, and the application of information and communication-technology systems to minimize errors are discussed in detail. Although evidence to support any single intervention to prevent prescribing errors in multimorbid elderly people is inconclusive or lacking, published data support focused prescriber education in geriatric pharmacotherapy, routine application of STOPP/START (screening tool of older people's prescriptions/screening tool to alert to right treatment) criteria for potentially inappropriate prescribing, electronic prescribing, and close liaison between clinical pharmacists and physicians in relation to structured medication review and reconciliation. Carrying out a structured medication review aimed at optimizing pharmacotherapy in this vulnerable patient population presents a major challenge. Another challenge is to design, build, validate, and test by clinical trials suitably versatile and efficient software engines that can reliably and swiftly perform complex medication reviews in

  3. Methods to reduce prescribing errors in elderly patients with multimorbidity

    PubMed Central

    Lavan, Amanda H; Gallagher, Paul F; O’Mahony, Denis

    2016-01-01

    The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribing errors in this patient population are multifaceted and complex, including prescribers’ lack of knowledge of aging physiology, geriatric medicine, and geriatric pharmacotherapy, overprescribing that frequently leads to major polypharmacy, inappropriate prescribing, and inappropriate drug omission. This review examines the various ways of minimizing prescribing errors in multimorbid older people. The role of education in physician prescribers and clinical pharmacists, the use of implicit and explicit prescribing criteria designed to improve medication appropriateness in older people, and the application of information and communication-technology systems to minimize errors are discussed in detail. Although evidence to support any single intervention to prevent prescribing errors in multimorbid elderly people is inconclusive or lacking, published data support focused prescriber education in geriatric pharmacotherapy, routine application of STOPP/START (screening tool of older people’s prescriptions/screening tool to alert to right treatment) criteria for potentially inappropriate prescribing, electronic prescribing, and close liaison between clinical pharmacists and physicians in relation to structured medication review and reconciliation. Carrying out a structured medication review aimed at optimizing pharmacotherapy in this vulnerable patient population presents a major challenge. Another challenge is to design, build, validate, and test by clinical trials suitably versatile and efficient software engines that can reliably and swiftly perform complex medication reviews

  4. Two administration methods for inhaled salbutamol in intubated patients

    PubMed Central

    Garner, S; Wiest, D; Bradley, J; Habib, D

    2002-01-01

    Aims: To compare serum concentrations and effects on respiratory mechanics and haemodynamics of salbutamol administered by small volume nebuliser (SVN) and metered dose inhaler (MDI) plus spacer. Methods: Blinded, randomised, crossover study in 12 intubated infants and children (mean age 17.8 months) receiving inhaled salbutamol therapy. Subjects received salbutamol as 0.15 mg/kg by SVN and four puffs (400 µg) by MDI plus spacer at a four hour interval in random order. Passive respiratory mechanics were measured by a single breath/single occlusion technique, and serum salbutamol concentrations by liquid chromatography–mass spectrometry at 30 minutes, 1, 2, and 4 hours after each dose. Haemodynamics (heart rate and blood pressure) were recorded at each measurement time. Results: There was no difference in percentage change in respiratory mechanics or haemodynamics between the two methods of administration. Mean area under the curve (AUC0–4) was 5.86 for MDI plus spacer versus 4.93 ng/ml x h for SVN. Conclusions: Serum concentrations and effects on respiratory mechanics and haemodynamics of salbutamol were comparable with the two administration methods under the conditions studied. Future studies are needed to determine the most effective and safe combination of dose and administration method of inhaled salbutamol in mechanically ventilated infants and children. PMID:12089124

  5. Efficacy and safety of ezetimibe added on to atorvastatin (40 mg) compared with uptitration of atorvastatin (to 80 mg) in hypercholesterolemic patients at high risk of coronary heart disease.

    PubMed

    Leiter, Lawrence A; Bays, Harold; Conard, Scott; Bird, Steven; Rubino, Joseph; Hanson, Mary E; Tomassini, Joanne E; Tershakovec, Andrew M

    2008-12-01

    The percentage of change from baseline in low-density lipoprotein (LDL) cholesterol after the addition of ezetimibe 10 mg to atorvastatin 40 mg was compared with uptitration to atorvastatin 80 mg. In this multicenter, double-blind, parallel-group study, adult hypercholesterolemic patients using atorvastatin 40 mg/day were randomly assigned to atorvastatin 40 mg plus ezetimibe 10 mg or uptitration to atorvastatin 80 mg. After 6 weeks of treatment, compared with atorvastatin 80 mg, atorvastatin 40 mg plus ezetimibe significantly reduced the primary end point of LDL cholesterol by -27% versus atorvastatin 80 mg by -11% (p <0.001), as well as significantly reduced non-high-density lipoprotein cholesterol, apolipoprotein B, total cholesterol, and triglycerides significantly more than atorvastatin 80 mg (all p <0.001). Percentages of change in high-sensitivity C-reactive protein, high-density lipoprotein cholesterol, and apolipoprotein A-I were similar between groups. Significantly more patients treated with atorvastatin 40 mg plus ezetimibe reached LDL cholesterol <70 mg/dl versus patients treated with atorvastatin 80 mg (74% vs 32%; p <0.001). Safety and tolerability profiles and incidence of liver and muscle adverse experiences were generally similar between groups. In conclusion, these results showed that adding ezetimibe to atorvastatin 40 mg was significantly more effective than uptitrating to atorvastatin 80 mg at lowering LDL cholesterol and other lipid parameters. Both treatments were generally well tolerated (clinical trial no. NCT00276484).

  6. A Method for Analyzing Therapist Interventions in the Psychotherapy of Borderline Patients

    PubMed Central

    KOENIGSBERG, HAROLD W.; KERNBERG, OTTO F.; APPELBAUM, ANN H.; SMITH, THOMAS

    1993-01-01

    The authors developed a method for studying the therapist’s use of technique in responding to specific patient themes during treatment of patients with borderline personality disorder. This method can monitor the use of expressive and supportive techniques as well as the congruence between patients’ theme categories and the direction of the therapist’s interventions. The method was developed to monitor adherence to an operationally defined treatment approach for psychodynamic psychotherapy of borderline patients. Data are presented on interrater agreement obtained with this method and on its application to 12 psychotherapy sessions. PMID:22700136

  7. Two Virasoro symmetries in stringy warped AdS3

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

    We study three-dimensional consistent truncations of type IIB supergravity which admit warped AdS3 solutions. These theories contain subsectors that have no bulk dynamics. We show that the symplectic form for these theories, when restricted to the non-dynamical subsectors, equals the symplectic form for pure Einstein gravity in AdS3. Consequently, for each consistent choice of boundary conditions in AdS3, we can define a consistent phase space in warped AdS3 with identical conserved charges. This way, we easily obtain a Virasoro × Virasoro asymptotic symmetry algebra in warped AdS3; two different types of Virasoro × Kač-Moody symmetries are also consistent alternatives.

  8. A mixed methods evaluation of a patient care clinic located within a pharmacy school.

    PubMed

    Jorgenson, Derek J; Landry, Eric J L; Lysak, Katherine J

    2016-08-01

    Background The Medication Assessment Center is a faculty and student run patient care clinic located within the pharmacy school at the University of Saskatchewan (Canada). It was created as a novel experiential education site for pharmacy students and to provide clinical pharmacist services for complex patients who have trouble accessing services elsewhere. Objective To determine if the clinical services provided by faculty and students at the Medication Assessment Center are valuable to patients who are referred to the program. Setting The Medication Assessment Center, which is faculty and student run patient care clinic. Method Convergent mixed methods design comprised of a retrospective patient chart audit and a paper based patient experience survey. All patients who attended at least one appointment at the Medication Assessment Center between March 1, 2014 and July 31, 2015 were included in the chart audit. All new patients who were referred between April 1, 2015 and October 26, 2015 were included in the survey. Main outcome measures Recommendations made by the pharmacist and patient experience survey indicators. Results 173 patients were included in the chart audit, which found that patients were elderly (64.8 years), highly medically complex (13.8 medications and 6.5 diagnoses each), and had a large number of recommendations made by the pharmacist to adjust drug therapy (6.2 per patient). 121 questionnaires were mailed to patients with a response rate of 66.9 % (n = 81). The survey found high levels of support and satisfaction for the program, including more than half of patients (59.2 %) who reported that their health had improved as a result of the Medication Assessment Center. Conclusion The patient care and experiential education program offered by the Medication Assessment Center provides a valuable service to patients who are referred to the clinic. PMID:27166829

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

    NASA Astrophysics Data System (ADS)

    Nakadate, Hiromichi; Sekizuka, Eiichi; Minamitani, Haruyuki

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

  10. Leading Change, Adding Value.

    PubMed

    Evans, Nick

    2016-09-12

    Essential facts Leading Change, Adding Value is NHS England's new nursing and midwifery framework. It is designed to build on Compassion in Practice (CiP), which was published 3 years ago and set out the 6Cs: compassion, care, commitment, courage, competence and communication. CiP established the values at the heart of nursing and midwifery, while the new framework sets out how staff can help transform the health and care sectors to meet the aims of the NHS England's Five Year Forward View. PMID:27615573

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    2014-01-01

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

  13. Adding More Junior Residents May Worsen Emergency Department Crowding

    PubMed Central

    Kawano, Takahisa; Nishiyama, Kei; Hayashi, Hiroyuki

    2014-01-01

    Background Although increasing staff numbers during shifts when emergency department (ED) crowding is severe can help meet patient demand, it remains unclear how different types of added staff, particularly junior residents, may affect crowding. Methods To identify associations between types of staff and ED crowding, we conducted a cross-sectional, single-center study in the ED of a large, teaching hospital in Japan between January and December 2012. Patients who visited the ED during the study period were enrolled. We excluded (1) patients previously scheduled to visit the ED, and (2) neonates transferred from other hospitals. During the study period, 27,970 patients were enrolled. Types of staff analyzed were junior (first and second year) residents, senior (third to fifth year) residents, attending (board-certified) physicians, and nurses. A generalized linear model was applied to length of ED stay for all patients as well as admitted and discharged patients to quantify an association with the additional staff. Results In the model, addition of one attending physician or senior resident was associated with decreased length of ED stay for total patients by 3.88 or 1.64 minutes, respectively (95% CI, 2.20–5.56 and 0.81–2.48 minutes); while additional nursing staff had no association. Surprisingly, however, one additional junior resident was associated with prolonged length of ED stay for total patients by 0.97 minutes (95% CI 0.37–1.57 minutes) and for discharged patients by 1.01 minutes (95% CI 0.45–1.59 minutes). Conclusion Staffing adjustments aimed at alleviating ED crowding should focus on adding more senior staff during peak-volume shifts. PMID:25369063

  14. Unannounced standardized patients: a promising method of assessing patient-centered care in your health care system

    PubMed Central

    2014-01-01

    Background While unannounced standardized patients (USPs) have been used to assess physicians’ clinical skills in the ambulatory setting, they can also provide valuable information on patients’ experience of the health care setting beyond the physician encounter. This paper explores the use of USPs as a methodology for evaluating patient-centered care in the health care system. Methods USPs were trained to complete a behaviorally-anchored assessment of core dimensions of patient-centered care delivered within the clinical microsystem, including: 1) Medical assistants’ safe practices, quality of care, and responsiveness to patients; 2) ease of clinic navigation; and 3) the patient-centeredness of care provided by the physician. Descriptive data is provided on these three levels of patient-centeredness within the targeted clinical microsystem. Chi-square analyses were used to signal whether variations by teams within the clinical microsystem were likely to be due to chance or might reflect true differences in patient-centeredness of specific teams. Results Sixty USP visits to 11 Primary Care teams were performed over an eight-month period (mean 5 visits/team; range 2–8). No medical assistants reported detecting an USP during the study period. USPs found the clinic easy to navigate and that teams were functioning well in 60% of visits. In 30% to 47% of visits, the physicians could have been more patient-centered. Medical assistants’ patient safety measures were poor: patient identity was confirmed in only 5% of visits and no USPs observed medical assistants wash their hands. Quality of care was relatively high for vital signs (e.g. blood pressure, weight and height), but low for depression screening, occurring in only 15% of visits. In most visits, medical assistants greeted the patient in a timely fashion but took time to fully explain matters in less than half of the visits and rarely introduced themselves. Physicians tried to help patients navigate the

  15. Applying Multiple Methods to Comprehensively Evaluate a Patient Portal’s Effectiveness to Convey Information to Patients

    PubMed Central

    Krist, Alex H; Aycock, Rebecca A; Kreps, Gary L

    2016-01-01

    Background Patient portals have yet to achieve their full potential for enhancing health communication and improving health outcomes. Although the Patient Protection and Affordable Care Act in the United States mandates the utilization of patient portals, and usage continues to rise, their impact has not been as profound as anticipated. Objective The objective of our case study was to evaluate how well portals convey information to patients. To demonstrate how multiple methodologies could be used to evaluate and improve the design of patient-centered portals, we conducted an in-depth evaluation of an exemplar patient-centered portal designed to promote preventive care to consumers. Methods We used 31 critical incident patient interviews, 2 clinician focus groups, and a thematic content analysis to understand patients’ and clinicians’ perspectives, as well as theoretical understandings of the portal’s use. Results We gathered over 140 critical incidents, 71.8% (102/142) negative and 28.2% (40/142) positive. Positive incident categories were (1) instant medical information access, (2) clear health information, and (3) patient vigilance. Negative incident categories were (1) standardized content, (2) desire for direct communication, (3) website functionality, and (4) difficulty interpreting laboratory data. Thematic analysis of the portal’s immediacy resulted in high scores in the attributes enhances understanding (18/23, 78%), personalization (18/24, 75%), and motivates behavior (17/24, 71%), but low levels of interactivity (7/24, 29%) and engagement (2/24, 8%). Two overarching themes emerged to guide portal refinements: (1) communication can be improved with directness and interactivity and (2) perceived personalization must be greater to engage patients. Conclusions Results suggest that simple modifications, such as increased interactivity and personalized messages, can make portals customized, robust, easily accessible, and trusted information sources

  16. DIAGNOSIS OF Strongyloides stercoralis INFECTION IN IMMUNOCOMPROMISED PATIENTS BY SEROLOGICAL AND MOLECULAR METHODS

    PubMed Central

    de PAULA, Fabiana Martins; MALTA, Fernanda Mello; CORRAL, Marcelo Andreetta; MARQUES, Priscilla Duarte; GOTTARDI, Maiara; MEISEL, Dirce Mary Correia Lima; YAMASHIRO, Juliana; PINHO, João Renato Rebello; CASTILHO, Vera Lucia Pagliusi; GONÇALVES, Elenice Messias do Nascimento; GRYSCHEK, Ronaldo César Borges; CHIEFFI, Pedro Paulo

    2016-01-01

    SUMMARY Strongyloidiasis is a potentially serious infection in immunocompromised patients. Thus, the availability of sensitive and specific diagnostic methods is desirable, especially in the context of immunosuppressed patients in whom the diagnosis and treatment of strongyloidiasis is of utmost importance. In this study, serological and molecular tools were used to diagnose Strongyloides stercoralis infections in immunosuppressed patients. Serum and stool samples were obtained from 52 patients. Stool samples were first analyzed by Lutz, Rugai, and Agar plate culture methods, and then by a quantitative real time polymerase chain reaction (qPCR). Serum samples were evaluated by an enzyme-linked immunosorbent assay (ELISA) using a soluble (AS) or a membrane fractions antigen (AM) obtained from alkaline solutions of the filariform larvae of Strongyloides venezuelensis. Of the 52 immunosuppressed patients, three (5.8%) were positive for S. stercoralis by parasitological methods, compared to two patients (3.8%) and one patient (1.9%) who were detected by ELISA using the AS and the AM antigens, respectively. S. stercoralis DNA was amplified in seven (13.5%) stool samples by qPCR. These results suggest the utility of qPCR as an alternative diagnostic tool for the diagnosis of S. stercoralis infection in immunocompromised patients, considering the possible severity of this helminthiasis in this group of patients. PMID:27680168

  17. Optimal Scoring Methods of Hand-Strength Tests in Patients with Stroke

    ERIC Educational Resources Information Center

    Huang, Sheau-Ling; Hsieh, Ching-Lin; Lin, Jau-Hong; Chen, Hui-Mei

    2011-01-01

    The purpose of this study was to determine the optimal scoring methods for measuring strength of the more-affected hand in patients with stroke by examining the effect of reducing measurement errors. Three hand-strength tests of grip, palmar pinch, and lateral pinch were administered at two sessions in 56 patients with stroke. Five scoring methods…

  18. Early detection of AD using cortical thickness measurements

    NASA Astrophysics Data System (ADS)

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

    2007-03-01

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

  19. Dressing phases of AdS3/CFT2

    NASA Astrophysics Data System (ADS)

    Borsato, Riccardo; Ohlsson Sax, Olof; Sfondrini, Alessandro; Stefański, Bogdan, Jr.; Torrielli, Alessandro

    2013-09-01

    We determine the all-loop dressing phases of the AdS3/CFT2 integrable system related to type IIB string theory on AdS3×S3×T4 by solving the recently found crossing relations and studying their singularity structure. The two resulting phases present a novel structure with respect to the ones appearing in AdS5/CFT4 and AdS4/CFT3. In the strongly coupled regime, their leading order reduces to the universal Arutyunov-Frolov-Staudacher phase as expected. We also compute their subleading order and compare it with recent one-loop perturbative results and comment on their weak-coupling expansion.

  20. Bubbling geometries for AdS2× S2

    NASA Astrophysics Data System (ADS)

    Lunin, Oleg

    2015-10-01

    We construct BPS geometries describing normalizable excitations of AdS2×S2. All regular horizon-free solutions are parameterized by two harmonic functions in R 3 with sources along closed curves. This local structure is reminiscent of the "bubbling solutions" for the other AdS p ×S q cases, however, due to peculiar asymptotic properties of AdS2, one copy of R 3 does not cover the entire space, and we discuss the procedure for analytic continuation, which leads to a nontrivial topological structure of the new geometries. We also study supersymmetric brane probes on the new geometries, which represent the AdS2×S2 counterparts of the giant gravitons.

  1. Swallowing therapy with neurologic patients: results of direct and indirect therapy methods in 66 patients suffering from neurological disorders.

    PubMed

    Neumann, S

    1993-01-01

    The results of direct and indirect therapy methods applied to 66 patients suffering from neurological disorders are presented. Variables considered were age, time since lesion, localization of central nervous system lesion, type of swallowing disorder (defined according to swallowing phase, type of aspiration and degree of aspiration), cognitive deficits (memory, planning/problem-solving, and attention deficits), and duration of therapy. Success of therapy was defined by progress in type, ease, and safety of feeding and by range of diet. Therapeutic outcome was correlated with the above-listed variables. The findings suggest that swallowing therapy is effective for patients with neurological disorders.

  2. [The choice of method of treatment of patients with stones in ureteropelvic junction].

    PubMed

    Nikulina, E S; Trapeznikova, M F; Urenkov, S B; Dutov, V V; Ivanov, A E; Podoĭnitsyn, A A

    2013-01-01

    Stones located in the UPJ are accompanied by the most severe violation of the upper urinary tract urodynamics compared to other localizations of stones, which often leads to severe septic complications requiring emergency care. The study has evaluated the results of treatment of 147 patients with UPJ stones using various methods of treatment, and their efficacy in these patients. Extracorporeal shockwave lithotripsy (ESWL) was performed in 55 patients, contact ureterolithotripsy (CULT)--in 23 patients, percutaneous nephroureterolithotripsy and nephroureterolithoextraction (PCNLT and PCNLE)--in 43 patients, and open surgery (ureterolithotomy, pelviolithotomy)--in 26 patients. The best results in all parameters were obtained from patients with stone size up to 1 cm after ESWL, as well as in patients with stone size greater than 1 cm after PCNLT (PCNLE). In these groups, full discharge of stone at 3 months after treatment was achieved in 95 and 97.7% of patients, respectively. Complications in the ESWL group were recorded in 14.6% of patients, in the PCNLT (PCNLE) group--in 9.2% of patients.

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

    ERIC Educational Resources Information Center

    Welch, Mary A., Ed.

    1989-01-01

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

  4. [Proposal of a conceptual method of supportive care for co-active patients].

    PubMed

    Abidli, Yamine; Piette, Danielle; Casini, Annalisa

    2015-01-01

    There is a broad consensus on the importance for health professionals to support co-active patients. However, in practice, very few "patient care partnership" approaches have been developed. We hypothesized that the lack of investment in supporting patient care partnerships is due to the lack of interest in the skills needed by caregivers to provide such support. This paper intends to address thisgap. The patient care partnership method is studied, adapted and developed from existing models. It complements, harmonizes and integrates various schools of thought arising from the need to place the patient at the center of care and life in general. The patient care partnership method includes 7 stages during which the professional accompanies the patient through the process of care. The methodological approach for training professionals is designed to ensure that professionals experience the change as well as its difficulties of the change they expect from the patient in the care relationship. This method now needs to be validated by the experience of other professionals in order define the limits of application and to allow further development. PMID:26168615

  5. How do I measure physical activity in my patients? Questionnaires and objective methods.

    PubMed

    Ainsworth, B E

    2009-01-01

    How do healthcare providers know if their patients are getting enough physical activity to promote good health and to reduce their risks of chronic diseases and injury? The first step is to identify the patient's current level of physical activity using questionnaires and/or motion sensors. Questionnaires assess activity levels by having patients answer a set of questions about the types and amounts of activity performed at some time in the past. Motion sensors assess physical activity by patients wearing a small monitoring device that records their body movement as it occurs. If a provider is interested in determining a patient's caloric energy expenditure, he/she can apply statistical regression models to the questionnaire and motion sensor data to estimate kilocalories. If more precise measures of energy expenditure are desired, a provider can use the isotopic doubly labelled water method to estimate kilocalories; however, this method is costly and is impractical in non-research clinical settings.

  6. Preferred Method of Education Among Patients in Ophthalmic Care in Saudi Arabia

    PubMed Central

    AlHilali, Sara M.; AlMuammar, Abdulrahman M.; AlKahtani, Eman; Khandekar, Rajiv; AlJasser, Abdulrahman A.

    2016-01-01

    Purpose: Educating patients about their diagnosis and proposed management is integral part of healthcare. Often patient noncompliance is due to a lack of knowledge that could result in irreversible ocular damage. In an era where access to information is virtually unlimited, an understanding of the preferred method of eye care education among patients is required for greater effectiveness in lowering morbidity and mortality of diseases. Subjects and Methods: Patients visiting the ophthalmology clinics of a tertiary hospital in Riyadh, Saudi Arabia, were interviewed. This cross-sectional study was conducted between December 2014 and March 2015. A representative sample of 200 patients was enrolled. Close-ended questionnaire covering current and client preferred health promotion methods were used to collect clients’ response. Data were analyzed with descriptive statistics. Results: Out of the 200 participants, 110 (55%) were males. The majority (n = 154; 77%) listed an ophthalmologist as their current primary source of information regarding their eye condition. Approximately half of the participants (n = 95; 48%) were keen to be educated regarding the causes of the eye disease. The top four educational methods preferred by patients were one-on-one session with an eye care provider (n = 116; 58%), a group session with an eye care provider (n = 30; 15%), an application on a smartphone (n = 53; 27%), video lectures on eye health and diseases (n = 8; 4%). Conclusion: Majority of patients in ophthalmic care prefer a one-on-one session with an eye care provider for their eye care education. PMID:27162447

  7. Action growth for AdS black holes

    NASA Astrophysics Data System (ADS)

    Cai, Rong-Gen; Ruan, Shan-Ming; Wang, Shao-Jiang; Yang, Run-Qiu; Peng, Rong-Hui

    2016-09-01

    Recently a Complexity-Action (CA) duality conjecture has been proposed, which relates the quantum complexity of a holographic boundary state to the action of a Wheeler-DeWitt (WDW) patch in the anti-de Sitter (AdS) bulk. In this paper we further investigate the duality conjecture for stationary AdS black holes and derive some exact results for the growth rate of action within the Wheeler-DeWitt (WDW) patch at late time approximation, which is supposed to be dual to the growth rate of quantum complexity of holographic state. Based on the results from the general D-dimensional Reissner-Nordström (RN)-AdS black hole, rotating/charged Bañados-Teitelboim-Zanelli (BTZ) black hole, Kerr-AdS black hole and charged Gauss-Bonnet-AdS black hole, we present a universal formula for the action growth expressed in terms of some thermodynamical quantities associated with the outer and inner horizons of the AdS black holes. And we leave the conjecture unchanged that the stationary AdS black hole in Einstein gravity is the fastest computer in nature.

  8. A Health Website Recommendation from Gold Coast General Practitioners to Their Patients: A Mixed Method Approach

    ERIC Educational Resources Information Center

    Usher, Wayne

    2011-01-01

    Introduction: To identify health website recommendation trends by Gold Coast (Australia) general practitioners (GPs) to their patients. Method: A mixed method approach to data collection and analysis was employed. Quantitative data were collected using a prepaid postal survey, consisting of 17 questions, mailed to 250 (61 per cent) of 410 GPs on…

  9. A Method to Determine the Impact of Patient-Centered Care Interventions in Primary Care

    PubMed Central

    Daaleman, Timothy P.; Shea, Christopher M.; Halladay, Jacqueline; Reed, David

    2014-01-01

    INTRODUCTION The implementation of patient-centered care (PCC) innovations continues to be poorly understood. We used the implementation effectiveness framework to pilot a method for measuring the impact of a PCC innovation in primary care practices. METHODS We analyzed data from a prior study that assessed the implementation of an electronic geriatric quality-of-life (QOL) module in 3 primary care practices in central North Carolina in 2011–12. Patients responded to the items and the subsequent patient-provider encounter was coded using the Roter Interaction Analysis System (RIAS) system. We developed an implementation effectiveness measure specific to the QOL module (i.e., frequency of usage during the encounter) using RIAS and then tested if there were differences with RIAS codes using analysis of variance. RESULTS A total of 60 patient-provider encounters examined differences in the uptake of the QOL module (i.e., implementation-effectiveness measure) with the frequency of RIAS codes during the encounter (i.e., patient-centeredness measure). There was a significant association between the effectiveness measure and patient-centered RIAS codes. CONCLUSION The concept of implementation effectiveness provided a useful framework determine the impact of a PCC innovation. PRACTICE IMPLICATIONS A method that captures real-time interactions between patients and care staff over time can meaningfully evaluate PCC innovations. PMID:25269410

  10. Tools for measuring patient safety in primary care settings using the RAND/UCLA appropriateness method

    PubMed Central

    2014-01-01

    Background The majority of patient contacts occur in general practice but general practice patient safety has been poorly described and under-researched to date compared to hospital settings. Our objective was to produce a set of patient safety tools and indicators that can be used in general practices in any healthcare setting and develop a ‘toolkit’ of feasible patient safety measures for general practices in England. Methods A RAND/UCLA Appropriateness Method exercise was conducted with a panel of international experts in general practice patient safety. Statements were developed from an extensive systematic literature review of patient safety in general practice. We used standard RAND/UCLA Appropriateness Method rating methods to identify necessary items for assessing patient safety in general practice, framed in terms of the Structure-Process-Outcome taxonomy. Items were included in the toolkit if they received an overall panel median score of ≥7 with agreement (no more than two panel members rating the statement outside a 3-point distribution around the median). Results Of 205 identified statements, the panel rated 101 as necessary for assessing the safety of general practices. Of these 101 statements, 73 covered structures or organisational issues, 22 addressed processes and 6 focused on outcomes. Conclusions We developed and tested tools that can lead to interventions to improve safety outcomes in general practice. This paper reports the first attempt to systematically develop a patient safety toolkit for general practice, which has the potential to improve safety, cost effectiveness and patient experience, in any healthcare system. PMID:24902490

  11. Superstring theory in AdS(3) and plane waves

    NASA Astrophysics Data System (ADS)

    Son, John Sang Won

    This thesis is devoted to the study of string theory in AdS 3 and its applications to recent developments in string theory. The difficulties associated with formulating a consistent string theory in AdS3 and its underlying SL(2, R) WZW model are explained. We describe how these difficulties can be overcome by assuming that the SL(2, R) WZW model contains spectral flow symmetry. The existence of spectral flow symmetry in the fully quantum treatment is proved by a calculation of the one-loop string partition function. We consider Euclidean AdS 3 with the time direction periodically identified, and compute the torus partition function in this background. The string spectrum can be reproduced by viewing the one-loop calculation as the free energy of a gas of strings, thus providing a rigorous proof of the results based on spectral flow arguments. Next, we turn to spacetimes that are quotients of AdS 3, which include the BTZ black hole and conical spaces. Strings propagating in the conical space are described by taking an orbifold of strings in AdS3. We show that the twisted states of these orbifolds can be obtained by fractional spectral flow. We show that the shift in the ground state energy usually associated with orbifold twists is absent in this case, and offer a unified framework in which to view spectral flow. Lastly, we consider the RNS superstrings in AdS 3 x S3 x M , where M may be K3 or T 4, based on supersymmetric extensions of SL(2, R) and SU(2) WZW models. We construct the physical states and calculate the spectrum. A subsector of this theory describes strings propagating in the six dimensional plane wave obtained by the Penrose limit of AdS3 x S3 x M . We reproduce the plane wave spectrum by taking J and the radius to infinity. We show that the plane wave spectrum actually coincides with the large J spectrum at fixed radius, i.e. in AdS3 x S3. Relation to some recent topics of interest such as the Frolov-Tseytlin string and strings with critical tension

  12. A Mixed Methods Study of Patient-Provider Communication about Opioid Analgesics

    PubMed Central

    Hughes, Helen Kinsman; Korthuis, P. Todd; Saha, Somnath; Eggly, Susan; Sharp, Victoria; Cohn, Jonathan; Moore, Richard; Beach, Mary Catherine

    2015-01-01

    Objective To describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes towards patients. Methods We audio-recorded 45 HIV providers and 423 patients in routine outpatient encounters at four sites across the country. Providers completed post-visit questionnaires assessing their attitudes towards patients. We identified discussions about opioid pain management and analyzed them qualitatively. We used logistic regression to assess the association between opioid discussion and providers’ attitudes towards patients. Results 48 encounters (11% of the total sample) contained substantive discussion of opioid-related pain management. Most conversations were initiated by patients (n=28, 58%) and ended by the providers (n=36, 75%). Twelve encounters (25%) contained dialogue suggesting a difference of opinion or conflict. Providers more often agreed than disagreed to give the prescription (50% vs. 23%), sometimes reluctantly; in 27% (n=13) of encounters, no decision was made. Fewer than half of providers (n=20, 42%) acknowledged the patient’s experience of pain. Providers had a lower odds of positive regard for the patient (adjusted OR=0.51, 95%CI: 0.27–0.95) when opioids were discussed. Conclusions Pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes towards patients. Practice Implications Empathy and pain acknowledgement are tools that clinicians can use to facilitate productive discussions of pain management. PMID:25601279

  13. Adding Math to Biology.

    ERIC Educational Resources Information Center

    Texley, Juliana

    2001-01-01

    Describes a teaching method in which students learn about evolutionary biology through the use of mathematics. Uses the concept of biostatistics, the mathematical analysis of the variation in nature, to understand evolution. (SAH)

  14. Optimal scoring methods of hand-strength tests in patients with stroke.

    PubMed

    Huang, Sheau-Ling; Hsieh, Ching-Lin; Lin, Jau-Hong; Chen, Hui-Mei

    2011-06-01

    The purpose of this study was to determine the optimal scoring methods for measuring strength of the more-affected hand in patients with stroke by examining the effect of reducing measurement errors. Three hand-strength tests of grip, palmar pinch, and lateral pinch were administered at two sessions in 56 patients with stroke. Five scoring methods were used to present the strength scores. The smallest real difference was used to provide information on the measurement error. The smallest real difference percentage was used to compare the effect on minimizing the error. Using mean score of tests for nonspastic patients carried out at least twice was found to be advisable to minimize measurement errors in the grip, palmar pinch, and lateral pinch tests. However, the use of hand-strength tests for patients with spasticity is limited because of the relatively high measurement errors.

  15. Music as a method of coping with cancer: A qualitative study among cancer patients in Sweden

    PubMed Central

    Ahmadi, Fereshteh

    2013-01-01

    Background: This study investigated patients’ understanding of the role of music in coping and in influencing their well-being. Methods: A qualitative study was conducted based on semi-structured interviews with 17 cancer patients. Participants were chosen from a group of patients who had listened to or played music as a means of coping with their illness. Results: The study shows the importance of considering the roles that different kinds of music play in coping with cancer. The music of nature, healing music, religious music and cheerful music each have different benefits for patients. Conclusions: A patient's situation and his or her individual characteristics determine the types of music that can act as a useful or harmful coping strategy. Therefore, it is essential to investigate the types of individual characteristics that can make listening to different kinds of music a helpful or harmful coping method. PMID:23805166

  16. Ethylene and ammonia traces measurements from the patients' breath with renal failure via LPAS method

    NASA Astrophysics Data System (ADS)

    Popa, C.; Dutu, D. C. A.; Cernat, R.; Matei, C.; Bratu, A. M.; Banita, S.; Dumitras, D. C.

    2011-11-01

    The application of laser photoacoustic spectroscopy (LPAS) for fast and precise measurements of breath biomarkers has opened up new promises for monitoring and diagnostics in recent years, especially because breath test is a non-invasive method, safe, rapid and acceptable to patients. Our study involved assessment of breath ethylene and breath ammonia levels in patients with renal failure receiving haemodialysis (HD) treatment. Breath samples from healthy subjects and from patients with renal failure were collected using chemically inert aluminized bags and were subsequently analyzed using the LPAS technique. We have found out that the composition of exhaled breath in patients with renal failure contains not only ethylene, but also ammonia and gives valuable information for determining efficacy and endpoint of HD. Analysis of ethylene and ammonia traces from the human breath may provide insight into severity of oxidative stress and metabolic disturbances and may ensure optimal therapy and prevention of pathology at patients on continuous HD.

  17. Asymptotically AdS spacetimes with a timelike Kasner singularity

    NASA Astrophysics Data System (ADS)

    Ren, Jie

    2016-07-01

    Exact solutions to Einstein's equations for holographic models are presented and studied. The IR geometry has a timelike cousin of the Kasner singularity, which is the less generic case of the BKL (Belinski-Khalatnikov-Lifshitz) singularity, and the UV is asymptotically AdS. This solution describes a holographic RG flow between them. The solution's appearance is an interpolation between the planar AdS black hole and the AdS soliton. The causality constraint is always satisfied. The entanglement entropy and Wilson loops are discussed. The boundary condition for the current-current correlation function and the Laplacian in the IR is examined. There is no infalling wave in the IR, but instead, there is a normalizable solution in the IR. In a special case, a hyperscaling-violating geometry is obtained after a dimensional reduction.

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

    PubMed

    Jatkar, Dileep P; Sinha, Aninda

    2011-04-29

    We show that the recently proposed Dirac-Born-Infeld extension of new massive gravity emerges naturally as a counterterm in four-dimensional anti-de Sitter space (AdS(4)). The resulting on-shell Euclidean action is independent of the cutoff at zero temperature. We also find that the same choice of counterterm gives the usual area law for the AdS(4) Schwarzschild black hole entropy in a cutoff-independent manner. The parameter values of the resulting counterterm action correspond to a c=0 theory in the context of the duality between AdS(3) gravity and two-dimensional conformal field theory. We rewrite this theory in terms of the gauge field that is used to recast 3D gravity as a Chern-Simons theory. PMID:21635026

  19. Methods and Guidelines for Venous Thromboembolism Prevention in Polytrauma Patients with Pelvic and Acetabular Fractures

    PubMed Central

    Chana-Rodríguez, Francisco; Mañanes, Rubén Pérez; Rojo-Manaute, José; Haro, José Antonio Calvo; Vaquero-Martín, Javier

    2015-01-01

    Sequential compression devices and chemical prophylaxis are the standard venous thromboembolism (VTE) prevention for trauma patients with acetabular and pelvic fractures. Current chemical pharmacological contemplates the use of heparins or fondaparinux. Other anticoagulants include coumarins and aspirin, however these oral agents can be challenging to administer and may need monitoring. When contraindications to anticoagulation in high-risk patients are present, prophylactic inferior vena cava filters can be an option to prevent pulmonary emboli. Unfortunately strong evidence about the most effective method, and the timing of their commencement, in patients with pelvic and acetabular fractures remains controversial. PMID:26312115

  20. [Right ventricular function evaluated by thermodilution method in patients with chronic pulmonary diseases].

