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  1. 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

  2. A method to find N = 1 AdS4 vacua in type IIB

    NASA Astrophysics Data System (ADS)

    Solard, Gautier

    2017-01-01

    In this paper, we are looking for N = 1, AdS4 sourceless vacua in type IIB. While several examples exist in type IIA, there exists only one example of such vacua in type IIB. Thanks to the framework of generalized geometry we were able to devise a semi-algorithmical method to look for sourceless vacua. We present this method, which can easily be generalized to more complex cases, and give two new vacua in type IIB.

  3. Partition functions in even dimensional AdS via quasinormal mode methods

    NASA Astrophysics Data System (ADS)

    Keeler, Cynthia; Ng, Gim Seng

    2014-06-01

    In this note, we calculate the one-loop determinant for a massive scalar (with conformal dimension Δ) in even-dimensional AdS d+1 space, using the quasinormal mode method developed in [1] by Denef, Hartnoll, and Sachdev. Working first in two dimensions on the related Euclidean hyperbolic plane H 2, we find a series of zero modes for negative real values of Δ whose presence indicates a series of poles in the one-loop partition function Z(Δ) in the Δ complex plane; these poles contribute temperature-independent terms to the thermal AdS partition function computed in [1]. Our results match those in a series of papers by Camporesi and Higuchi, as well as Gopakumar et al. [2] and Banerjee et al. [3]. We additionally examine the meaning of these zero modes, finding that they Wick-rotate to quasinormal modes of the AdS2 black hole. They are also interpretable as matrix elements of the discrete series representations of SO(2, 1) in the space of smooth functions on S 1. We generalize our results to general even dimensional AdS2 n , again finding a series of zero modes which are related to discrete series representations of SO(2 n, 1), the motion group of H 2 n .

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

    NASA Astrophysics Data System (ADS)

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

    2016-10-01

    We extend the results of [1], computing one loop partition functions for massive fields with spin half in AdS2 using the quasinormal mode method proposed by Denef, Hartnoll, and Sachdev [2]. We find the finite representations of SO(2, 1) for spin zero and spin half, consisting of a highest weight state | h> and descendants with non-unitary values of h. These finite representations capture the poles and zeroes of the one loop determinants. Together with the asymptotic behavior of the partition functions (which can be easily computed using a large mass heat kernel expansion), these are sufficient to determine the full answer for the one loop determinants. We also discuss extensions to higher dimensional AdS2 n and higher spins.

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

    NASA Astrophysics Data System (ADS)

    Liu, Quanhua; Weng, Fuzhong

    2006-12-01

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

  6. 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

  7. 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

  8. 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

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

    PubMed

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

    2013-01-01

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

  10. 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.

  11. 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

  12. 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…

  13. 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.

  14. Ad hoc methods for accurate determination of Bader's atomic boundary

    NASA Astrophysics Data System (ADS)

    Polestshuk, Pavel M.

    2013-08-01

    In addition to the recently published triangulation method [P. M. Polestshuk, J. Comput. Chem. 34, 206 (2013)], 10.1002/jcc.23121, two new highly accurate approaches, ZFSX and SINTY, for the integration over an atomic region covered by a zero-flux surface (zfs) were developed and efficiently interfaced into the TWOE program. ZFSX method was realized as three independent modules (ZFSX-1, ZFSX-3, and ZFSX-5) handling interatomic surfaces of a different complexity. Details of algorithmic implementation of ZFSX and SINTY are discussed. A special attention to an extended analysis of errors in calculations of atomic properties is paid. It was shown that uncertainties in zfs determination caused by ZFSX and SINTY approaches contribute negligibly (less than 10-6 a.u.) to the total atomic integration errors. Moreover, the new methods are able to evaluate atomic integrals with a reasonable time and can be universally applied for the systems of any complexity. It is suggested, therefore, that ZFSX and SINTY can be regarded as benchmark methods for the computation of any Quantum Theory of Atoms in Molecules atomic property.

  15. Ad hoc methods for accurate determination of Bader's atomic boundary.

    PubMed

    Polestshuk, Pavel M

    2013-08-07

    In addition to the recently published triangulation method [P. M. Polestshuk, J. Comput. Chem. 34, 206 (2013)], two new highly accurate approaches, ZFSX and SINTY, for the integration over an atomic region covered by a zero-flux surface (zfs) were developed and efficiently interfaced into the TWOE program. ZFSX method was realized as three independent modules (ZFSX-1, ZFSX-3, and ZFSX-5) handling interatomic surfaces of a different complexity. Details of algorithmic implementation of ZFSX and SINTY are discussed. A special attention to an extended analysis of errors in calculations of atomic properties is paid. It was shown that uncertainties in zfs determination caused by ZFSX and SINTY approaches contribute negligibly (less than 10(-6) a.u.) to the total atomic integration errors. Moreover, the new methods are able to evaluate atomic integrals with a reasonable time and can be universally applied for the systems of any complexity. It is suggested, therefore, that ZFSX and SINTY can be regarded as benchmark methods for the computation of any Quantum Theory of Atoms in Molecules atomic property.