    PubMed

    Nakashima, T; Imamura, T; Shikuwa, M; Hara, K

    1991-01-01

    The right ventricular ejection fraction (RVEF) is an objective evaluation of the right ventricular systolic function. Recently a rapid-response thermister pulmonary artery catheter which measures RVEF and stroke volume (SV) was introduced. With this new method, RVEF and the right ventricular volumes (RVV) were measured in patients with chronic pulmonary diseases (CPD) and normal subjects. In addition, to evaluate the validity of this method, the data was compared with Kr81m perfusion method. The RVEF and the RVV of CPD patients were also compared with pulmonary hemodynamic data. There was a good correlation between the RVEFs obtained by the Kr81m perfusion method and the TD method. (r = 0.71, p less than 0.001). There was a tendency towards a low RVEF in patient with CPD with pulmonary hypertension (PAm greater than 20 mmHg) or high pulmonary vascular resistance (PAR greater than 160 dyne/sec/cm-5) and the RVV increased in the same group. These results suggested that the right ventricle was unable to respond to the increase of afterload in the CPD group and the evaluation of RVEF and RVV in patients with CPD using the new TD method was valuable for assessing the right ventricular function.

  1. Atlas to patient registration with brain tumor based on a mesh-free method.

    PubMed

    Diaz, Idanis; Boulanger, Pierre

    2015-08-01

    Brain atlas to patient registration in the presence of tumors is a challenging task because its presence cause brain structure deformations and introduce large intensity variation between the affected areas. This large dissimilarity affects the results of traditional registration methods based on intensity or shape similarities. In order to overcome these problems, we propose a novel method that brings closer the atlas and the patient's image by simulating the mechanical behavior of brain deformation under a tumor pressure. The proposed method use a mesh-free total Lagrangian Explicit Dynamic algorithm for the simulation of atlas deformation and a data driven model of the tumor using multi-modal MRI segmentation. Experimental results look structurally very similar to the patient's image and outperform two of the top ranking algorithms.

  2. Holography and AdS4 self-gravitating dyons

    NASA Astrophysics Data System (ADS)

    Lugo, A. R.; Moreno, E. F.; Schaposnik, F. A.

    2010-11-01

    We present a self-gravitating dyon solution of the Einstein-Yang-Mills-Higgs equations of motion in asymptotically AdS space. The back reaction of gauge and Higgs fields on the space-time geometry leads to the metric of an asymptotically AdS black hole. Using the gauge/gravity correspondence we analyze relevant properties of the finite temperature quantum field theory defined on the boundary. In particular we identify an order operator, characterize a phase transition of the dual theory on the border and also compute the expectation value of the finite temperature Wilson loop.

  3. Phases of global AdS black holes

    NASA Astrophysics Data System (ADS)

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

    2016-06-01

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

  4. A new method to analyze the subjective visual vertical in patients with bilateral vestibular dysfunction

    PubMed Central

    Funabashi, Martha; Santos-Pontelli, Taiza Elaine Grespan; Colafêmina, José Fernando; Pavan, Theo Zeferino; Carneiro, Antonio Adilton Oliveira; Takayanagui, Osvaldo Massaiti

    2012-01-01

    OBJECTIVE: The aim of this study was to assess the subjective visual vertical in patients with bilateral vestibular dysfunction and to propose a new method to analyze subjective visual vertical data in these patients. METHODS: Static subjective visual vertical tests were performed in 40 subjects split into two groups. Group A consisted of 20 healthy volunteers, and Group B consisted of 20 patients with bilateral vestibular dysfunction. Each patient performed six measurements of the subjective visual vertical test, and the mean values were calculated and analyzed. RESULTS: Analyses of the numerical values of subjective visual vertical deviations (the conventional method of analysis) showed that the mean deviation was 0.326±1.13° in Group A and 0.301±1.87° in Group B. However, by analyzing the absolute values of the subjective visual vertical (the new method of analysis proposed), the mean deviation became 1.35±0.48° in Group A and 2.152±0.93° in Group B. The difference in subjective visual vertical deviations between groups was statistically significant (p<0.05) only when the absolute values and the range of deviations were considered. CONCLUSION: An analysis of the absolute values of the subjective visual vertical more accurately reflected the visual vertical misperception in patients with bilateral vestibular dysfunction. PMID:23070337

  5. Monitoring burst suppression in critically ill patients: Multi-centric evaluation of a novel method

    PubMed Central

    Fürbass, Franz; Herta, Johannes; Koren, Johannes; Westover, M. Brandon; Hartmann, Manfred M.; Gruber, Andreas; Baumgartner, Christoph; Kluge, Tilmann

    2016-01-01

    Objective To develop a computational method to detect and quantify burst suppression patterns (BSP) in the EEGs of critical care patients. A multi-center validation study was performed to assess the detection performance of the method. Methods The fully automatic method scans the EEG for discontinuous patterns and shows detected BSP and quantitative information on a trending display in real-time. The method is designed to work without setting any patient specific parameters and to be insensitive to EEG artifacts and periodic patterns. For validation a total of 3982 h of EEG from 88 patients were analyzed from three centers. Each EEG was annotated by two reviewers to assess the detection performance and the inter-rater agreement. Results Average inter-rater agreement between pairs of reviewers was κ = 0.69. On average 22% of the review segments included BSP. An average sensitivity of 90% and a specificity of 84% were measured on the consensus annotations of two reviewers. More than 95% of the periodic patterns in the EEGs were correctly suppressed. Conclusion A fully automatic method to detect burst suppression patterns was assessed in a multi-center study. The method showed high sensitivity and specificity. Significance Clinically applicable burst suppression detection method validated in a large multi-center study. PMID:26971487

  6. Adding a Woman's Touch.

    ERIC Educational Resources Information Center

    Levine, Dana

    1985-01-01

    "Females in Engineering, Methods, Motivation, and Experience" (FEMME) is a precollege program at New Jersey Institute of Technology giving academically talented ninth-grade girls an introduction to engineering. Four experiments (windmill building, burglar alarm construction, electrochemistry, and spatial reasoning activities) helpful in achieving…

  7. Adding Confidence to Knowledge

    ERIC Educational Resources Information Center

    Goodson, Ludwika Aniela; Slater, Don; Zubovic, Yvonne

    2015-01-01

    A "knowledge survey" and a formative evaluation process led to major changes in an instructor's course and teaching methods over a 5-year period. Design of the survey incorporated several innovations, including: a) using "confidence survey" rather than "knowledge survey" as the title; b) completing an…

  8. Detection of metals and metalloproteins in the plasma of stroke patients by mass spectrometry methods.

    PubMed

    Kodali, Phanichand; Chitta, Karnakar R; Landero Figueroa, Julio A; Caruso, Joseph A; Adeoye, Opeolu

    2012-10-01

    Stroke is the leading cause of adult disability, worldwide. Metalloproteins and metals play key roles in epigenetic events in living organisms, including hypertension, the most important modifiable risk factor for stroke. Thus, metalloproteins may be important target biomarkers for disease diagnosis. The primary goal of this study was to assess metal containing proteins in blood plasma, detected by ICP-MS, followed by ESIMS for peptide/protein identification. We then compared the relative concentration differences between samples from patients with ischemic stroke, hemorrhagic stroke and stroke mimics. In 29 plasma samples (10 stroke mimics, 10 ischemic stroke and 9 hemorrhagic stroke patients) previously collected from patients who presented to the University of Cincinnati Emergency Department within 12 hours of symptom onset for a plasma banking project. For the metal associated protein study, Mg, Mn, Cu, Se concentrations were statistically different when compared between stroke mimics vs. ischemic stroke patients and ischemic stroke patients vs. hemorrhagic stroke patients. Pb concentrations were statistically different when compared between stroke mimics vs. ischemic stroke patients and Mo levels were statistically the same among the three groups. In addition, we also report concentration levels and preliminary correlation studies for total elemental analysis among the three sets of patients. This pilot study demonstrates that mass spectrometry methods may be highly valuable in detecting novel stroke biomarkers in blood plasma. Expanded studies are warranted to confirm these findings.

  9. A Mixed Methods Feasibility Trial of PKCι Inhibition with Auranofin in Asymptomatic Patients with Ovarian Cancer

    PubMed Central

    Jatoi, Aminah; Breitkopf, Carmen Radecki; Foster, Nathan R.; Block, Matthew S.; Grudem, Megan; Hendrickson, Andrea Wahner; Carlson, Rachel E.; Barrette, Brigitte; Karlin, Nina; Fields, Alan P.

    2015-01-01

    Purpose This trial was undertaken to 1) determine the feasibility of enrolling asymptomatic ovarian cancer patients with Ca-125 elevation to a trial with the PKCι inhibitor, auranofin, and 2) understand patients’ perceptions of Ca-125 monitoring. Methods Asymptomatic ovarian cancer patients with Ca-125 elevation received auranofin 3 mg orally twice/day and were evaluated. Patients participated in interviews about Ca-125 monitoring. Results Ten patients were enrolled in slightly over 6 months, exceeding our anticipated rate. Four manifested stable Ca-125 levels for 1 month or longer. The median progression-free survival was 2.8 months (95% confidence interval: 1.3, 3.8 months); auranofin was well tolerated. One patient had baseline and monthly Ca-125 levels of 5570, 6085, 3511, and 2230 units/mL, respectively, stopped auranofin because of radiographic progression at 3 months, and manifested an increase in Ca-125 to 7168 units/mL approximately 3 months later. Patient interviews revealed: 1) the important role of Ca-125 in cancer monitoring; 2) ardent advocacy for Ca-125 testing; and 3) evolution toward the Ca-125 assuming a life of its own. Conclusions This study showed feasibility; and patients favored Ca-125 monitoring. One patient had a decline in Ca-125, suggesting that PKCι inhibition merits further study in ovarian cancer. PMID:25502607

  10. A privacy challenge to longitudinal study methods: patient-derived codes.

    PubMed

    Clay, Fiona J; Ozanne-Smith, Joan; Watson, Wendy; Congiu, Melinda; Fox, Barbara

    2006-08-01

    Recent changes to privacy legislation in Australia have resulted in more stringent requirements with respect to maintaining the confidentiality of patient health information. We describe a method employed to de-identify health information collected in a longitudinal study using codes. Using a patient-derived code that did not change during the life of the study follow-up resulted in errors in a quarter of the follow-up surveys. This may introduce bias that could compromise the validity of the study. Alternative methods of coding may alleviate some of these issues. However, removal of some of the constraints imposed by interpretations of privacy legislation may be the best way forward.

  11. [NDT-Bobath method used in the rehabilitation of patients with a history of ischemic stroke].

    PubMed

    Klimkiewicz, Paulina; Kubsik, Anna; Woldańska-Okońska, Marta

    2012-01-01

    Ischemic stroke is the third leading cause of death and disability in human. The vitally important problem after ischemic stroke is hemiparesis of the body. The most common methods used in improving the mobility of patients after ischemic stroke is a Bobath-NDT (Neuro-Developmental Treatment - Bobath), which initiated the Berta and Karel Bobath for children with cerebral palsy. It is a method designed to neurophysiological recovery of these vital functions that the patient was lost due to illness, and wants it back. PMID:23289255

  12. A pilot mixed methods study of patient satisfaction with chiropractic care for back pain

    PubMed Central

    Polipnick, Judith

    2008-01-01

    Objective Patient satisfaction is important to payers, clinicians, and patients. The concept of satisfaction is multifactorial and measurement is challenging. Our objective was to explore use of a mixed-methods design to examine patient satisfaction with chiropractic care for low back pain. Methods Patients were treated 3 times per week for 3 weeks. Outcomes were collected at Week 3 and Week 4. Qualitative interviews were conducted by the treating clinician and a non-treating staff member. Outcome Measures were the Roland Morris Questionnaire (RMQ), the Visual Analog Scale (VAS), and the Patient Satisfaction Scale (PSS). Interviews were recorded and transcribed, and analyzed for themes and constructs of satisfaction. We compared qualitative interview data with quantitative outcomes, and qualitative data from 2 different interviewers. Results All patients reported high levels of satisfaction. Clinical outcomes were unremarkable with little change noted on VAS and RMQ scores. We categorized patient comments into the same constructs of satisfaction as those identified for the PSS: Quality of Care, Information, Effectiveness, and Caring. An additional construct (Quality of Care) and additional subcategories were identified. Satisfaction with care is not explained by outcome alone. The qualitative data collected from 2 different interviewers had few differences. Conclusion The results of this study suggest that it is feasible to use a mixed-method design to examine patient satisfaction. We were able to refine data collection and analysis procedures for the outcome measures and qualitative interview data. We identified limitations and offer recommendations for the next step: the implementation of a larger study. PMID:18984243

  13. Effect of 2 different anesthesia methods on stress response in neurosurgical patients with hypertension or normal

    PubMed Central

    Chen, Ying; Jiang, Shan; Wu, Yong

    2016-01-01

    Abstract Hypertensive patients in neurosurgery are becoming more common, which increased the risk of surgical stress response. Meanwhile, the relationship between hypertension and anesthesia methods is unclear on the stress response. The purpose of this study is to compare the effect of different anesthesia methods on high-sensitivity C-reactive protein (Hs-CRP), blood glucose, and leucocyte levels in neurosurgical patients with hypertension or normal. Eighty neurosurgical patients were randomly divided into 4 groups (n = 20): balanced anesthesia group (A), balanced anesthesia with hypertension group (B), total intravenous anesthesia group (C), total intravenous anesthesia with hypertension group (D). The levels of Hs-CRP, blood glucose, leucocyte count, and neutrophil percentage and were detected at before anesthesia (T0), during anesthesia (T1), 2 hours post anesthesia (T2), 24 hours post anesthesia (T3). Patients with hypertension had higher Hs-CRP expression, blood glucose, and neutrophil percentage at time T0 than those of normal, but not leucocyte count. At time T3, patients with hypertension in D group had lower Hs-CRP expression than those in B group (P < 0.01). Patients with normal in C group had lower Hs-CRP expression (P < 0.01), blood glucose (P < 0.05), and leukocyte count (P < 0.05) than those in A group. Both hypertension history and anesthesia method had significant effects on the Hs-CRP expression, blood glucose, and leukocyte count. Total intravenous anesthesia decreases Hs-CRP expressions more efficiently than balanced anesthesia in neurosurgical patients with hypertension or normal. Moreover, total intravenous anesthesia can availably reduce the perioperative stress response by attenuating the increase of blood glucose and leukocyte count in normal tensive patients. PMID:27583931

  14. Hairy black holes in AdS5 × S 5

    NASA Astrophysics Data System (ADS)

    Markeviciute, Julija; Santos, Jorge E.

    2016-06-01

    We use numerical methods to exhaustively study a novel family of hairy black hole solutions in AdS5. These solutions can be uplifted to solutions of type IIB supergravity with AdS5 × S 5 asymptotics and are thus expected to play an important role in our understanding of AdS/CFT. We find an intricate phase diagram, with the aforementioned family of hairy black hole solutions branching from the Reissner-Nordström black hole at the onset of the superradiance instability. We analyse black holes with spherical and planar horizon topology and explain how they connect in the phase diagram. Finally, we detail their global and local thermodynamic stability across several ensembles.

  15. Detection method of flexion relaxation phenomenon based on wavelets for patients with low back pain

    NASA Astrophysics Data System (ADS)

    Nougarou, François; Massicotte, Daniel; Descarreaux, Martin

    2012-12-01

    The flexion relaxation phenomenon (FRP) can be defined as a reduction or silence of myoelectric activity of the lumbar erector spinae muscle during full trunk flexion. It is typically absent in patients with chronic low back pain (LBP). Before any broad clinical utilization of this neuromuscular response can be made, effective, standardized, and accurate methods of identifying FRP limits are needed. However, this phenomenon is clearly more difficult to detect for LBP patients than for healthy patients. The main goal of this study is to develop an automated method based on wavelet transformation that would improve time point limits detection of surface electromyography signals of the FRP in case of LBP patients. Conventional visual identification and proposed automated methods of time point limits detection of relaxation phase were compared on experimental data using criteria of accuracy and repeatability based on physiological properties. The evaluation demonstrates that the use of wavelet transform (WT) yields better results than methods without wavelet decomposition. Furthermore, methods based on wavelet per packet transform are more effective than algorithms employing discrete WT. Compared to visual detection, in addition to demonstrating an obvious saving of time, the use of wavelet per packet transform improves the accuracy and repeatability in the detection of the FRP limits. These results clearly highlight the value of the proposed technique in identifying onset and offset of the flexion relaxation response in LBP subjects.

  16. A Safe Method of Tracheal Polyflex Stent Placement: A Review of 20 Patients

    PubMed Central

    Pejhan, Saviz; Javaherzadeh, Mojtaba; Daneshvar, Abolghasem; Farzanegan, Roya

    2015-01-01

    Background: Surgery is an appropriate therapeutic approach for tracheal stenosis due to various benign and malignant conditions. When surgery is postponed for certain reasons, other options are chosen for airway patency. One alternative is using airway stents. Objectives: We aimed to introduce a safe method of tracheal polyflex stent placement in patients with tracheal stenoses. Patients and Methods: During a 7-year period (2002 - 2008), polyflex stents were used 29 times among 20 patients for various indications. After encountering many difficulties in earlier cases, we gradually developed our new method and used it in most of our patients. In this method, without using large rigid bronchoscopes, the introducer tube could be used as a bronchoscope with the aid of a zero-degree lens and ventilating apparatus. In this method, the rate of possible trauma to the airway can be minimized by avoiding the use of thick rigid bronchoscopies and the stent can be placed faster and more accurately. Results: Polyflex stents were used in 11 men (55%) and 9 women with a mean age of 38.5 years. Stents were removed and changed in 12 cases and replaced with another type of stent in 3 patients. Indications were recurrence of tracheal stenosis (7), multisegmental tracheal stenosis (3), anesthesia limitations (3), tracheal tumors (2), dehiscence of tracheal anastomosis (1), severe inflammation of the tracheal mucosa (1), esophagobronchial fistula (1), and external pressure on the left main bronchus (1). In one patient, a stent was used to open a kinked Dumon stent as a temporary life-saving procedure. We found 6 cases of stent migration, 3 cases of granulation tissue formation, 1 case of infection, and 1 case of surgical site dehiscence. Conclusions: Stents would be regarded as a temporary means of reaching the ideal condition for resection and reconstruction in most patients with tracheal stenoses. Although an optimal stent has not been introduced yet, we used polyflex stents in most

  17. D-branes on AdS flux compactifications

    NASA Astrophysics Data System (ADS)

    Koerber, Paul; Martucci, Luca

    2008-01-01

    We study D-branes in Script N = 1 flux compactifications to AdS4. We derive their supersymmetry conditions and express them in terms of background generalized calibrations. Basically because AdS has a boundary, the analysis of stability is more subtle and qualitatively different from the usual case of Minkowski compactifications. For instance, stable D-branes filling AdS4 may wrap trivial internal cycles. Our analysis gives a geometric realization of the four-dimensional field theory approach of Freedman and collaborators. Furthermore, the one-to-one correspondence between the supersymmetry conditions of the background and the existence of generalized calibrations for D-branes is clarified and extended to any supersymmetric flux background that admits a time-like Killing vector and for which all fields are time-independent with respect to the associated time. As explicit examples, we discuss supersymmetric D-branes on IIA nearly Kähler AdS4 flux compactifications.

  18. Dyonic AdS black holes from magnetohydrodynamics

    NASA Astrophysics Data System (ADS)

    Caldarelli, Marco M.; Dias, Óscar J. C.; Klemm, Dietmar

    2009-03-01

    We use the AdS/CFT correspondence to argue that large dyonic black holes in anti-de Sitter spacetime are dual to stationary solutions of the equations of relativistic magnetohydrodynamics on the conformal boundary of AdS. The dyonic Kerr-Newman-AdS4 solution corresponds to a charged diamagnetic fluid not subject to any net Lorentz force, due to orthogonal magnetic and electric fields compensating each other. The conserved charges, stress tensor and R-current of the fluid are shown to be in exact agreement with the corresponding quantities of the black hole. Furthermore, we obtain stationary solutions of the Navier-Stokes equations in four dimensions, which yield predictions for (yet to be constructed) charged rotating black strings in AdS5 carrying nonvanishing momentum along the string. Finally, we consider Scherk-Schwarz reduced AdS gravity on a circle. In this theory, large black holes and black strings are dual to lumps of deconfined plasma of the associated CFT. We analyze the effects that a magnetic field introduces in the Rayleigh-Plateau instability of a plasma tube, which is holographically dual to the Gregory-Laflamme instability of a magnetically charged black string.

  19. AdS Branes from Partial Breaking of Superconformal Symmetries

    SciTech Connect

    Ivanov, E.A.

    2005-10-01

    It is shown how the static-gauge world-volume superfield actions of diverse superbranes on the AdS{sub d+1} superbackgrounds can be systematically derived from nonlinear realizations of the appropriate AdS supersymmetries. The latter are treated as superconformal symmetries of flat Minkowski superspaces of the bosonic dimension d. Examples include the N = 1 AdS{sub 4} supermembrane, which is associated with the 1/2 partial breaking of the OSp(1|4) supersymmetry down to the N = 1, d = 3 Poincare supersymmetry, and the T-duality related L3-brane on AdS{sub 5} and scalar 3-brane on AdS{sub 5} x S{sup 1}, which are associated with two different patterns of 1/2 breaking of the SU(2, 2|1) supersymmetry. Another (closely related) topic is the AdS/CFT equivalence transformation. It maps the world-volume actions of the codimension-one AdS{sub d+1} (super)branes onto the actions of the appropriate Minkowski (super)conformal field theories in the dimension d.

  20. Worldsheet dilatation operator for the AdS superstring

    NASA Astrophysics Data System (ADS)

    Ramírez, Israel; Vallilo, Brenno Carlini

    2016-05-01

    In this work we propose a systematic way to compute the logarithmic divergences of composite operators in the pure spinor description of the AdS 5 × S 5 superstring. The computations of these divergences can be summarized in terms of a dilatation operator acting on the local operators. We check our results with some important composite operators of the formalism.

  1. Facilitating mental health research for patients, clinicians and researchers: a mixed-method study

    PubMed Central

    Robotham, D; Waterman, S; Oduola, S; Papoulias, C; Craig, T; Wykes, T

    2016-01-01

    Objectives Research registers using Consent for Contact (C4C) can facilitate recruitment into mental health research studies, allowing investigators to contact patients based on clinical records information. We investigated whether such a register was useful for mental health research, seeking the perspectives of patients and research investigators. Setting and design In 2012, a C4C register was developed in a large secondary mental health provider within the UK; almost 9000 patients have joined. This mixed-method study audited the effectiveness of the register. Participants A ‘mystery shopper’ exercise was conducted, and patients (n=21) were recruited to ask clinicians about the availability of research opportunities. Structured interviews were conducted with patients (n=52) about their experiences of being on the register. Similar interviews were conducted with 18 investigators from 19 studies, who had attempted to use the register to recruit participants. Outcome measures The impact of C4C on study recruitment, and whether it helped patients learn about research. Results So far, the register has provided 928 individuals with 1085 research opportunities (in 60% of cases, the individual agreed to participate in the study). Clinicians were willing to link patients to research opportunities, but often lacked information about studies. For patients, the register provided opportunities which they may not otherwise have; 27 of 52 had participated in studies since joining the register (18 participating for the first time). Most investigators used the register to supplement recruitment to their studies, but described problems in prescreening potential participants from a clinical record for complex studies. Conclusions Although the register helped investigators recruit for studies, and provided patients with research opportunities, clinicians' input is still useful for identifying suitable participants. C4C registers should be adapted to provide clinicians with

  2. A method for patient dose reduction in dynamic contrast enhanced CT study

    SciTech Connect

    Mo Kim, Sun; Haider, Masoom A.; Milosevic, Michael; Jaffray, David A.; Yeung, Ivan W. T.

    2011-09-15

    Purpose: In dynamic contrast enhanced CT (DCE-CT) study, prolonged CT scanning with high temporal resolution is required to give accurate and precise estimates of kinetic parameters. However, such scanning protocol could lead to substantial radiation dose to the patient. A novel method is proposed to reduce radiation dose to patient, while maintaining high accuracy for kinetic parameter estimates in DCE-CT study. Methods: The method is based on a previous investigation that the arterial impulse response (AIR) in DCE-CT study can be predicted using a population-based scheme. In the proposed method, DCE-CT scanning is performed with relatively low temporal resolution, hence, giving rise to reduction in patient dose. A novel method is proposed to estimate the arterial input function (AIF) based on the coarsely sampled AIF. By using the estimated AIF in the tracer kinetic analysis of the coarsely sampled DCE-CT study, the calculated kinetic parameters are able to achieve a high degree of accuracy. The method was tested on a DCE-CT data set of 48 patients with cervical cancer scanned at high temporal resolution. A random cohort of 34 patients was chosen to construct the orthonormal bases of the AIRs via singular value decomposition method. The determined set of orthonormal bases was used to fit the AIFs in the second cohort (14 patients) at varying levels of down sampling. For each dataset in the second cohort, the estimated AIF was used for kinetic analyses of the modified Tofts and adiabatic tissue homogeneity models for each of the down-sampling schemes between intervals from 2 to 15 s. The results were compared with analyses done with the ''raw'' down-sampled AIF. Results: In the first group of 34 patients, there were 11 orthonormal bases identified to describe the AIRs. The AIFs in the second group were estimated in high accuracy based on the 11 orthonormal bases established in the first group along with down-sampled AIFs. Using the 11 orthonormal bases, the

  3. Earned Value-Added

    NASA Technical Reports Server (NTRS)

    Jansen, Michael

    2005-01-01

    Earned value management [EVM] ...either you swear by it, or swear at it. Either way, there s no getting around the fact that EVM can be one of the most efficient and insightful methods of synthesizing cost, schedule, and technical status information into a single set of program health metrics. Is there a way of implementing EVM that allows a program to reap its early warning benefits while avoiding the pitfalls that make it infamous to its detractors? That s the question recently faced by the International Space Station [ISS] program.

  4. Evaluation of the objective posturo-locomotor-manual method in patients with parkinsonian syndromes.

    PubMed

    Zackrisson, Theresa; Bergquist, Filip; Holmberg, Björn; Johnels, Bo; Thorlin, Thorleif

    2013-01-01

    Objective methods for quantifying patients' movement capacity would be useful in evaluating progression and interventions in neurodegenerative diseases. The Posturo-Locomotor-Manual (PLM) test is a standardized automated movement test developed to measure hypokinetic movements in patients with Parkinsonism. Our hypotheses were that the PLM movement time (MT) correlates with the Unified Parkinson's disease rating scale (UPDRS III) motor section, and that the components of the PLM test correlate with the corresponding constructed domains of UPDRS III. We also evaluated the coherence between the results of the two assessment methods after a test dose of levodopa (l-DOPA). We assessed motor function using the PLM method and UPDRS III in parallel, in the absence of medication and after administration of 200 mg l-DOPA, in 73 patients with moderate to advanced Parkinsonism: 47 with Parkinson's disease (PD), 17 with multiple system atrophy (MSA), and 9 with progressive supranuclear palsy (PSP). There was a fair correlation between the two assessment tools in the PD patients but not in the MSA or PSP patients. In the full dataset, there was a fair to good correlation between UPDRS III and the PLM MT. At group level, the UPDRS III l-DOPA test differentiated PD from MSA/PSP, whereas the PLM l-DOPA test differentiated between all three diagnoses.

  5. Using the job characteristics model to compare patient care assignment methods of nurses.

    PubMed

    Mohamed, A H

    2004-05-01

    The aim of this study was to use Hackman and Oldman's job characteristics model to compare 2 methods of patient care assignment as perceived by nurses in 12 inpatient units of Alexandria Main University Hospital. The job diagnostic survey was used to determine nurses' perceptions toward the components of the model in relation to their performance in utilizing the case and functional methods of patient care assignment. The jobs of intensive care unit nurses who utilized the case method were more enriched than those who utilized the functional method of assignment in the general care units, in terms of their perception scores towards all parts of the model (core job characteristics, critical psychological states, affective and personal outcomes, context satisfaction and individual growth-need strength). PMID:16212217

  6. The efficiency assessment of rehabilitation with DBC method in low back pain patients.

    PubMed

    Giemza, Czesław; Bodnar, Agnieszka; Kabała, Tomasz; Gruszecka, Dominika; Lipnicki, Wojciech; Magiera, Przemysław; Kowalski, Jacek

    2006-12-29

    Rehabilitation in patients with low back pain is one of the crucial therapeutic and social problems. This work attempts to present therapeutic procedures according to DBC (Documentation Based Care) treatment concept. The aim of the research was to assess the efficiency of DBC method on the basis of spine mobility in frontal, saggital and transverse plane and also on the basis of patient's subjective feelings. The research was carried out among 50 patients (52,5 years on average) including 23 females and 27 males. All the patients participating in the research were chosen deliberately and suffered from chronic low back pain caused by degenerative changes. On the basis of research range of motion (ROM) improvement in all planes, decrease of pain and functional impairment were stated.

  7. Newer imaging methods for triaging patients presenting to the emergency department with chest pain.

    PubMed

    McCord, James; Amsterdam, Ezra A

    2005-11-01

    The usefulness of electron beam CT (EBCT) for the risk stratification of patients in the emergency department (ED) who have possible acute coronary syndrome has been evaluated in three small studies. The results of these studies are promising, as patients who have no coronary calcium detected by EBCT essentially had no adverse cardiac events. Although the negative predictive value of EBCT was excellent, the limited positive predictive value that would lead to further diagnostic testing makes this strategy less attractivei f applied to a broad population. Further larger studies may help define which patients in the ED who have chest pain and nondiagnostic ECGs can be effectively evaluated by EBCT. Recent advances in noninvasive coronary angiography by multislice computed tomography are of considerable interest in the ED evaluation of patients with undefined chest pain, but the utility of this method in this setting awaits clinical studies. PMID:16278123

  8. Scale space methods for analysis of type 2 diabetes patients' blood glucose values.

    PubMed

    Skrøvseth, Stein Olav; Godtliebsen, Fred

    2011-01-01

    We describe how scale space methods can be used for quantitative analysis of blood glucose concentrations from type 2 diabetes patients. Blood glucose values were recorded voluntarily by the patients over one full year as part of a self-management process, where the time and frequency of the recordings are decided by the patients. This makes a unique dataset in its extent, though with a large variation in reliability of the recordings. Scale space and frequency space techniques are suited to reveal important features of unevenly sampled data, and useful for identifying medically relevant features for use both by patients as part of their self-management process, and provide useful information for physicians. PMID:21436873

  9. Scale Space Methods for Analysis of Type 2 Diabetes Patients' Blood Glucose Values

    PubMed Central

    Skrøvseth, Stein Olav; Godtliebsen, Fred

    2011-01-01

    We describe how scale space methods can be used for quantitative analysis of blood glucose concentrations from type 2 diabetes patients. Blood glucose values were recorded voluntarily by the patients over one full year as part of a self-management process, where the time and frequency of the recordings are decided by the patients. This makes a unique dataset in its extent, though with a large variation in reliability of the recordings. Scale space and frequency space techniques are suited to reveal important features of unevenly sampled data, and useful for identifying medically relevant features for use both by patients as part of their self-management process, and provide useful information for physicians. PMID:21436873

  10. Evidence-Based Indicators of Neuropsychological Change in the Individual Patient: Relevant Concepts and Methods

    PubMed Central

    Duff, Kevin

    2012-01-01

    Repeated assessments are a relatively common occurrence in clinical neuropsychology. The current paper will review some of the relevant concepts (e.g., reliability, practice effects, alternate forms) and methods (e.g., reliable change index, standardized based regression) that are used in repeated neuropsychological evaluations. The focus will be on the understanding and application of these concepts and methods in the evaluation of the individual patient through examples. Finally, some future directions for assessing change will be described. PMID:22382384

  11. A cephalometric method to diagnosis the craniovertebral junction abnormalities in osteogenesis imperfecta patients

    PubMed Central

    Ríos-Rodenas, Mercedes; Gutiérrez-Díez, María-Pilar; Feijóo, Gonzalo; Mourelle, Maria-Rosa; Garcilazo, Mario; Ortega-Aranegui, Ricardo

    2015-01-01

    Osteogenesis imperfecta (OI) is a hereditary bone fragility disorder that in most patients is caused by mutations affecting collagen type I. Their typical oral and craneofacial characteristics (Dentinogenesis imperfecta type I and class III malocclusion), involve the dentist in the multidisciplinary team that treat these patients. It is usual to perform lateral skull radiographs for the orthodontic diagnosis. In addition, this radiograph is useful to analyse the junctional area between skull base and spine, that could be damaged in OI. Pathology in the craneovertebral junction (CVJ) is a serious complication of OI with a prevalence ranging from rare to 37%. To diagnosis early skull base anomalies in these patients, previously the neurological symptoms have been appear, we make a simple cephalometric analysis of the CVJ. This method has four measurements and one angle. Once we calculate the values of the OI patient, we compare the result with the mean and the standard deviations of an age-appropriate average in healthy controls. If the patient has a result more than 2,5 SDs above the age-appropriate average in healthy controls, we should to refer the patient to his/her pediatrician or neurologist. These doctors have to consider acquiring another diagnostic images to be used to determine cranial base measurements with more reliability. Thereby, dentists who treat these patients, must be aware of the normal radiological anatomy of the cervical spine on the lateral cephalogram. Key words:Osteogenesis imperfecta, craniovertebral junction, cephalometric. PMID:25810828

  12. Low-Cost Method to Monitor Patient Adherence to HIV Antiretroviral Therapy Using Multiplex Cathepsin Zymography.

    PubMed

    Platt, Manu O; Evans, Denise; Keegan, Philip M; McNamara, Lynne; Parker, Ivana K; Roberts, LaDeidra M; Caulk, Alexander W; Gleason, Rudolph L; Seifu, Daniel; Amogne, Wondwossen; Penny, Clement

    2016-01-01

    Monitoring patient adherence to HIV antiretroviral therapy (ART) by patient survey is inherently error prone, justifying a need for objective, biological measures affordable in low-resource settings where HIV/AIDS epidemic is highest. In preliminary studies conducted in Ethiopia and South Africa, we observed loss of cysteine cathepsin activity in peripheral blood mononuclear cells of HIV-positive patients on ART. We optimized a rapid protocol for multiplex cathepsin zymography to quantify cysteine cathepsins, and prospectively enrolled 350 HIV-positive, ART-naïve adults attending the Themba Lethu Clinic, Johannesburg, South Africa, to test if suppressed cathepsin activity could be a biomarker of ART adherence (103 patients were included in final analysis). Poor adherence was defined as detectable viral load (>400 copies/ml) or simplified medication adherence questionnaire, 4-6 months after ART initiation. 86 % of patients with undetectable viral loads after 6 months were cathepsin negative, and cathepsin-positive patients were twice as likely to have detectable viral loads (RR 2.32 95 % CI 1.26-4.29). Together, this demonstrates proof of concept that multiplex cathepsin zymography may be an inexpensive, objective method to monitor patient adherence to ART. Low cost of this electrophoresis-based assay makes it a prime candidate for implementation in resource-limited settings. PMID:26589706

  13. Methods for detection of circulating tumour cells and their clinical value in cancer patients.

    PubMed

    Mikulová, V; Kološtová, K; Zima, T

    2011-01-01

    Currently available analytical methods enable identification, detection and characterization of circulating tumour cells in the peripheral blood and disseminated tumour cells in the bone marrow of breast cancer patients. About 0.01 % of the circulating tumour cells observed in the blood are able to form metastases. Therefore, they could be used for estimation of the risk for metastatic relapse, as a diagnostic tool for patient stratification, early determination of the therapy failure, or potential risk of resistance to the given therapeutic intervention. New therapeutic molecular targets could be identified for management of cancer patients using circulating tumour cell detection. The following review summarizes introduced methods of circulating tumour cell detection and their possible application in clinics.

  14. [Hypnosis and modified hypnotherapeutic methods. Indications and results in hospitalized and ambulatory patients].

    PubMed

    Sampson, H; Schmidbauer, H; Klingler, D

    1980-06-15

    164 patients were treated hypnotherapeutically. The therapeutical methods used were heterohypnosis and the so-called gestufte Aktivhypnose (graded active hypnosis), a method which is closely related to autogenous training. In most patients independent continuation of the application of guiding principles in autogenous training was envisaged for stabilizing the results of the hypnotherapy and also achieved. The indications include a wide range of psychovegetative syndromes, including addictions. Especially syndromes showing predominantly vegetative symptoms and a relatively insignificant neurotic component responded most positively to this type of treatment. The results were less satisfactory in patients suffering from pronounced personality disorders. Hynotherapy now supplements psychotherapeutical treatment, hitherto mainly orientated to behaviour therapy, in such a way, that psychotherapy in a general hospital can be realized more effectively.

  15. A new nasal cavity nursing methods application in patients with mechanical ventilation

    PubMed Central

    Wei, Liuqing; Qin, Gang; Yang, Xining; Hu, Meichun; Jiang, Fufu; Lai, Tianwei

    2013-01-01

    Objective: To compare different nasal cavity nursing methods on mechanically ventilated patients. Methods: According to acute physiology and chronic health evaluation (APACHEII), 615 cases of mechanically ventilated patients were divided into group A, group B and group C by stratified random method. Traditional oral nursing plus aspirating secretions from oral cavity and nasal cavity q6h were done in group A. Based on methods in group A, normal saline was used for cleaning nasal cavity in group B. Besides the methods in group A, atomizing nasal cleansing a6h was also used in group C. Incidence rate of Ventilator-Associated Pneumonia (VAP) and APACHE II scores after administrating were compared. The correlation between APACHE II score and outcomes was analyzed by Spearman-rank correlation. Results: In group A, incidence of VAP was 36.76%, group B was 30.24%, group C was 20.38%, and the difference was statistically significant. APACHE II scores in group C were significantly lower compared with group A and B. APACHE II score was negatively correlated with clinical outcomes. Conclusions: For mechanically ventilated patients, nasal nursing can’t be ignored and the new atomizing nasal cleaning is an effective method for VAP prevention. PMID:24353671

  16. A simple and inexpensive method to routinely produce customized neck supports for patient immobilization during radiotherapy.

    PubMed

    McKernan, B; Bydder, S; Ebert, M; Waterhouse, D; Joseph, D

    2008-12-01

    Accurate and reproducible patient positioning is fundamental to the success of fractionated radiotherapy. Poor patient positioning could result in geographic misses. We have recently reported on an improved method of customized face mask production using laser surface scanning. In this report, we sought to identify and develop a method to routinely make customized neck supports for patients prescribed radiotherapy to the brain or head and neck regions. We identified a potentially suitable product--sealed packs containing two liquids that produce expanding polyurethane foam when mixed--and developed a method for their use. The neck supports are inexpensive and simple to produce (taking less than 5 min of radiation therapist labour). We assessed the customized neck supports in several ways. The effect on setup accuracy was assessed by comparing two consecutive cohorts of patients. Statistically significant differences favouring the customized neck supports included a reduced total displacement error (mean 3.4 vs. 2.1 mm) and a reduced left-right setup error (mean 1.8 vs. 1.1 mm). This is consistent with the greater support provided by the customized neck supports. This method could easily be undertaken by other departments. PMID:19178638

  17. Proposal for a recovery prediction method for patients affected by acute mediastinitis

    PubMed Central

    2012-01-01

    Background An attempt to find a prediction method of death risk in patients affected by acute mediastinitis. There is not such a tool described in available literature for that serious disease. Methods The study comprised 44 consecutive cases of acute mediastinitis. General anamnesis and biochemical data were included. Factor analysis was used to extract the risk characteristic for the patients. The most valuable results were obtained for 8 parameters which were selected for further statistical analysis (all collected during few hours after admission). Three factors reached Eigenvalue >1. Clinical explanations of these combined statistical factors are: Factor1 - proteinic status (serum total protein, albumin, and hemoglobin level), Factor2 - inflammatory status (white blood cells, CRP, procalcitonin), and Factor3 - general risk (age, number of coexisting diseases). Threshold values of prediction factors were estimated by means of statistical analysis (factor analysis, Statgraphics Centurion XVI). Results The final prediction result for the patients is constructed as simultaneous evaluation of all factor scores. High probability of death should be predicted if factor 1 value decreases with simultaneous increase of factors 2 and 3. The diagnostic power of the proposed method was revealed to be high [sensitivity =90%, specificity =64%], for Factor1 [SNC = 87%, SPC = 79%]; for Factor2 [SNC = 87%, SPC = 50%] and for Factor3 [SNC = 73%, SPC = 71%]. Conclusion The proposed prediction method seems a useful emergency signal during acute mediastinitis control in affected patients. PMID:22574625

  18. Methods of Suicide among Cancer Patients: A Nationwide Population-Based Study

    ERIC Educational Resources Information Center

    Chung, Kuo-Hsuan; Lin, Herng-Ching

    2010-01-01

    A 3-year nationwide population-based data set was used to explore methods of suicide (violent vs. nonviolent) and possible contributing factors among cancer patients in Taiwan. A total of 1,065 cancer inpatients who committed suicide were included as our study sample. The regression shows that those who had genitourinary cancer were 0.55 times (p…

  19. Comparison of Patient Education Methods: Effects on Knowledge of Cardiac Rehabilitation Principles.

    ERIC Educational Resources Information Center

    Thomas, Julie Jepsen

    1996-01-01

    Patient education programs for persons undergoing cardiac surgery related to knowledge of cardiac rehabilitation principles were conducted with either traditional (n=49) or collaborative (n=47) educational interventions. The two methods produced similar levels of knowledge, but significant differences appeared depending on whether subjects had…

  20. Epsilon waves detected by various electrocardiographic recording methods: in patients with arrhythmogenic right ventricular cardiomyopathy.

    PubMed

    Wang, Jing; Yang, Bing; Chen, Hongwu; Ju, Weizhu; Chen, Kai; Zhang, Fengxiang; Cao, Kejiang; Chen, Minglong

    2010-01-01

    We analyzed the shape and distribution of epsilon waves by 3 various methods of electrocardiographic recording in patients with arrhythmogenic right ventricular cardiomyopathy.Thirty-two patients who met recognized diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy were included in this study (24 men and 8 women; mean age, 42.3 ± 12.9 yr). Epsilon waves were detected by standard 12-lead electrocardiography (S-ECG), right-sided precordial lead electrocardiography (R-ECG), and Fontaine bipolar precordial lead electrocardiography (F-ECG). We found 3 types of epsilon waves: wiggle waves, small spike waves, and smooth potential waves that formed an atypical prolonged R' wave. The most common configuration was small spiked waves. In some circumstances, epsilon waves were evident in some leads (especially in leads V(1) through V(3)), but notches were recorded in the other leads during the corresponding phase. These waves could be detected only by S-ECG in 1 patient, R-ECG in 3 patients, and F-ECG in 5 patients; the rates of epsilon-wave detection by these 3 methods were 38% (12/32), 38% (12/32), and 50% (16/32), respectively. However, the detection rate using combined methods was significantly higher than that by S-ECG alone (SF-ECG 56% vs S-ECG 38%, P = 0.0312; and SRF-ECG 66% vs S-ECG 38%, P = 0.0039). In addition, the rate of widespread T-wave inversion (exceeding V(3)) was significantly higher in patients with epsilon waves than in those without (48% vs 9%, P = 0.029), as was ventricular tachycardia (95% vs 64%, P = 0.019).These 3 electrocardiographic recording methods should be used in combination to improve the detection rate of epsilon waves. PMID:20844612

  1. Saliva collection methods for DNA biomarker analysis in oral cancer patients.

    PubMed

    Matthews, April M; Kaur, Harpal; Dodd, Michael; D'Souza, Jacob; Liloglou, Triantafillos; Shaw, Richard J; Risk, Janet M

    2013-07-01

    Patients with head and neck cancers are predisposed to local recurrence and second primaries because of the phenomenon of field cancerisation, and clinical detection of recurrence remains challenging. DNA biomarkers in saliva may prove to be an adjunct to current diagnostic methods, but irradiation of the primary site often leads to xerostomia. We assessed 3 methods of collecting saliva for their ability to generate DNA of sufficient quantity and quality to use in biomarker assays. Paired saliva samples were collected from 2 groups of patients with oral squamous cell carcinoma (SCC). In the first group saliva was collected in Oragene(®) vials and as saline mouthwash from non-irradiated patients (n=21) (4 had had radiotherapy before collection); in the second group it was collected using Oragene(®) sponge kits and as mouthwash from irradiated patients (n=24). Quantitative polymerase chain reaction (qPCR) showed that Oragene(®) vials contained DNA in significantly greater amounts (median 122 μg, range 4-379) than mouthwash (median 17 μg, range 2-194) (p=0.0001) in the non-irradiated patients, while Oragene(®) sponge kits (median 4 μg, range 0.1-61) and mouthwash (median 5.5 μg, range 0.1-75) generated comparable concentrations of DNA from the irradiated group. All 90 samples contained DNA of sufficient quantity and quality for p16 promoter quantitative methylation-specific PCR (qMSP). While Oragene(®) vials contained the most DNA, all 3 methods yielded enough to detect DNA biomarkers using qMSP. The method of collection should depend on the compliance of the patient and oral competency.

  2. Concordance between two methods in measuring treatment adherence in patients with type 2 diabetes

    PubMed Central

    López-Simarro, Flora; Brotons, Carlos; Moral, Irene; Aguado-Jodar, Alba; Cols-Sagarra, Cèlia; Miravet-Jiménez, Sònia

    2016-01-01

    Objective We analyzed the concordance between two methods for measuring treatment adherence (TA) and studied the determinants of TA in patients with type 2 diabetes mellitus. Methods We conducted a cross-sectional descriptive study in a primary care center, involving 320 diabetic patients. TA was measured using the Haynes–Sackett (H–S) adherence test during the patient interview and based on pharmacy refill data. TA was calculated globally and by drug groups (antihypertensive, lipid-lowering, and antidiabetic drugs). Results Poor TA as measured by the H–S test was observed in 11.2% of the patients. Based on pharmacy refill data, there was a poor global TA rate of 30.3%, which was 33.3%, 26.6%, and 34.2% for oral antidiabetic, antihypertensive, and lipid-lowering drugs, respectively. Concordance between the two methods was poor. There was no relationship between the degree of disease control and TA as measured by the H–S test. Good TA measured based on pharmacy refill data for antidiabetic and antihypertensive drugs was associated with lower glycosylated hemoglobin and diastolic blood pressure values, respectively. Patients with good global TA showed lower glycosylated hemoglobin, diastolic blood pressure, and low-density lipoprotein cholesterol values. The multivariate analysis found good oral antidiabetic adherence to be associated to free pharmacy service; good antihypertensive drug adherence to the existence of comorbidities; and good lipid-lowering drug adherence to a history of ischemic heart disease, and a more experienced physician and/or female physician. Conclusion Concordance between the two methods in assessing TA was low. Approximately one-third of the patients with type 2 diabetes mellitus presented poor TA in relation to antihypertensive, lipid-lowering, and antidiabetic medication. An improved TA was associated with a better control of the studied parameters. Comorbidities, such as ischemic heart disease and access to free pharmacy service

  3. "Value Added" Gauge of Teaching Probed

    ERIC Educational Resources Information Center

    Viadero, Debra

    2009-01-01

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

  4. Adding Users to the Website Design Process

    ERIC Educational Resources Information Center

    Tomeo, Megan L.

    2012-01-01

    Alden Library began redesigning its website over a year ago. Throughout the redesign process the students, faculty, and staff that make up the user base were added to the conversation by utilizing several usability test methods. This article focuses on the usability testing conducted at Alden Library and delves into future usability testing, which…

  5. Value-Added Analysis in Instruction

    ERIC Educational Resources Information Center

    Nicholson, Michael R.; Brown, Jeffrey R.

    2010-01-01

    Value-added data provide a viable alternative for gauging school effectiveness--one virtually free of the confounding effects of student demographics and other factors relating to student learning. How is it different from other measuring methods? It concentrates on growth, rather than attainment. This strengthens the concept and measurement of…

  6. Effective Ad-Hoc Committees.

    ERIC Educational Resources Information Center

    Young, David G.

    1983-01-01

    Ad-hoc committees may be symbolic, informational, or action committees. A literature survey indicates such committees' structural components include a suprasystem and three subsystems involving linkages, production, and implementation. Other variables include size, personal factors, and timing. All the factors carry implications about ad-hoc…

  7. Lorentzian AdS geometries, wormholes, and holography

    SciTech Connect

    Arias, Raul E.; Silva, Guillermo A.; Botta Cantcheff, Marcelo

    2011-03-15

    We investigate the structure of two-point functions for the quantum field theory dual to an asymptotically Lorentzian Anti de Sitter (AdS) wormhole. The bulk geometry is a solution of five-dimensional second-order Einstein-Gauss-Bonnet gravity and causally connects two asymptotically AdS spacetimes. We revisit the Gubser-Klebanov-Polyakov-Witten prescription for computing two-point correlation functions for dual quantum field theories operators O in Lorentzian signature and we propose to express the bulk fields in terms of the independent boundary values {phi}{sub 0}{sup {+-}} at each of the two asymptotic AdS regions; along the way we exhibit how the ambiguity of normalizable modes in the bulk, related to initial and final states, show up in the computations. The independent boundary values are interpreted as sources for dual operators O{sup {+-}} and we argue that, apart from the possibility of entanglement, there exists a coupling between the degrees of freedom living at each boundary. The AdS{sub 1+1} geometry is also discussed in view of its similar boundary structure. Based on the analysis, we propose a very simple geometric criterion to distinguish coupling from entanglement effects among two sets of degrees of freedom associated with each of the disconnected parts of the boundary.

  8. Effect of the carbohydrate counting method on glycemic control in patients with type 1 diabetes

    PubMed Central

    2010-01-01

    Background The importance of achieving and maintaining an appropriate metabolic control in patients with type 1 diabetes mellitus (DM1) has been established in many studies aiming to prevent the development of chronic complications. The carbohydrate counting method can be recommended as an additional tool in the nutritional treatment of diabetes, allowing patients with DM1 to have more flexible food choices. This study aimed to evaluate the influence of nutrition intervention and the use of multiple short-acting insulin according to the carbohydrate counting method on clinical and metabolic control in patients with DM1. Methods Our sample consisted of 51 patients with DM1, 32 females, aged 25.3 ± 1.55 years. A protocol of nutritional status evaluation was applied and laboratory analysis was performed at baseline and after a three-month intervention. After the analysis of the food records, a balanced diet was prescribed using the carbohydrate counting method, and short-acting insulin was prescribed based on the total amount of carbohydrate per meal (1 unit per 15 g of carbohydrate). Results A significant decrease in A1c levels was observed from baseline to the three-month evaluation after the intervention (10.40 ± 0.33% and 9.52 ± 0.32%, respectively, p = 0.000). It was observed an increase in daily insulin dose after the intervention (0.99 ± 0.65 IU/Kg and 1.05 ± 0.05 IU/Kg, respectively, p = 0.003). No significant differences were found regarding anthropometric evaluation (BMI, waist, hip or abdominal circumferences and waist to hip ratio) after the intervention period. Conclusions The use of short-acting insulin based on the carbohydrate counting method after a short period of time resulted in a significant improvement of the glycemic control in patients with DM1 with no changes in body weight despite increases in the total daily insulin doses. PMID:20716374

  9. Kolmogorov-Zakharov spectrum in AdS gravitational collapse.

    PubMed

    de Oliveira, H P; Pando Zayas, Leopoldo A; Rodrigues, E L

    2013-08-01

    We study black hole formation during the gravitational collapse of a massless scalar field in asymptotically D-dimensional anti-de Sitter AdS(D) spacetimes for D = 4, 5. We conclude that spherically symmetric gravitational collapse in asymptotically AdS spaces is turbulent and characterized by a Kolmogorov-Zakharov spectrum. Namely, we find that after an initial period of weakly nonlinear evolution, there is a regime where the power spectrum of the Ricci scalar evolves as ω(-s) with the frequency, ω, and s ≈ 1.7 ± 0.1.

  10. Efficacy and safety of the glucagon-like peptide-1 receptor agonist liraglutide added to insulin therapy in poorly regulated patients with type 1 diabetes—a protocol for a randomised, double-blind, placebo-controlled study: The Lira-1 study

    PubMed Central

    Dejgaard, Thomas Fremming; Knop, Filip Krag; Tarnow, Lise; Frandsen, Christian Seerup; Hansen, Tanja Stenbæk; Almdal, Thomas; Holst, Jens Juul; Madsbad, Sten; Andersen, Henrik Ullits

    2015-01-01

    Introduction Intensive insulin therapy is recommended for the treatment of type 1 diabetes (T1D). Hypoglycaemia and weight gain are the common side effects of insulin treatment and may reduce compliance. In patients with insulin-treated type 2 diabetes, the addition of glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy has proven effective in reducing weight gain and insulin dose. The present publication describes a protocol for a study evaluating the efficacy and safety of adding a GLP-1RA to insulin treatment in overweight patients with T1D in a randomised, double-blinded, controlled design. Methods and analysis In total, 100 patients with type 1 diabetes, poor glycaemic control (glycated haemoglobin (HbA1c) >8%) and overweight (body mass index >25 kg/m2) will be randomised to either liraglutide 1.8 mg once daily or placebo as an add-on to intensive insulin therapy in this investigator initiated, double-blinded, placebo-controlled parallel study. The primary end point is glycaemic control as measured by changes in HbA1c. Secondary end points include changes in the insulin dose, hypoglyacemic events, body weight, lean body mass, fat mass, food preferences and adverse events. Glycaemic excursions, postprandial glucagon levels and gastric emptying rate during a standardised liquid meal test will also be studied. Ethics and dissemination The study is approved by the Danish Medicines Authority, the Regional Scientific-Ethical Committee of the Capital Region of Denmark and the Data Protection Agency. The study will be carried out under the surveillance and guidance of the good clinical practice (GCP) unit at Copenhagen University Hospital Bispebjerg in accordance with the ICH-GCP guidelines and the Helsinki Declaration. Trial registration number NCT01612468. PMID:25838513

  11. Assessment of Different Quit Smoking Methods Selected by Patients in Tobacco Cessation Centers in Iran

    PubMed Central

    Heydari, Gholamreza; Masjedi, Mohammadreza; Ahmady, Arezoo Ebn; Leischow, Scott J.; Harry, A. Lando; Shadmehr, Mohammad B.; Fadaizadeh, Lida

    2015-01-01

    Background: Health systems play key roles in identifying tobacco users and providing evidence-based care to help them quit. This treatment includes different methods such as simple medical consultation, medication, and telephone counseling. To assess different quit smoking methods selected by patients in tobacco cessation centers in Iran in order to identify those that are most appropriate for the country health system. Methods: In this cross-sectional and descriptive study, a random sample of all quit centers at the country level was used to obtain a representative sample. Patients completed the self-administered questionnaire which contained 10 questions regarding the quality, cost, effect, side effects and the results of quitting methods using a 5-point Likert-type scale. Percentages, frequencies, mean, T-test, and variance analyses were computed for all study variables. Results: A total of 1063 smokers returned completed survey questionnaires. The most frequently used methods were Nicotine Replacement Therapy (NRT) and combination therapy (NRT and Counseling) with 228 and 163 individuals reporting these respectively. The least used methods were hypnotism (n = 8) and the quit and win (n = 17). The methods which gained the maximum scores were respectively the combined method, personal and Champix with means of 21.4, 20.4 and 18.4. The minimum scores were for e-cigarettes, hypnotism and education with means of 12.8, 11 and 10.8, respectively. There were significant differences in mean scores based on different cities and different methods. Conclusions: According to smokers’ selection the combined therapy, personal methods and Champix are the most effective methods for quit smoking and these methods could be much more considered in the country health system. PMID:26442750

  12. Changes in Quality of Life in 7 Older Adult Patients Receiving Activator Methods Chiropractic Technique

    PubMed Central

    Russell, David G.; Kimura, Melissa N.; Cowie, Harriet R.; de Groot, Caroline M.M.; McMinn, Elise A.P.; Sherson, Matthew W.

    2016-01-01

    Objective The purpose of this case series is to report on symptomatic and quality of life (QoL) changes in 7 older adult chiropractic patients who were receiving care using Activator Methods Chiropractic Technique (AMCT). Clinical Features Seven patients were selected from 2 chiropractic offices in Auckland, New Zealand. Patients were included if they were older adults receiving AMCT care and for whom at least 2 QoL assessments had been performed. The patients, aged 69-80 years, primarily received care for a variety of musculoskeletal complaints. Intervention and Outcomes The patients reported improvements in their presenting complaints as well as a number of nonmusculoskeletal symptoms. Each patient demonstrated clinical improvements in their RAND 36-Item Short Form Health Survey (SF-36) results. The average improvement in QoL measured using a SF-36 questionnaire was 8.0 points in the physical component and 4.1 points in the mental component. Four cases had a second progress evaluation using the SF-36 and showed an overall improvement of 5.2 in the physical and 9.8 in the mental components from baseline. Conclusion This case series describes an improvement in QoL, as measured by the SF-36 instrument, as well as subjectively reported improvements in both musculoskeletal and nonmusculoskeletal symptoms in 7 older adults receiving chiropractic care. PMID:27069434

  13. An automated method for assessing routine radiographs of patients with total hip replacements.

    PubMed

    Redhead, A L; Kotcheff, A C; Taylor, C J; Porter, M L; Hukins, D W

    1997-01-01

    This paper describes a new, fully automated method of locating objects on radiographs of patients with total joint replacements (TJRs). A statistical computer model, known as an active shape model, was trained to identify the position of the femur, pelvis, stem and cup marker wire on radiographs of patients with Charnley total hip prostheses. Once trained, the model was able to locate these objects through a process of automatic image searching, despite their appearance depending on the orientation and anatomy of the patient. Experiments were carried out to test the accuracy with which the model was able to fit to previously unseen data and with which reference points could be calculated from the model points. The model was able to locate the femur and stem with a mean error of approximately 0.8 mm and a 95 per cent confidence limit of 1.7 mm. Once the model had successfully located these objects, the midpoint of the stem head could be calculated with a mean error of approximately 0.2 mm. Although the model has been trained on Charnley total hip replacements, the method is generic and so can be applied to radiographs of patients with any TJR. This paper shows that computer models can form the basis of a quick, automatic method of taking measurements from standard clinical radiographs.

  14. Exploring methods for identifying related patient safety events using structured and unstructured data.

    PubMed

    Fong, Allan; Hettinger, A Zachary; Ratwani, Raj M

    2015-12-01

    Most healthcare systems have implemented patient safety event reporting systems to identify safety hazards. Searching the safety event data to find related patient safety reports and identify trends is challenging given the complexity and quantity of these reports. Structured data elements selected by the event reporter may be inaccurate and the free-text narrative descriptions are difficult to analyze. In this paper we present and explore methods for utilizing both the unstructured free-text and structured data elements in safety event reports to identify and rank similar events. We evaluate the results of three different free-text search methods, including a unique topic modeling adaptation, and structured element weights, using a patient fall use case. The various search techniques and weight combinations tended to prioritize different aspects of the event reports leading to different search and ranking results. These search and prioritization methods have the potential to greatly improve patient safety officers, and other healthcare workers, understanding of which safety event reports are related.

  15. Estimating differences in volumetric flat bone growth in pediatric patients by radiation treatment method

    SciTech Connect

    Hua Chiaho . E-mail: Chia-Ho.Hua@stjude.org; Shukla, Hemant I.; Merchant, Thomas E.; Krasin, Matthew J.

    2007-02-01

    Purpose: To estimate potential differences in volumetric bone growth in children with sarcoma treated with intensity-modulated (IMRT) and conformal (CRT) radiation therapy using an empiric dose-effect model. Methods and Materials: A random coefficient model was used to estimate potential volumetric bone growth of 36 pelvic bones (ischiopubis and ilium) from 11 patients 4 years after radiotherapy. The model incorporated patient age, pretreatment bone volume, integral dose >35 Gy, and time since completion of radiation therapy. Three dosimetry plans were entered into the model: the actual CRT/IMRT plan, a nontreated comparable IMRT/CRT plan, and an idealized plan in which dose was delivered only to the planning target volume. The results were compared with modeled normal bone growth. Results: The model predicted that by using the idealized, IMRT, and CRT approaches, patients would maintain 93%, 87%, and 84%, respectively (p = 0.06), of their expected normal growth. Patients older than 10 years would maintain 98% of normal growth, regardless of treatment method. Those younger than 10 years would maintain 87% (idealized), 76% (IMRT), or 70% (CRT) of their expected growth (p = 0.015). Post hoc testing (Tukey) revealed that the CRT and IMRT approaches differed significantly from the idealized one but not from each other. Conclusions: Dose-effect models facilitate the comparison of treatment methods and potential interventions. Although treatment methods do not alter the growth of flat bones in older pediatric patients, they may significantly impact bone growth in children younger than age 10 years, especially as we move toward techniques with high conformity and sharper dose gradient.

  16. Perception of patient appearance following various methods of reconstruction after orbital exenteration.

    PubMed

    Kuiper, Justin J; Zimmerman, M Bridget; Pagedar, Nitin A; Carter, Keith D; Allen, Richard C; Shriver, Erin M

    2016-08-01

    This article compares the perception of health and beauty of patients after exenteration reconstruction with free flap, eyelid-sparing, split-thickness skin graft, or with a prosthesis. Cross-sectional evaluation was performed through a survey sent to all students enrolled at the University of Iowa Carver College of Medicine. The survey included inquiries about observer comfort, perceived patient health, difficulty of social interactions, and which patient appearance was least bothersome. Responses were scored from 0 to 4 for each method of reconstruction and an orbital prosthesis. A Friedman test was used to compare responses among each method of repair and the orbital prosthesis for each of the four questions, and if this was significant, then post-hoc pairwise comparison was performed with p values adjusted using Bonferroni's method. One hundred and thirty two students responded to the survey and 125 completed all four questions. Favorable response for all questions was highest for the orbital prosthesis and lowest for the split-thickness skin graft. Patient appearance with an orbital prosthesis had significantly higher scores compared to patient appearance with each of the other methods for all questions (p value < 0.0001). Second highest scores were for the free flap, which were higher than eyelid-sparing and significantly higher compared to split-thickness skin grafting (p value: Question 1: < 0.0001; Question 2: 0.0005; Question 3: 0.006; and Question 4: 0.019). The orbital prosthesis was the preferred post-operative appearance for the exenterated socket for each question. Free flap was the preferred appearance for reconstruction without an orbital prosthesis. Split-thickness skin graft was least preferred for all questions.

  17. Perception of patient appearance following various methods of reconstruction after orbital exenteration.

    PubMed

    Kuiper, Justin J; Zimmerman, M Bridget; Pagedar, Nitin A; Carter, Keith D; Allen, Richard C; Shriver, Erin M

    2016-08-01

    This article compares the perception of health and beauty of patients after exenteration reconstruction with free flap, eyelid-sparing, split-thickness skin graft, or with a prosthesis. Cross-sectional evaluation was performed through a survey sent to all students enrolled at the University of Iowa Carver College of Medicine. The survey included inquiries about observer comfort, perceived patient health, difficulty of social interactions, and which patient appearance was least bothersome. Responses were scored from 0 to 4 for each method of reconstruction and an orbital prosthesis. A Friedman test was used to compare responses among each method of repair and the orbital prosthesis for each of the four questions, and if this was significant, then post-hoc pairwise comparison was performed with p values adjusted using Bonferroni's method. One hundred and thirty two students responded to the survey and 125 completed all four questions. Favorable response for all questions was highest for the orbital prosthesis and lowest for the split-thickness skin graft. Patient appearance with an orbital prosthesis had significantly higher scores compared to patient appearance with each of the other methods for all questions (p value < 0.0001). Second highest scores were for the free flap, which were higher than eyelid-sparing and significantly higher compared to split-thickness skin grafting (p value: Question 1: < 0.0001; Question 2: 0.0005; Question 3: 0.006; and Question 4: 0.019). The orbital prosthesis was the preferred post-operative appearance for the exenterated socket for each question. Free flap was the preferred appearance for reconstruction without an orbital prosthesis. Split-thickness skin graft was least preferred for all questions. PMID:27341072

  18. Patient and provider attitudes toward genomic testing for prostate cancer susceptibility: a mixed method study

    PubMed Central

    2013-01-01

    Background The strong association between family history and prostate cancer (PCa) suggests a significant genetic contribution, yet specific highly penetrant PCa susceptibility genes have not been identified. Certain single-nucleotide-polymorphisms have been found to correlate with PCa risk; however uncertainty remains regarding their clinical utility and how to best incorporate this information into clinical decision-making. Genetic testing is available directly to consumers and both patients and healthcare providers are becoming more aware of this technology. Purchasing online allows patients to bypass their healthcare provider yet patients may have difficulty interpreting test results and providers may be called upon to interpret results. Determining optimal ways to educate both patients and providers, and strategies for appropriately incorporating this information into clinical decision-making are needed. Methods A mixed-method study was conducted in Utah between October 2011 and December 2011. Eleven focus group discussions were held and surveys were administered to 23 first-degree relatives of PCa patients living in Utah and 24 primary-care physicians and urologists practicing in Utah to present specific information about these assessments and determine knowledge and attitudes regarding health implications of using these assessments. Results Data was independently coded by two researchers (relative Kappa = .88; provider Kappa = .77) and analyzed using a grounded theory approach. Results indicated differences in attitudes and behavioral intentions between patient and provider. Despite the test’s limitations relatives indicated interest in genetic testing (52%) while most providers indicated they would not recommend the test for their patients (79%). Relatives expected providers to interpret genetic test results and use results to provide personalized healthcare recommendations while the majority of providers did not think the information would be useful in

  19. Semiclassical Virasoro blocks from AdS3 gravity

    NASA Astrophysics Data System (ADS)

    Hijano, Eliot; Kraus, Per; Perlmutter, Eric; Snively, River

    2015-12-01

    We present a unified framework for the holographic computation of Virasoro conformal blocks at large central charge. In particular, we provide bulk constructions that correctly reproduce all semiclassical Virasoro blocks that are known explicitly from conformal field theory computations. The results revolve around the use of geodesic Witten diagrams, recently introduced in [1], evaluated in locally AdS3 geometries generated by backreaction of heavy operators. We also provide an alternative computation of the heavy-light semiclassical block — in which two external operators become parametrically heavy — as a certain scattering process involving higher spin gauge fields in AdS3; this approach highlights the chiral nature of Virasoro blocks. These techniques may be systematically extended to compute corrections to these blocks and to interpolate amongst the different semiclassical regimes.

  20. AdS6 solutions of type II supergravity

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

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

  1. Conserved higher-spin charges in AdS4

    NASA Astrophysics Data System (ADS)

    Gelfond, O. A.; Vasiliev, M. A.

    2016-03-01

    Gauge invariant conserved conformal currents built from massless fields of all spins in 4d Minkowski space-time and AdS4 are described in the unfolded dynamics approach. The current cohomology associated with non-zero conserved charges is found. The resulting list of charges is shown to match the space of parameters of the conformal higher-spin symmetry algebra in four dimensions.

  2. On information loss in AdS3/CFT2

    DOE PAGES

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

    2016-05-18

    We discuss information loss from black hole physics in AdS3, focusing on two sharp signatures infecting CFT2 correlators at large central charge c: ‘forbidden singularities’ arising from Euclidean-time periodicity due to the effective Hawking temperature, and late-time exponential decay in the Lorentzian region. We study an infinite class of examples where forbidden singularities can be resolved by non-perturbative effects at finite c, and we show that the resolution has certain universal features that also apply in the general case. Analytically continuing to the Lorentzian regime, we find that the non-perturbative effects that resolve forbidden singularities qualitatively change the behavior ofmore » correlators at times t ~SBH, the black hole entropy. This may resolve the exponential decay of correlators at late times in black hole backgrounds. By Borel resumming the 1/c expansion of exact examples, we explicitly identify ‘information-restoring’ effects from heavy states that should correspond to classical solutions in AdS3. Lastly, our results suggest a line of inquiry towards a more precise formulation of the gravitational path integral in AdS3.« less

  3. Lattice Boltzmann method for fast patient-specific simulation of liver tumor ablation from CT images.

    PubMed

    Audigier, Chloé; Mansi, Tommaso; Delingette, Hervé; Rapaka, Saikiran; Mihalef, Viorel; Sharma, Puneet; Carnegie, Daniel; Boctor, Emad; Choti, Michael; Kamen, Ali; Comaniciu, Dorin; Ayache, Nicholas

    2013-01-01

    Radio-frequency ablation (RFA), the most widely used minimally invasive ablative therapy of liver cancer, is challenged by a lack of patient-specific planning. In particular, the presence of blood vessels and time-varying thermal diffusivity makes the prediction of the extent of the ablated tissue difficult. This may result in incomplete treatments and increased risk of recurrence. We propose a new model of the physical mechanisms involved in RFA of abdominal tumors based on Lattice Boltzmann Method to predict the extent of ablation given the probe location and the biological parameters. Our method relies on patient images, from which level set representations of liver geometry, tumor shape and vessels are extracted. Then a computational model of heat diffusion, cellular necrosis and blood flow through vessels and liver is solved to estimate the extent of ablated tissue. After quantitative verifications against an analytical solution, we apply our framework to 5 patients datasets which include pre- and post-operative CT images, yielding promising correlation between predicted and actual ablation extent (mean point to mesh errors of 8.7 mm). Implemented on graphics processing units, our method may enable RFA planning in clinical settings as it leads to near real-time computation: 1 minute of ablation is simulated in 1.14 minutes, which is almost 60x faster than standard finite element method.

  4. Methods for the selection of platelet products for alloimmune-refractory patients.

    PubMed

    Kopko, Patricia M; Warner, Paul; Kresie, Lesley; Pancoska, Carol

    2015-02-01

    The ability to efficiently and accurately diagnose the cause(s) of platelet (PLT) refractoriness is paramount in providing effective PLT products for transfusion. Recent advances in methods for detecting and identifying alloantibodies against human leukocyte antigens (HLAs) and human PLT antigens, combined with accurate molecular techniques for HLA typing, have provided a framework for the development of clinical algorithms to support such patients. Alloantibodies may be detected and/or identified by several methods, including complement-dependent cytotoxicity, enzyme-linked immunosorbent assays (ELISA), and microbead-based assays using Luminex or flow cytometry. The primary difference in these assays is the sensitivity of detection and the range of antibody specificities that may be reliably identified. Direct PLT cross-matching to identify compatible PLTs can be accomplished by several methods, including solid-phase red cell adherence, modified antigen capture ELISA, and flow cytometry. A survey of blood centers and laboratories providing transfusion support has identified the heterogeneity of testing options available, areas of concern and need for improvement, and common obstacles in providing appropriate and timely support to immune-refractory PLT patients. Depending on the testing methods and the pool of HLA-typed PLT donors available, there are numerous options for developing suitable algorithms to provide effective support to immune-refractory PLT patients.

  5. Lattice Boltzmann method for fast patient-specific simulation of liver tumor ablation from CT images.

    PubMed

    Audigier, Chloé; Mansi, Tommaso; Delingette, Hervé; Rapaka, Saikiran; Mihalef, Viorel; Sharma, Puneet; Carnegie, Daniel; Boctor, Emad; Choti, Michael; Kamen, Ali; Comaniciu, Dorin; Ayache, Nicholas

    2013-01-01

    Radio-frequency ablation (RFA), the most widely used minimally invasive ablative therapy of liver cancer, is challenged by a lack of patient-specific planning. In particular, the presence of blood vessels and time-varying thermal diffusivity makes the prediction of the extent of the ablated tissue difficult. This may result in incomplete treatments and increased risk of recurrence. We propose a new model of the physical mechanisms involved in RFA of abdominal tumors based on Lattice Boltzmann Method to predict the extent of ablation given the probe location and the biological parameters. Our method relies on patient images, from which level set representations of liver geometry, tumor shape and vessels are extracted. Then a computational model of heat diffusion, cellular necrosis and blood flow through vessels and liver is solved to estimate the extent of ablated tissue. After quantitative verifications against an analytical solution, we apply our framework to 5 patients datasets which include pre- and post-operative CT images, yielding promising correlation between predicted and actual ablation extent (mean point to mesh errors of 8.7 mm). Implemented on graphics processing units, our method may enable RFA planning in clinical settings as it leads to near real-time computation: 1 minute of ablation is simulated in 1.14 minutes, which is almost 60x faster than standard finite element method. PMID:24505777

  6. Predicting Appropriate Admission of Bronchiolitis Patients in the Emergency Department: Rationale and Methods

    PubMed Central

    Stone, Bryan L; Johnson, Michael D; Nkoy, Flory L

    2016-01-01

    unsafe. Objective The goal of this study is to develop a predictive model to guide appropriate hospital admission for ED patients with bronchiolitis. Methods This study will: (1) develop an operational definition of appropriate hospital admission for ED patients with bronchiolitis, (2) develop and test the accuracy of a new model to predict appropriate hospital admission for an ED patient with bronchiolitis, and (3) conduct simulations to estimate the impact of using the model on bronchiolitis outcomes. Results We are currently extracting administrative and clinical data from the enterprise data warehouse of an integrated health care system. Our goal is to finish this study by the end of 2019. Conclusions This study will produce a new predictive model that can be operationalized to guide and improve disposition decisions for ED patients with bronchiolitis. Broad use of the model would reduce iatrogenic risk, patient and parental distress, health care use, and costs and improve outcomes for bronchiolitis patients. PMID:26952700

  7. [Choice of components and a method of anesthesia in geriatric cancer patients with high cardiovascular risk].