  16. The Daily Life of Complicated Grief Patients--What Gets Missed, What Gets Added?

    ERIC Educational Resources Information Center

    Monk, Timothy H.; Houck, Patricia R.; Shear, M. Katherine

    2006-01-01

    Many patients with complicated grief suffer severe symptoms for several years after the loss, interfering with daily life. We sought to determine which elements of a patient's daily routine were likely to be missed or added. Sixty-four patients completed a diary each evening for 2 weeks. The diary asked whether each of 13 daily life activities…

  17. 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…

  18. RC Model-based Comparison Tests of the Added Compliance Method with Computer Simulations and a Standard Method

    NASA Astrophysics Data System (ADS)

    Pałko, Krzysztof J.; Rogalski, Andrzej; Zieliński, Krzysztof; Glapiński, Jarosław; Kozarski, Maciej; Pałko, Tadeusz; Darowski, Marek

    2007-01-01

    Ventilation of the lungs involves the exchange of gases during inhalation and exhalation causing the movement of respiratory gases between alveolars and the atmosphere as a result of a pressure drop between alveolars and the atmosphere. During artificial ventilation what is most important is to keep specific mechanical parameters of the lungs such as total compliance of the respiratory system Cp (consisting of the lung and the thorax compliances) and the airway resistance Rp when the patient is ventilated. Therefore, as the main goal of this work and as the first step to use our earlier method of added lung compliance in clinical practice was: 1) to carry out computer simulations to compare the application of this method during different expiratory phases, and 2) to compare this method with the standard method for its accuracy. The primary tests of the added-compliance method of the main lung parameters measurement have been made using the RC mechanical model of the lungs.

  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. Dynamical nonstationarity of resting EEGs in patients with attention-deficit/hyperactivity disorder (AD/HD).

    PubMed

    Latchoumane, Charles-Francois V; Kim, In-Hye; Sohn, Hansem; Jeong, Jaeseung

    2013-01-01

    This study applied dynamical nonstationarity analysis (DNA) to the resting EEGs of patients with attention-deficit/hyperactivity disorder (AD/HD). We aimed to assess and characterize AD/HD using features based on the local and global duration of dynamical microstate. We hypothesized that AD/HD patients would have difficulties in maintaining stable cognitive states (e.g., attention deficit and impulsivity) and that they would thus exhibit EEGs with temporal dynamics distinct from normal controls, i.e., rapidly and frequently changing dynamics. To test this hypothesis, we recorded EEGs from 12 adolescent subjects with AD/HD and 11 age-matched healthy subjects in the resting state with eyes closed and eyes open. We found that AD/HD patients exhibited significantly faster changes in dynamics than controls in the right temporal region during the eyes closed condition, but slower changes in dynamics in the frontal region during the eyes open condition. AD/HD patients exhibited a disruption in the rate of change of dynamics in the frontotemporal region at rest, probably due to executive and attention processes. We suggest that the DNA using complementary local and global features based on the duration of dynamical microstates could be a useful tool for the clinical diagnosis of subjects with AD/HD.

  1. Influence of education on the pattern of cognitive deterioration in AD patients: the cognitive reserve hypothesis.

    PubMed

    Le Carret, Nicolas; Auriacombe, Sophie; Letenneur, Luc; Bergua, Valérie; Dartigues, Jean-François; Fabrigoule, Colette

    2005-03-01

    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 patients because the neuropathology is more advanced. However, these studies have only investigated the decline of global cognition or an isolated cognitive process. To study the differential deterioration pattern of several cognitive processes according to education, the performance of 20 AD patients with a high educational level and a low educational level were compared with the performance of 20 control subjects on a neuropsychological battery. The results showed that cognitive deterioration of AD patients is different according to education, although the global performance was similar in AD patients. The high-educated patients exhibited greater impairment of abstract thinking whereas the low-educated patients showed greater impairment of memory and attentional function. This confirms that some cognitive processes, such as abstract thinking, decline more rapidly in high-educated patients whereas others seem to evolve more slowly if compared to low-educated patients. In this latter case, high-educated patients may still benefit from cognitive reserve after the diagnosis of the dementia.

  2. Classification of patients with MCI and AD from healthy controls using directed graph measures of resting-state fMRI.

    PubMed

    Khazaee, Ali; Ebrahimzadeh, Ata; Babajani-Feremi, Abbas

    2017-03-30

    Brain network alterations in patients with Alzheimer's disease (AD) has been the subject of much investigation, but the biological mechanisms underlying these alterations remain poorly understood. Here, we aim to identify the changes in brain networks in patients with AD and mild cognitive impairment (MCI), and provide an accurate algorithm for classification of these patients from healthy control subjects (HC) by using a graph theoretical approach and advanced machine learning methods. Multivariate Granger causality analysis was performed on resting-state functional magnetic resonance imaging (rs-fMRI) data of 34 AD, 89 MCI, and 45 HC to calculate various directed graph measures. The graph measures were used as the original feature set for the machine learning algorithm. Filter and wrapper feature selection methods were applied to the original feature set to select an optimal subset of features. An accuracy of 93.3% was achieved for classification of AD, MCI, and HC using the optimal features and the naïve Bayes classifier. We also performed a hub node analysis and found that the number of hubs in HC, MCI, and AD were 12, 10, and 9, respectively, suggesting that patients with AD experience disturbance of critical communication areas in their brain network as AD progresses. The findings of this study provide insight into the neurophysiological mechanisms underlying MCI and AD. The proposed classification method highlights the potential of directed graph measures of rs-fMRI data for identification of the early stage of AD.

  3. Decreased dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) concentrations in plasma of Alzheimer's disease (AD) patients.

    PubMed

    Aldred, Sarah; Mecocci, Patrizia

    2010-01-01

    DHEA is secreted by the adrenal cortex and is also a neurosteroid. Its sulfate (DHEAS) is the most abundant steroid in circulation. The levels of both are seen to decline in concentration with age. Evidence is available for altered levels of DHEA and DHEAS in AD but is limited to relatively few studies assessing small cohorts. This study assessed plasma DHEA and DHEAS levels in AD sufferers (n=72) and compared them to age-matched controls (n=72). Plasma DHEA concentrations were significantly lower in AD patients compared to control (4.24+/-0.4 ng/ml for AD; 3.38+/-0.3 ng/ml for control, p=0.027, Mann-Whitney 1-tailed) and DHEA levels were significantly correlated to DHEAS levels in both control and AD conditions (Spearman's rho correlation coefficient=0.635 in controls and 0.467 in AD, ppatients suffering from AD when compared to age-matched controls.