    PubMed

    Khoronenko, V E; Osipova, N A; Shemetova, M M; Edeleva, N V

    2009-01-01

    Investigations were made at surgical treatment stages in 102 cancer patients (mean age 72 +/- 5.8 years) at high cardiovascular risk, who received continuous therapy that reduced heart rate and blood pressure, in order to compensate for the course of coronary heart disease and arterial hypertension. The time course of changes in the major circulatory and metabolic parameters was analyzed in patients during operations on the abdomen and small pelvis while using three different multimodal anesthetic techniques (general intravenous anesthesia-based diazepam, propofol, fentanyl, ketamine; sevofluorane-based inhalational; combined epidural and intravenous one). The advantages and limitations of the above methods were shown in patients on cardio- and vasotropic therapies. Correcting modes (transesophageal atrial pacing, morning-dose drug withdrawal) for its possible related bradycardiac and hypotensive disorders, which reduce a risk of perioperative cardiovascular complications, are set forth.

  8. A new approach to eliciting patients' preferences for palliative day care: the choice experiment method.

    PubMed

    Douglas, Hannah-Rose; Normand, Charles E; Higginson, Irene J; Goodwin, Danielle M

    2005-05-01

    Palliative day care (PDC) provides individualized care to meet patients' needs and preferences and has posed problems for economic evaluation. Current methods are limited in their ability to capture relevant outcomes. The choice experiment elicits preferences for multiple aspects of care rather than a single outcome. A choice experiment was undertaken at four centers in England. A random effects probit model was used. Interaction terms relating to patient and service characteristics were explored. Seventy-nine patients participated. All characteristics of PDC except bathing and hairdressing were significant (P < 0.001). Access to specialist therapies was three times as important as medical support and twice as important as staying all day. Interaction terms were not significant, except for age and preference for specialist therapies, although the sample may not have been adequate to detect differences. Choice experiments provided useful insights by quantifying preferences for services, providing an alternative to cost-effectiveness analysis. PMID:15904746

  9. Patient Monitoring in the Operating Room: Validation of Instrument Readings by Artificial Intelligence Methods

    PubMed Central

    Garfinkel, D.; Matsiras, P.V.; Mavrides, T.; McAdams, J.; Aukburg, S.J.

    1989-01-01

    Physiological monitoring in the operating room is needed to follow the patient's state of ventilation, circulation, etc. Parameters such as heart rate, blood pressure, and respiratory gas content are observed with devices of uncertain reliability. These provide speedy information in the form of cautions and alarms, which may indicate that corrective action is needed. In practice the large number of alarms when there is no hazard to the patient (false alarms) is a considerable problem. We describe a method of comparing and validating instrument readings in this situation involving a knowledge base whose core is a set of 36 rules. This was applied to 7803 warnings (6287 cautions and 1516 alarms) from 68 day surgery patients undergoing 115 hours of surgery. Most of the cautions were validated by our analysis, but 734 of the 1516 alarms were invalidated while 419 were validated and 363 left indeterminate. This translates to a potential reduction from one alarm every 4 minutes to one every 16 minutes.

  10. Non-Surgical Breast-Conserving Treatment (KORTUC-BCT) Using a New Radiosensitization Method (KORTUC II) for Patients with Stage I or II Breast Cancer

    PubMed Central

    Ogawa, Yasuhiro; Kubota, Kei; Aoyama, Nobutaka; Yamanishi, Tomoaki; Kariya, Shinji; Hamada, Norihiko; Nogami, Munenobu; Nishioka, Akihito; Onogawa, Masahide; Miyamura, Mitsuhiko

    2015-01-01

    The purpose of the present study was to establish a non-surgical breast-conserving treatment (BCT) using KORTUC II radiosensitization treatment. A new radiosensitizing agent containing 0.5% hydrogen peroxide and 0.83% sodium hyaluronate (a CD44 ligand) has been developed for intra-tumoral injection into various tumors. This new method, named KORTUC II, was approved by our local ethics committee for the treatment of breast cancer and metastatic lymph nodes. A total of 72 early-stage breast cancer patients (stage 0, 1 patient; stage I, 23; stage II, 48) were enrolled in the KORTUC II trial after providing fully informed consent. The mean age of the patients was 59.7 years. A maximum of 6 mL (usually 3 mL for tumors of less than approximately 3 cm in diameter) of the agent was injected into breast tumor tissue twice a week under ultrasonographic guidance. For radiotherapy, hypofraction radiotherapy was administered using a tangential fields approach including an ipsilateral axillary region and field-in-field method; the energy level was 4 MV, and the total radiation dose was 44 Gy administered as 2.75 Gy/fraction. An electron boost of 3 Gy was added three times. Treatment was well tolerated with minimal adverse effects in all 72 patients. No patients showed any significant complications other than mild dermatitis. A total of 24 patients under 75 years old with stage II breast cancer underwent induction chemotherapy (EC and/or taxane) prior to KORTUC II treatment, and 58 patients with estrogen receptor-positive tumors also received hormonal therapy following KORTUC II. The mean duration of follow-up as of the end of September 2014 was 51.1 months, at which time 68 patients were alive without any distant metastases. Only one patient had local recurrence and died of cardiac failure at 6.5 years. Another one patient had bone metastases. For two of the 72 patients, follow-up ended after several months following KORTUC II treatment. In conclusion, non-surgical BCT can be

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

    ERIC Educational Resources Information Center

    Sinharay, Sandip

    2014-01-01

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

  12. A Novel Method in the Stratification of Post-Myocardial-Infarction Patients Based on Pathophysiology

    PubMed Central

    Yang, Fan; Sun, Yujun; Li, Zheng; Jiang, Meng; Fan, Yiting; Pu, Jun; Shen, Xuedong

    2015-01-01

    Objectives We proposed that the severity of ST-segment elevation myocardial infarction (STEMI) could be classified based on pathophysiological changes. Methods First-STEMI patients were classified within hospitalization. Grade 0: no detectable myocardial necrosis; Grade 1: myocardial necrosis without functional and morphological abnormalities; Grade 2: myocardial necrosis with reduced LVEF; Grade 3: reduced LVEF on the basis of cardiac remodeling; Grade 4: mitral regurgitation additional to the Grade-3 criteria. Results Of 180 patients, 1.7, 43.9, 26.1, 23.9 and 4.4% patients were classified as Grade 0 to 4, respectively. The classification is an independent predicator of 90-day MACEs (any death, resuscitated cardiac arrest, acute heart failure and stroke): the rate was 0, 5.1, 8.5, 48.8 and 75% from Grade 0 to 4 (p<0.001), respectively. The Grade-2 patients were more likely to have recovered left ventricular ejection fraction than the Grade-3/4 patients did after 90 days (48.9% vs. 19.1%, p<0.001). Avoiding complicated quantification, the classification served as a good reflection of infarction size as measured by cardiac magnetic resonance imaging (0±0, 15.68±8.48, 23.68±9.32, 36.12±11.35 and 40.66±14.33% of the left ventricular mass by Grade 0 to 4, P<0.001), and with a comparable prognostic value (AUC 0.819 vs. 0.813 for infarction size, p = 0.876 by C-statistics) for MACEs. Conclusions The new classification represents an easy and objective method to scale the cardiac detriments for STEMI patients. PMID:26090807

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

    PubMed Central

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

    2014-01-01

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

  14. Patient preferences for the allocation of deceased donor kidneys for transplantation: a mixed methods study

    PubMed Central

    2012-01-01

    Background Deceased donor kidneys are a scarce health resource, yet patient preferences for organ allocation are largely unknown. The aim of this study was to determine patient preferences for how kidneys should be allocated for transplantation. Methods Patients on dialysis and kidney transplant recipients were purposively selected from two centres in Australia to participate in nominal/focus groups in March 2011. Participants identified and ranked criteria they considered important for deceased donor kidney allocation. Transcripts were thematically analysed to identify reasons for their rankings. Results From six groups involving 37 participants, 23 criteria emerged. Most agreed that matching, wait-list time, medical urgency, likelihood of surviving surgery, age, comorbidities, duration of illness, quality of life, number of organs needed and impact on the recipient's life circumstances were important considerations. Underpinning their rankings were four main themes: enhancing life, medical priority, recipient valuation, and deservingness. These were predominantly expressed as achieving equity for all patients, or priority for specific sub-groups of potential recipients regarded as more "deserving". Conclusions Patients believed any wait-listed individual who would gain life expectancy and quality of life compared with dialysis should have access to transplantation. Equity of access to transplantation for all patients and justice for those who would look after their transplant were considered important. A utilitarian rationale based on maximizing health gains from the allocation of a scarce resource to avoid "wastage," were rarely expressed. Organ allocation organisations need to seek input from patients who can articulate preferences for allocation and advocate for equity and justice in organ allocation. PMID:22510248

  15. A new cluster-based oversampling method for improving survival prediction of hepatocellular carcinoma patients.

    PubMed

    Santos, Miriam Seoane; Abreu, Pedro Henriques; García-Laencina, Pedro J; Simão, Adélia; Carvalho, Armando

    2015-12-01

    Liver cancer is the sixth most frequently diagnosed cancer and, particularly, Hepatocellular Carcinoma (HCC) represents more than 90% of primary liver cancers. Clinicians assess each patient's treatment on the basis of evidence-based medicine, which may not always apply to a specific patient, given the biological variability among individuals. Over the years, and for the particular case of Hepatocellular Carcinoma, some research studies have been developing strategies for assisting clinicians in decision making, using computational methods (e.g. machine learning techniques) to extract knowledge from the clinical data. However, these studies have some limitations that have not yet been addressed: some do not focus entirely on Hepatocellular Carcinoma patients, others have strict application boundaries, and none considers the heterogeneity between patients nor the presence of missing data, a common drawback in healthcare contexts. In this work, a real complex Hepatocellular Carcinoma database composed of heterogeneous clinical features is studied. We propose a new cluster-based oversampling approach robust to small and imbalanced datasets, which accounts for the heterogeneity of patients with Hepatocellular Carcinoma. The preprocessing procedures of this work are based on data imputation considering appropriate distance metrics for both heterogeneous and missing data (HEOM) and clustering studies to assess the underlying patient groups in the studied dataset (K-means). The final approach is applied in order to diminish the impact of underlying patient profiles with reduced sizes on survival prediction. It is based on K-means clustering and the SMOTE algorithm to build a representative dataset and use it as training example for different machine learning procedures (logistic regression and neural networks). The results are evaluated in terms of survival prediction and compared across baseline approaches that do not consider clustering and/or oversampling using the

  16. Assessing Critical Thinking Outcomes of Dental Hygiene Students Utilizing Virtual Patient Simulation: A Mixed Methods Study.

    PubMed

    Allaire, Joanna L

    2015-09-01

    Dental hygiene educators must determine which educational practices best promote critical thinking, a quality necessary to translate knowledge into sound clinical decision making. The aim of this small pilot study was to determine whether virtual patient simulation had an effect on the critical thinking of dental hygiene students. A pretest-posttest design using the Health Science Reasoning Test was used to evaluate the critical thinking skills of senior dental hygiene students at The University of Texas School of Dentistry at Houston Dental Hygiene Program before and after their experience with computer-based patient simulation cases. Additional survey questions sought to identify the students' perceptions of whether the experience had helped develop their critical thinking skills and improved their ability to provide competent patient care. A convenience sample of 31 senior dental hygiene students completed both the pretest and posttest (81.5% of total students in that class); 30 senior dental hygiene students completed the survey on perceptions of the simulation (78.9% response rate). Although the results did not show a significant increase in mean scores, the students reported feeling that the use of virtual patients was an effective teaching method to promote critical thinking, problem-solving, and confidence in the clinical realm. The results of this pilot study may have implications to support the use of virtual patient simulations in dental hygiene education. Future research could include a larger controlled study to validate findings from this study.

  17. [The Fick method underestimates pulmonary flow calculation in patients subjected to bidirectional Glenn procedure].

    PubMed

    Alva, Carlos; Gómez, Felipe David; Ortegón Cardeña, José; Yáñez Gutiérrez, Lucelli; Lazcano, Sonia

    2008-01-01

    In patients with Bidirectional Glenn who have undergone surgery, the superior caval venous flow provides the only pulmonary blood supply. This is the effective pulmonary flow and at the same time its volume is not enough to overflow the single ventricle. The unsaturated, inferior vena cava flow is not oxygenated, since it goes across the interatrial septal communication and gets mixed in the left ventricle with the pulmonary venous blood. In this work, a bidirectional Glenn case is analyzed. The hemodynamic data before and after the operation are shown. It was evident from this case that the use of the Fick method to measure pulmonary flow in patients with bidirectional Glenn operation is not appropriate. Alternative methods, such as Doppler echocardiography and Magnetic Resonance Imaging, are recommended. A literature review on this subject was carefully done.

  18. Semiclassical energy of the AdS4 × Bbb CBbb P3 folded string

    NASA Astrophysics Data System (ADS)

    Beccaria, Matteo; Macorini, Guido; Ratti, CarloAlberto; Valatka, Saulius

    2013-01-01

    We consider the classical solution describing a folded type IIA string in the background AdS4 × Bbb CBbb P3. The string is spinning in AdS and has angular momentum in Bbb CBbb P3. In the 't Hooft limit, this is the gravity dual of twist operators in the ABJM superconformal theory. We quantize the classical solution by algebraic curve methods and determine the first semiclassical correction to the energy. An integral representation is given, valid for all values of the charges. We analyze its properties in the special regimes associated with a short or long string. Finally, we investigate various properties of the leading term of the energy for short strings (the so-called slope).

  19. Renormalization, averaging, conservation laws and AdS (in)stability

    NASA Astrophysics Data System (ADS)

    Craps, Ben; Evnin, Oleg; Vanhoof, Joris

    2015-01-01

    We continue our analytic investigations of non-linear spherically symmetric perturbations around the anti-de Sitter background in gravity-scalar field systems, and focus on conservation laws restricting the (perturbatively) slow drift of energy between the different normal modes due to non-linearities. We discover two conservation laws in addition to the energy conservation previously discussed in relation to AdS instability. A similar set of three conservation laws was previously noted for a self-interacting scalar field in a non-dynamical AdS background, and we highlight the similarities of this system to the fully dynamical case of gravitational instability. The nature of these conservation laws is best understood through an appeal to averaging methods which allow one to derive an effective Lagrangian or Hamiltonian description of the slow energy transfer between the normal modes. The conservation laws in question then follow from explicit symmetries of this averaged effective theory.

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

    NASA Astrophysics Data System (ADS)

    Hijano, Eliot; Kraus, Per; Perlmutter, Eric; Snively, River

    2016-01-01

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

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

    DOE PAGES

    Hijano, Eliot; Kraus, Per; Perlmutter, Eric; Snively, River

    2016-01-25

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

  2. ADS/CFT and QCD

    SciTech Connect

    Brodsky, Stanley J.; de Teramond, Guy F.; /Costa Rica U. /SLAC

    2007-02-21

    The AdS/CFT correspondence between string theory in AdS space and conformal .eld theories in physical spacetime leads to an analytic, semi-classical model for strongly-coupled QCD which has scale invariance and dimensional counting at short distances and color confinement at large distances. Although QCD is not conformally invariant, one can nevertheless use the mathematical representation of the conformal group in five-dimensional anti-de Sitter space to construct a first approximation to the theory. The AdS/CFT correspondence also provides insights into the inherently non-perturbative aspects of QCD, such as the orbital and radial spectra of hadrons and the form of hadronic wavefunctions. In particular, we show that there is an exact correspondence between the fifth-dimensional coordinate of AdS space z and a specific impact variable {zeta} which measures the separation of the quark and gluonic constituents within the hadron in ordinary space-time. This connection allows one to compute the analytic form of the frame-independent light-front wavefunctions, the fundamental entities which encode hadron properties and allow the computation of decay constants, form factors, and other exclusive scattering amplitudes. New relativistic lightfront equations in ordinary space-time are found which reproduce the results obtained using the 5-dimensional theory. The effective light-front equations possess remarkable algebraic structures and integrability properties. Since they are complete and orthonormal, the AdS/CFT model wavefunctions can also be used as a basis for the diagonalization of the full light-front QCD Hamiltonian, thus systematically improving the AdS/CFT approximation.

  3. Identifying Quality Indicators Used by Patients to Choose Secondary Health Care Providers: A Mixed Methods Approach

    PubMed Central

    Zaman, Saman Sara; Kahlon, Gurnaaz Kaur; Naik, Aditi; Jessel, Amar Singh; Nanavati, Niraj; Shah, Akash; Cox, Benita; Darzi, Ara

    2015-01-01

    Background Patients in health systems across the world can now choose between different health care providers. Patients are increasingly using websites and apps to compare the quality of health care services available in order to make a choice of provider. In keeping with many patient-facing platforms, most services currently providing comparative information on different providers do not take account of end-user requirements or the available evidence base. Objective To investigate what factors were considered most important when choosing nonemergency secondary health care providers in the United Kingdom with the purpose of translating these insights into a ratings platform delivered through a consumer mHealth app. Methods A mixed methods approach was used to identify key indicators incorporating a literature review to identify and categorize existing quality indicators, a questionnaire survey to formulate a ranked list of performance indicators, and focus groups to explore rationales behind the rankings. Findings from qualitative and quantitative methodologies were mapped onto each other under the four categories identified by the literature review. Results Quality indicators were divided into four categories. Hospital access was the least important category. The mean differences between the other three categories hospital statistics, hospital staff, and hospital facilities, were not statistically significant. Staff competence was the most important indicator in the hospital staff category; cleanliness and up-to-date facilities were equally important in hospital facilities; ease of travel to the hospital was found to be most important in hospital access. All quality indicators within the hospital statistics category were equally important. Focus groups elaborated that users find it difficult to judge staff competence despite its importance. Conclusions A mixed methods approach is presented, which supported a patient-centered development and evaluation of a

  4. [Biofeedback: a new method for the prevention of amputations in patients with diabetes].

    PubMed

    Pataky, Zoltan; Allet, Lara; Golay, Alain

    2014-01-15

    Lower limb amputations in patients with diabetes are still a huge public health problem. Despite of our knowledge and advanced technical tools, the incidence of amputations and they relapses remain very high and inacceptable. A key role in primary and secondary prevention of amputations is the foot off-loading. We dispose different off-loading devices and techniques which are efficient on short term. However, knowledge about its long term efficacy is missing. In this article, we review different methods of foot off-loading. We also describe a new method for diabetic foot off-loading based on the biofeedback technique we recently developed.

  5. Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients

    PubMed Central

    Asadian, Simin; Khatony, Alireza; Moradi, Gholamreza; Abdi, Alireza; Rezaei, Mansour

    2016-01-01

    Introduction An accurate determination of body temperature in critically ill patients is a fundamental requirement for initiating the proper process of diagnosis, and also therapeutic actions; therefore, the aim of the study was to assess the accuracy and precision of four noninvasive peripheral methods of temperature measurement compared to the central nasopharyngeal measurement. Methods In this observational prospective study, 237 patients were recruited from the intensive care unit of Imam Ali Hospital of Kermanshah. The patients’ body temperatures were measured by four peripheral methods; oral, axillary, tympanic, and forehead along with a standard central nasopharyngeal measurement. After data collection, the results were analyzed by paired t-test, kappa coefficient, receiver operating characteristic curve, and using Statistical Package for the Social Sciences, version 19, software. Results There was a significant meaningful correlation between all the peripheral methods when compared with the central measurement (P<0.001). Kappa coefficients showed good agreement between the temperatures of right and left tympanic membranes and the standard central nasopharyngeal measurement (88%). Paired t-test demonstrated an acceptable precision with forehead (P=0.132), left (P=0.18) and right (P=0.318) tympanic membranes, oral (P=1.00), and axillary (P=1.00) methods. Sensitivity and specificity of both the left and right tympanic membranes were more than for other methods. Conclusion The tympanic and forehead methods had the highest and lowest accuracy for measuring body temperature, respectively. It is recommended to use the tympanic method (right and left) for assessing a patient’s body temperature in the intensive care units because of high accuracy and acceptable precision.

  6. Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients

    PubMed Central

    Asadian, Simin; Khatony, Alireza; Moradi, Gholamreza; Abdi, Alireza; Rezaei, Mansour

    2016-01-01

    Introduction An accurate determination of body temperature in critically ill patients is a fundamental requirement for initiating the proper process of diagnosis, and also therapeutic actions; therefore, the aim of the study was to assess the accuracy and precision of four noninvasive peripheral methods of temperature measurement compared to the central nasopharyngeal measurement. Methods In this observational prospective study, 237 patients were recruited from the intensive care unit of Imam Ali Hospital of Kermanshah. The patients’ body temperatures were measured by four peripheral methods; oral, axillary, tympanic, and forehead along with a standard central nasopharyngeal measurement. After data collection, the results were analyzed by paired t-test, kappa coefficient, receiver operating characteristic curve, and using Statistical Package for the Social Sciences, version 19, software. Results There was a significant meaningful correlation between all the peripheral methods when compared with the central measurement (P<0.001). Kappa coefficients showed good agreement between the temperatures of right and left tympanic membranes and the standard central nasopharyngeal measurement (88%). Paired t-test demonstrated an acceptable precision with forehead (P=0.132), left (P=0.18) and right (P=0.318) tympanic membranes, oral (P=1.00), and axillary (P=1.00) methods. Sensitivity and specificity of both the left and right tympanic membranes were more than for other methods. Conclusion The tympanic and forehead methods had the highest and lowest accuracy for measuring body temperature, respectively. It is recommended to use the tympanic method (right and left) for assessing a patient’s body temperature in the intensive care units because of high accuracy and acceptable precision. PMID:27621673

  7. Euclidean and Noetherian entropies in AdS space

    SciTech Connect

    Dutta, Suvankar; Gopakumar, Rajesh

    2006-08-15

    We examine the Euclidean action approach, as well as that of Wald, to the entropy of black holes in asymptotically AdS spaces. From the point of view of holography these two approaches are somewhat complementary in spirit and it is not obvious why they should give the same answer in the presence of arbitrary higher derivative gravity corrections. For the case of the AdS{sub 5} Schwarzschild black hole, we explicitly study the leading correction to the Bekenstein-Hawking entropy in the presence of a variety of higher derivative corrections studied in the literature, including the Type IIB R{sup 4} term. We find a nontrivial agreement between the two approaches in every case. Finally, we give a general way of understanding the equivalence of these two approaches.

  8. New Features in ADS Labs

    NASA Astrophysics Data System (ADS)

    Accomazzi, Alberto; Kurtz, M. J.; Henneken, E. A.; Grant, C. S.; Thompson, D.; Di Milia, G.; Luker, J.; Murray, S. S.

    2013-01-01

    The NASA Astrophysics Data System (ADS) has been working hard on updating its services and interfaces to better support our community's research needs. ADS Labs is a new interface built on the old tried-and-true ADS Abstract Databases, so all of ADS's content is available through it. In this presentation we highlight the new features that have been developed in ADS Labs over the last year: new recommendations, metrics, a citation tool and enhanced fulltext search. ADS Labs has long been providing article-level recommendations based on keyword similarity, co-readership and co-citation analysis of its corpus. We have now introduced personal recommendations, which provide a list of articles to be considered based on a individual user's readership history. A new metrics interface provides a summary of the basic impact indicators for a list of records. These include the total and normalized number of papers, citations, reads, and downloads. Also included are some of the popular indices such as the h, g and i10 index. The citation helper tool allows one to submit a set of records and obtain a list of top 10 papers which cite and/or are cited by papers in the original list (but which are not in it). The process closely resembles the network approach of establishing "friends of friends" via an analysis of the citation network. The full-text search service now covers more than 2.5 million documents, including all the major astronomy journals, as well as physics journals published by Springer, Elsevier, the American Physical Society, the American Geophysical Union, and all of the arXiv eprints. The full-text search interface interface allows users and librarians to dig deep and find words or phrases in the body of the indexed articles. ADS Labs is available at http://adslabs.org

  9. Patients and Methods of the PATH Biobank - A Resource for Breast Cancer Research.

    PubMed

    Waldmann, A; Anzeneder, T; Katalinic, A

    2014-04-01

    Introduction: The foundation PATH (Patients' Tumour Bank of Hope) collects in a tumour bank samples of blood, tumour, and tumour-near normal tissue from breast cancer patients and supplements them systematically with health-care data. Material and Methods: For patients from the diagnosis years 2006-2009 quantitative data were evaluated with the help of mean values and standard deviations while for qualitative data absolute and relative incidences were assessed. Demographic and clinical features of women who used different numbers of information sources were tested for statistical significance by means of ANOVA and χ(2) tests. The benchmark report of the WBC and two DMP reports were used to compare oncological care. Results: For research purposes tumour tissue samples are available for 59 % of the cases, normal tissue for 62 % and blood serum samples for 92 %. From 3573 women (diagnoses 2006-2009), a total of 2697 women (75.5 %) took part in follow-up. The characteristics of the follow-up patients did not relevantly differ from those of all the patients. The responsible physician was named as the most important source of information about the disease. Young women in particular consulted several sources and also used the internet to obtain information. Discussion: Compared with data on therapy from WBC and the DMP breast cancer in Bavaria or, respectively, North Rhineland reports, the PATH patients represent an only slightly selected sample. The PATH biobank is a (still) poorly used data and sample source, which is made available upon request and positive evaluation of the study protocol. Thus, it is possible to address current questions in a short time without having to undertake extensive recruiting procedures.

  10. Feasible method for routine surveillance culturing of stools from neutropenic patients.

    PubMed Central

    Smith, J A; Sherlock, C H; Burdge, D R

    1984-01-01

    This study was undertaken to develop an accurate, yet inexpensive, method for determining whether the bowel of a neutropenic patient is colonized with bacteria resistant to the antimicrobial agents used in empiric therapy. Selective agar media were prepared in which Mueller-Hinton agar or MacConkey agar were supplemented with one of the following antimicrobial agents: carbenicillin (16 micrograms/ml), gentamicin (4 micrograms/ml), or tobramycin (4 micrograms/ml). Moxalactam was incorporated initially at 16 micrograms/ml and subsequently at 8 micrograms/ml. Stools from neutropenic patients and bone marrow transplant recipients were inoculated on these media and on unsupplemented MacConkey agar. All bacteria that grew on the antibiotic-containing media were categorized as resistant to the supplementing drug; failure to detect an organism that did grow on the antibiotic-free MacConkey agar indicated susceptibility. These results were compared with those obtained for all isolates on all media by agar disk diffusion. There were 512 gram-negative enteric isolates from 320 stools obtained from 98 patients. The antibiotic-containing media suppressed the growth of 95% of bacteria that were identified as susceptible by agar disk diffusion. In detecting resistant organisms, the correlation between agar disk diffusion and direct stool screening with Mueller-Hinton agar ranged from 73 to 83%, and on MacConkey agar it ranged from 87 to 97%. The predictive value of a resistant result was 80 to 97% for the four antimicrobial agents when MacConkey agar was used. MacConkey agar performed better than Mueller-Hinton agar because of the greater ease of detecting different bacterial morphotypes. The cost of direct stool screening with antibiotic-supplemented MacConkey agar is approximately half the cost of routine methods of surveillance. Its cost and accuracy make the method a useful adjunct to the routine management of neutropenic patients. PMID:6394620

  11. Most general AdS3 boundary conditions

    NASA Astrophysics Data System (ADS)

    Grumiller, Daniel; Riegler, Max

    2016-10-01

    We consider the most general asymptotically anti-de Sitter boundary conditions in three-dimensional Einstein gravity with negative cosmological constant. The metric contains in total twelve independent functions, six of which are interpreted as chemical potentials (or non-normalizable fluctuations) and the other half as canonical boundary charges (or normalizable fluctuations). Their presence modifies the usual Fefferman-Graham expansion. The asymptotic symmetry algebra consists of two sl{(2)}_k current algebras, the levels of which are given by k = ℓ/(4 G N ), where ℓ is the AdS radius and G N the three-dimensional Newton constant.

  12. A new method and device of aligning patient setup lasers in radiation therapy.

    PubMed

    Hwang, Ui-Jung; Jo, Kwanghyun; Lim, Young Kyung; Kwak, Jung Won; Choi, Sang Hyuon; Jeong, Chiyoung; Kim, Mi Young; Jeong, Jong Hwi; Shin, Dongho; Lee, Se Byeong; Park, Jeong-Hoon; Park, Sung Yong; Kim, Siyong

    2016-01-08

    The aim of this study is to develop a new method to align the patient setup lasers in a radiation therapy treatment room and examine its validity and efficiency. The new laser alignment method is realized by a device composed of both a metallic base plate and a few acrylic transparent plates. Except one, every plate has either a crosshair line (CHL) or a single vertical line that is used for alignment. Two holders for radiochromic film insertion are prepared in the device to find a radiation isocenter. The right laser positions can be found optically by matching the shadows of all the CHLs in the gantry head and the device. The reproducibility, accuracy, and efficiency of laser alignment and the dependency on the position error of the light source were evaluated by comparing the means and the standard deviations of the measured laser positions. After the optical alignment of the lasers, the radiation isocenter was found by the gantry and collimator star shots, and then the lasers were translated parallel to the isocenter. In the laser position reproducibility test, the mean and standard deviation on the wall of treatment room were 32.3 ± 0.93 mm for the new method whereas they were 33.4 ± 1.49 mm for the conventional method. The mean alignment accuracy was 1.4 mm for the new method, and 2.1 mm for the conventional method on the walls. In the test of the dependency on the light source position error, the mean laser position was shifted just by a similar amount of the shift of the light source in the new method, but it was greatly magnified in the conventional method. In this study, a new laser alignment method was devised and evaluated successfully. The new method provided more accurate, more reproducible, and faster alignment of the lasers than the conventional method.

  13. A new method and device of aligning patient setup lasers in radiation therapy.

    PubMed

    Hwang, Ui-Jung; Jo, Kwanghyun; Lim, Young Kyung; Kwak, Jung Won; Choi, Sang Hyuon; Jeong, Chiyoung; Kim, Mi Young; Jeong, Jong Hwi; Shin, Dongho; Lee, Se Byeong; Park, Jeong-Hoon; Park, Sung Yong; Kim, Siyong

    2016-01-01

    The aim of this study is to develop a new method to align the patient setup lasers in a radiation therapy treatment room and examine its validity and efficiency. The new laser alignment method is realized by a device composed of both a metallic base plate and a few acrylic transparent plates. Except one, every plate has either a crosshair line (CHL) or a single vertical line that is used for alignment. Two holders for radiochromic film insertion are prepared in the device to find a radiation isocenter. The right laser positions can be found optically by matching the shadows of all the CHLs in the gantry head and the device. The reproducibility, accuracy, and efficiency of laser alignment and the dependency on the position error of the light source were evaluated by comparing the means and the standard deviations of the measured laser positions. After the optical alignment of the lasers, the radiation isocenter was found by the gantry and collimator star shots, and then the lasers were translated parallel to the isocenter. In the laser position reproducibility test, the mean and standard deviation on the wall of treatment room were 32.3 ± 0.93 mm for the new method whereas they were 33.4 ± 1.49 mm for the conventional method. The mean alignment accuracy was 1.4 mm for the new method, and 2.1 mm for the conventional method on the walls. In the test of the dependency on the light source position error, the mean laser position was shifted just by a similar amount of the shift of the light source in the new method, but it was greatly magnified in the conventional method. In this study, a new laser alignment method was devised and evaluated successfully. The new method provided more accurate, more reproducible, and faster alignment of the lasers than the conventional method. PMID:26894331

  14. Effectiveness of hand washing and disinfection methods in removing transient bacteria after patient nursing.

    PubMed

    Ojajärvi, J

    1980-10-01

    The effectiveness of various hand washing and disinfection methods in removing transient skin bacteria was studied in hospital after dry or moist contamination of the hands when nursing burn patients. The results were compared with those of laboratory tests with volunteers. A fairly good correlation of the bacterial reductions existed between hospital and laboratory tests. All other methods removed Staph. aureus from the hands more effectively than liquid soap. Gram-negative bacilli were more easily removed than staphylococci, even with soap wash alone. In hospital, none of the washing and disinfection methods always removed all patient-borne bacteria from the hands. After dry or moist contamination and subsequent washing with soap only, colonies of Staph. aureus were often detected in finger-print samples. Staphylococci were more often completely removed by a 4% chlorhexidine detergent scrub and alcoholic solutions (either with or without previous soap wash) than by liquid soap, hexachlorophene or iodophor preparations. Gram-negative bacilli were more easily removed by all the washing and disinfection methods. After moist contamination, Gram-negative bacilli were more often completely removed from the hands by ethanol than by other treatments. The results of the present study emphasize the importance of always using gloves when nursing a profuse spreader of bacteria or one who must be protected from infection.

  15. A Convenient Method for Measuring Blood Ascorbate Concentrations in Patients Receiving High-Dose Intravenous Ascorbate

    PubMed Central

    Ma, Yan; Sullivan, Garrett G; Schrick, Elizabeth; Choi, In-Young; He, Zhuoya; Lierman, JoAnn; Lee, Phil; Drisko, Jeanne A; Chen, Qi

    2013-01-01

    Objective A simple method of using fingerstick blood glucose monitors (FSBG) to estimate blood ascorbate values after high-dose intravenous (IV) ascorbate infusion is evaluated as a substitution for HPLC measurement. Methods In 33 participants, readings from FSBG were taken before and after IV ascorbate infusions at various time points, with the post-infusion FSBG readings subtracted by the baseline glucose readings. The results of the subtractions (AAFSBG) were correlated with ascorbate concentrations detected by HPLC (AAHPLC). Results A linear regression was found between ascorbate concentrations detected by the fingersitck method (AAFSBG) and by HPLC (AAHPLC). The linear correlations were identical in healthy subjects, diabetic subjects and cancer patients. ANOVA analysis obtained an AAFSBG/AAHPLC ratio of 0.90, with 90% confidence interval of (0.69, 1.20). The corrections of AAFSBG improved similarity to AAHPLC, but did not significantly differ from the un-corrected values. Conclusion The FSBG method can be used as an approximate estimation of high blood ascorbate concentration after IV ascorbate (>50 mg/dL, or 2.8 mM) without correction. However this measurement is not accurate in detecting lower or baseline blood ascorbate. It is also important to highlight that in regard to glucose monitoring, FSBG readings will be erroneously elevated following intravenous ascorbate use and insulin should not be administered to patients based on these readings. PMID:23885992

  16. Patient utilities in chronic musculoskeletal pain: how useful is the standard gamble method?

    PubMed

    Goossens, M E; Vlaeyen, J W; Rutten-van Mölken, M P; van der Linden, S M

    1999-03-01

    The main goal of current pain management approaches is to increase the patients' quality of life by improving pain coping skills and by reducing the levels of disability in daily life, often despite persistent pain. Direct measurement of quality of life is of crucial importance in economic evaluation research, in which not only is the estimation of financial costs and benefits included, but so is the evaluation of costs and benefits in terms of changes in health states. The purpose of this study is to compare the psychometric qualities of two instruments for assessing patients' utilities, the rating scale (RS) and the standard gamble (SG). Such instruments are designed for their application in economic evaluation research, but have seldomly been used in chronic pain trials. Both methods provide a single measure between 0 and 1. The relationship between these utility measures and descriptive and domain-specific quality of life measures was examined in 133 fibromyalgia patients and 148 patients with chronic non-specific low back pain. Mean utility score at baseline was 0.43 with the RS and 0.78 for the SG. The correlation between both methods was found to be poor (r = 0.21). Both measures appeared to be fairly stable in a 2-week test-retest period (intra class correlation coefficient (ICC) = 0.74 and 0.77). Scores on the description of patient's own health on six domains, global assessment of change and domain specific measures correlated moderately with the RS scores and low with the SG. Multiple regression analyses demonstrated that 32% of the variance in RS values and only 13% of the variance in SG utilities could be explained by domain-specific measures. These results suggest an acceptable construct validity for the RS but insufficient construct validity for the SG. Valuations of ones own health appear only partially to be related to the assessment of the pain-specific measures and measures of distress. It can be concluded that the RS and domain-specific measures

  17. [Features of fluor intoxication development in patients with nondifferentiated connective tissue dysplasia and physical therapy methods for these patients].

    PubMed

    Tereshina, L G; Budkar', L N; Obukhova, T Iu; Bugaeva, I V; Karpova, E A

    2013-01-01

    The article covers results of studies concerning time of fluorosis development in patients with signs of connective tissue dysplasia syndrome (CTDS). if compared with patients without CTDS, and of studies concerning hyperostosis coefficient in accordance with presence or absence of CTDS. Efficiency of physical therapy and balneotherapy for these patients are also reported by the authors.

  18. Introducing ADS 2.0

    NASA Astrophysics Data System (ADS)

    Accomazzi, Alberto; Kurtz, M. J.; Henneken, E. A.; Grant, C. S.; Thompson, D.; Luker, J.; Chyla, R.; Murray, S. S.

    2014-01-01

    In the spring of 1993, the Smithsonian/NASA Astrophysics Data System (ADS) first launched its bibliographic search system. It was known then as the ADS Abstract Service, a component of the larger Astrophysics Data System effort which had developed an interoperable data system now seen as a precursor of the Virtual Observatory. As a result of the massive technological and sociological changes in the field of scholarly communication, the ADS is now completing the most ambitious technological upgrade in its twenty-year history. Code-named ADS 2.0, the new system features: an IT platform built on web and digital library standards; a new, extensible, industrial strength search engine; a public API with various access control capabilities; a set of applications supporting search, export, visualization, analysis; a collaborative, open source development model; and enhanced indexing of content which includes the full-text of astronomy and physics publications. The changes in the ADS platform affect all aspects of the system and its operations, including: the process through which data and metadata are harvested, curated and indexed; the interface and paradigm used for searching the database; and the follow-up analysis capabilities available to the users. This poster describes the choices behind the technical overhaul of the system, the technology stack used, and the opportunities which the upgrade is providing us with, namely gains in productivity and enhancements in our system capabilities.

  19. Total glutamine synthetase levels in cerebrospinal fluid of Alzheimer's disease patients are unchanged.

    PubMed

    Timmer, Nienke M; Herbert, Megan K; Claassen, Jurgen A H R; Kuiperij, H Bea; Verbeek, Marcel M

    2015-03-01

    Decreased cerebral protein and activity levels of glutamine synthetase (GS) have been reported for Alzheimer's disease (AD) patients. Using a recently established method, we quantified total GS levels in cerebrospinal fluid (CSF) from AD patients and control subjects. Furthermore, we investigated if total GS levels in CSF could differentiate AD from frontotemperal dementia and dementia with Lewy bodies patients. As we found no significantly altered total GS levels in any of the patient groups compared with control subjects, we conclude that levels of total GS in CSF have no diagnostic value for AD, dementia with Lewy bodies, or frontotemperal dementia.

  20. On elliptic string solutions in AdS3 and dS3

    NASA Astrophysics Data System (ADS)

    Bakas, Ioannis; Pastras, Georgios

    2016-07-01

    Classical string actions in AdS3 and dS3 can be connected to the sinh-Gordon and cosh-Gordon equations through Pohlmeyer reduction. We show that the problem of constructing a classical string solution with a given static or translationally invariant Pohlmeyer counterpart is equivalent to solving four pairs of effective Schrödinger problems. Each pair consists of a flat potential and an n = 1 Lamé potential whose eigenvalues are connected, and, additionally, the four solutions satisfy a set of constraints. An approach for solving this system is developed by employing an interesting connection between the specific class of classical string solutions and the band structure of the Lamé potential. This method is used for the construction of several families of classical string solutions, one of which turns out to be the spiky strings in AdS3. New solutions include circular rotating strings in AdS3 with singular time evolution of their radius and angular velocity as well as classical string solutions in dS3.

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

    PubMed Central

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

    2005-01-01

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

  2. Research methods to change clinical practice for patients with rare cancers.

    PubMed

    Billingham, Lucinda; Malottki, Kinga; Steven, Neil

    2016-02-01

    Rare cancers are a growing group as a result of reclassification of common cancers by molecular markers. There is therefore an increasing need to identify methods to assess interventions that are sufficiently robust to potentially affect clinical practice in this setting. Methods advocated for clinical trials in rare diseases are not necessarily applicable in rare cancers. This Series paper describes research methods that are relevant for rare cancers in relation to the range of incidence levels. Strategies that maximise recruitment, minimise sample size, or maximise the usefulness of the evidence could enable the application of conventional clinical trial design to rare cancer populations. Alternative designs that address specific challenges for rare cancers with the aim of potentially changing clinical practice include Bayesian designs, uncontrolled n-of-1 trials, and umbrella and basket trials. Pragmatic solutions must be sought to enable some level of evidence-based health care for patients with rare cancers.

  3. A Comparison of Methods for Analyzing Viral Load Data in Studies of HIV Patients.

    PubMed

    Rose, Charles E; Gardner, Lytt; Craw, Jason; Girde, Sonali; Wawrzyniak, Andrew J; Drainoni, Mari-Lynn; Davila, Jessica; DeHovitz, Jack; Keruly, Jeanne C; Westfall, Andrew O; Marks, Gary

    2015-01-01

    HIV RNA viral load (VL) is a pivotal outcome variable in studies of HIV infected persons. We propose and investigate two frameworks for analyzing VL: (1) a single-measure VL (SMVL) per participant and (2) repeated measures of VL (RMVL) per participant. We compared these frameworks using a cohort of 720 HIV patients in care (4,679 post-enrollment VL measurements). The SMVL framework analyzes a single VL per participant, generally captured within a "window" of time. We analyzed three SMVL methods where the VL binary outcome is defined as suppressed or not suppressed. The omit-participant method uses a 8-month "window" (-6/+2 months) around month 24 to select the participant's VL closest to month 24 and removes participants from the analysis without a VL in the "window". The set-to-failure method expands on the omit-participant method by including participants without a VL within the "window" and analyzes them as not suppressed. The closest-VL method analyzes each participant's VL measurement closest to month 24. We investigated two RMVL methods: (1) repeat-binary classifies each VL measurement as suppressed or not suppressed and estimates the proportion of participants suppressed at month 24, and (2) repeat-continuous analyzes VL as a continuous variable to estimate the change in VL across time, and geometric mean (GM) VL and proportion of participants virally suppressed at month 24. Results indicated the RMVL methods have more precision than the SMVL methods, as evidenced by narrower confidence intervals for estimates of proportion suppressed and risk ratios (RR) comparing demographic strata. The repeat-continuous method had the most precision and provides more information than other considered methods. We generally recommend using the RMVL framework when there are repeated VL measurements per participant because it utilizes all available VL data, provides additional information, has more statistical power, and avoids the subjectivity of defining a "window." PMID

  4. SU-E-T-484: A New Method of Aligning Patient Setup Lasers in Radiation Therapy

    SciTech Connect

    Hwang, U; Lim, Y; Cho, K; Jeong, C; Kim, M; Jeong, J; Park, J; Shin, D; Lee, S; Kim, J; Choi, S; Kwak, J; Yoon, K; Park, S; Kim, S

    2014-06-01

    Purpose: To develop a new method to align the patient setup lasers in radiation therapy and examine its validity and effectiveness. Methods: The new laser alignment method was realized by a device composed of both a metallic base plate and few acrylic transparent plates with a cross hair line on each of them. The holders of radiochromic films were prepared in the device to find a radiation isocenter. The right laser positions could be found optically by matching the shadows of all the cross hairs in the gantry head and the device. The repeatability and reproducibility (R and R) of laser alignments and the dependency of the alignment on the position error of the light source were evaluated by comparing the standard deviations and the means of the measured laser positions. After aligning the lasers optically, a radiation isocenter was found by a collimator spoke shot and the gantry spoke shot, and then the lasers were parallely translated to the isocenter. Results: In the R and R test, the standard deviation was 1.14 mm for the new method whereas it was 1.49 mm or 2.76 mm for the conventional method with either high- or low-precision levels. In the test of the dependency on the position error of the light source, the mean laser position was shifted by 5.3 mm corresponding to the shift of the light source, 4.8 mm for the new method, but for the conventional method the laser position was shifted more than 7 times than that. The positional shift could be corrected by a parallel translation to the isocenter in the new method. Conclusion: A new laser alignment method was devised for radiation therapy and tested successfully. The method enabled us to align the lasers easily and accurately without repetition, and all lasers could be finally aligned to the radiation isocenter.

  5. Influence of coagulation factor x on in vitro and in vivo gene delivery by adenovirus (Ad) 5, Ad35, and chimeric Ad5/Ad35 vectors.

    PubMed

    Greig, Jenny A; Buckley, Suzanne Mk; Waddington, Simon N; Parker, Alan L; Bhella, David; Pink, Rebecca; Rahim, Ahad A; Morita, Takashi; Nicklin, Stuart A; McVey, John H; Baker, Andrew H

    2009-10-01

    The binding of coagulation factor X (FX) to the hexon of adenovirus (Ad) 5 is pivotal for hepatocyte transduction. However, vectors based on Ad35, a subspecies B Ad, are in development for cancer gene therapy, as Ad35 utilizes CD46 (which is upregulated in many cancers) for transduction. We investigated whether interaction of Ad35 with FX influenced vector tropism using Ad5, Ad35, and Ad5/Ad35 chimeras: Ad5/fiber(f)35, Ad5/penton(p)35/f35, and Ad35/f5. Surface plasmon resonance (SPR) revealed that Ad35 and Ad35/f5 bound FX with approximately tenfold lower affinities than Ad5 hexon-containing viruses, and electron cryomicroscopy (cryo-EM) demonstrated a direct Ad35 hexon:FX interaction. The presence of physiological levels of FX significantly inhibited transduction of vectors containing Ad35 fibers (Ad5/f35, Ad5/p35/f35, and Ad35) in CD46-positive cells. Vectors were intravenously administered to CD46 transgenic mice in the presence and absence of FX-binding protein (X-bp), resulting in reduced liver accumulation for all vectors. Moreover, Ad5/f35 and Ad5/p35/f35 efficiently accumulated in the lung, whereas Ad5 demonstrated poor lung targeting. Additionally, X-bp significantly reduced lung genome accumulation for Ad5/f35 and Ad5/p35/f35, whereas Ad35 was significantly enhanced. In summary, vectors based on the full Ad35 serotype will be useful vectors for selective gene transfer via CD46 due to a weaker FX interaction compared to Ad5.

  6. [NASO-OROGASTRIC TUBE IN PAEDIATRIC PATIENTS. REVIEW OF METHODS OF CONFIRMATION OF PLACEMENT].

    PubMed

    Guerrero-Márquez, Gloria; Martínez-Serrano, Ana; Míguez-Navarro, Concepción

    2014-09-01

    Nasogastric tube (NGT) placement is a frequent procedure in the paediatric population. Nasogastric and orogastric tubes are commonly used in hospitalized children, in the paediatric emergency departments and in critical care departments. They have diagnostic, therapeutic, descompression or evacuation of gastric aspirates objectives. Making a blind placement of nasogastric tubes, involve that nasogastric tube could be misplaced in 4.7 % to 69 % of cases. An accurate method for confirmation of nasogastric tube positioning is therefore needed. Chest X-ray remains the only hundred per cent reliable method (gold standard), but it only confirms tube positioning at the exact time of the X-ray. Non-radiologic verification methods provide an accurate alternative and contribute to decrease radiation exposure for pediatric patients. Non-radiologic methods to verify appropiate placement of tubes are many and are supported by different degrees of evidence in the literature: measurement of tube length from point of entry; auscultation; placing the tube in water to assess bubbling; aspiration of stomach or intestinal contents for visual inspection; pH testing; use of CO2 monitoring devices, or combinations of these methods. In this article we thoroughly review the reliability and safety of these non radiologic methods for the verification of nasogastric tube placement.

  7. New Treatment for Percutaneous Sites in Patients with a Ventricular Assist Device: Nihon University Crystal Violet Method

    PubMed Central

    Niino, Tetsuya; Osaka, Shunji; Yaoita, Hiroko; Arimoto, Munehito; Hata, Hiroaki; Shiono, Motomi

    2016-01-01

    Background: Infection of the percutaneous site of a ventricular assist device (VAD) is a challenging complication. We report our experience with crystal violet Solbase (Nihon University crystal violet method) for prevention of driveline or cannula infections in VAD patients. Patients and Methods: The crystal violet method was used in 10 patients (prophylaxis in nine and treatment in one). Eight patients had an extracorporeal VAD (Nipro) and two had an implantable VAD (Heart Mate II). Results: The infection-free period was 4–623 days (mean: 144.2 ± 222.9 days). All eight patients with an extracorporeal VAD died, while the two patients with an implantable VAD (Heart Mate II) survived. Infection was improved in a patient with MRSA, and the results of bacteriological examination were always negative in the patients receiving prophylaxis. The two patients with an implantable VAD had no infection for 2 and 20 months after implantation. Conclusion: These findings suggest that the Nihon University crystal violet method is effective for prevention and treatment of driveline or cannula infections in patients with a VAD. PMID:27086670

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

    PubMed

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

    2010-01-01

    Memory for object locations, as part of spatial memory function, has rarely been studied in patients with Alzheimer dementia (AD), while studies in patients with Mild Cognitive Impairment (MCI) patients are lacking altogether. The present study examined categorical spatial memory function using the Location Learning Test (LLT) in MCI patients (n = 30), AD patients (n = 30), and healthy controls (n = 40). Two scoring methods were compared, aimed at disentangling positional recall (location irrespective of object identity) and object-location binding. The results showed that AD patients performed worse than the MCI patients on the LLT, both on recall of positional information and on recall of the locations of different objects. In addition, both measures could validly discriminate between AD and MCI patients. These findings are in agreement with the notion that visual cued-recall tests may have better diagnostic value than traditional (verbal) free-recall tests in the assessment of patients with suspected MCI or AD. PMID:19883520

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

    PubMed

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

    2010-01-01

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

  10. Shoulder muscle strengh in asyntomatic patients, according to age, sex and method of determination

    PubMed Central

    Arcuri, Francisco; Barclay, Fernando; Nacul, Iván

    2015-01-01

    Objective: Determine the normal value of shoulder muscle strengh, in an adult population divided in six groups between 20 to 86 years, without known shoulder pathology. Materials and Methods: 523 individuals, 1046 shoulders, had their muscle strengh evaluated in two different positions, in 90 abduction and 90º fowarf flexion in the scapular plane. Three measurements were performed and the aveage one was recorded. Patiens with known shoulder pathology, reumathoid diseases, cancer were excluded. The patients were divided in six groups according to age, from 20 to 29 (68 patients), 30 to 39 (92 patients), 40 to 49 (109 patients), 50 to 59 (103 patients), 60 to 69 (91 patients) and 70 to 90 (60 patients). The strengh eas measured in pounds. Results: Average mucle strengh was 17,64 at the scapular plane and 16,82 lb at 90ª (p<0,0001)For the right shoulder, the average muscle strengh of the second decade group was 22 lb at scapular plane and 20,73 at 90º. The third decade was 19,93 and 18,50 respectively. The fouth decade values were 20,45 and 19,58, on the fifth decade 17,83 and 17,07. On the sixth decade was 15,57 and 15,23 and for the seventh decade was 11,40 and 11 lb respectively. The values for the left shoulder were for the second decade 21,53 om the scapular plane and 20,53 at 90º. On the third decade were 19,33 and 18,17, on the fourth decade 19,62 and 18,95, on the fifth decade were 16,8 and 16,2 , on the sixth decade 15,57 and 15,23. And for the final group 11,4 and 11 lb. Significant differences were seen between both shoulders ,sex (p<0,0001), position of the arm at time of measure (p0,0001), dominace (p0,001) Conclusion: The objective measurement of the muscle strengh of the shoulder varies significantly with age, sex and position of the arm at time of measure, putting in dout the validity of the contralateral shoulder as a value to compare against.

  11. Prevention of nausea and vomiting: methods and utility after surgery in cancer patients?

    PubMed

    Firoozabadi, Mehdi Dehghani; Rahmani, Hossein

    2015-01-01

    Most cancer patients experience nausea and vomiting after surgery. Today, many methods of treatment have been developed and used for the control of such symptoms. The most important are drug therapy, relaxation, oxygen therapy and gas therapy. In addition, dexamethasone, massage therapy and using a Venturi mask have also proven effective. Due to the nature of gas consumption which leads to nausea it is recommended that use of N2O in the operating room be avoided or applied in combination with oxygen or other gases with fewer complications. PMID:25854338

  12. Understanding the patient's use of the method of free association: an ego psychological approach.

    PubMed

    Busch, F

    1997-01-01

    While most of our methods of listening have been geared toward unearthing unconscious fantasies, those directed toward the ego's all-inclusive role in effecting the associative process have lagged far behind. It is the thesis of this paper that listening from the perspective of the ego allows the analyst to work more closely with what the patient is ready to understand. Clinical technique, using an ego psychological view, is elaborated, demonstrated, and compared to technique dependent on the reading of signs and symbols of the unconscious.

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

    ERIC Educational Resources Information Center

    Ford, Richard; Rice, Kerry

    2015-01-01

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

  14. Added Value in Electronic Publications.

    ERIC Educational Resources Information Center

    Bothma, Theo J. D.

    Electronic publications are flooding the market. Some of these publications are created specifically for the electronic environment, but many are conversions of existing material to electronic format. It is not worth the time and effort merely to publish existing material in electronic format if no value is added in the conversion process. The…

  15. Evaluation of an Innovative Method for Calculating Energy Intake of Hospitalized Patients

    PubMed Central

    Cox Sullivan, Sheila; Bopp, Melinda M.; Roberson, Paula K.; Lensing, Shelly; Sullivan, Dennis H.

    2016-01-01

    The purpose of this study was to evaluate a multi-component method for capturing nutrient intake, which used observation, photography, and an innovative computer program. To assess reliability and accuracy, multiple responsible employees (REs) independently conducted nutrient intake assessments on simulated meals; each RE’s results relating to energy intake were compared to those from the other REs and to those obtained by pre- and post-meal weighing of the food items. System efficiency was assessed by having REs perform independent assessments on the same set of simulated meals using either the new or traditional hospital method for which the REs had to document each food item served and then find the items in a computer database–steps that were automated in the new method. Interrater reliability for energy intake estimated on clinic wards was excellent (intraclass correlation coefficient = 0.975, 95% CI 0.958 to 0.992) and there was a high level of agreement between the REs’ estimates and the true values determined by food weighing; per the method of Bland and Altman the mean difference between the two types of estimates was 0.3 kcal (95% CI, −8.1 to 8.7 kcal) with limits of agreement of −79.5 kcal to 80.1 kcal. Compared to the traditional method, energy intake assessments could be completed using the multi-component method in less than a third of the time. These results indicate the multi-component method is an accurate, reliable, and efficient method of obtaining energy intake assessments for hospitalized patients. PMID:27618096

  16. Evaluation of an Innovative Method for Calculating Energy Intake of Hospitalized Patients.

    PubMed

    Cox Sullivan, Sheila; Bopp, Melinda M; Roberson, Paula K; Lensing, Shelly; Sullivan, Dennis H

    2016-01-01

    The purpose of this study was to evaluate a multi-component method for capturing nutrient intake, which used observation, photography, and an innovative computer program. To assess reliability and accuracy, multiple responsible employees (REs) independently conducted nutrient intake assessments on simulated meals; each RE's results relating to energy intake were compared to those from the other REs and to those obtained by pre- and post-meal weighing of the food items. System efficiency was assessed by having REs perform independent assessments on the same set of simulated meals using either the new or traditional hospital method for which the REs had to document each food item served and then find the items in a computer database-steps that were automated in the new method. Interrater reliability for energy intake estimated on clinic wards was excellent (intraclass correlation coefficient = 0.975, 95% CI 0.958 to 0.992) and there was a high level of agreement between the REs' estimates and the true values determined by food weighing; per the method of Bland and Altman the mean difference between the two types of estimates was 0.3 kcal (95% CI, -8.1 to 8.7 kcal) with limits of agreement of -79.5 kcal to 80.1 kcal. Compared to the traditional method, energy intake assessments could be completed using the multi-component method in less than a third of the time. These results indicate the multi-component method is an accurate, reliable, and efficient method of obtaining energy intake assessments for hospitalized patients. PMID:27618096

  17. Listening to patients with cancer: using a literary-based research method to understand patient-focused care

    PubMed Central

    Begley, Amanda; Pritchard-Jones, Kathy; Biriotti, Maurice; Kydd, Anna; Burdsey, Tim; Townsley, Emma

    2014-01-01

    Objective In spite of considerable attention, patients diagnosed with cancer continue to report poor experiences of care. The root causes of this remain unclear. This exploratory study aimed to investigate new ways of understanding the experience of patients with cancer, using a literary-based research approach. Design Interviews were undertaken with four patients diagnosed with high-grade brain cancers at least 6 months from diagnosis and with people (n=5) identified by the patients as important in their care pathway. Interview transcripts were analysed by humanities academics as pieces of literature, where each patient's story was told from more than one person's perspective. The academics then came together in a facilitated workshop to agree major themes within the patient experiences. The themes were presented at a patient and carer event involving 70 participants to test the validity of the insights. Results Insights into the key issues for patients with cancer could be grouped into six themes: accountability; identity; life context; time; language; rigour and emotion. Patients often held a different perspective to the traditionally held medical views of what constitutes good care. For example, patients did not see any conflict between a doctor having scientific rigour and portraying emotion. Conclusions One key feature of the approach was its comparative nature: patients often held different views from those traditionally held by physicians of what constitutes health and good outcomes. This revealed aspects that may be considered by healthcare professionals when designing improvements. Proposals for further testing are discussed, with a particular emphasis on the need for sensitivity to individual differences in experiences. PMID:25324319

  18. An investigation of AdS2 backreaction and holography

    NASA Astrophysics Data System (ADS)

    Engelsöy, Julius; Mertens, Thomas G.; Verlinde, Herman

    2016-07-01

    We investigate a dilaton gravity model in AdS2 proposed by Almheiri and Polchinski [1] and develop a 1d effective description in terms of a dynamical boundary time with a Schwarzian derivative action. We show that the effective model is equivalent to a 1d version of Liouville theory, and investigate its dynamics and symmetries via a standard canonical framework. We include the coupling to arbitrary conformal matter and analyze the effective action in the presence of possible sources. We compute commutators of local operators at large time separation, and match the result with the time shift due to a gravitational shockwave interaction. We study a black hole evaporation process and comment on the role of entropy in this model.

  19. Superconformal algebras on the boundary of AdS3

    NASA Astrophysics Data System (ADS)

    Rasmussen, Jørgen

    1999-07-01

    Motivated by recent progress on the correspondence between string theory on nti-de Sitter space and conformal field theory, we provide an explicit construction of an infinite dimensional class of superconformal algebras on the boundary of AdS3. These space-time algebras are N extended superconformal algebras of the kind obtainable by hamiltonian reduction of affine SL(2|N/2) current superalgebras for N even, and are induced by the same current superalgebras residing on the world sheet. Thus, such an extended superconformal algebra is generated by N supercurrents and an SL(N/2) current algebra in addition to a U(1) current algebra. The results are obtained within the framework of free field realizations.

  20. Empathy and the wounded healer: a mixed-method study of patients and doctors views on empathy.

    PubMed

    Brady, C; Bambury, R M; O'Reilly, S

    2015-04-01

    Empathy is increasingly being recognized as a crucial component for an effective doctor-patient relationship. Using a mixed method approach, we surveyed 125 patients and 361 medical practitioners (doctors and medical students) views of the doctor-patient relationship. We qualitatively assessed patients' views of what constituted a good doctor and qualitatively measured empathy using a validated scale in medical practitioners. Patients desire a doctor that is both clinically proficient 66 (55%) and caring 32 (27%). Doctors who have a personal experience of illness have a statistically higher empathy score. These doctors may be well placed to help develop and foster empathy in our profession.

  1. Tampons: a novel patient-administered method for the assessment of genital human papillomavirus infection.

    PubMed

    Fairley, C K; Chen, S; Tabrizi, S N; Quinn, M A; McNeil, J J; Garland, S M

    1992-06-01

    Assessment of human papillomavirus (HPV) infection usually requires a speculum examination to collect genital specimens. A technique using tampons as a patient-administered method for the collection of specimens was studied by dot blot hybridization (HPV types 6, 11, 16, 18, 31, and 33) and polymerase chain reaction (PCR). Tampons and cervical scrapes were collected from 48 consecutive women attending a dysplasia clinic. Tampons provided a significantly larger pellet volume (P less than .002) and more DNA (P less than .01) than scrapes. There was a close correlation when samples were analyzed for the presence of HPV DNA. Using dot blot hybridization, 8 cervical scrapes (17%) and 9 tampons (19%) were positive for HPV DNA (90% correlation). By PCR, 35 cervical scrapes (73%) and 33 tampons (69%) were positive for HPV DNA (88% correlation). Thus, tampon specimens are an easy method for assessment of genital HPV infection.

  2. Systematics of Coupling Flows in AdS Backgrounds

    SciTech Connect

    Goldberger, Walter D.; Rothstein, Ira Z.

    2003-03-18

    We give an effective field theory derivation, based on the running of Planck brane gauge correlators, of the large logarithms that arise in the predictions for low energy gauge couplings in compactified AdS}_5 backgrounds, including the one-loop effects of bulk scalars, fermions, and gauge bosons. In contrast to the case of charged scalars coupled to Abelian gauge fields that has been considered previously in the literature, the one-loop corrections are not dominated by a single 4D Kaluza-Klein mode. Nevertheless, in the case of gauge field loops, the amplitudes can be reorganized into a leading logarithmic contribution that is identical to the running in 4D non-Abelian gauge theory, and a term which is not logarithmically enhanced and is analogous to a two-loop effect in 4D. In a warped GUT model broken by the Higgs mechanism in the bulk,we show that the matching scale that appears in the large logarithms induced by the non-Abelian gauge fields is m_{XY}^2/k where m_{XY} is the bulk mass of the XY bosons and k is the AdS curvature. This is in contrast to the UV scale in the logarithmic contributions of scalars, which is simply the bulk mass m. Our results are summarized in a set of simple rules that can be applied to compute the leading logarithmic predictions for coupling constant relations within a given warped GUT model. We present results for both bulk Higgs and boundary breaking of the GUT gauge

  3. Comparative diagnostic value of a new computerized vectorcardiographic method (cardiogoniometry) and other noninvasive tests in medically treated patients with chest pain

    SciTech Connect

    Meier, A.; Hoeflin, F.H.; Herrmann, H.J.; Wolf, C.; Gurtner, H.P.; Roesler, H.

    1987-05-01

    The diagnostic value of cardiogoniometry (CGM), a new computerized vectorcardiographic method, for the identification of coronary artery disease was compared with other noninvasive tests in 48 medically treated patients with chest pain. Coronary angiography revealed one-vessel disease in 18, two- or three-vessel disease in 21, and normal coronary arteries in 9 patients. Cardiogoniometry was less sensitive (63%) than thallium-/sup 201/ (201T1) scanning (82%), but slightly more sensitive than the exercise ECG (50%) or a recently proposed parameter of exercise performance (50%). On the other hand, specificity was comparable among these tests (exercise ECG 78%, thallium-201 scanning 72%, CGM 67%, new parameter of exercise performance 66%). Moreover, the false negative rate of noninvasive testing was reduced from 8 to 3% when CGM was added to thallium-201 scanning and exercise ECG. Our findings indicate that in view of the easier feasibility with computerized technology, the future role of vectorcardiographic methods such as CGM in the noninvasive diagnosis of coronary artery disease should be redefined.

  4. The Postoperative Analgesic Effect of Morphine and Paracetamol in the Patients Undergoing Laparotomy, Using PCA Method

    PubMed Central

    Yaghoubi, Siamak; Pourfallah, Reza; Barikani, Ameneh; Kayalha, Hamid

    2014-01-01

    Objective: postoperative pain increases the activity of the sympathetic system, causes hypermetabolic conditions, retains salt and water, increases glucose, fatty acid lactate and oxygen consumption, weakens the immunity system which delays wound healing. Our object was comparison of the analgesic effect of morphine and paracetamol in the patients undergoing laparotomy, using PCA method. Method: Seventy patients who had undergone laparotomy were studied using double blind randomized clinical trial (35 patients received morphine and 35 paracetamol) in the Shahid Rajaee Center and Velayat Hospital (Qazvin, Iran). People using opioids, painkillers and sedatives regularly and in large doses and patients with a history of lung or liver problems did not participate in this project. The parameters of the severity of pain and nausea (VAS), hemodynamic changes (BP and HR), pruritus, arterial oxygen desaturation and patient satisfaction (VAS) of both groups were measured by a third party (trained colleague). The data was analyzed using SPSS 16 statistical software then descriptive results were extracted and ultimately the groups were compared using the following statistical tests: student’s T-test, chi 2 and Fisher’s exact test (P<0.05). Findings: The mean age of the participants was 45±12.5 years. Women constituted 24.3% of the patients and men 75.7%. The average pain severity for morphine and paracetamol groups (VAS) was 5.3±2.2and 6.37±1.7 after2 hours and reached 1.91±1.3 and 2.49±1.3 after 8 hours (after the operation) respectively. There was a significant difference between the groups after 2 and 4 hours in terms of pain severity (after 2 hours P=0.007 and after 4 hours P=0.047). However there was no significant difference between the average pain severity of the studied groups (after 6 hours P=0.4 and 8 hours P=0.08). After 8 hours, the average nausea severity was the minimum in both groups being 1.71±1.6 and 1.43±1.1 in morphine and paracetamol groups

  5. Comparison of Gingival Crevicular Fluid Sampling Methods in Patients with Severe Chronic Periodontitis

    PubMed Central

    Guentsch, Arndt; Kramesberger, Martin; Sroka, Aneta; Pfister, Wolfgang; Potempa, Jan; Eick, Sigrun

    2011-01-01

    Background Analysis of samplings from periodontal pockets is important in diagnosis and therapy control of periodontitis. In this study, three different sampling techniques were compared to determine if one method can yield samples suitable for reproducible and simultaneous determination of bacterial load, cytokines, neutrophil elastase, and Arg-specific gingipains. R-gingipains are an important virulence factor of Porphyromonas gingivalis, the exact concentration of which in gingival crevicular fluid (GCF) has not yet been quantified. Methods GCF was sampled from four sites per patient (each two sites one method) in 36 chronic periodontitis patients. One week later, the procedure was repeated with alternative methods. The variables that had been determined were: loads of Aggregatibacter actinomycetemcomitans and P. gingivalis, levels of interleukin-6 and interleukin-8, activity of neutrophil elastase and level of R-gingipains. Results The detected cytokine levels were higher using paper strips compared to paper points. Bacteria were found in similar loads from the paper strips and paper points. R-gingipains were detectable in high quantities only by washing of the periodontal pocket. The level of R-gingipains correlated with the load of P. gingivalis. Conclusion The use of paper strips is suitable for simultaneous determination of microbial and immunological parameters. Obtaining GCF by washing can be useful for special purposes. Gingipain concentration in periodontal pockets was directly determined to be up to 1.5 μM. This value indicates that most of so far identified substrates of these proteases by in vitro assays can be easily degraded in P. gingivalis infected sites. PMID:21235330

  6. Development of CT scanner models for patient organ dose calculations using Monte Carlo methods

    NASA Astrophysics Data System (ADS)

    Gu, Jianwei

    There is a serious and growing concern about the CT dose delivered by diagnostic CT examinations or image-guided radiation therapy imaging procedures. To better understand and to accurately quantify radiation dose due to CT imaging, Monte Carlo based CT scanner models are needed. This dissertation describes the development, validation, and application of detailed CT scanner models including a GE LightSpeed 16 MDCT scanner and two image guided radiation therapy (IGRT) cone beam CT (CBCT) scanners, kV CBCT and MV CBCT. The modeling process considered the energy spectrum, beam geometry and movement, and bowtie filter (BTF). The methodology of validating the scanner models using reported CTDI values was also developed and implemented. Finally, the organ doses to different patients undergoing CT scan were obtained by integrating the CT scanner models with anatomically-realistic patient phantoms. The tube current modulation (TCM) technique was also investigated for dose reduction. It was found that for RPI-AM, thyroid, kidneys and thymus received largest dose of 13.05, 11.41 and 11.56 mGy/100 mAs from chest scan, abdomen-pelvis scan and CAP scan, respectively using 120 kVp protocols. For RPI-AF, thymus, small intestine and kidneys received largest dose of 10.28, 12.08 and 11.35 mGy/100 mAs from chest scan, abdomen-pelvis scan and CAP scan, respectively using 120 kVp protocols. The dose to the fetus of the 3 month pregnant patient phantom was 0.13 mGy/100 mAs and 0.57 mGy/100 mAs from the chest and kidney scan, respectively. For the chest scan of the 6 month patient phantom and the 9 month patient phantom, the fetal doses were 0.21 mGy/100 mAs and 0.26 mGy/100 mAs, respectively. For MDCT with TCM schemas, the fetal dose can be reduced with 14%-25%. To demonstrate the applicability of the method proposed in this dissertation for modeling the CT scanner, additional MDCT scanner was modeled and validated by using the measured CTDI values. These results demonstrated that the

  7. Limitations of the of the oscillometric method for blood pressure measurements in dialyzed patients

    PubMed Central

    Czarkowski, Marek; Staszków, Monika; Kostyra, Kacper; Shebani, Zuhier; Różanowski, Krzysztof; Matuszkiewicz-Rowińska, Joanna; Niemczyk, Stanisław

    2011-01-01

    Summary Background Despite more frequent use of the oscillometric method (OSC) for arterial blood pressure (BP) measurement, little is known about OSC’s accuracy when used with hemodialysed patients. This study was undertaken to determine if hemodialysis (HD) and individual features in examined patients can affect the accuracy of OSC for BP measurement. Material/Methods In 54 hemodialysed patients (57±15 years), during 2 sessions (before and after HD), 3 pairs of BP measurements each were performed on arms, alternately employing OSC and auscultatory method, with mercury manometers by 2 observers (REF). Results No difference was found in systolic BP measured before and after HD (SBP before HD: REF −147.3±27.3, OSC −147.5±25.0 mmHg, p>0.05, SBP after HD: REF-141.1±33.9, OSC-141.2±31.5 mmHg, p>0.05, respectively), but diastolic BP (DBP) was significantly higher both before and after HD during REF measurement in comparison with OSC (DBP before HD: REF −79.0±17.0, OSC −76.7±15.0 mmHg, DBP after HD: REF −78.6±18.8, OSC −76.7±16.7 mmHg, p<0.001, respectively). No significant correlation between loss of body weight caused by HD and differences in BP measured by REF and OSC after HD was indicated (Pearson’s correlation coefficients: for SBP −0.041, for DBP 0.030). However, a significant correlation between differences in BP measured by REF and OSC before HD and differences in BP measured by REF and OSC after HD was observed (Spearman’s rank correlation coefficients: for SBP 0.502 and for DBP 0.557, p<0.000001). Conclusions Our study found that individual features, not HD, determine the accuracy of OSC for BP measurement in hemodialysed patients. PMID:21455115

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

    ERIC Educational Resources Information Center

    Ozdemir, Selda

    2010-01-01

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

  9. Patients recording clinical encounters: a path to empowerment? Assessment by mixed methods

    PubMed Central

    Elwyn, Glyn; Barr, Paul James; Grande, Stuart W

    2015-01-01

    Objective To examine the motivations of patients recording clinical encounters, covertly or otherwise, and why some do not wish to record encounters. Design Mixed-methods analysis of survey data and nested semistructured interviews. Setting Survey to UK audience, using social media and radio broadcast. Participants 168 survey respondents, of whom 161 were 18 years of age or older (130 completions). Of the 56 participants who agreed to be contacted, we included data from 17 interviews. Results 19 (15%) respondents indicated having secretly recorded a clinical encounter and 14 (11%) were aware of someone who had secretly recorded a clinical encounter. 45 (35%) said they would consider recording secretly and 44 (34%) said they would record after asking permission. Totally, 69% of respondents indicated their desire to record clinical encounters, split equally between wanting to do so covertly or with permission. Thematic analysis of the interviews showed that most patients are motivated by the wish to replay, relisten and share the recording with others. Some are also motivated by the idea of owning a personal record, and its potential use as verification of a poor healthcare experience. The rationale for permission seeking was based on the wish to prioritise a trusting relationship with a health professional. Those who preferred to record covertly described a pre-existing lack of trust, a fear that recording would be denied, and a concern that an affronted clinician would deny them access to future care. There was a general wish that recording should be facilitated. Conclusions Patients’ prime motivation for recording is to enhance their experience of care, and to share it with others. Patients know that recording challenges the ‘ceremonial order of the clinic’, and so some decide to act covertly. Patients wanted clearer, more permissive policies to be developed. PMID:26264274

  10. Development and clinical evaluation of a simple optical method to detect and measure patient external motion.

    PubMed

    Barbés, Benigno; Azcona, Juan Diego; Prieto, Elena; de Foronda, José Manuel; García, Marina; Burguete, Javier

    2015-01-01

    A simple and independent system to detect and measure the position of a number of points in space was devised and implemented. Its application aimed to detect patient motion during radiotherapy treatments, alert of out-of-tolerances motion, and record the trajectories for subsequent studies. The system obtains the 3D position of points in space, through its projections in 2D images recorded by two cameras. It tracks black dots on a white sticker placed on the surface of the moving object. The system was tested with linear displacements of a phantom, circular trajectories of a rotating disk, oscillations of an in-house phantom, and oscillations of a 4D phantom. It was also used to track 461 trajectories of points on the surface of patients during their radiotherapy treatments. Trajectories of several points were reproduced with accuracy better than 0.3 mm in the three spatial directions. The system was able to follow periodic motion with amplitudes lower than 0.5 mm, to follow trajectories of rotating points at speeds up to 11.5 cm/s, and to track accurately the motion of a respiratory phantom. The technique has been used to track the motion of patients during radiotherapy and to analyze that motion. The method is flexible. Its installation and calibration are simple and quick. It is easy to use and can be implemented at a very affordable price. Data collection does not involve any discomfort to the patient and does not delay the treatment, so the system can be used routinely in all treatments. It has an accuracy similar to that of other, more sophisticated, commercially available systems. It is suitable to implement a gating system or any other application requiring motion detection, such as 4D CT, MRI or PET. PMID:26699313

  11. Developing a Healthy Web-Based Cookbook for Pediatric Cancer Patients and Survivors: Rationale and Methods

    PubMed Central

    Raber, Margaret

    2015-01-01

    Background Obesity has been a growing problem among children and adolescents in the United States for a number of decades. Childhood cancer survivors (CCS) are more susceptible to the downstream health consequences of obesity such as cardiovascular disease, endocrine issues, and risk of cancer recurrence due to late effects of treatment and suboptimal dietary and physical activity habits. Objective The objective of this study was to document the development of a Web-based cookbook of healthy recipes and nutrition resources to help enable pediatric cancer patients and survivors to lead healthier lifestyles. Methods The Web-based cookbook, named “@TheTable”, was created by a committee of researchers, a registered dietitian, patients and family members, a hospital chef, and community advisors and donors. Recipes were collected from several sources including recipe contests and social media. We incorporated advice from current patients, parents, and CCS. Results Over 400 recipes, searchable by several categories and with accompanying nutritional information, are currently available on the website. In addition to healthy recipes, social media functionality and cooking videos are integrated into the website. The website also features nutrition information resources including nutrition and cooking tip sheets available on several subjects. Conclusions The “@TheTable” website is a unique resource for promoting healthy lifestyles spanning pediatric oncology prevention, treatment, and survivorship. Through evaluations of the website’s current and future use, as well as incorporation into interventions designed to promote energy balance, we will continue to adapt and build this unique resource to serve cancer patients, survivors, and the general public. PMID:25840596

  12. Using Community-Based Research Methods to Design Cancer Patient Navigation Training

    PubMed Central

    Braun, Kathryn L.; Allison, Amanda; Tsark, JoAnn U.