  4. 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.…

  5. 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.

  6. 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…

  7. A B-spline method used to calculate added resistance in waves

    NASA Astrophysics Data System (ADS)

    Zangeneh, Razieh; Ghiasi, Mahmood

    2017-03-01

    Making an exact computation of added resistance in sea waves is of high interest due to the economic effects relating to ship design and operation. In this paper, a B-spline based method is developed for computation of added resistance. Based on the potential flow assumption, the velocity potential is computed using Green's formula. The Kochin function is applied to compute added resistance using Maruo's far-field method, the body surface is described by a B-spline curve and potentials and normal derivation of potentials are also described by B-spline basis functions and B-spline derivations. A collocation approach is applied for numerical computation, and integral equations are then evaluated by applying Gauss-Legendre quadrature. Computations are performed for a spheroid and different hull forms; results are validated by a comparison with experimental results. All results obtained with the present method show good agreement with experimental results.

  8. A B-spline method used to calculate added resistance in waves

    NASA Astrophysics Data System (ADS)

    Zangeneh, Razieh; Ghiasi, Mahmood

    2017-01-01

    Making an exact computation of added resistance in sea waves is of high interest due to the economic effects relating to ship design and operation. In this paper, a B-spline based method is developed for computation of added resistance. Based on the potential flow assumption, the velocity potential is computed using Green's formula. The Kochin function is applied to compute added resistance using Maruo's far-field method, the body surface is described by a B-spline curve and potentials and normal derivation of potentials are also described by B-spline basis functions and B-spline derivations. A collocation approach is applied for numerical computation, and integral equations are then evaluated by applying Gauss-Legendre quadrature. Computations are performed for a spheroid and different hull forms; results are validated by a comparison with experimental results. All results obtained with the present method show good agreement with experimental results.

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

    PubMed

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

    2008-01-01

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

  10. [Influence of antiplatelet drugs (AD) on the efectiveness of combined therapy in patients with small cell lung cancer. Part I. Influence of AD on the haemostatic system].

    PubMed

    Ochmański, Władysław

    2008-01-01

    In the last years, a sharp rise in the morbidity due to lung cancer is observed, especially in the male population. Despite the intensive, multidirectional development of oncology, early detection and effective treatment of lung cancer is still limited. Its detection is delayed because of the lack of characteristic early signs. Especially poor in prognosis are patients with small cell lung cancer (SCLC), who usually die in consequence of distant metastases. This may result due to coating of the surface of circulating neoplastic cells with thrombocytes and clots. Platelets aggregates on the surface of neoplastic cells may have a protective action in relation to cytostatic drugs. This is why neoplastic cells that persist through this phase, implant themselves into various organs giving rise to metastases. The aim of the 1st part of the paper was to evaluate the influence of antiplatelet drugs (AD) on the haemostatic system of patients with SCLC. There is data in literature indicating a ameliorating influence of AD on time of survival of patients with certain neoplasms. The study was performed in 87 male patients aged 35-73 years with SCLC, limited to half of the chest (limited disease). After 2 i.v. chemotherapy series in 3 week intervals (VAC scheme according Greco): --Adriamycin (ADR) 40 mg on 1sq.m of body surface; --Vincristin (VCR) 1 mg; on 1sq.m of body surface; --Cyclophosfamid (CTX) 1000 mg on 1sq.m of body surface; radiation was also applied--40 Gy during 20 days on the tumor and mediastinum. The described treatment was performed in 22 patients from controls (Group I). Patients from Group II (n = 22) received additionally Defibrotide, Group III (n = 22) Ticlide and Group IV (n = 21) Aspirin. To evaluate of the influence of AD on the haemostatic system--every 3 months during the consecutive 27 weeks, the following tests were performed: bleeding time, clotting time, platelet aggregation, platelets aggregation ratio, euglobulin clot lysis time (ECLT

  11. 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.

  12. Bosentan added to sildenafil therapy in patients with pulmonary arterial hypertension.

    PubMed

    McLaughlin, Vallerie; Channick, Richard N; Ghofrani, Hossein-Ardeschir; Lemarié, Jean-Christophe; Naeije, Robert; Packer, Milton; Souza, Rogério; Tapson, Victor F; Tolson, Jonathan; Al Hiti, Hikmet; Meyer, Gisela; Hoeper, Marius M

    2015-08-01

    The safety and efficacy of adding bosentan to sildenafil in pulmonary arterial hypertension (PAH) patients was investigated.In this prospective, double-blind, event-driven trial, symptomatic PAH patients receiving stable sildenafil (≥20 mg three times daily) for ≥3 months were randomised (1:1) to placebo or bosentan (125 mg twice daily). The composite primary end-point was the time to the first morbidity/mortality event, defined as all-cause death, hospitalisation for PAH worsening or intravenous prostanoid initiation, atrial septostomy, lung transplant, or PAH worsening. Secondary/exploratory end-points included change in 6-min walk distance and World Health Organization functional class at 16 weeks, change in N-terminal pro-brain natriuretic peptide (NT-proBNP) over time, and all-cause death.Overall, 334 PAH patients were randomised to placebo (n=175) or bosentan (n=159). A primary end-point event occurred in 51.4% of patients randomised to placebo and 42.8% to bosentan (hazard ratio 0.83, 97.31% CI 0.58-1.19; p=0.2508). The mean between-treatment difference in 6-min walk distance at 16 weeks was +21.8 m (95% CI +5.9-37.8 m; p=0.0106). Except for NT-proBNP, no difference was observed for any other end-point. The safety profile of bosentan added to sildenafil was consistent with the known bosentan safety profile.In COMPASS-2, adding bosentan to stable sildenafil therapy was not superior to sildenafil monotherapy in delaying the time to the first morbidity/mortality event.