    2008-01-01

    Background Cancer mortality continues to be higher in Native Hawaiians than Whites, and research has identified numerous barriers to good cancer care. Cancer navigator programs provide individualized assistance to patients and family members to overcome barriers, promoting early diagnosis and timely and complete treatment. Objectives Our purpose was to design a training curriculum to provide community-based outreach workers serving Native Hawaiians with cancer patient navigator skills. Methods The Ho`okele i ke Ola (Navigating to Health) curriculum was informed by data gathered from Native Hawaiian cancer patients and their family members, outreach workers in Native Hawaiian communities, and cancer care providers. Based on findings, the 48-hour curriculum focused on cancer knowledge, cancer resources, and cancer communications. Three versions were developed: 1) 6 days of training and on-site tours in urban Honolulu; 2) 4 days of training on a neighbor island, with 2 days of on-site tours in Honolulu; and 3) a 3-credit community college independent study course. Graduates were interviewed after each session and 3 months after graduation about application of navigation skills. Results In 18 months, 62 health workers from community-based, clinical and community college settings were trained—31 in Honolulu-based trainings, 29 in neighbor island trainings where earlier graduates served as co-faculty, and 2 through Maui Community College. Follow-up data suggest increased knowledge, skills, capacity, and feelings of competence among trainees. Conclusions All three versions of the Ho`okele i ke Ola curriculum, developed with community input, have proven successful in increasing cancer patient navigation skills of trainees. PMID:20208313

  13. Designing patient-specific 3D printed craniofacial implants using a novel topology optimization method.

    PubMed

    Sutradhar, Alok; Park, Jaejong; Carrau, Diana; Nguyen, Tam H; Miller, Michael J; Paulino, Glaucio H

    2016-07-01

    Large craniofacial defects require efficient bone replacements which should not only provide good aesthetics but also possess stable structural function. The proposed work uses a novel multiresolution topology optimization method to achieve the task. Using a compliance minimization objective, patient-specific bone replacement shapes can be designed for different clinical cases that ensure revival of efficient load transfer mechanisms in the mid-face. In this work, four clinical cases are introduced and their respective patient-specific designs are obtained using the proposed method. The optimized designs are then virtually inserted into the defect to visually inspect the viability of the design . Further, once the design is verified by the reconstructive surgeon, prototypes are fabricated using a 3D printer for validation. The robustness of the designs are mechanically tested by subjecting them to a physiological loading condition which mimics the masticatory activity. The full-field strain result through 3D image correlation and the finite element analysis implies that the solution can survive the maximum mastication of 120 lb. Also, the designs have the potential to restore the buttress system and provide the structural integrity. Using the topology optimization framework in designing the bone replacement shapes would deliver surgeons new alternatives for rather complicated mid-face reconstruction. PMID:26660897

  14. Designing patient-specific 3D printed craniofacial implants using a novel topology optimization method.

    PubMed

    Sutradhar, Alok; Park, Jaejong; Carrau, Diana; Nguyen, Tam H; Miller, Michael J; Paulino, Glaucio H

    2016-07-01

    Large craniofacial defects require efficient bone replacements which should not only provide good aesthetics but also possess stable structural function. The proposed work uses a novel multiresolution topology optimization method to achieve the task. Using a compliance minimization objective, patient-specific bone replacement shapes can be designed for different clinical cases that ensure revival of efficient load transfer mechanisms in the mid-face. In this work, four clinical cases are introduced and their respective patient-specific designs are obtained using the proposed method. The optimized designs are then virtually inserted into the defect to visually inspect the viability of the design . Further, once the design is verified by the reconstructive surgeon, prototypes are fabricated using a 3D printer for validation. The robustness of the designs are mechanically tested by subjecting them to a physiological loading condition which mimics the masticatory activity. The full-field strain result through 3D image correlation and the finite element analysis implies that the solution can survive the maximum mastication of 120 lb. Also, the designs have the potential to restore the buttress system and provide the structural integrity. Using the topology optimization framework in designing the bone replacement shapes would deliver surgeons new alternatives for rather complicated mid-face reconstruction.

  15. The step-and-shoot IMRT overshooting phenomenon: a novel method to mitigate patient overdosage.

    PubMed

    Zhen, Heming; Ouyang, Luo; Bao, Qinan; Qin, Nan; Stojadinovic, Strahinja; Pompos, Arnold

    2016-01-01

    The goal of this work is to evaluate the dosimetric impact of an overshooting phenomenon in step-and-shoot IMRT delivery, and to demonstrate a novel method to mitigate the issue. Five pelvis IMRT patients treated on Varian 2100C EX linacs with larger than +4.5% phantom ion chamber point-dose difference relative to planned dose were investigated. For each patient plan, 5 fractions were delivered. DynaLog files were recorded and centi-MU pulses from dose integrator board for every control point (CP) were counted using a commercial pulse counter. The counter recorded CP MU agrees with DynaLog records, both showing an ~ 0.6MU overshoot of the first segment of every beam. The 3D patient dose was recalculated from the counter records and compared to the planned dose, showing that the overshoot resulted in on average 2.05% of PTV D95 error, and 2.49%, 2.61% and 2.45% of D1cc error for rectum, bladder, and bowel, respectively. The initial plans were then modified by inserting a specially designed MLC segment to the start of every beam. The modified plans were also delivered five times. The dose from the modified delivery was calculated using counter recorded CP MU. The corresponding Dx parameters were all within 0.31% from the original plan. IMRT QA results also show a 2.2% improvement in ion chamber point-dose agreement. The results demonstrate that the proposed plan modification method effectively eliminates the overdosage from the overshooting phenomenon. PMID:27455482

  16. Recent developments of protein kinase inhibitors as potential AD therapeutics.

    PubMed

    Tell, Volkmar; Hilgeroth, Andreas

    2013-01-01

    Present Alzheimer's disease (AD) therapies suffer from inefficient effects on AD symptoms like memory or cognition, especially in later states of the disease. Used acteylcholine esterase inhibitors or the NMDA receptor antagonist memantine address one target structure which is involved in a complex, multifactorial disease progression. So the benefit for patients is presently poor. A more close insight in the AD progression identified more suggested target structures for drug development. Strategies of AD drug development concentrate on novel target structures combined with the established ones dedicated for combined therapy regimes, preferably by the use of one drug which may address two target structures. Protein kinases have been identified as promising target structures because they are involved in AD progression pathways like pathophysiological tau protein phosphorylations and amyloid β toxicity. The review article will shortly view early inhibitors of single protein kinases like glycogen synthase kinase (gsk3) β and cyclin dependent kinase 5. Novel inhibitors will be discussed which address novel AD relevant protein kinases like dual-specificity tyrosine phosphorylation regulated kinase 1A (DYRK1A). Moreover, multitargeting inhibitors will be presented which target several protein kinases and those which are suspected in influencing other AD relevant processes. Such a multitargeting is the most promising strategy to effectively hamper the multifactorial disease progression and thus gives perspective hopes for a future better patient benefit. PMID:24312003

  17. Recent developments of protein kinase inhibitors as potential AD therapeutics

    PubMed Central

    Tell, Volkmar; Hilgeroth, Andreas

    2013-01-01

    Present Alzheimer’s disease (AD) therapies suffer from inefficient effects on AD symptoms like memory or cognition, especially in later states of the disease. Used acteylcholine esterase inhibitors or the NMDA receptor antagonist memantine address one target structure which is involved in a complex, multifactorial disease progression. So the benefit for patients is presently poor. A more close insight in the AD progression identified more suggested target structures for drug development. Strategies of AD drug development concentrate on novel target structures combined with the established ones dedicated for combined therapy regimes, preferably by the use of one drug which may address two target structures. Protein kinases have been identified as promising target structures because they are involved in AD progression pathways like pathophysiological tau protein phosphorylations and amyloid β toxicity. The review article will shortly view early inhibitors of single protein kinases like glycogen synthase kinase (gsk3) β and cyclin dependent kinase 5. Novel inhibitors will be discussed which address novel AD relevant protein kinases like dual-specificity tyrosine phosphorylation regulated kinase 1A (DYRK1A). Moreover, multitargeting inhibitors will be presented which target several protein kinases and those which are suspected in influencing other AD relevant processes. Such a multitargeting is the most promising strategy to effectively hamper the multifactorial disease progression and thus gives perspective hopes for a future better patient benefit. PMID:24312003

  18. Assessing the added value of health technologies: reconciling different perspectives.

    PubMed

    Drummond, Michael; Tarricone, Rosanna; Torbica, Aleksandra

    2013-01-01

    Providing universal access to innovative, high-cost technologies leads to tensions in today's health care systems. The tension becomes particularly evident in the context of scarce resources, where the risk of taking contentious coverage decisions increases rapidly. To ensure economic sustainability, the payers of health care think that the benefits from the use of the new technologies need to be commensurate with the costs. Therefore, many jurisdictions have programs of health technology assessment, which often results in restrictions of access to care, either through complete refusal to reimburse the technology or its restriction of use to only a subset of the eligible patient population. However, manufacturers feel that they should be adequately rewarded for their innovations and require sufficient funds to invest in further research. Finally, patients perceive these technologies to have added benefits, and so they are concerned when they are denied access. If sustainable access to health care is to be maintained in the future, approaches are needed to reconcile these different perspectives. This article explores the approaches, in both methods and policy, to help bring about this reconciliation. These include rethinking the notion of social value (on the part of payers), aligning manufacturers' research more closely with societal objectives, and increasing patient participation in health technology assessment. PMID:23317646

  19. UHPLC-MS/MS method with protein precipitation extraction for the simultaneous quantification of ten antihypertensive drugs in human plasma from resistant hypertensive patients.

    PubMed

    De Nicolò, Amedeo; Avataneo, Valeria; Rabbia, Franco; Bonifacio, Gabriele; Cusato, Jessica; Tomasello, Cristina; Perlo, Elisa; Mulatero, Paolo; Veglio, Franco; Di Perri, Giovanni; D'Avolio, Antonio

    2016-09-10

    Today the management of resistant hypertension is a critical health problem: the main difficulty on this field is the discrimination of cases of poor therapeutic adherence from cases of real resistance. This gives rise to the need of high throughput and reliable quantification methods for the Therapeutic Drug Monitoring (TDM) of antihypertensive drugs. The aim of this work was the development and validation of a UHPLC-Tandem mass spectrometry assay for this application and its use in plasma from patients with resistant hypertension. The novelty of this method resides in the ability to simultaneously quantify a wide panel of antihypertensive drugs: amlodipine, atenolol, clonidine, chlortalidone, doxazosin, hydrochlorothiazide, nifedipine, olmesartan, ramipril and telmisartan. Moreover, this method stands out for its simplicity and cheapness, resulting feasible for clinical routine. Both standards and quality controls were prepared in human plasma. After the addition of internal standard, each sample underwent protein precipitation with acetonitrile and was then dried. Extracts were resuspended in water:acetonitrile 90:10 (0.05% formic acid) and then injected into the chromatographic system. Chromatographic separation was performed on an Acquity(®) UPLC HSS T3 1.8μm 2.1×150mm column, with a gradient of water and acetonitrile, both added with 0.05% formic acid. Accuracy, intra-day and inter-day precision fitted FDA guidelines for all analytes, while matrix effects and recoveries resulted stable between samples for each analyte. Finally, we tested this method by monitoring plasma concentrations in 22 hypertensive patients with good results. This simple analytical method could represent a useful tool for the management of antihypertensive therapy. PMID:27497654

  20. ADS's Dexter Data Extraction Applet

    NASA Astrophysics Data System (ADS)

    Demleitner, M.; Accomazzi, A.; Eichhorn, G.; Grant, C. S.; Kurtz, M. J.; Murray, S. S.

    The NASA Astrophysics Data System (ADS) now holds 1.3 million scanned pages, containing numerous plots and figures for which the original data sets are lost or inaccessible. The availability of scans of the figures can significantly ease the regeneration of the data sets. For this purpose, the ADS has developed Dexter, a Java applet that supports the user in this process. Dexter's basic functionality is to let the user manually digitize a plot by marking points and defining the coordinate transformation from the logical to the physical coordinate system. Advanced features include automatic identification of axes, tracing lines and finding points matching a template. This contribution both describes the operation of Dexter from a user's point of view and discusses some of the architectural issues we faced during implementation.

  1. Scattering States in AdS/CFT

    SciTech Connect

    Fitzpatrick, A.Liam; Kaplan, Jared; /SLAC

    2012-02-14

    We show that suitably regulated multi-trace primary states in large N CFTs behave like 'in' and 'out' scattering states in the flat-space limit of AdS. Their transition matrix elements approach the exact scattering amplitudes for the bulk theory, providing a natural CFT definition of the flat space S-Matrix. We study corrections resulting from the AdS curvature and particle propagation far from the center of AdS, and show that AdS simply provides an IR regulator that disappears in the flat space limit.

  2. SU-E-J-11: A New Optical Method to Register Patient External Motion

    SciTech Connect

    Barbes, B; Azcona, J; Moreno, M; Prieto, E; Foronda, J; Burguete, J

    2014-06-01

    Purpose: To devise and implement a new system to measure and register the patient motion during radiotherapy treatments. Methods: The system can obtain the position of several points in the 3D-space, through their projections in the 2D-images recorded by two cameras. The algorithm needs a series of constants, that are obtained using the images of a calibrated phantom.To test the system, some adhesive labels were placed on the surface of an object. Two cameras recorded the moving object over time. An in-house developed software localized the labels in each image. In the first pair of images, the program used a first approximation given by the user. In the subsequent images, it used the last position as an approximate location. The final exact coordinates of the point were obtained in a two-step process using the contrast of the images. From the 2D-positions of the point in each frame, the 3D-trajectories of each of these marks were obtained.The system was tested with linear displacements, oscillations of a mechanical oscillator, circular trajectories of a rotating disk, and with respiratory motion of a volunteer. Results: Trajectories of several points were reproduced with sub-millimeter accuracy in the three directions of the space. The system was able to follow periodic motion with amplitudes lower than 0.5mm; and trajectories of rotating points at speeds up to 200mm/s. The software could also track accurately the respiration motion of a person. Conclusion: A new, inexpensive optical tracking system for patient motion has been demonstrated. The system detects motion with high accuracy. Installation and calibration of the system is simple and quick. Data collection is not expected to involve any discomfort for the patient, nor any delay for the treatment. The system could be also used as a method of warning for patient movements, and for gating. We acknowledge financial support from Fundacion Mutua Madrilena, Madrid, Spain.

  3. Multidrug punch cards in primary care: a mixed methods study on patients' preferences and impact on adherence

    PubMed Central

    Boeni, Fabienne; Hersberger, Kurt E.; Arnet, Isabelle

    2014-01-01

    Background: Multidrug punch cards are frame cards with 28 plastic cavities filled with a patient's oral solid medication. They are used in primary care to facilitate medication management and to enhance adherence. Main criticism concerned handling difficulties and fading knowledge about medication of patients using them. This study aimed at exploring daily use, preferences, and adherence of primary care patients using multidrug punch cards. Methods: Community pharmacies in Switzerland recruited primary care patients using multidrug punch cards. A mixed methods approach was applied with quantitative interviews performed by telephone and qualitative interviews face-to-face. Results: Of 149 eligible patients from 21 community pharmacies, 22 participated 2011 in the quantitative and 11 participated 2013/14 in the qualitative interview. Patients were very satisfied with the multidrug punch cards and stated increased medication safety. All considered adherence as very important. Self-reported adherence was 10 (median) on a visual analog scale (0 = no intake, 10 = perfect adherence). The absence of package inserts and predefined handling difficulties e.g., tablets spiking at removal were not perceived as problems. Conclusions: Patients are satisfied with the multidrug punch cards, feel safe, mostly have no handling problems and adhere to their treatment. Trust in health-care professionals and patients' experiences emerged as key variables for initiating multidrug punch card use and for medication adherence. This mixed methods study invalidates previous concerns about disadvantages of multidrug punch cards. Health-care professionals should actively recommend them for primary care patients with polypharmacy and poor adherence. PMID:25324777

  4. Magnetic mass in 4D AdS gravity

    NASA Astrophysics Data System (ADS)

    Araneda, René; Aros, Rodrigo; Miskovic, Olivera; Olea, Rodrigo

    2016-04-01

    We provide a fully covariant expression for the diffeomorphic charge in four-dimensional anti-de Sitter gravity, when the Gauss-Bonnet and Pontryagin terms are added to the action. The couplings of these topological invariants are such that the Weyl tensor and its dual appear in the on-shell variation of the action and such that the action is stationary for asymptotic (anti-)self-dual solutions in the Weyl tensor. In analogy with Euclidean electromagnetism, whenever the self-duality condition is global, both the action and the total charge are identically vanishing. Therefore, for such configurations, the magnetic mass equals the Ashtekhar-Magnon-Das definition.

  5. Canonical energy and hairy AdS black holes

    NASA Astrophysics Data System (ADS)

    Hyun, Seungjoon; Park, Sang-A.; Yi, Sang-Heon

    2016-08-01

    We propose the modified version of the canonical energy which was introduced originally by Hollands and Wald. Our construction depends only on the Euler-Lagrange expression of the system and thus is independent of the ambiguity in the Lagrangian. After some comments on our construction, we briefly mention on the relevance of our construction to the boundary information metric in the context of the AdS/CFT correspondence. We also study the stability of three-dimensional hairy extremal black holes by using our construction.

  6. Methods for Selection of Cancer Patients and Predicting Efficacy of Combination Therapy | NCI Technology Transfer Center | TTC

    Cancer.gov

    The Lung Cancer Biomarkers Group of the National Cancer Institute (NCI) seeks parties interested in collaborative research to further co-develop methods for selecting cancer patients for combination therapy.

  7. Variations of 14C around AD 775 and AD 1795 - due to solar activity

    NASA Astrophysics Data System (ADS)

    Neuhäuser, R.; Neuhäuser, D. L.

    2015-12-01

    The motivation for our study is the disputed cause for the strong variation of 14C around AD 775. Our method is to compare the 14C variation around AD 775 with other periods of strong variability. Our results are: (a) We see three periods, where 14C varied over 200 yr in a special way showing a certain pattern of strong secular variation: after a Grand Minimum with strongly increasing 14C, there is a series of strong short-term drop(s), rise(s), and again drop(s) within 60 yr, ending up to 200 yr after the start of the Grand Minimum. These three periods include the strong rises around BC 671, AD 775, and AD 1795. (b) We show with several solar activity proxies (radioisotopes, sunspots, and aurorae) for the AD 770s and 1790s that such intense rapid 14C increases can be explained by strong rapid decreases in solar activity and, hence, wind, so that the decrease in solar modulation potential leads to an increase in radioisotope production. (c) The strong rises around AD 775 and 1795 are due to three effects, (i) very strong activity in the previous cycles (i.e. very low 14C level), (ii) the declining phase of a very strong Schwabe cycle, and (iii) a phase of very weak activity after the strong 14C rise - very short and/or weak cycle(s) like the suddenly starting Dalton minimum. (d) Furthermore, we can show that the strong change at AD 1795 happened after a pair of two packages of four Schwabe cycles with certain hemispheric leadership (each package consists of two Gnevyshev-Ohl pairs, respectively two Hale-Babcock pairs). We show with several additional arguments that the rise around AD 775 was not that special. We conclude that such large, short-term rises in 14C (around BC 671, AD 775, and 1795) do not need to be explained by highly unlikely solar super-flares nor other rare events, but by extra-solar cosmic rays modulated due to solar activity variations.

  8. Improved Method to Stratify Elderly Patients With Cancer at Risk for Competing Events

    PubMed Central

    Carmona, Ruben; Zakeri, Kaveh; Green, Garrett; Hwang, Lindsay; Gulaya, Sachin; Xu, Beibei; Verma, Rohan; Williamson, Casey W.; Triplett, Daniel P.; Rose, Brent S.; Shen, Hanjie; Vaida, Florin; Murphy, James D.

    2016-01-01

    Purpose To compare a novel generalized competing event (GCE) model versus the standard Cox proportional hazards regression model for stratifying elderly patients with cancer who are at risk for competing events. Methods We identified 84,319 patients with nonmetastatic prostate, head and neck, and breast cancers from the SEER-Medicare database. Using demographic, tumor, and clinical characteristics, we trained risk scores on the basis of GCE versus Cox models for cancer-specific mortality and all-cause mortality. In test sets, we examined the predictive ability of the risk scores on the different causes of death, including second cancer mortality, noncancer mortality, and cause-specific mortality, using Fine-Gray regression and area under the curve. We compared how well models stratified subpopulations according to the ratio of the cumulative cause-specific hazard for cancer mortality to the cumulative hazard for overall mortality (ω) using the Akaike Information Criterion. Results In each sample, increasing GCE risk scores were associated with increased cancer-specific mortality and decreased competing mortality, whereas risk scores from Cox models were associated with both increased cancer-specific mortality and competing mortality. GCE models created greater separation in the area under the curve for cancer-specific mortality versus noncancer mortality (P < .001), indicating better discriminatory ability between these events. Comparing the GCE model to Cox models of cause-specific mortality or all-cause mortality, the respective Akaike Information Criterion scores were superior (lower) in each sample: prostate cancer, 28.6 versus 35.5 versus 39.4; head and neck cancer, 21.1 versus 29.4 versus 40.2; and breast cancer, 24.6 versus 32.3 versus 50.8. Conclusion Compared with standard modeling approaches, GCE models improve stratification of elderly patients with cancer according to their risk of dying from cancer relative to overall mortality. PMID:26884579

  9. AN EMPIRICAL METHOD FOR MATERIALITY: WOULD CONFLICT OF INTEREST DISCLOSURES CHANGE PATIENT DECISIONS?

    PubMed

    Spece, Roy; Yokum, David; Okoro, Andrea-Gale; Robertson Christopher

    2014-01-01

    The law has long been concerned with the agency problems that arise when advisors, such as attorneys or physicians, put themselves in financial relationships that create conflicts of interest. If the financial relationship is "material" to the transactions proposed by the advisor, then non-disclosure of the relationship may be pertinent to claims of malpractice, informed consent, and even fraud, as well as to professional discipline. In these sorts of cases, materiality is closely related to the question of causation, roughly turning on whether the withheld information might have changed the decision of a reasonable advisee (i.e., a patient). The injured plaintiff will predictably testify that the information would have impacted his or her choice, but that self-serving testimony may be unreliable. The fact finder is left to speculate about the counterfactual world in which the information was disclosed. This Article shows how randomized vignette-based experimentation may create a valuable form of evidence to address these questions, for both litigation and policymaking. To demonstrate this method and investigate conflicts of interest in healthcare in particular, we recruited 691 human subjects and asked them to imagine themselves as patients facing a choice about whether to undergo a cardiac stenting procedure recommended by a cardiologist. We manipulated the vignettes in a 2 x 3 between-subjects design, where we systematically varied the appropriateness of the proposed treatment, which was described in terms of patient risk without the procedure (low or high), and manipulated the type of disclosure provided by the physician (none, standard, or enhanced). We used physician ownership of the specialty hospital where the surgery would be performed as the conflict of interest, disclosed or not, and the "enhanced" disclosure included notice that such relationships have been associated with biases in prescribing behavior. We found that the mock patients were

  10. Methods for Assessing Expiratory Flow Limitation during Tidal Breathing in COPD Patients.

    PubMed

    Koulouris, Nickolaos G; Kaltsakas, Georgios; Palamidas, Anastasios F; Gennimata, Sofia-Antiopi

    2012-01-01

    Patients with severe COPD often exhale along the same flow-volume curve during quite breathing as during forced expiratory vital capacity manoeuvre, and this has been taken as indicating expiratory flow limitation at rest (EFL(T)). Therefore, EFL(T), namely, attainment of maximal expiratory flow during tidal expiration, occurs when an increase in transpulmonary pressure causes no increase in expiratory flow. EFL(T) leads to small airway injury and promotes dynamic pulmonary hyperinflation with concurrent dyspnoea and exercise limitation. In fact, EFL(T) occurs commonly in COPD patients (mainly in GOLD III and IV stage) in whom the latter symptoms are common. The existing up-to-date physiological methods for assessing expiratory flow limitation (EFL(T)) are reviewed in the present work. Among the currently available techniques, the negative expiratory pressure (NEP) has been validated in a wide variety of settings and disorders. Consequently, it should be regarded as a simple, non invasive, most practical, and accurate new technique.

  11. Vulnerable Blood in High Risk Vascular Patients: Study Design and Methods

    PubMed Central

    McDermott, Mary M.; Greenland, Philip; Liu, Kiang; Tian, Lu; Green, David; Shah, Sanjiv J.; Huffman, Mark; Wilkins, John; Kibbe, Melina; Liao, Yihua; Huang, Chiang-Ching; Skelly, Christopher; Jacobs, Chad; McCarthy, Walter; Auerbach, Amanda; Lloyd-Jones, Donald

    2014-01-01

    BACKGROUND Basic research suggests that rapid increases in circulating inflammatory and hemostatic blood markers may trigger or indicate impending plaque rupture and coronary thrombosis, resulting in acute ischemic heart disease (IHD) events. However, these associations are not established in humans. METHODS AND RESULTS The Biomarker Risk Assessment in Vulnerable Outpatients (BRAVO) Study will determine whether levels of inflammatory and hemostatic biomarkers rapidly increase during the weeks prior to an acute IHD event in people with lower extremity peripheral artery disease (PAD). The BRAVO Study will determine whether biomarker levels measured immediately prior to an IHD event are higher than levels not preceding an IHD event; whether participants who experience an IHD event (cases) have higher biomarker levels immediately prior to the event and higher biomarker levels at each time point leading up to the IHD event than participants without an IHD event (controls); and whether case participants have greater increases in biomarkers during the months leading up to the event than controls. BRAVO enrolled 595 patients with PAD, a population at high risk for acute IHD events. After a baseline visit, participants returned every two months for blood collection, underwent an electrocardiogram to identify new silent myocardial infarctions, and were queried about new hospitalizations since their prior study visit. Mortality data were also collected. Participants were followed prospectively for up to three years. CONCLUSIONS BRAVO results will provide important information about the pathophysiology of IHD events and may lead to improved therapies for preventing IHD events in high-risk patients. PMID:24721480

  12. Methods for Assessing Expiratory Flow Limitation during Tidal Breathing in COPD Patients.

    PubMed

    Koulouris, Nickolaos G; Kaltsakas, Georgios; Palamidas, Anastasios F; Gennimata, Sofia-Antiopi

    2012-01-01

    Patients with severe COPD often exhale along the same flow-volume curve during quite breathing as during forced expiratory vital capacity manoeuvre, and this has been taken as indicating expiratory flow limitation at rest (EFL(T)). Therefore, EFL(T), namely, attainment of maximal expiratory flow during tidal expiration, occurs when an increase in transpulmonary pressure causes no increase in expiratory flow. EFL(T) leads to small airway injury and promotes dynamic pulmonary hyperinflation with concurrent dyspnoea and exercise limitation. In fact, EFL(T) occurs commonly in COPD patients (mainly in GOLD III and IV stage) in whom the latter symptoms are common. The existing up-to-date physiological methods for assessing expiratory flow limitation (EFL(T)) are reviewed in the present work. Among the currently available techniques, the negative expiratory pressure (NEP) has been validated in a wide variety of settings and disorders. Consequently, it should be regarded as a simple, non invasive, most practical, and accurate new technique. PMID:23008769

  13. A Novel Rapid MALDI-TOF-MS-Based Method for Measuring Urinary Globotriaosylceramide in Fabry Patients

    NASA Astrophysics Data System (ADS)

    Alharbi, Fahad J.; Geberhiwot, Tarekegn; Hughes, Derralynn A.; Ward, Douglas G.

    2016-04-01

    Fabry disease is an X-linked lysosomal storage disorder caused by deficiency of α-galactosidase A, resulting in the accumulation of glycosphingolipids in various organs. Globotriaosylceramide (Gb3) and its isoforms and analogues have been identified and quantified as biomarkers of disease severity and treatment efficacy. The current study aimed to establish rapid methods for urinary Gb3 extraction and quantitation. Urine samples from 15 Fabry patients and 21 healthy control subjects were processed to extract Gb3 by mixing equal volumes of urine, methanol containing an internal standard, and chloroform followed by sonication and centrifugation. Thereafter, the lower phase was analyzed by MALDI-TOF MS and the relative peak areas of the internal standard and four major species of Gb3 determined. The results showed high reproducibility with intra- and inter-assay coefficients variation of 9.9% and 13.7%, respectively. The limit of detection was 0.15 ng/μL and the limit of quantitation was 0.30 ng/μL. Total urinary Gb3 levels in both genders of classic Fabry patients were significantly higher than in healthy controls (p < 0.0001). Gb3 levels in Fabry males were higher than in Fabry females (p = 0.08). We have established a novel assay for urinary total Gb3 that takes less than 15 min from start to finish.

  14. Lifshitz-like systems and AdS null deformations

    SciTech Connect

    Narayan, K.

    2011-10-15

    Following K. Balasubramanian and K. Narayan [J. High Energy Phys. 08 (2010) 014], we discuss certain lightlike deformations of AdS{sub 5}xX{sup 5} in type IIB string theory sourced by a lightlike dilaton {Phi}(x{sup +}) dual to the N=4 super Yang-Mills theory with a lightlike varying gauge coupling. We argue that, in the case where the x{sup +} direction is noncompact, these solutions describe anisotropic 3+1-dim Lifshitz-like systems with a potential in the x{sup +} direction generated by the lightlike dilaton. We then describe solutions of this sort with a linear dilaton. This enables a detailed calculation of two-point correlation functions of operators dual to bulk scalars and helps illustrate the spatial structure of these theories. Following this, we discuss a nongeometric string construction involving a compactification along the x{sup +} direction of this linear dilaton system. We also point out similar IIB axionic solutions. Similar bulk arguments for x{sup +}-noncompact can be carried out for deformations of AdS{sub 4}xX{sup 7} in M theory.

  15. AdS black holes from duality in gauged supergravity

    NASA Astrophysics Data System (ADS)

    Halmagyi, Nick; Vanel, Thomas

    2014-04-01

    We study and utilize duality transformations in a particular STU-model of four dimensional gauged supergravity. This model is a truncation of the de Wit-Nicolai =8 theory and as such has a lift to eleven-dimensional supergravity on the seven-sphere. Our duality group is U(1)3 and while it can be applied to any solution of this theory, we consider known asymptotically AdS4, supersymmetric black holes and focus on duality transformations which preserve supersymmetry. For static black holes we generalize the supersymmetric solutions of Cacciatori and Klemm from three magnetic charges to include two additional electric charges and argue that this is co-dimension one in the full space of supersymmetric static black holes in the STU-model. These new static black holes have nontrivial profiles for axions. For rotating black holes, we generalize the known two-parameter supersymmetric solution to include an additional parameter. When lifted to M-theory, these black holes correspond to the near horizon geometry of a stack of BPS rotating M2-branes, spinning on an S 7 which is fibered non-trivially over a Riemann surface.

  16. Stability of charged global AdS4 spacetimes

    NASA Astrophysics Data System (ADS)

    Arias, Raúl; Mas, Javier; Serantes, Alexandre

    2016-09-01

    We study linear and nonlinear stability of asymptotically AdS4 solutions in Einstein-Maxwell-scalar theory. After summarizing the set of static solutions we first examine thermodynamical stability in the grand canonical ensemble and the phase transitions that occur among them. In the second part of the paper we focus on nonlinear stability in the microcanonical ensemble by evolving radial perturbations numerically. We find hints of an instability corner for vanishingly small perturbations of the same kind as the ones present in the uncharged case. Collapses are avoided, instead, if the charge and mass of the perturbations come to close the line of solitons. Finally we examine the soliton solutions. The linear spectrum of normal modes is not resonant and instability turns on at extrema of the mass curve. Linear stability extends to nonlinear stability up to some threshold for the amplitude of the perturbation. Beyond that, the soliton is destroyed and collapses to a hairy black hole. The relative width of this stability band scales down with the charge Q, and does not survive the blow up limit to a planar geometry.

  17. The PredictAD project: development of novel biomarkers and analysis software for early diagnosis of the Alzheimer's disease.

    PubMed

    Antila, Kari; Lötjönen, Jyrki; Thurfjell, Lennart; Laine, Jarmo; Massimini, Marcello; Rueckert, Daniel; Zubarev, Roman A; Orešič, Matej; van Gils, Mark; Mattila, Jussi; Hviid Simonsen, Anja; Waldemar, Gunhild; Soininen, Hilkka

    2013-04-01

    Alzheimer's disease (AD) is the most common cause of dementia affecting 36 million people worldwide. As the demographic transition in the developed countries progresses towards older population, the worsening ratio of workers per retirees and the growing number of patients with age-related illnesses such as AD will challenge the current healthcare systems and national economies. For these reasons AD has been identified as a health priority, and various methods for diagnosis and many candidates for therapies are under intense research. Even though there is currently no cure for AD, its effects can be managed. Today the significance of early and precise diagnosis of AD is emphasized in order to minimize its irreversible effects on the nervous system. When new drugs and therapies enter the market it is also vital to effectively identify the right candidates to benefit from these. The main objective of the PredictAD project was to find and integrate efficient biomarkers from heterogeneous patient data to make early diagnosis and to monitor the progress of AD in a more efficient, reliable and objective manner. The project focused on discovering biomarkers from biomolecular data, electrophysiological measurements of the brain and structural, functional and molecular brain images. We also designed and built a statistical model and a framework for exploiting these biomarkers with other available patient history and background data. We were able to discover several potential novel biomarker candidates and implement the framework in software. The results are currently used in several research projects, licensed to commercial use and being tested for clinical use in several trials.

  18. The PredictAD project: development of novel biomarkers and analysis software for early diagnosis of the Alzheimer's disease

    PubMed Central

    Antila, Kari; Lötjönen, Jyrki; Thurfjell, Lennart; Laine, Jarmo; Massimini, Marcello; Rueckert, Daniel; Zubarev, Roman A.; Orešič, Matej; van Gils, Mark; Mattila, Jussi; Hviid Simonsen, Anja; Waldemar, Gunhild; Soininen, Hilkka

    2013-01-01

    Alzheimer's disease (AD) is the most common cause of dementia affecting 36 million people worldwide. As the demographic transition in the developed countries progresses towards older population, the worsening ratio of workers per retirees and the growing number of patients with age-related illnesses such as AD will challenge the current healthcare systems and national economies. For these reasons AD has been identified as a health priority, and various methods for diagnosis and many candidates for therapies are under intense research. Even though there is currently no cure for AD, its effects can be managed. Today the significance of early and precise diagnosis of AD is emphasized in order to minimize its irreversible effects on the nervous system. When new drugs and therapies enter the market it is also vital to effectively identify the right candidates to benefit from these. The main objective of the PredictAD project was to find and integrate efficient biomarkers from heterogeneous patient data to make early diagnosis and to monitor the progress of AD in a more efficient, reliable and objective manner. The project focused on discovering biomarkers from biomolecular data, electrophysiological measurements of the brain and structural, functional and molecular brain images. We also designed and built a statistical model and a framework for exploiting these biomarkers with other available patient history and background data. We were able to discover several potential novel biomarker candidates and implement the framework in software. The results are currently used in several research projects, licensed to commercial use and being tested for clinical use in several trials. PMID:24427524

  19. Life-table methods for evaluating antiarrhythmic drug efficacy in patients with paroxysmal atrial tachycardia.

    PubMed

    Pritchett, E L; Hammill, S C; Reiter, M J; Lee, K L; McCarthy, E A; Zimmerman, J M; Shand, D G

    1983-11-01

    Spontaneous variability in the occurrence of paroxysmal arrhythmias has made it difficult to apply objective and quantitative methods to describe their clinical course. In this study of paroxysmal atrial tachycardia, the "tachycardia-free interval" was used as a quantitative measure of drug efficacy during treatment with oral verapamil. The tachycardia-free interval is the time a patient remains free from an episode of tachycardia after drug treatment is begun. We documented recurrent tachycardia by telephone transmission of the electrocardiogram. Improvement caused by increasing the drug dose (360 versus 480 mg/day) or by comparing verapamil with placebo treatment was demonstrated by upward shifts in the cumulative tachycardia-free interval curves. The tachycardia-free interval is an easily measured clinical variable that has substantial promise in the study of paroxysmal arrhythmias.

  20. Comparison of methods of estimating body fat in normal subjects and cancer patients

    SciTech Connect

    Cohn, S.H.; Ellis, K.J.; Vartsky, D.; Sawitsky, A.; Gartenhaus, W.; Yasumura, S.; Vaswani, A.N.

    1981-12-01

    Total body fat can be indirectly estimated by the following noninvasive techniques: determination of lean body mass by measurement of body potassium or body water, and determination of density by underwater weighing or by skinfold measurements. The measurement of total body nitrogen by neutron activation provides another technique for estimating lean body mass and hence body fat. The nitrogen measurement can also be combined with the measurement of total body potassium in a two compartment model of the lean body mass from which another estimate of body fat can be derived. All of the above techniques are subject to various errors and are based on a number of assumptions, some of which are incompletely validated. These techniques were applied to a population of normal subjects and to a group of cancer patients. The advantages and disadvantages of each method are discussed in terms of their ability to estimate total body fat.

  1. The ADS All Sky Survey

    NASA Astrophysics Data System (ADS)

    Goodman, Alyssa

    We will create the first interactive sky map of astronomers' understanding of the Universe over time. We will accomplish this goal by turning the NASA Astrophysics Data System (ADS), widely known for its unrivaled value as a literature resource, into a data resource. GIS and GPS systems have made it commonplace to see and explore information about goings-on on Earth in the context of maps and timelines. Our proposal shows an example of a program that lets a user explore which countries have been mentioned in the New York Times, on what dates, and in what kinds of articles. By analogy, the goal of our project is to enable this kind of exploration-on the sky-for the full corpus of astrophysical literature available through ADS. Our group's expertise and collaborations uniquely position us to create this interactive sky map of the literature, which we call the "ADS All-Sky Survey." To create this survey, here are the principal steps we need to follow. First, by analogy to "geotagging," we will "astrotag," the ADS literature. Many "astrotags" effectively already exist, thanks to curation efforts at both CDS and NED. These efforts have created links to "source" positions on the sky associated with each of the millions of articles in the ADS. Our collaboration with ADS and CDS will let us automatically extract astrotags for all existing and future ADS holdings. The new ADS Labs, which our group helps to develop, includes the ability for researchers to filter article search results using a variety of "facets" (e.g. sources, keywords, authors, observatories, etc.). Using only extracted astrotags and facets, we can create functionality like what is described in the Times example above: we can offer a map of the density of positions' "mentions" on the sky, filterable by the properties of those mentions. Using this map, researchers will be able to interactively, visually, discover what regions have been studied for what reasons, at what times, and by whom. Second, where

  2. There are no differences in IL-6, CRP and homocystein concentrations between women whose mothers had AD and women whose mothers did not have AD.

    PubMed

    Devčić, Sanja; Glamuzina, Ljubomir; Ruljancic, Nedjeljka; Mihanovic, Mate

    2014-12-30

    A wide range of recent studies have detected inflammation as one of the most influent factors in the appearance and spreading of neurodegenerative brain diseases. We aimed to understand the influence of Interleukin-6 (IL-6), C-reactive protein (CRP) and homocysteine (Hcy) on patients suffering from Alzheimer׳s disease (AD) and on their descendants. Three groups of subjects were analyzed: 55 patients suffering from AD, 51 middle-aged daughters of the patients of the first group, and 53 subjects without positive family history of AD. The results of the conducted research are in accordance with the present scientific knowledge, namely a statistically significant difference for examined parameters has been determined between women suffering from AD and their daughters and control group examinees. No difference was found in serum concentrations of IL-6, highly sensitive C-reactive protein (hsCRP) and Hcy between the groups of the middle-aged descendants of patients with AD and healthy controls without family history of AD. This finding supports the hypothesis that these markers may not play causal role in the development of AD. This is supported by the obtained positive correlation between IL-6 and hsCRP and IL-6 and Hcy in AD patients while there is no such correlation between female subjects with or without a family history of AD. PMID:25240941

  3. DOMINO-AD protocol: donepezil and memantine in moderate to severe Alzheimer's disease – a multicentre RCT

    PubMed Central

    Jones, Rob; Sheehan, Bart; Phillips, Patrick; Juszczak, Ed; Adams, Jessica; Baldwin, Ashley; Ballard, Clive; Banerjee, Sube; Barber, Bob; Bentham, Peter; Brown, Richard; Burns, Alistair; Dening, Tom; Findlay, David; Gray, Richard; Griffin, Mary; Holmes, Clive; Hughes, Alan; Jacoby, Robin; Johnson, Tony; Jones, Roy; Knapp, Martin; Lindesay, James; McKeith, Ian; McShane, Rupert; Macharouthu, Ajay; O'Brien, John; Onions, Caroline; Passmore, Peter; Raftery, James; Ritchie, Craig; Howard, Rob

    2009-01-01

    Background Alzheimer's disease (AD) is the commonest cause of dementia. Cholinesterase inhibitors, such as donepezil, are the drug class with the best evidence of efficacy, licensed for mild to moderate AD, while the glutamate antagonist memantine has been widely prescribed, often in the later stages of AD. Memantine is licensed for moderate to severe dementia in AD but is not recommended by the England and Wales National Institute for Health and Clinical Excellence. However, there is little evidence to guide clinicians as to what to prescribe as AD advances; in particular, what to do as the condition progresses from moderate to severe. Options include continuing cholinesterase inhibitors irrespective of decline, adding memantine to cholinesterase inhibitors, or prescribing memantine instead of cholinesterase inhibitors. The aim of this trial is to establish the most effective drug option for people with AD who are progressing from moderate to severe dementia despite treatment with donepezil. Method DOMINO-AD is a pragmatic, 15 centre, double-blind, randomized, placebo controlled trial. Patients with AD, currently living at home, receiving donepezil 10 mg daily, and with Standardized Mini-Mental State Examination (SMMSE) scores between 5 and 13 are being recruited. Each is randomized to one of four treatment options: continuation of donepezil with memantine placebo added; switch to memantine with donepezil placebo added; donepezil and memantine together; or donepezil placebo with memantine placebo. 800 participants are being recruited and treatment continues for one year. Primary outcome measures are cognition (SMMSE) and activities of daily living (Bristol Activities of Daily Living Scale). Secondary outcomes are non-cognitive dementia symptoms (Neuropsychiatric Inventory), health related quality of life (EQ-5D and DEMQOL-proxy), carer burden (General Health Questionnaire-12), cost effectiveness (using Client Service Receipt Inventory) and institutionalization

  4. A comparison of thoracic or lumbar patient-controlled epidural analgesia methods after thoracic surgery

    PubMed Central

    2014-01-01

    Background We aimed to compare patient-controlled thoracic or lumbar epidural analgesia methods after thoracotomy operations. Methods One hundred and twenty patients were prospectively randomized to receive either thoracic epidural analgesia (TEA group) or lumbar epidural analgesia (LEA group). In both groups, epidural catheters were administered. Hemodynamic measurements, visual analog scale scores at rest (VAS-R) and after coughing (VAS-C), analgesic consumption, and side effects were compared at 0, 2, 4, 8, 16, and 24 hours postoperatively. Results The VAS-R and VAS-C values were lower in the TEA group in comparison to the LEA group at 2, 4, 8, and 16 hours after surgery (for VAS-R, P = 0.001, P = 0.01, P = 0.008, and P = 0.029, respectively; and for VAS-C, P = 0.035, P = 0.023, P = 0.002, and P = 0.037, respectively). Total 24-hour analgesic consumption was different between groups (175 +/- 20 mL versus 185 +/- 31 mL; P = 0.034). The comparison of postoperative complications revealed that the incidence of hypotension (21/57, 36.8% versus 8/63, 12.7%; P = 0.002), bradycardia (9/57, 15.8% versus 2/63, 3.2%; P = 0.017), atelectasis (1/57, 1.8% versus 7/63, 11.1%; P = 0.04), and the need for intensive care unit (ICU) treatment (0/57, 0% versus 5/63, 7.9%; P = 0.03) were lower in the TEA group in comparison to the LEA group. Conclusions TEA has beneficial hemostatic effects in comparison to LEA after thoracotomies along with more satisfactory pain relief profile. PMID:24885545

  5. A Reliable Method to Measure Lip Height Using Photogrammetry in Unilateral Cleft Lip Patients.

    PubMed

    van der Zeeuw, Frederique; Murabit, Amera; Volcano, Johnny; Torensma, Bart; Patel, Brijesh; Hay, Norman; Thorburn, Guy; Morris, Paul; Sommerlad, Brian; Gnarra, Maria; van der Horst, Chantal; Kangesu, Loshan

    2015-09-01

    There is still no reliable tool to determine the outcome of the repaired unilateral cleft lip (UCL). The aim of this study was therefore to develop an accurate, reliable tool to measure vertical lip height from photographs. The authors measured the vertical height of the cutaneous and vermilion parts of the lip in 72 anterior-posterior view photographs of 17 patients with repairs to a UCL. Points on the lip's white roll and vermillion were marked on both the cleft and the noncleft sides on each image. Two new concepts were tested. First, photographs were standardized using the horizontal (medial to lateral) eye fissure width (EFW) for calibration. Second, the authors tested the interpupillary line (IPL) and the alar base line (ABL) for their reliability as horizontal lines of reference. Measurements were taken by 2 independent researchers, at 2 different time points each. Overall 2304 data points were obtained and analyzed. Results showed that the method was very effective in measuring the height of the lip on the cleft side with the noncleft side. When using the IPL, inter- and intra-rater reliability was 0.99 to 1.0, with the ABL it varied from 0.91 to 0.99 with one exception at 0.84. The IPL was easier to define because in some subjects the overhanging nasal tip obscured the alar base and gave more consistent measurements possibly because the reconstructed alar base was sometimes indistinct. However, measurements from the IPL can only give the percentage difference between the left and right sides of the lip, whereas those from the ABL can also give exact measurements. Patient examples were given that show how the measurements correlate with clinical assessment. The authors propose this method of photogrammetry with the innovative use of the IPL as a reliable horizontal plane and use of the EFW for calibration as a useful and reliable tool to assess the outcome of UCL repair. PMID:26147027

  6. A Reliable Method to Measure Lip Height Using Photogrammetry in Unilateral Cleft Lip Patients.

    PubMed

    van der Zeeuw, Frederique; Murabit, Amera; Volcano, Johnny; Torensma, Bart; Patel, Brijesh; Hay, Norman; Thorburn, Guy; Morris, Paul; Sommerlad, Brian; Gnarra, Maria; van der Horst, Chantal; Kangesu, Loshan

    2015-09-01

    There is still no reliable tool to determine the outcome of the repaired unilateral cleft lip (UCL). The aim of this study was therefore to develop an accurate, reliable tool to measure vertical lip height from photographs. The authors measured the vertical height of the cutaneous and vermilion parts of the lip in 72 anterior-posterior view photographs of 17 patients with repairs to a UCL. Points on the lip's white roll and vermillion were marked on both the cleft and the noncleft sides on each image. Two new concepts were tested. First, photographs were standardized using the horizontal (medial to lateral) eye fissure width (EFW) for calibration. Second, the authors tested the interpupillary line (IPL) and the alar base line (ABL) for their reliability as horizontal lines of reference. Measurements were taken by 2 independent researchers, at 2 different time points each. Overall 2304 data points were obtained and analyzed. Results showed that the method was very effective in measuring the height of the lip on the cleft side with the noncleft side. When using the IPL, inter- and intra-rater reliability was 0.99 to 1.0, with the ABL it varied from 0.91 to 0.99 with one exception at 0.84. The IPL was easier to define because in some subjects the overhanging nasal tip obscured the alar base and gave more consistent measurements possibly because the reconstructed alar base was sometimes indistinct. However, measurements from the IPL can only give the percentage difference between the left and right sides of the lip, whereas those from the ABL can also give exact measurements. Patient examples were given that show how the measurements correlate with clinical assessment. The authors propose this method of photogrammetry with the innovative use of the IPL as a reliable horizontal plane and use of the EFW for calibration as a useful and reliable tool to assess the outcome of UCL repair.

  7. Anthropometric evaluation of pediatric patients with nonprogressive chronic encephalopathy according to different methods of classification☆

    PubMed Central

    Teixeira, Jéssica Socas; Gomes, Mirian Martins

    2014-01-01

    Objective: To perform anthropometric assessment of patients with quadriplegic, chronic non-progressive encephalopathy, comparing two distinct references of nutritional classification and to compare the estimated height to the length measured by stadiometer. Method: Cross-sectional study including 0-3-year children with quadriplegic chronic non-progressive encephalopathy in secondary public hospital. Length, weight, arm circumference, triceps skinfold and knee height were measured. The arm muscle circumference and estimated height were calculated. The following relations were evaluated: weight-for-age, length-for-age and weight-for-length, using as reference the charts of the World Health Organization (WHO) and those proposed by Krick et al. Results: Fourteen children with a mean age of 21 months were evaluated. Assessment of anthropometric indicators showed significant difference between the two classification methods to assess nutritional indicators length/age (p=0.014), weight/age (p=0.014) and weight/length (p=0.001). There was significant correlation between measured length and estimated height (r=0.796, p=0.001). Evaluation of arm circumference and triceps skinfold showed that most patients presented some degree of malnutrition. According to arm muscle circumference, most were eutrophic. Conclusions: Specific curves for children with chronic non-progressive encephalopathy appear to underestimate malnutrition when one takes into account indicators involving weight. Curves developed for healthy children can be a good option for clinical practice and weight-for-length indicator and body composition measurements should be considered as complementary tools. PMID:25479849

  8. [BILATERAL NEPHROURETERECTOMY WITH CYSTOPROSTATECTOMY AD BLOC AND LYMPHADENECTOMY IN A PATIENT WITH END-STAGE RENAL FAILURE AND CANCER OF THE URINARY BLADDER T2BN0M0].

    PubMed

    Vtorenko, V I; Trushkin, R N; Lubennikov, A E; Podkorytova, O L; Motin, P I

    2015-01-01

    The article introduces a clinical example of a patient who was first diagnosed with bladder cancer, which contributed to the development of end-stage renal failure. Initially, given the significant upper urinary tract retention and post renal acute renal failure, the patient underwent bilateral percutaneous nephrostomy. Taking into account periodic gross hematuria, cystoscopy and transurethral electrocoagulation and biopsy of bladder tumor were performed and bladder cancer was identified. Despite adequate functioning of nephrostome drainage and daily urine output up to 3000 ml, kidney failure was not resolved. After creation of an arteriovenous fistula, a hemodialysis program was launched. The patient continued to experience persistent gross hematuria, he had a hectic fever, which was estimated as a symptom of acute pyelonephritis. The patient was scheduled for bilateral nephroureterectomy, cystoprostatectomy as the only option to remove the source of bleeding and infection. The operation was carried out without complications. The patient is currently maintained on chronic hemodialysis and followed by an oncologist at the place of residence; there are no data of bladder

  9. A review of antithrombotic therapy and the rationale and design of the randomized edoxaban in patients with peripheral artery disease (ePAD) trial adding edoxaban or clopidogrel to aspirin after femoropopliteal endovascular intervention.

    PubMed

    Tangelder, Marco J D; Nwachuku, Chuke E; Jaff, Michael; Baumgartner, Iris; Duggal, Anil; Adams, George; Ansel, Gary; Grosso, Michael; Mercuri, Michele; Shi, Minggao; Minar, Erich; Moll, Frans L

    2015-04-01

    Compared with the coronary setting, knowledge about antithrombotic therapies after endovascular treatment (EVT) is inadequate in patients with peripheral artery disease (PAD). Based on a review of trials and guidelines, which is summarized in this article, there is scant evidence that antithrombotic drugs improve outcome after peripheral EVT. To address this knowledge gap, the randomized, open-label, multinational edoxaban in patients with Peripheral Artery Disease (ePAD) study (ClinicalTrials.gov identifier NCT01802775) was designed to explore the safety and efficacy of a combined regimen of antiplatelet therapy with clopidogrel and anticoagulation with edoxaban, a selective and direct factor Xa inhibitor, both combined with aspirin. As of July 2014, 203 patients (144 men; mean age 67 years) from 7 countries have been enrolled. These patients have been allocated to once-daily edoxaban [60 mg for 3 months (or 30 mg in the presence of factors associated with increased exposure)] or clopidogrel (75 mg/d for 3 months). All patients received aspirin (100 mg/d) for the 6-month duration of the study. The primary safety endpoint is major or clinically relevant nonmajor bleeding; the primary efficacy endpoint is restenosis or reocclusion at the treated segment(s) measured at 1, 3, and 6 months using duplex ultrasound scanning. All outcomes will be assessed and adjudicated centrally in a masked fashion. The ePAD study is the first of its kind to investigate a combined regimen of antiplatelet therapy and anticoagulation through factor Xa inhibition with edoxaban. PMID:25809373

  10. Contributors to Frequent Telehealth Alerts Including False Alerts for Patients with Heart Failure: A Mixed Methods Exploration

    PubMed Central

    Radhakrishna, K.; Bowles, K.; Zettek-Sumner, A.

    2013-01-01

    Summary Background Telehealth data overload through high alert generation is a significant barrier to sustained adoption of telehealth for managing HF patients. Objective To explore the factors contributing to frequent telehealth alerts including false alerts for Medicare heart failure (HF) patients admitted to a home health agency. Materials and Methods A mixed methods design that combined quantitative correlation analysis of patient characteristic data with number of telehealth alerts and qualitative analysis of telehealth and visiting nurses’ notes on follow-up actions to patients’ telehealth alerts was employed. All the quantitative and qualitative data was collected through retrospective review of electronic records of the home heath agency. Results Subjects in the study had a mean age of 83 (SD = 7.6); 56% were female. Patient co-morbidities (p<0.05) of renal disorders, anxiety, and cardiac arrhythmias emerged as predictors of telehealth alerts through quantitative analysis (n = 168) using multiple regression. Inappropriate telehealth measurement technique by patients (54%) and home healthcare system inefficiencies (37%) contributed to most telehealth false alerts in the purposive qualitative sub-sample (n = 35) of patients with high telehealth alerts. Conclusion Encouraging patient engagement with the telehealth process, fostering a collaborative approach among all the clinicians involved with the telehealth intervention, tailoring telehealth alert thresholds to patient characteristics along with establishing patient-centered telehealth outcome goals may allow meaningful generation of telehealth alerts. Reducing avoidable telehealth alerts could vastly improve the efficiency and sustainability of telehealth programs for HF management. PMID:24454576

  11. Verification of the agreement of two dosimetric methods with radioiodine therapy in hyperthyroid patients

    SciTech Connect

    Canzi, Cristina; Zito, Felicia; Voltini, Franco; Reschini, Eugenio; Gerundini, Paolo

    2006-08-15

    The aim of this study was to verify the capability of an MIRD formula-based dosimetric method to predict radioiodine kinetics (fraction of administered iodine transferred to the thyroid, U{sub 0}, and effective clearance rate, {lambda}{sub eff}) and absorbed dose after oral therapeutic {sup 131}I administration. The method is based on {sup 123}I intravenous administration and five subsequent gamma camera measured uptake values determined separately on different structures within the thyroid. Another dosimetric method based on only the {sup 123}I 24-h uptake and a fixed {lambda}{sub eff} value was also considered. Eighty-nine hyperthyroid patients (10 with Graves' disease and 79 with autonomously functioning nodules) were studied and 132 thyroidal structures were evaluated. The mean time interval between dosimetry and therapy was 20{+-}10d. Uptake values were measured at 2, 4, 24, 48, and 120 h during dosimetry and at 2, 4, 24, 48, 96, and 168 h during therapy. The value 0.125d{sup -1} was chosen in the fixed-{lambda}{sub eff} method. The planned doses to the target ranged from 120 to 250 Gy depending on the type and severity of hyperthyroidism. The following significant correlations between therapeutic and dosimetric parameters were found: U{sub 0}ther=0.88U{sub 0}dos (r=0.97,p<0.01), {lambda}{sub eff}ther=1.01{lambda}{sub eff}dos (r=0.85,p<0.01), and D{sub estimated}=0.85D{sub planned} (r=0.88,p<0.01). The percent difference between U{sub 0}ther and U{sub 0}dos ranged from -44 to 32% and between {lambda}{sub eff}ther and {lambda}{sub eff}dos from -32 to 48%. U{sub 0}ther was lower than U{sub 0}dos in 74% of cases: this can be explained by the self-stunning effect of {sup 131}I therapeutic activity that produced a dose of about 20 Gy with a maximum dose rate of 0.6 Gy/h over the initial 24-48 h. The differences, {delta}D, between the estimated and the planned doses ranged from -42% (-87 Gy) to 32% (59 Gy); in 73% of cases the difference was within {+-}35 Gy

  12. [THE USE OF THE METHOD FOR DETERMINING THE "ORTHOPEDIC INDEX" IN THE TREATMENT OF PATIENTS WITH FEMORAL NECK FRACTURE].

    PubMed

    Brizhan', L K; Buriachenko, B P; Varfolomeev, D I; Maksimov, B I; Mantserov, K M; Davydov, D V

    2015-01-01

    The choice of surgical strategy for the treatment of femoral neck fracture is a serious challenge to modern traumatology and orthopedics. Group I of this study was comprised of patients in whom orthopedic age was determined by our original method including assessment of the quality of life based on the SF-36 questionnaire. The somatic state of the patients was evaluated from the Charlson index and bone quality in the surgical area by densitometry. Patients of the control group were treated by the standard methods adopted in this country and abroad. It was shown that the difference between orthopedic and calendar ages results in the increase of the frequency of complications. The clinical and statistical results of the study indicate that the new method permits to reduce the number of revision interventions, decrease postoperative lethality, and improve the patients' quality of life. PMID:26117924

  13. Eigenvector methods for automated detection of electrocardiographic changes in partial epileptic patients.

    PubMed

    Ubeyli, Elif Derya

    2009-07-01

    In this paper, the automated diagnostic systems trained on diverse and composite features were presented for detection of electrocardiographic changes in partial epileptic patients. In practical applications of pattern recognition, there are often diverse features extracted from raw data that require recognizing. Methods of combining multiple classifiers with diverse features are viewed as a general problem in various application areas of pattern recognition. Two types (normal and partial epilepsy) of ECG beats (180 records from each class) were obtained from the Physiobank database. The multilayer perceptron neural network (MLPNN), combined neural network (CNN), mixture of experts (ME), and modified mixture of experts (MME) were tested and benchmarked for their performance on the classification of the studied ECG signals, which were trained on diverse or composite features. Decision making was performed in two stages: feature extraction by eigenvector methods and classification using the classifiers trained on the extracted features. The present research demonstrated that the MME trained on the diverse features achieved accuracy rates (total classification accuracy is 99.44%) that were higher than that of the other automated diagnostic systems. PMID:19273021

  14. Condom ads slated for TV.

    PubMed

    1987-02-20

    3 CBS-owned television stations and NBC's New York television station announced yesterday that they would begin accepting condom advertising. In addition, the ABC network announced it will begin running a 30-second public service message with Dr. C. Everett Koop, the US surgeon general, saying that condoms are the best protection against sexual transmission of AIDS. CBS said it will allow the 4 television stations and 18 radio stations it owns to accept condom advertising based on the attitudes of the local viewing or listening community. WCBS-TV in New York, WCAU-TV in Philadelphia and KCBS-TV in Los Angeles said they would accept such ads. CBS also owns a television station in Chicago. WCAU will air condom ads after 11 p.m. only, beginning probably next week, said Paul Webb, a station spokesman. "We recognize the legitimate sensitivities of some members of the community in regard to this issue," said Steve Cohen, the WCAU general manager. "However, it is the judgment of this station that the importance of providing information about the AIDS epidemic and means of prevention is an overriding consideration." NBC's New York television station, WNBC, announced that it will accept condom advertising and public service announcements. PMID:12269166

  15. Using of laser spectroscopy and chemometrics methods for identification of patients with lung cancer, patients with COPD and healthy people from absorption spectra of exhaled air

    NASA Astrophysics Data System (ADS)

    Bukreeva, Ekaterina B.; Bulanova, Anna A.; Kistenev, Yury V.; Kuzmin, Dmitry A.; Nikiforova, Olga Yu.; Ponomarev, Yurii N.; Tuzikov, Sergei A.; Yumov, Evgeny L.

    2014-11-01

    The results of application of the joint use of laser photoacoustic spectroscopy and chemometrics methods in gas analysis of exhaled air of patients with chronic respiratory diseases (chronic obstructive pulmonary disease and lung cancer) are presented. The absorption spectra of exhaled breath of representatives of the target groups and healthy volunteers were measured; the selection by chemometrics methods of the most informative absorption coefficients in scan spectra in terms of the separation investigated nosology was implemented.

  16. Hybrid Method for Prediction of Metastasis in Breast Cancer Patients Using Gene Expression Signals

    PubMed Central

    Dehnavi, Alireza Mehri; Sehhati, Mohammad Reza; Rabbani, Hossein

    2013-01-01

    Using primary tumor gene expression has been shown to have the ability of finding metastasis-driving gene markers for prediction of breast cancer recurrence (BCR). However, there are some difficulties associated with analysis of microarray data, which led to poor predictive power and inconsistency of previously introduced gene signatures. In this study, a hybrid method was proposed for identifying more predictive gene signatures from microarray datasets. Initially, the parameters of a Rough-Set (RS) theory based feature selection method were tuned to construct a customized gene extraction algorithm. Afterward, using RS gene selection method the most informative genes selected from six independent breast cancer datasets. Then, combined set of these six signature sets, containing 114 genes, was evaluated for prediction of BCR. In final, a meta-signature, containing 18 genes, selected from the combination of datasets and its prediction accuracy compared to the combined signature. The results of 10-fold cross-validation test showed acceptable misclassification error rate (MCR) over 1338 cases of breast cancer patients. In comparison to a recent similar work, our approach reached more than 5% reduction in MCR using a fewer number of genes for prediction. The results also demonstrated 7% improvement in average accuracy in six utilized datasets, using the combined set of 114 genes in comparison with 18-genes meta-signature. In this study, a more informative gene signature was selected for prediction of BCR using a RS based gene extraction algorithm. To conclude, combining different signatures demonstrated more stable prediction over independent datasets. PMID:24098861

  17. The rationale for patient-reported outcomes surveillance in cancer and a reproducible method for achieving it.

    PubMed

    Smith, Tenbroeck G; Castro, Kathleen M; Troeschel, Alyssa N; Arora, Neeraj K; Lipscomb, Joseph; Jones, Shelton M; Treiman, Katherine A; Hobbs, Connie; McCabe, Ryan M; Clauser, Steven B

    2016-02-01

    Patient-reported outcomes (PROs) measure quality of life, symptoms, patient functioning, and patient perceptions of care; they are essential for gaining a full understanding of cancer care and the impact of cancer on people's lives. Repeatedly captured facility-level and/or population-level PROs (PRO surveillance) could play an important role in quality monitoring and improvement, benchmarking, advocacy, policy making, and research. This article describes the rationale for PRO surveillance and the methods of the Patient Reported Outcomes Symptoms and Side Effects Study (PROSSES), which is the first PRO study to use the American College of Surgeons Commission on Cancer's Rapid Quality Reporting System to identify patients and manage study data flow. The American Cancer Society, the National Cancer Institute, the Commission on Cancer, and RTI International collaborated on PROSSES. PROSSES was conducted at 17 cancer programs that participated in the National Cancer Institute Community Cancer Centers Program among patients diagnosed with locoregional breast or colon cancer. The methods piloted in PROSSES were successful as demonstrated by high eligibility (93%) and response (61%) rates. Differences in clinical and demographic characteristics between respondents and nonrespondents were mostly negligible, with the exception that non-white individuals were somewhat less likely to respond. These methods were consistent across cancer centers and reproducible over time. If repeated and expanded, they could provide PRO surveillance data from patients with cancer on a national scale.

  18. Informing Patients About Placebo Effects: Using Evidence, Theory, and Qualitative Methods to Develop a New Website

    PubMed Central

    Greville-Harris, Maddy; Bostock, Jennifer; Din, Amy; Graham, Cynthia A; Lewith, George; Liossi, Christina; O’Riordan, Tim; White, Peter; Yardley, Lucy

    2016-01-01

    Background According to established ethical principles and guidelines, patients in clinical trials should be fully informed about the interventions they might receive. However, information about placebo-controlled clinical trials typically focuses on the new intervention being tested and provides limited and at times misleading information about placebos. Objective We aimed to create an informative, scientifically accurate, and engaging website that could be used to improve understanding of placebo effects among patients who might be considering taking part in a placebo-controlled clinical trial. Methods Our approach drew on evidence-, theory-, and person-based intervention development. We used existing evidence and theory about placebo effects to develop content that was scientifically accurate. We used existing evidence and theory of health behavior to ensure our content would be communicated persuasively, to an audience who might currently be ignorant or misinformed about placebo effects. A qualitative ‘think aloud’ study was conducted in which 10 participants viewed prototypes of the website and spoke their thoughts out loud in the presence of a researcher. Results The website provides information about 10 key topics and uses text, evidence summaries, quizzes, audio clips of patients’ stories, and a short film to convey key messages. Comments from participants in the think aloud study highlighted occasional misunderstandings and off-putting/confusing features. These were addressed by modifying elements of content, style, and navigation to improve participants’ experiences of using the website. Conclusions We have developed an evidence-based website that incorporates theory-based techniques to inform members of the public about placebos and placebo effects. Qualitative research ensured our website was engaging and convincing for our target audience who might not perceive a need to learn about placebo effects. Before using the website in clinical trials

  19. [Craniosynostoses in Egypt: clinical forms and treatment methods. A study of 55 surgically treated patients].

    PubMed

    Gheita, A; Assaad, A

    1989-01-01

    The relative incidence of the various craniosynostosis deformities in Egypt is given on a total of 55 patients who were operated upon. The most common deformity was oxycephaly, 25 cases (i.e. 45%). Various surgical methods have been applied depending on the deformity present. In isolated scaphocephalic deformities (9 cases), 3 pairs of strip craniectomies also called "the triple strip" were sufficient and gave satisfactory results. For other types of deformities, an attempt was made to improve the aesthetic results following simple forehead advancement, which was done for the first five cases. A newly suggested combined procedure of multiple craniectomies and forehead advancement was applied on 41 patients. This combined "three flap procedure" has been previously presented by the authors (Gheita and Assaad, 1987). In this study it has been further modified so as to be suitable for infantile as well as adult deformities, thus defining them as type I and type II variations. The principle of the technique consists of combining the forehead advancement flap with two pairs of strip craniectomies: a pair of para-sagittal ones and another pair of spheno-temporal ones going to the cranial base as far as the edge of the foramen ovale. This is known as type I. In the type II variety the median strip of bone overlying the sagittal sinus is broken posteriorly so as to lower the vault of the skull whenever necessary, and the spheno-temporal craniectomy is not carried as far downward to the foramen ovale but stops at the level of the zygomatic arch. The details of these techniques are demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Neurocognitive Function in HIV-Infected Patients: Comparison of Two Methods to Define Impairment

    PubMed Central

    Arenas-Pinto, Alejandro; Winston, Alan; Stöhr, Wolfgang; Day, John; Wiggins, Rebecca; Quah, Say Pheng; Ainsworth, Jonathan; Fleck, Sue; Dunn, David; Accoroni, Alex; Paton, Nicholas I.

    2014-01-01

    Objective To compare two definitions of neurocognitive impairment (NCI) in a large clinical trial of effectively-treated HIV-infected adults at baseline. Methods Hopkins Verbal Learning test-Revised (HVLT-R), Colour Trail (CTT) and Grooved Pegboard (GPT) tests were applied exploring five cognitive domains. Raw scores were transformed into Z-scores and NCI defined as summary NPZ-5 score one standard deviation below the mean of the normative dataset (i.e. <−1SD) or Z-scores <−1SD in at least two individual domains (categorical scale). Principal component analysis (PCA) was performed to explore the contribution of individual tests to the total variance. Results Mean NPZ-5 score was −0.72 (SD 0.98) and 178/548 (32%) participants had NPZ-5 scores <−1SD. When impairment was defined as <−1SD in at least two individual tests, 283 (52%) patients were impaired. Strong correlations between the two components of the HVLT-R test (learning/recall) (r = 0.73), and the CTT and (attention/executive functioning) (r = 0.66) were observed. PCA showed a clustering with three components accounting for 88% of the total variance. When patients who scored <−1SD only in two correlated tests were considered as not impaired, prevalence of NCI was 43%. When correlated test scores were averaged, 36% of participants had NPZ-3 scores <−1SD and 32% underperformed in at least two individual tests. Conclusion Controlling for differential contribution of individual test-scores on the overall performance and the level of correlation between components of the test battery used appear to be important when testing cognitive function. These two factors are likely to affect both summary scores and categorical scales in defining cognitive impairment. Trial registration EUDRACT: 2007-006448-23 and ISRCTN04857074. PMID:25078406

  1. Preperitoneal catheter analgesia is an effective method for pain management after colorectal surgery: the results of 100 consecutive patients

    PubMed Central

    Ozer, Ali; Yılmazlar, Aysun; Oztürk, Ersin; Yılmazlar, Tuncay

    2014-01-01

    Background In a previous prospective randomized trial, we showed that local anesthetic infusion using a preperitoneal catheter is an effective postoperative analgesic method following colorectal resections. Over time, we have improved the technique of preperitoneal catheter analgesia. In this prospective cohort study, we report the results of 100 consecutive patients who underwent colorectal resections. Materials and methods Preperitoneal catheter analgesia was performed via a multihole catheter placed in the preperitoneal space using 10 mL 0.5% levobupivacaine every 4 hours following the operation for the first 3 days. Additional analgesics were used whenever necessary. Postoperative pain was assessed with the visual analog scale score. Short-term clinical outcomes, such as need for systemic analgesics, time to first gas and stool discharge, length of hospital stay, and morbidity, particularly surgical site infections, were reported. Results From May 2009 to May 2010, 100 consecutive patients were recruited in the study. A total of 83 patients were operated on for malignancy, and the tumor was located in the rectum in 52 patients and in the colon in 31 patients. The median pain score was 4 (0–6), 3 (0–9), 2 (0–8), 1 (0–8), 1 (0–6), 0 (0–6), and 0 (0–3) at postoperative hours 0, 1, 4, 12, 24, 48, and 72, respectively. Additional analgesics were required in 34 patients: 21 of them required only nonsteroidal anti-inflammatory drugs, and 13 patients needed opioids additionally. The median amounts of opioid analgesics and nonsteroidal anti-inflammatory drugs were 1.76±0.78 mg and 6.70±1.18 mg, respectively. However, almost all of the additional analgesics were given in the first 24 hours. Surgical site infections were detected in eight patients. Conclusion Preperitoneal catheter analgesia is an effective analgesic method. When applied and used properly, it may even be used as the sole analgesic method in some patients. PMID:25336988

  2. Dual Purpose Landscaping Tools: Small Extra Dimensions in AdS/CFT

    SciTech Connect

    Polchinski, Joseph; Silverstein, Eva; /Santa Barbara, KITP /UC, Santa Barbara /SLAC /Stanford U., Phys. Dept.