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

    DOEpatents

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

    2012-02-07

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

  14. 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.

  15. 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.

  16. From Malicious Eyes: A Method for Concise Representation of Ad-Hoc Networks and Efficient Attack Survivability Analysis

    DTIC Science & Technology

    2012-07-01

    a modification of OSPF that is optimized for mobile ad-hoc networks . OSPFv3MDR uses IPv6 addressing. Topology. In attempts to achieve a suitable...From Malicious Eyes: A Method for Concise Representation of Ad-Hoc Networks and Efficient Attack Survivability Analysis by Jaime C. Acosta...White Sands Missile Range, NM 88002-5501 ARL-TR-6035 July 2012 From Malicious Eyes: A Method for Concise Representation of Ad-Hoc Networks

  17. Expression profiles of cytokines in the brains of Alzheimer’s disease (AD) patients, compared to the brains of non-demented patients with and without increasing AD pathology

    PubMed Central

    Morimoto, Kaori; Horio, Juri; Satoh, Haruhisa; Sue, Lucia; Beach, Thomas; Arita, Seizaburo; Tooyama, Ikuo; Konishi, Yoshihiro

    2012-01-01

    Neuroinflammation is involved in the Alzheimer’s disease (AD) pathology. Our major focus was to clarify whether neuroinflammation plays important roles in AD pathogenesis, particularly prior to the manifestation of overt dementia. We analyzed cytokine expression profiles of the brain, with focus on non-demented patients with increasing AD pathology, referred to as high pathology control (HPC) patients, who provide an intermediate subset between AD and normal control subjects, referred to as low pathology control (LPC) patients. With real-time PCR techniques, we found significant differences in interleukin (IL)-1β, 10, 13, 18, and 33, tumor necrosis factor (TNF)α converting enzyme (TACE), and transforming growth factor (TGF)β1 mRNA expression ratios between HPC and AD patients, while no significant differences in the expression ratios of any cytokine tested here were observed between LPC and HPC patients. The cytokine mRNA expression ratios were determined as follows: first, cytokine mRNA levels were normalized to mRNA levels of a housekeeping gene, peptidyl-prolyl isomerase A (PPIA), which showed the most stable expression among ten housekeeping genes tested here; then, the normalized data of cytokine levels in the temporal cortex were divided by those in the cerebellum, which is resistant to AD pathology. Subsequently, the expression ratios of the temporal cortex to cerebellum were compared among LPC, HPC and AD patient groups. Our results indicate that cytokines are more mobilized and implicated in the later AD stage when a significant cognitive decline occurs and develops than in the developmental course of AD pathology prior to the manifestation of overt dementia. PMID:21368376

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

    ERIC Educational Resources Information Center

    McCaffrey, Daniel F.

    2012-01-01

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

  19. The added value of C-reactive protein measurement in diagnosing pneumonia in primary care: a meta-analysis of individual patient data

    PubMed Central

    Minnaard, Margaretha C.; de Groot, Joris A.H.; Hopstaken, Rogier M.; Schierenberg, Alwin; de Wit, Niek J.; Reitsma, Johannes B.; Broekhuizen, Berna D.L.; van Vugt, Saskia F.; Neven, Arie Knuistingh; Graffelman, Aleida W.; Melbye, Hasse; Rainer, Timothy H.; Steurer, Johann; Holm, Anette; Gonzales, Ralph; Dinant, Geert-Jan; van de Pol, Alma C.; Verheij, Theo J.M.

    2017-01-01

    BACKGROUND: C-reactive protein (CRP) is increasingly being included in the diagnostic work-up for community-acquired pneumonia in primary care. Its added diagnostic value beyond signs and symptoms, however, remains unclear. We conducted a meta-analysis of individual patient data to quantify the added value of CRP measurement. METHODS: We included studies of the diagnostic accuracy of CRP in adult outpatients with suspected lower respiratory tract infection. We contacted authors of eligible studies for inclusion of data and for additional data as needed. The value of adding CRP measurement to a basic signs-and-symptoms prediction model was assessed. Outcome measures were improvement in discrimination between patients with and without pneumonia in primary care and improvement in risk classification, both within the individual studies and across studies. RESULTS: Authors of 8 eligible studies (n = 5308) provided their data sets. In all of the data sets, discrimination between patients with and without pneumonia improved after CRP measurement was added to the prediction model (extended model), with a mean improvement in the area under the curve of 0.075 (range 0.02–0.18). In a hypothetical cohort of 1000 patients, the proportion of patients without pneumonia correctly classified at low risk increased from 28% to 36% in the extended model, and the proportion with pneumonia correctly classified at high risk increased from 63% to 70%. The number of patients with pneumonia classified at low risk did not change (n = 4). Overall, the proportion of patients assigned to the intermediate-risk category decreased from 56% to 51%. INTERPRETATION: Adding CRP measurement to the diagnostic work-up for suspected pneumonia in primary care improved the discrimination and risk classification of patients. However, it still left a substantial group of patients classified at intermediate risk, in which clinical decision-making remains challenging. PMID:27647618

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  1. Impact of Adding a Decision Aid to Patient Education in Adults with Asthma: A Randomized Clinical Trial

    PubMed Central

    Légaré, France; Moisan, Jocelyne; Boulet, Louis-Philippe

    2017-01-01

    Background Not providing adequate patient education interventions to asthma patients remains a major care gap. To help asthma patients and caregivers discuss inhaled controller medication use, our team has previously developed a decision aid (DA). We sought to assess whether adding this DA to education interventions improved knowledge, decisional conflict, and asthma control among adults with asthma. Methods A parallel clinical trial (NCT02516449). We recruited adults with asthma, aged 18 to 65 years, prescribed inhaled controller medication to optimize asthma control. Educators randomly allocated participants either to the education + DA or to the education group. At baseline and two-month follow-up, we measured asthma knowledge (primary outcome) with a validated self-administered questionnaire (score –37 to +37). Secondary outcomes included decisional conflict and asthma control. Blinded assessors collected data. Between the two time points, the within- and between-group changes were estimated by generalized linear mixed models. Results Fifty-one participants (response rate: 53%; age: 44 ± 13 years; women: n = 32) were randomized either to the education + DA group (n = 26) or to the education group (n = 25), and included in statistical analyses. Between baseline and follow-up, mean [95% CI] knowledge scores increased from 21.5 [19.9–23.2] to 25.1 [23.1–27.0] in the education + DA group (P = 0.0002) and from 24.0 [22.3–25.7] to 26.0 [24.0–28.0] in the education group (P = 0.0298). In both of the groups, decisional conflict and asthma control improved. There were no differences between groups. Conclusions Education improved knowledge, decisional conflict, and asthma control whether the DA was added or not. PMID:28107540

  2. 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)

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

    PubMed Central

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

    2014-01-01

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

  4. 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.

  5. Comparison of embedded and added motor imagery training in patients after stroke: results of a randomised controlled pilot trial

    PubMed Central

    2012-01-01

    Background Motor imagery (MI) when combined with physiotherapy can offer functional benefits after stroke. Two MI integration strategies exist: added and embedded MI. Both approaches were compared when learning a complex motor task (MT): 'Going down, laying on the floor, and getting up again'. Methods Outpatients after first stroke participated in a single-blinded, randomised controlled trial with MI embedded into physiotherapy (EG1), MI added to physiotherapy (EG2), and a control group (CG). All groups participated in six physiotherapy sessions. Primary study outcome was time (sec) to perform the motor task at pre and post-intervention. Secondary outcomes: level of help needed, stages of MT-completion, independence, balance, fear of falling (FOF), MI ability. Data were collected four times: twice during one week baseline phase (BL, T0), following the two week intervention (T1), after a two week follow-up (FU). Analysis of variance was performed. Results Thirty nine outpatients were included (12 females, age: 63.4 ± 10 years; time since stroke: 3.5 ± 2 years; 29 with an ischemic event). All were able to complete the motor task using the standardised 7-step procedure and reduced FOF at T0, T1, and FU. Times to perform the MT at baseline were 44.2 ± 22s, 64.6 ± 50s, and 118.3 ± 93s for EG1 (N = 13), EG2 (N = 12), and CG (N = 14). All groups showed significant improvement in time to complete the MT (p < 0.001) and degree of help needed to perform the task: minimal assistance to supervision (CG) and independent performance (EG1+2). No between group differences were found. Only EG1 demonstrated changes in MI ability over time with the visual indicator increasing from T0 to T1 and decreasing from T1 to FU. The kinaesthetic indicator increased from T1 to FU. Patients indicated to value the MI training and continued using MI for other difficult-to-perform tasks. Conclusions Embedded or added MI training combined with physiotherapy seem to be feasible and benefi

  6. 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).

  7. 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…

  8. 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.

  9. Linear ion trap with added octopole field component: the property and method.

    PubMed

    Dang, Qiankun; Xu, Fuxing; Huang, Xiaohua; Fang, Xiang; Wang, Rizhi; Ding, Chuan-Fan

    2015-12-01

    It is well known that superimposition of some positive octopole field will benefit the performance of ion trap mass analyzer. In the radial-ejection linear ion trap (LIT), adding some octopole field component to the main quadrupole field is usually accomplished by stretching the ejection rod pair. In this study, the effect of octopole potential and some other higher order potential on the performance of LIT mass analyzer is investigated. A simple and effective method, which is to add some octopole component by building a LIT with a pair of rectangular electrodes and a pair of semi-circular electrodes, is reported. Its properties were studied by numerical simulations and experiments. The results showed that a certain amount of positive octopole component could be produced by simply adjusting the position and width of the rectangular electrodes. A resolution of over 1200 at m/z 609 (~1600 Da/s) was observed in this type of LIT. They also performed tandem mass spectrometry well. The device with optimum geometry for ion ejection from rectangular electrodes provided comparable performance to that for ion ejection from semi-circular electrodes. This type of LIT design is easy for fabrication and assembly.

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

    PubMed

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

    2015-10-01

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

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

    PubMed

    Manning, Emily N; 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

    2015-12-01

    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.

  12. 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.

  13. The effect of three different methods of adding O2 additive on O concentration of atmospheric pressure plasma jets (APPJs)

    NASA Astrophysics Data System (ADS)

    Yue, Y.; Xian, Y.; Pei, X.; Lu, X.

    2016-12-01

    In order to maximize the O concentration generated by the atmospheric pressure plasma jets (APPJs), several different methods of adding O2 additive to working gas have been proposed. However, it is not clear, which method is capable of generating the highest concentration of O atom. In this paper, the concentration of O atoms in an APPJs by adding O2 to (1) the working gas, to (2) the downstream inside the tube, and (3) to the shielding gas is investigated by two-photon absorption laser-induced fluorescence spectrometry. The results clearly demonstrate that the highest O density is achieved when 1.5% of O2 is added to the working gas rather than the other two methods. In other words, the most effective way to generate O atoms is by premixing O2 with the working gas. Further investigation suggests that O atoms are mainly generated around the electrode region, where the electric field is highest. In addition, when O2 is added to the working gas, if in the meantime extra O2 is added to the downstream inside the tube, a significant decrease of O density is observed.