    2010-08-26

    We propose a class of AdS/CFT dual pairs which have small internal dimensions on the gravity side. Starting from known Freund-Rubin AdS/CFT dual pairs, we use 7-branes to nearly cancel the curvature energy of the internal dimensions while maintaining their stabilization. This leads to a new corner of the landscape - a class of AdS solutions with a hierarchically large AdS radius - with a dual field theory given (implicitly) by the infrared limit of a concrete brane construction involving D3-branes, 7-branes, and curvature. We first construct a class of hierarchical AdS5/CFT4 dual pairs with a simple formula for the number of degrees of freedom which we interpret in the dual QFT. We then generalize these to AdS4/CFT3 duals, and suggest extensions of the method to obtain de Sitter solutions.

  3. Comparison of the Roll Plate Method to the Sonication Method To Diagnose Catheter Colonization and Bacteremia in Patients with Long-Term Tunnelled Catheters: a Randomized Prospective Study▿

    PubMed Central

    Slobbe, Lennert; el Barzouhi, Abdelilah; Boersma, Eric; Rijnders, Bart J. A.

    2009-01-01

    Diagnosing catheter-related bloodstream infection (CRBSI) still often involves tip culture. The conventional method is the semiquantitative roll plate method. However, the use of a quantitative sonication technique could have additional value, as it may detect endoluminal microorganisms more easily. Because endoluminal infection tends to occur in long-term central venous catheters, we compared both techniques for patients with long-term tunnelled catheters. For 313 consecutive Hickman catheter tips from 279 hematological patients, colonization detection rates were compared by performing both techniques in a random order, using conventional detection cutoffs. Additionally, for the subgroup of patients with clinical suspicion of CRBSI (n = 89), the diagnostic values of both techniques were compared. The overall tip colonization rate was 25%. For each technique, the detection rate tended to be better if that technique was performed first. The diagnostic performance for the subgroup of patients with clinical suspicion of CRBSI was limited and not different for both methods. Sensitivity and specificity were 45% and 84%, respectively, for sonication versus 35% and 90%, respectively, for the roll plate technique. The fact that 35 of 40 patients with CRBSI received antimicrobial therapy before catheter removal and tip culture, in an attempt to salvage the catheter, may partly explain this poor performance. No differences were observed when catheters were stratified according to in situ time below or above the median of 4 weeks. The sonication culture technique was not better than the roll plate method to diagnose tip colonization or CRBSI in patients with long-term tunnelled catheters. PMID:19171682

  4. Brain areas involved in the acupuncture treatment of AD model rats: a PET study

    PubMed Central

    2014-01-01

    Background Acupuncture may effectively treat certain symptoms of Alzheimer’s disease (AD). Although several studies have used functional brain imaging to investigate the mechanisms of acupuncture treatment on AD, these mechanisms are still poorly understood. We therefore further explored the mechanism by which needling at ST36 may have a therapeutic effect in a rat AD model. Methods A total of 80 healthy Wistar rats were divided into healthy control (n = 15) and pre-model (n = 65) groups. After inducing AD-like disease, a total of 45 AD model rats were randomly divided into three groups: the model group (n = 15), the sham-point group (n = 15), and the ST36 group (n = 15). The above three groups underwent PET scanning. PET images were processed with SPM2. Results The brain areas that were activated in the sham-point group relative to the model group were primarily centred on the bilateral limbic system, the right frontal lobe, and the striatum, whereas the activated areas in the ST36 group were primarily centred on the bilateral limbic system (pyriform cortex), the bilateral temporal lobe (olfactory cortex), the right amygdala and the right hippocampus. Compared with the sham-point group, the ST36 group showed greater activation in the bilateral amygdalae and the left temporal lobe. Conclusion We concluded that needling at a sham point or ST36 can increase blood perfusion and glycol metabolism in certain brain areas, and thus may have a positive influence on the cognition of AD patients. PMID:24886495

  5. Mapping hospice patients' perception and verbal communication of end-of-life needs: an exploratory mixed methods inquiry

    PubMed Central

    2011-01-01

    Background Comprehensive "Total Pain" assessments of patients' end-of-life needs are critical for providing improved patient-clinician communication, assessing needs, and offering high quality palliative care. However, patients' needs-based research methodologies and findings remain highly diverse with their lack of consensus preventing optimum needs assessments and care planning. Mixed-methods is an underused yet robust "patient-based" approach for reported lived experiences to map both the incidence and prevalence of what patients perceive as important end of life needs. Methods Findings often include methodological artifacts and their own selection bias. Moving beyond diverse findings therefore requires revisiting methodological choices. A mixed methods research cross-sectional design is therefore used to reduce limitations inherent in both qualitative and quantitative methodologies. Audio-taped phenomenological "thinking aloud" interviews of a purposive sample of 30 hospice patients are used to identify their vocabulary for communicating perceptions of end-of-life needs. Grounded theory procedures assisted by QSR-NVivo software is then used for discovering domains of needs embedded in the interview narratives. Summary findings are translated into quantified format for presentation and analytical purposes. Results Findings from this mixed-methods feasibility study indicate patients' narratives represent 7 core domains of end-of-life needs. These are (1) time, (2) social, (3) physiological, (4) death and dying, (5) safety, (6) spirituality, (7) change & adaptation. The prevalence, rather than just the occurrence, of patients' reported needs provides further insight into their relative importance. Conclusion Patients' perceptions of end-of-life needs are multidimensional, often ambiguous and uncertain. Mixed methodology appears to hold considerable promise for unpacking both the occurrence and prevalence of cognitive structures represented by verbal encoding that

  6. An Insight into Methods and Practices in Hip Arthroplasty in Patients with Rheumatoid Arthritis

    PubMed Central

    Mosleh-shirazi, Mohammad Saeed; Ibrahim, Mazin; Pastides, Philip; Khan, Wasim; Rahman, Habib

    2015-01-01

    Total hip arthroplasty (THA) has improved the quality of life of patients with hip arthritis. Orthopedic community is striving for excellence to improve surgical techniques and postoperative care. Despite these efforts, patients continue facing postoperative complications. In particular, patients with rheumatoid arthritis display a higher risk of certain complications such as dislocation, periprosthetic infection, and shorter prosthesis durability. In this review we present the current knowledge of hip arthroplasty in patients with rheumatoid arthritis with more insight into common practices and interventions directed at enhancing recovery of these patients and current shortfalls. PMID:26236339

  7. The Prevalence and Contents of Advance Directives in Patients With Pacemakers

    PubMed Central

    Pasalic, Dario; Tajouri, Tanya H.; Ottenberg, Abigale L.; Mueller, Paul S.

    2013-01-01

    Background Little is known about the use of advance directives (ADs) in patients who have implantable cardiac pacemakers (PMs). Methods We conducted a retrospective review of the medical records of residents of Olmsted County, Minnesota, who underwent implantation of a cardiac PM at Mayo Clinic (Rochester, Minnesota) during 2006 and 2007 and determined the prevalence and contents of ADs in these patients. Results During the study period, 205 residents of Olmsted County (men, 53%) underwent PM implantation (mean age [SD] at implantation, 77 [15] years). Overall, 120 patients (59%) had ADs. Of these, 63 ADs (53%) were executed more than 12 months before and 33 (28%) were executed after PM implantation. Many patients specifically mentioned life-prolonging treatments in their ADs: cardiopulmonary resuscitation, 76 (63%); mechanical ventilation, 56 (47%); and hemodialysis, 31 (26%). Pain control was mentioned in 79 ADs (66%) and comfort measures were mentioned in 42 ADs (35%). Furthermore, the AD of many patients contained a general statement about end-of-life care (eg, no “heroic measures”). However, only 1 AD (1%) specifically addressed the end-of-life management of the PM. Conclusions More than half of the patients with PMs in our study had executed an AD, but only 1 patient specifically mentioned her PM in her AD. These results suggest that patients with PMs should be encouraged to execute ADs and, specifically address end-of-life device management in their ADs. Doing so may prevent end-of-life ethical dilemmas related to PM management. PMID:24215172

  8. [Lasers in general dental practice, an added value].

    PubMed

    De Moor, R; Nammour, S

    2009-01-01

    Laser treatment in promoting dental care is present in many areas and disciplines. Modern practice management implies also the introduction of new technology. As there is evidence of the added value for lasers in different disciplines in dentistry practitioners should not be hold back and not wait for patients demanding for this technology for dental treatment.

  9. Efficacy of patient discharge instructions: A pointer toward caregiver friendly communication methods from pediatric emergency personnel

    PubMed Central

    Al-Harthy, Nesrin; Sudersanadas, Kavita M.; Al-Mutairi, Mohammed; Vasudevan, Senthilvel; Bin Saleh, Ghada; Al-Mutairi, Malak; Hussain, Lenna W.

    2016-01-01

    Background: Discharge instructions are vital in postemergency patient care to help the caregiver understand the diagnosis and identify symptoms which require prompt readmission. In general, oral or written instructions are provided on discharge. However, there is a dearth of information on the efficacy of discharge instructions provided by physicians in KSA. Objectives: To evaluate the efficacy of discharge instructions for postpediatrics emergency visit. Materials and Methods: This observational cross-sectional survey conducted in the Department of Paediatric Emergency at King Abdul Aziz Medical City, Riyadh, KSA, included 173 literate adult caregivers who had given their consent. Those who had been on admission earlier and been discharged from the emergency department were excluded. Demographic data and variables like knowledge of medicine and treatment follow-up were collected using a structured questionnaire and analyzed using SPSS version 16. Results: Verbal only, written only, or both verbal and written discharge instructions were provided. Written and verbal instructions, when provided together, were the most effective modes of communication with caregivers. The majority of the respondents were unaware of the follow-up plan (64.16%), unable to identify problems that would necessitate a follow-up (58.96%), and unable to identify the signs and symptoms that would require a revisit (62.43%) irrespective of the mode of instruction. However, more attention is necessary because of the 34.68% of the subjects who left the hospital without discharge instructions. Conclusions: Instructions given both verbally and in writing were observed to be more effective than verbal only or written only. The effectiveness of discharge instructions was highly influenced by the level of education of the caregivers. Improved caregiver friendly methods of communication from the pediatric emergency health-care team are necessary for the delivery of discharge instructions. PMID:27625582

  10. Efficacy of patient discharge instructions: A pointer toward caregiver friendly communication methods from pediatric emergency personnel

    PubMed Central

    Al-Harthy, Nesrin; Sudersanadas, Kavita M.; Al-Mutairi, Mohammed; Vasudevan, Senthilvel; Bin Saleh, Ghada; Al-Mutairi, Malak; Hussain, Lenna W.

    2016-01-01

    Background: Discharge instructions are vital in postemergency patient care to help the caregiver understand the diagnosis and identify symptoms which require prompt readmission. In general, oral or written instructions are provided on discharge. However, there is a dearth of information on the efficacy of discharge instructions provided by physicians in KSA. Objectives: To evaluate the efficacy of discharge instructions for postpediatrics emergency visit. Materials and Methods: This observational cross-sectional survey conducted in the Department of Paediatric Emergency at King Abdul Aziz Medical City, Riyadh, KSA, included 173 literate adult caregivers who had given their consent. Those who had been on admission earlier and been discharged from the emergency department were excluded. Demographic data and variables like knowledge of medicine and treatment follow-up were collected using a structured questionnaire and analyzed using SPSS version 16. Results: Verbal only, written only, or both verbal and written discharge instructions were provided. Written and verbal instructions, when provided together, were the most effective modes of communication with caregivers. The majority of the respondents were unaware of the follow-up plan (64.16%), unable to identify problems that would necessitate a follow-up (58.96%), and unable to identify the signs and symptoms that would require a revisit (62.43%) irrespective of the mode of instruction. However, more attention is necessary because of the 34.68% of the subjects who left the hospital without discharge instructions. Conclusions: Instructions given both verbally and in writing were observed to be more effective than verbal only or written only. The effectiveness of discharge instructions was highly influenced by the level of education of the caregivers. Improved caregiver friendly methods of communication from the pediatric emergency health-care team are necessary for the delivery of discharge instructions.

  11. The ethical leadership challenge for effective resolution of patient and family complaints and grievances: proven methods and models.

    PubMed

    Piper, Llewellyn E; Tallman, Erin

    2015-01-01

    Health care leaders and managers face the ethical leadership challenge in ensuring effective resolution of patient and family complaints and grievances. In today's society of increasing discontent about safety, quality, cost, and satisfaction, patient complaints and grievances are becoming more prevalent. Under the mandates of the Patient Protection and Affordable Care Act for transparency of quality and patient satisfaction scores and to be compliant with the standards from the Centers for Medicare & Medicaid Services and The Joint Commission, it is imperative that leadership ensure an ethical culture for effective resolution of patient and family complaints and grievances. This article addresses this ethical leadership challenge by providing a systematic approach with proven methods and models for effective resolution of complaints and grievances and thereby improving satisfaction, quality, safety, and cost.

  12. A Fast Method for DEFB1 - 44C/G SNP Genotyping in Brazilian Patients with Periodontitis

    PubMed Central

    Cavalcanti de Siqueira, Rafael Rafael Amorim; Crovella, Sergio; Eleutério de Souza, Paulo Roberto; Donos, Nikos

    2014-01-01

    Aim Defensins are cationic antimicrobial peptides expressed in epithelial cells. Such peptides exhibit antibacterial, antifungal and antiviral properties, and are a component of the innate immune response. It has been suggested that they have a protective role in the oral cavity. This study evaluated the DEFB1 polymorphism in diabetic patients with or without periodontitis in comparison to healthy controls. Material and Methods We used Hairpin-Shaped Primer (HP) assay to study the distribution of the -44 C/G SNP (rs1800972) in 119 human DNAs obtained from diabetic patients and healthy control patients. Results The results indicate that there are no differences in distribution between groups and that in diabetic periodontitis patients the homozygous mutant could be found more frequently. Conclusion Further studies are necessary in order to investigate the role of DEFB1 polymorphisms in diabetic periodontitis patients and the influence of the peptide in periodontal pathogens.

  13. Validation and Clinical Evaluation of a Novel Method To Measure Miltefosine in Leishmaniasis Patients Using Dried Blood Spot Sample Collection

    PubMed Central

    Rosing, H.; Hillebrand, M. J. X.; Blesson, S.; Mengesha, B.; Diro, E.; Hailu, A.; Schellens, J. H. M.; Beijnen, J. H.

    2016-01-01

    To facilitate future pharmacokinetic studies of combination treatments against leishmaniasis in remote regions in which the disease is endemic, a simple cheap sampling method is required for miltefosine quantification. The aims of this study were to validate a liquid chromatography-tandem mass spectrometry method to quantify miltefosine in dried blood spot (DBS) samples and to validate its use with Ethiopian patients with visceral leishmaniasis (VL). Since hematocrit (Ht) levels are typically severely decreased in VL patients, returning to normal during treatment, the method was evaluated over a range of clinically relevant Ht values. Miltefosine was extracted from DBS samples using a simple method of pretreatment with methanol, resulting in >97% recovery. The method was validated over a calibration range of 10 to 2,000 ng/ml, and accuracy and precision were within ±11.2% and ≤7.0% (≤19.1% at the lower limit of quantification), respectively. The method was accurate and precise for blood spot volumes between 10 and 30 μl and for Ht levels of 20 to 35%, although a linear effect of Ht levels on miltefosine quantification was observed in the bioanalytical validation. DBS samples were stable for at least 162 days at 37°C. Clinical validation of the method using paired DBS and plasma samples from 16 VL patients showed a median observed DBS/plasma miltefosine concentration ratio of 0.99, with good correlation (Pearson's r = 0.946). Correcting for patient-specific Ht levels did not further improve the concordance between the sampling methods. This successfully validated method to quantify miltefosine in DBS samples was demonstrated to be a valid and practical alternative to venous blood sampling that can be applied in future miltefosine pharmacokinetic studies with leishmaniasis patients, without Ht correction. PMID:26787691

  14. Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1,973 patients.

    PubMed

    Veronesi, U; Salvadori, B; Luini, A; Greco, M; Saccozzi, R; del Vecchio, M; Mariani, L; Zurrida, S; Rilke, F

    1995-09-01

    Breast conservation has become well-established in the treatment of early mammary carcinoma. However, a standardised treatment modality has not emerged. We have analysed the data from 1,973 patients treated in three consecutive randomised trials by four different radiosurgical procedures: Halsted mastectomy, quadrantectomy plus radiotherapy, lumpectomy plus radiotherapy, and quadrantectomy without radiotherapy, to compare the outcomes of these procedures in terms of local recurrence rate and overall survival. Eligibility criteria were similar in the three trials, and comparability between the four subgroups was excellent. Median follow-up for all patients was 82 months. The annual rates of local recurrence varied markedly according to the treatment. Patients treated with Halsted mastectomy and quadrantectomy plus radiotherapy had low annual rates of local recurrence (0.20 and 0.46, respectively) while both lumpectomy plus radiotherapy and quadrantectomy without radiotherapy had significantly higher rates (2.45 and 3.28, respectively). Patients under 45 years of age had a much higher incidence of local recurrences, while in women over 55 years local recurrences were much less frequent. Overall survival curves were identical in the four groups of patients, so that the three breast conserving radiosurgical procedures had the same survival rates as Halsted mastectomy. However, local recurrence rates were markedly influenced by the treatment method, patient age and specific histological features.

  15. Measurement tools and process indicators of patient safety culture in primary care. A mixed methods study by the LINNEAUS collaboration on patient safety in primary care

    PubMed Central

    Parker, Dianne; Wensing, Michel; Esmail, Aneez; Valderas, Jose M

    2015-01-01

    ABSTRACT Background: There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture. Objective: To identify useful tools for assessing patient safety culture in primary care organizations in Europe; to identify those aspects of performance that should be assessed when investigating the relationship between safety culture and performance in primary care. Methods: Two consensus-based studies were carried out, in which subject matter experts and primary healthcare professionals from several EU states rated (a) the applicability to their healthcare system of several existing safety culture assessment tools and (b) the appropriateness and usefulness of a range of potential indicators of a positive patient safety culture to primary care settings. The safety culture tools were field-tested in four countries to ascertain any challenges and issues arising when used in primary care. Results: The two existing tools that received the most favourable ratings were the Manchester patient safety framework (MaPsAF primary care version) and the Agency for healthcare research and quality survey (medical office version). Several potential safety culture process indicators were identified. The one that emerged as offering the best combination of appropriateness and usefulness related to the collection of data on adverse patient events. Conclusion: Two tools, one quantitative and one qualitative, were identified as applicable and useful in assessing patient safety culture in primary care settings in Europe. Safety culture indicators in primary care should focus on the processes rather than the outcomes of care. PMID:26339832

  16. Testing with fine fragrances in eczema patients: results and test methods.

    PubMed

    Johansen, J D; Frosch, P J; Rastogi, S C; Menné, T

    2001-05-01

    The frequencies of contact allergic reactions to 2 fine fragrances were studied by patch testing. Further, a comparison was made of test results before and after evaporation of the solvent. A total of 480 consecutive eczema patients were included, 100 in the Dortmund clinic and 380 in the Gentofte clinic. Patch testing was done with 2 international brand prestige fragrances. Each fragrance was tested in duplicate. One was applied immediately and the other was allowed to dry for 5 min before application. Testing procedures and assessment of reactions followed the international recommendations. In Dortmund 11% (11/100) and in Gentofte 5.8% (22/380) gave a positive patch test reaction to one or both of the fine fragrances. Assessments done in Gentofte showed that in 73% of the cases the positive reaction indicated a clinically relevant fragrance allergy. More irritant reactions were found to the wet, non-evaporated form of the fragrances compared with the dried form, while the method of testing did not significantly influence the number of positive reactions. It is recommended that patch testing be performed with hydro-alcoholic fragrance products after evaporation of the solvent.

  17. In vivo reliability of an infrared fluorescence method for quantification of carious lesions in orthodontic patients.

    PubMed

    Aljehani, Abdulaziz; Bamzahim, Mohammad; Yousif, Mirgani Awad; Shi, Xie-Qi

    2006-01-01

    The aim of this study was to evaluate the reliability of a laser-induced infrared fluorescence method, DIAGNOdent, for measuring orthodontically induced white spot lesions. The subjects comprised 13 orthodontic patients, aged 13-17 years, who had recently completed fixed appliance therapy: 137 test teeth were selected, with white spot lesions on the facial or buccal smooth surfaces. An initial visual inspection was performed to localise and record the measuring region. The predetermined measuring regions were scanned to locate the sites of the highest reading. The readings and their corresponding sites were registered on the print out photographs. Following the measurement by the first examiner, the second and the third examiners took DIAGNOdent readings independently at the same lesion sites indicated on the photographs, under identical conditions. One week later, DIAGNOdent readings of the same lesions were retaken by the three observers working independently. Intra- and inter- examiner agreements on DIAGNOdent quantification of lesion severity were analysed by Intra-class correlation coefficient (ICC). The ICC values for intra-examiner agreement for the three examiners were 0.91, 0.97, and 0.98, respectively, with a mean value of 0.95, indicating excellent agreement. The ICC values for inter-examiner agreement were comparatively lower: 0.69 and 0.82 for the first and second measurements, respectively. It was concluded that the reliability of the DIAGNOdent readings on white spot lesions associated with orthodontic banding was good.

  18. Use of quantitative PCR to evaluate methods of bacteria sampling in periodontal patients.

    PubMed

    Masunaga, Hiroshi; Tsutae, Wataru; Oh, Hyun; Shinozuka, Naoki; Kishimoto, Noriyoshi; Ogata, Yorimasa

    2010-12-01

    Periodontal disease is associated with specific periodontal pathogens and may persist as gingivitis or progress to more severe disease. The bacteria involved in disease initiation and progression have not been identified. We used quantitative polymerase chain reaction (PCR) to compare the levels of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, and total bacteria detected by different sampling methods. On the basis of the results of clinical examinations, 57 patients were divided into 3 groups: healthy group (group A), gingivitis group (group B), and periodontitis group (group C). Bacterial samples were collected from saliva, mouthwash, and by paper-point sampling of gingival crevicular fluid (GCF), and the samples were analyzed with quantitative PCR targeting 16S rRNA. The numbers of total bacteria in samples of GCF, saliva, and mouthwash were 10⁵ to 10⁶, 10⁸, and 10⁷, respectively, per milliliter. The number of P. gingivalis in GCF samples was lower than 10 in group A; however, in groups B and C, the values were 10³ and 10⁴, respectively, indicating that the number of P. gingivalis increased with worsening clinical status. Findings were similar in the samples of saliva and mouthwash. The numbers of T. forsythia showed a pattern similar to that of P. gingivalis in all 3 samples. These results suggest that saliva and mouthwash samples are clinically useful for bacterial testing of periodontal diseases by quantitative PCR. In addition, mouthwash sampling is more feasible and straightforward than saliva sampling.

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

    NASA Astrophysics Data System (ADS)

    Androulaki, Elli; Bellovin, Steven M.

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

  20. Screening of patients with bronchopulmonary diseases using methods of infrared laser photoacoustic spectroscopy and principal component analysis

    NASA Astrophysics Data System (ADS)

    Kistenev, Yury V.; Karapuzikov, Alexander I.; Kostyukova, Nadezhda Yu.; Starikova, Marina K.; Boyko, Andrey A.; Bukreeva, Ekaterina B.; Bulanova, Anna A.; Kolker, Dmitry B.; Kuzmin, Dmitry A.; Zenov, Konstantin G.; Karapuzikov, Alexey A.

    2015-06-01

    A human exhaled air analysis by means of infrared (IR) laser photoacoustic spectroscopy is presented. Eleven healthy nonsmoking volunteers (control group) and seven patients with chronic obstructive pulmonary disease (COPD, target group) were involved in the study. The principal component analysis method was used to select the most informative ranges of the absorption spectra of patients' exhaled air in terms of the separation of the studied groups. It is shown that the data of the profiles of exhaled air absorption spectrum in the informative ranges allow identifying COPD patients in comparison to the control group.

  1. [Definite of nutritional status in patients with metabolic syndrome with the use of modern methods of nutrimetabolomica].

    PubMed

    Viskunova, A A; Kaganov, B S; Sharafetdinov, Kh Kh; Plotnikova, O A; Pogozheva, A V; Vorozhko, I V

    2010-01-01

    A comprehensive assessment of nutritional status in 73 patients with metabolic syndrome was assessed. The consumption food pattern of the majority of examined patients have had increased energy intake with excessive fat consumption inadequate intake of complex carbohydrates. In patients with type 2 diabetes inadequate compensation of carbohydrate and lipid metabolism was marked. When assessing body composition method bioelectrical impedance analysis increased content of adipose tissue was revealed are positively correlated with insulin and tumor necrosis factor-alpha. According to indirect calorimetry, increase in the level of resting energy expenditure, reducing the rate of oxidation of fat, increase the rate of oxidation of protein and carbohydrates was noted.

  2. Introduction of Auricular Acupuncture in Elderly Patients Suffering from Major Depression: Protocol of a Mixed Methods Feasibility Study

    PubMed Central

    Geib, Janina; Rieger, Monika A.; Eschweiler, Gerhard W.; Dresler, Thomas; Metzger, Florian G.

    2015-01-01

    Background. Due to an increasing number of elderly people suffering from major depression and potential side effects of the prescribed drugs, the introduction of new therapeutic approaches is needed. Currently, in Germany, auricular acupuncture is no part of clinical care for gerontopsychiatric patients. Based on promising clinical experiences and existing evidence for treating addiction and trauma, a benefit of auricular acupuncture integrated in existing treatment programs in elderly patients may be hypothesized. Within this project auricular acupuncture according to the National Acupuncture Detoxification Association (NADA) will be integrated in the multimodal treatment regime for elderly patients with major depression in a daytime ward setting. Methods/Design. To evaluate the feasibility and acceptance a mixed method approach is used. In a day clinic, a sample of 20 psychogeriatric patients with the diagnosis of major depression will be enrolled. The patients will receive a total of nine auricular acupuncture treatments according to the standardized NADA protocol in a group setting. The therapeutic process, its organization, the experience, and the willingness of patients to participate will be evaluated by interviews with patients and the therapeutic team. Data will be analyzed qualitatively using content analysis. Additionally, quantitative outcome parameters will be measured by standardized questionnaires. PMID:25954756

  3. Percutaneous nephrolithotomy with one-shot dilation method: Is it safe in patients who had open surgery before?

    PubMed Central

    Süelözgen, Tufan; Isoglu, Cemal Selcuk; Turk, Hakan; Yoldas, Mehmet; Karabicak, Mustafa; Ergani, Batuhan; Boyacioglu, Hayal; Ilbey, Yusuf Ozlem; Zorlu, Ferruh

    2016-01-01

    Introduction: This study aimed to evaluate whether one-shot dilatation technique is as safe in patients with a history of open-stone surgery as it is in patients without previous open-stone surgery. Methods: Between January 2007 and February 2015, 82 patients who underwent percutaneous nephrolithotomy (PNL) surgery with one-shot dilation technique who previously had open-stone surgery were retrospectively reviewed and evaluated (Group 1). Another 82 patients were selected randomly among patients who had PNL with one-shot dilation technique, but with no history of open renal surgery (Group 2). Age, gender, type of kidney stone, duration of surgery, radiation exposure time, and whether or not there was any bleeding requiring perioperative and postoperative transfusion were noted for each patient. Results: The stone-free rates, operation and fluoroscopy time, and peroperative and postoperative complication rates were similar in both groups (p>0.05). Conclusions: Our experience indicated that PNL with one-shot dilation technique is a reliable method in patients with a history of open-stone surgery. PMID:27217866

  4. A Modified Method of Proximal Segment Alignment After Sagittal Split Ramus Osteotomy for Patients With Mandibular Asymmetry

    PubMed Central

    Xia, James J.; Wang, Xudong

    2015-01-01

    Purpose The purpose of this study was to evaluate a modified method of aligning the proximal segment after bilateral sagittal split ramus osteotomy (BSSO) in the treatment of patients with facial asymmetry. Patients and Methods Eleven patients with mandibular excess and facial asymmetries were enrolled in this prospective study. The surgery was planned according to a computer-aided surgical simulation protocol. In addition, the proximal segment on the hypoplastic side was intentionally flared out after the distal segment was rotationally set back. If the gap between the proximal and distal segments was too wide, then bone grafts were used. The surgery was completed according to the computerized plan. The proximal segment on the hypoplastic side was fixed with bicortical lag screws, and the proximal segment on the hyperplastic side was fixed with a 4-hole titanium miniplate. Postoperative evaluation was performed 6 months after surgery. Statistical analyses were performed. Results All surgeries were completed uneventfully. Of the 11 patients, 4 also underwent genioplasty and 3 underwent bone grafting to fill in the gap and smooth the anterior step. The physicians and patients were satisfied with the surgical outcomes. Only 1 patient underwent a secondary revision using an onlay hydroxyapatite implant. Results of statistical analyses showed that the computerized surgical plan could be accurately transferred to the patients at the time of surgery and the surgical outcomes achieved with this modified method were better than with the routine method of aligning the proximal and distal segments in maximal contact. Conclusion The present modified method of aligning the proximal segment for BSSO can effectively correct mandibular asymmetry and obviate a secondary revision surgery. PMID:26026710

  5. Intraocular lens-edge design and material factors contributing to posterior-capsulotomy rates: comparing Hoya FY60aD, PY60aD, and AcrySof SN60WF

    PubMed Central

    Morgan-Warren, Peter J; Smith, JM Alaric

    2013-01-01

    Purpose To compare neodymium-doped yttrium aluminum garnet laser posterior capsulotomy (LPC) rates between the Hoya FY60AD, Hoya PY60AD, and Alcon AcrySof SN60WF intraocular lenses (IOLs) after routine cataract surgery. Methods In this retrospective comparative study, patients undergoing uncomplicated cataract surgery over a 3-year period were included, and those subsequently undergoing LPC were identified from laser clinic records. LPC rates at 2 years postoperatively were compared between the round-edged Hoya FY60AD, the newer sharp-edged Hoya PY60AD three-piece IOLs, and the one-piece AcrySof SN60WF IOL. Results A total of 1,265 cataract operations were included, and 49 eyes (3.9%) underwent LPC within 2 years of surgery. Twenty-eight of 315 eyes (8.9%) implanted with the FY60AD underwent LPC by 2 years, compared to eleven of 254 (4.3%) with the newer sharp square-edged PY60AD and ten of 696 (1.4%) with the one-piece SN60WF (P < 0.05, Chi-squared analyses). Conclusions The newer, sharper-edged Hoya PY60AD IOL has a lower LPC rate than the Hoya FY60AD IOL at 2 years post-cataract surgery. The one-piece AcrySof SN60WF has a lower LPC rate than both the three-piece Hoya IOLs in the same time period postoperatively. Variations in IOL-edge design and material effect may have contributed to the different rates observed. PMID:24003302

  6. Influence of different anesthetic and analgesic methods on early cognitive function of elderly patients receiving non-cardiac surgery

    PubMed Central

    Wang, Yong; Zhang, Jie; Zhang, Shuijun

    2016-01-01

    Objective: To discuss over influence of two different anesthetic and analgesic methods on early cognitive function of elderly patients who received non-cardiac surgery. Methods: Two hundred and six elderly patients who underwent non-cardiac surgery were selected as research subjects. They were randomly divided into observation group (103 cases) and control group (103 cases). Patients in observation group were given combined spinal and epidural anesthesia and epidural analgesia, while patients in control group adopted general anesthesia and intravenous analgesia. Neurological function test was carried out one day before surgery and on the 7th day after surgery. Moreover, changes of postoperative pain degree, neuropsychological function and cognitive function were observed and compared. Results: On the 7th day after surgery, incidence of cognition impairment in observation group and control group was 48.50% (50/103 cases) and 44.70% (46/103 cases), and difference between groups had no statistical significance. Visual Analogue Scale (VAS) Score of observation group was much lower than control group in the 12th, 24th and 48th h after surgery (p < 0.05). Logistic regression analysis suggested that, short education years and general surgery were independent risk factors for early cognition impairment. Conclusion: About 46.60% elderly patients undergoing non-cardiac surgery developed cognition impairment, but influence of different anesthetic and analgesic methods on incidence of postoperative cognition impairment of elderly patients had no significant difference. PMID:27182242

  7. Is there any superiority among diagnostic methods in organizing pneumonia in terms of clinical features of the patients?

    PubMed Central

    Kavakli, Kuthan; Ocal, Nesrin; Dogan, Deniz; Cicek, Ali Fuat; Isik, Hakan; Gurkok, Sedat

    2016-01-01

    Background Organizing pneumonia (OP) can be idiopathic or secondary to some clinical situations. If an etiological cause is not present, this phenomenon is called cryptogenic OP. Secondary OP is associated with various diseases that are known to induce the OP. Objectives The aim of this study was to evaluate the clinical features of the cases with OP and compare the patients diagnosed by bronchoscopic transbronchial biopsy with patients diagnosed by surgical lung biopsy. Patients and methods Medical records of 41 patients diagnosed with OP between 2004 and 2014 were reviewed retrospectively. Results Totally, 41 patients with OP were identified. In all, 39.02% of the cases were diagnosed by bronchoscopic methods, and 60.97% of the cases were diagnosed by surgical procedures. Although the frequency of ground glass opacities, consolidations, and micronodules was higher in the group diagnosed by bronchoscopy, mass-like lesions were more common in the cases diagnosed by surgery. Bronchoscopy, performed in 30 patients totally, had a diagnostic efficacy of 53.33%. Diagnostic value of bronchoscopy was significantly higher in cryptogenic OPs. Although diffuse radiological pattern was more common in “successful bronchoscopy” group, frequency of focal pattern was higher in “failed bronchoscopy” group. Ground glass opacity in successful bronchoscopy group and mass-like lesions in failed bronchoscopy group reached significant differences. Conclusion There were significant differences between the diagnostic procedures in terms of radiological patterns. This is the first study about the relationship between the diagnostic methods and the characteristics of OP. PMID:27713632

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

    PubMed Central

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

    2014-01-01

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

  9. Selection of Genetic and Phenotypic Features Associated with Inflammatory Status of Patients on Dialysis Using Relaxed Linear Separability Method

    PubMed Central

    Bobrowski, Leon; Łukaszuk, Tomasz; Lindholm, Bengt; Stenvinkel, Peter; Heimburger, Olof; Axelsson, Jonas; Bárány, Peter; Carrero, Juan Jesus; Qureshi, Abdul Rashid; Luttropp, Karin; Debowska, Malgorzata; Nordfors, Louise; Schalling, Martin; Waniewski, Jacek

    2014-01-01

    Identification of risk factors in patients with a particular disease can be analyzed in clinical data sets by using feature selection procedures of pattern recognition and data mining methods. The applicability of the relaxed linear separability (RLS) method of feature subset selection was checked for high-dimensional and mixed type (genetic and phenotypic) clinical data of patients with end-stage renal disease. The RLS method allowed for substantial reduction of the dimensionality through omitting redundant features while maintaining the linear separability of data sets of patients with high and low levels of an inflammatory biomarker. The synergy between genetic and phenotypic features in differentiation between these two subgroups was demonstrated. PMID:24489753

  10. The New York Times