  14. 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

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. Bacterial resistance and immunological profiles in HIV-infected and non-infected patients at Mbouda AD LUCEM Hospital in Cameroon.

    PubMed

    Marbou, Wiliane J T; Kuete, Victor

    2016-04-28

    This study investigated the variations in some cells of the immune system, as well as the antibiotic resistance of the bacteria responsible for enteric infections among HIV+ patients compared to HIV- patients in Mbouda AD LUCEM Hospital, Cameroon. A cross-sectional study was performed from September 2014 to February 2015 in 67 human immunodeficiency virus (HIV)-seropositive (HIV+) and 37 HIV-seronegative (HIV-) patients. Blood collected from these patients was used to perform cluster of differentiation 4 (CD4) and cluster of differentiation 8 (CD8) lymphocyte blood counts and a white blood cell count, as well as to measure C-reactive protein (CRP) blood by flow cytometry and perform optical and immuno-turbidimetric detection. Enteric bacteria were isolated from the stool of patients, and their antibiotic susceptibility profiles were determined using agar diffusion methods. The results showed that Escherichia coli was the main pathogenic bacteria in the digestive tracts of HIV+ (85.3%) and HIV- (81.1%) patients, and infections with Klebsiella sp. were also predominant among HIV- patients (29.4%). Resistance of Klebsiella sp. to ceftriaxone (CRO; P=0.001), gentamicin (GEN; P=0.005), chloramphenicol (CHL; P=0.0004), ciprofloxacin (CIP; P=0.005) and doxycycline (DOX; P<0.0001) was significantly higher in HIV+ patients than in HIV- patients. Enterobacter sp. showed high resistance to GEN (P=0.009) and CIP (P=0.001) in HIV+ patients compared to HIV- patients. Citrobacter sp. was resistant to GEN (P=0.009) in HIV+ patients compared to HIV- patients. Salmonella sp. showed high resistance to CHL (P<0.0001) and DOX (P<0.0001) in HIV+ patients compared to HIV- patients. Resistance of Serratia sp. to AMO (P=0.005), AMC (P=0.005) and CHL (P=0.005) was significantly higher in HIV+ patients than in HIV- patients. Lymphopenia was higher in HIV+ patients (36.8%) than in HIV- patients (2.7%). In 45.9% of the HIV- patients, the CRP rate was higher than 6mg/L compared to 16.2% in HIV

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

    NASA Astrophysics Data System (ADS)

    Murugan, R.; Vijayaprasath, G.; Mahalingam, T.; Anandhan, N.; Ravi, G.

    2014-04-01

    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.

  1. 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.

  2. Comparative studies of glycine added potassium dihydrogen phosphate single crystals grown by conventional and Sankaranaryanan-Ramasamy methods

    NASA Astrophysics Data System (ADS)

    Boopathi, K.; Rajesh, P.; Ramasamy, P.; Manyum, Prapun

    2013-03-01

    Glycine added potassium dihydrogen phosphate (KDP) crystals have been grown by slow evaporation solution technique, slow cooling along with seed rotation and Sankaranaryanan-Ramasamy (SR) method. The size of the grown crystal in slow cooling method was 35 × 25 × 20 mm3 and in SR method it was 20 mm in diameter and 110 mm in length. The grown crystals were subjected to powder X-ray diffraction, UV-Vis, thermal analysis, Vickers microhardness, dielectric, laser damage threshold, higher resolution X-ray diffraction (HRXRD) and nonlinear optical (NLO) studies. All the grown crystals have good transparency in the entire visible region. In order to determine mechanical strength of crystal, Vickers micro-hardness measurement was carried out. Dielectric study reveals higher dielectric constant and low dielectric loss for SR method grown crystal. High laser damage threshold was observed in SR method grown glycine added KDP crystal compared to SR method grown pure KDP crystal. The second harmonic efficiency of the glycine added KDP is increased compared to pure KDP.

  3. 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.

  4. A method for controlling hydrogen sulfide in water by adding solid phase oxygen.

    PubMed

    Chang, Yu-Jie; Chang, Yi-Tang; Chen, Hsi-Jien

    2007-01-01

    This work evaluates the addition of solid phase oxygen, a magnesium peroxide (MgO(2)) formulation manufactured by Regenesis (oxygen-releasing compounds, ORC), to inhibit the production of hydrogen sulfide (H(2)S) in an SRB-enriched environment. The initial rate of release of oxygen by the ORC was determined over a short period by adding sodium sulfite (Na(2)SO(3)), which was a novel approach developed for this study. The ability of ORCs to control H(2)S by releasing oxygen was evaluated in a bench-scale column containing cultured sulfate reducing bacteria (SRB). After a series of batch tests, 0.4% ORC was found to be able to inhibit the formation of H(2)S for more than 40 days. In comparison, the concentration of H(2)S dropped from 20 mg S/L to 0.05 mg S/L immediately after 0.1% hydrogen peroxide (H(2)O(2)) was added, but began to recover just four days later. Thus, H(2)O(2) does not seem to be able to inhibit the production of sulfide for an extended period of time. By providing long-term inhibition of the SRB population, ORC provides a good alternative means of controlling the production of H(2)S in water.

  5. The effect of galantamine added to clozapine on cognition of five patients with schizophrenia.

    PubMed

    Bora, Emre; Veznedaroğlu, Baybars; Kayahan, Bülent

    2005-01-01

    Although clozapine may be beneficial for the treatment of cognitive dysfunction in schizophrenia, it may also impair some cognitive skills as a result of its anticholinergic activity. In this case series, the impact of galantamine administration on 5 patients with schizophrenia who had been treated with clozapine are reported. Neuropsychological assessment was administered before and after 8 weeks of 16 mg/d galantamine treatment. In this case series, galantamine was well tolerated by all of the patients. Three of the patients were much improved in sustained attention tasks. Most of the patients were also improved in psychomotor speed and selective attention tasks. Two patients with low pretreatment memory scores seemed to also be improved. Our results suggest that the possible role of galantamine as a cognitive enhancer in schizophrenia should be investigated in controlled trials.

  6. Feasibility of Neoadjuvant Ad-REIC Gene Therapy in Patients with High-Risk Localized Prostate Cancer Undergoing Radical Prostatectomy.

    PubMed

    Kumon, Hiromi; Sasaki, Katsumi; Ariyoshi, Yuichi; Sadahira, Takuya; Araki, Motoo; Ebara, Shin; Yanai, Hiroyuki; Watanabe, Masami; Nasu, Yasutomo

    2015-12-01

    In a phase I/IIa study of in situ gene therapy using an adenovirus vector carrying the human REIC/Dkk-3 gene (Ad-REIC), we assessed the inhibitory effects of cancer recurrence after radical prostatectomy (RP), in patients with high risk localized prostate cancer (PCa). After completing the therapeutic interventions with initially planned three escalating doses of 1.0 × 10(10) , 1.0 × 10(11) , and 1.0 × 10(12) viral particles (VP) in 1.0-1.2 mL (n = 3, 3, and 6), an additional higher dose of 3.0 × 10(12) VP in 3.6 mL (n = 6) was further studied. Patients with recurrence probability of 35% or more within 5 years after RP as calculated by Kattan's nomogram, were enrolled. They received two ultrasound-guided intratumoral injections at 2-week intervals, followed by RP 6 weeks after the second injection. Based on the findings of MRI and biopsy mapping, as a rule, one track injection to the most prominent cancer area was given to initial 12 patients and 3 track injections to multiple cancer areas in additional 6 patients. As compared to the former group, biochemical recurrence-free survival of the latter showed a significantly favorable outcome. Neoadjuvant Ad-REIC, mediating simultaneous induction of cancer selective apoptosis and augmentation of antitumor immunity, is a feasible approach in preventing cancer recurrence after RP. (199).

  7. 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.

  8. 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

  9. 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.

  10. Reduction of nausea and vomiting from epidural opioids by adding droperidol to the infusate in home-bound patients.

    PubMed

    Aldrete, J A

    1995-10-01

    In 184 adult patients with severe nonmalignant low back pain from postlaminectomy syndrome, temporary lumbar epidural catheters were infused with either 0.25% bupivacaine 92 mL, fentanyl 600 micrograms, and droperidol 5 mg (Group A), or 0.25% bupivacaine 92 mL, fentanyl 600 micrograms, and NaCl 0.9% 2 mL (Group B). Infusion rates ranged from 0.5 to 2 mL per hour, with an option for turning the infusion off when the patient had no pain and turning it on when the pain returned. Infusions were continued from 2 to 55 days, during which time the patient was at home. In Group A, only two patients had nausea without emesis, while in Group B, nausea occurred in 18 patients (P < 0.04) and four vomited (P < 0.05). The number of patients with headache, pruritus, somnolence, and/or numbness was minimal and without statistically significant group differences. During treatments, pain levels were 2 or less on a 10-cm visual analogue scale. Added to the epidural infusate, droperidol appears to significantly reduce nausea and vomiting in ambulatory patients receiving fentanyl and bupivacaine in extended epidural infusions. The possibility that droperidol potentiates analgesic effects could not be evaluated.

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

    PubMed

    Guo, Xing-Zhong; Yang, Hui

    2005-03-01

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

  12. 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%.

  13. Care interaction adding challenges to old patients' well-being during surgical hospital treatment.

    PubMed

    Uhrenfeldt, Lisbeth; Høybye, Mette Terp

    2015-01-01

    Today, hospitals offer surgical treatment within a short hospital admission. This brief interaction may challenge the well-being of old patients. The aim of this study was to explore how the well-being of old hospitalized patients was affected by the interaction with staff during a fast-track surgical treatment and hospital admission for colon cancer. We used an ethnographic methodology with field observations and unstructured interviews focusing on one patient at a time (n=9) during a full day; the hours ranging from 7:45 a.m. to 8 p.m. Participants were between 74 and 85 years of age and of both sexes. The study was reported to the Danish Data Protection Agency with reference number (2007-58-0010). The encounter between old patients and the staff was a main theme in our findings elucidating a number of care challenges. The identified care challenges illustrated "well-being as a matter of different perspectives," "vulnerability in contrast to well-being," and "staff mix influencing the care encounter." The experience of well-being in old cancer patients during hospital admission was absent or challenged when staff did not acknowledge their individual vulnerability and needs.

  14. Intraprostatic distribution and long term follow-up after AdV-tk immunotherapy as neoadjuvant to surgery in patients with prostate cancer

    PubMed Central

    Rojas-Martínez, Augusto; Manzanera, Andrea G.; Sukin, Steven W.; Esteban-María, Jacinto; González-Guerrero, Juan Francisco; Gomez-Guerra, Lauro; Garza-Guajardo, Raquel; Flores-Gutiérrez, Juan Pablo; Riojas, Guillermo Elizondo; Delgado-Enciso, Iván; Ortiz-López, Rocío; Aguilar, Laura K.; Butler, E. Brian; Barrera-Saldaña, Hugo A.; Aguilar-Cordova, Estuardo

    2013-01-01

    A phase I-II study to evaluate gene mediated cytotoxic immunotherapy in newly diagnosed prostate cancer before radical prostatectomy was conducted in Monterrey, Mexico. Methods To investigate delivery of adenovirus to the prostate, fluorescently labeled vector was injected into fresh prostatectomy specimens and distribution visually analyzed. The optimal volume and site instillation was then used for transrectal ultrasound guided intraprostatic injection in 10 patients with adenocarcinoma scheduled for radical prostatectomy. Each received 2-apical and 2-basal 0.5 ml injections of AdV-tk for a total of 1×1011 vp followed by 14 days of prodrug. Nine patients continued to tumor resection: 6 high-risk, 1 intermediate and 2 low-risk. In-vivo vector distribution was analyzed from resected tissue of four patients. Patients were monitored for tumor progression and acute and long-term safety. Results Two apical and two basal injections of 0.5ml led to optimal organ-wide distribution of an adenoviral vector ex-vivo and in-vivo. Cytotoxicity was evidenced by transient rise in PSA and tumor histology. There were no significant adverse events deemed related to the treatment and no late toxicities after median follow up of 11.3 years. All six high-risk patients had positive surgical margins and one had seminal vesicle involvement. Despite slow PSA rise post-surgery in 3 of these patients, none developed metastases. The intermediate and low-risk patients had complete resections and none have progressed. Conclusion In-vivo transrectal ultrasound guided instillation of an adenoviral vector into four sites in the prostate was practical as an outpatient procedure, well tolerated and led to distribution throughout the intraprostatic tumor mass. AdV-tk demonstrated no significant acute or late toxicities. Trends in PSA and disease progression conveyed the possibility of a sustained immune response against residual disease. PMID:24052127

  15. Empagliflozin added to metformin and sulfonylurea therapy in patients with sub-optimally controlled type 2 diabetes mellitus.

    PubMed

    Lewin, Andrew J; Frías, Juan P

    2015-04-01

    The combination of metformin and a sulfonylurea is commonly used in type 2 diabetes mellitus. Many patients on this combination therapy do not achieve or maintain glycemic targets and require the addition of a third antihyperglycemic agent. Among the options are the sodium glucose cotransporter 2 (SGLT2) inhibitors, a recently developed class of medications that effectively improve glycemic control and are associated with reduction in body weight and blood pressure. This article evaluates a 24-week, randomized, placebo-controlled study of the SGLT2 inhibitor empagliflozin, added to metformin plus sulfonylurea regimens. Empagliflozin led to significant reductions in glycated hemoglobin and fasting plasma glucose, as well as body weight and systolic blood pressure. Adverse events typically recorded with SGLT2 inhibitors were observed; notably, genital infections occurred in more patients on empagliflozin than placebo. Overall, empagliflozin was well tolerated. These results indicate that SGLT2 inhibitors can be successfully added to metformin plus sulfonylurea regimens. SGLT2 inhibitors are not the only therapeutic option in this clinical situation; however, based on the secondary effects observed in this and other studies, they appear to be of particular value for patients who are obese or overweight.

  16. 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.

  17. 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…

  18. Coherence penalty functional: a simple method for adding decoherence in Ehrenfest dynamics.

    PubMed

    Akimov, Alexey V; Long, Run; Prezhdo, Oleg V

    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.

  19. Adding Ultrasound to the Evaluation of Patients with Pathologic Nipple Discharge to Diagnose Additional Breast Cancers: Preliminary Data.

    PubMed

    Yoon, Haesung; Yoon, Jung Hyun; Kim, Eun-Kyung; Moon, Hee Jung; Park, Byeong-Woo; Kim, Min Jung

    2015-08-01

    The aim of this study was to assess the malignancy yield of ultrasound Breast Imaging Reporting and Data System (BI-RADS) classification and the diagnostic value of adding ultrasound to diagnosis of breast cancer in patients with pathologic nipple discharge. Of 267 patients with pathologic nipple discharge seen from February 2003 to March 2011, 198 with histopathologic confirmation and follow-up data were included. Ultrasound images and mammograms were analyzed according to BI-RADS. The malignancy rate for each BI-RADS category and the difference in diagnostic performance resulting from the addition of ultrasound to mammography were calculated. Of the 198 enrolled patients, 34 were diagnosed with a malignancy. The malignancy rates obtained with the addition of ultrasound to mammography were 0.0% (0 of 27) for category 1, 5.9% (1/17) for category 2, 9.4% (5/53) for category 3, 21.5% (20/93) for category 4 and 100% (8/8) for category 5. The malignancy rates for mammography alone were 7.7%-9.0% for categories 1-3, 68.5% (13/19) for category 4 and 100.0% (5/5) for category 5. Adding US to mammography did not significantly increase sensitivity compared with mammography alone. Other diagnostic performance markers such as specificity and positive predictive value were not improved. Among patients for whom mammograms were available, ultrasound detected 5 breast cancers (26.3%) in addition to the 19 breast cancers found by positive mammography. Although it did not increase overall diagnostic performance in patients with pathologic nipple discharge, addition of ultrasound to mammography did detect an additional 26.3% of malignant lesions.

  20. ICSM: An order N method for calculating electrostatic interactions added to TINKER

    NASA Astrophysics Data System (ADS)

    Baker, Katherine; Baumketner, Andrij; Lin, Yuchun; Deng, Shaozhong; Jacobs, Donald; Cai, Wei

    2013-01-01

    We present an order N method for calculating electrostatic interactions that has been integrated into the molecular dynamics portion of the TINKER Molecular Modeling package. This method, introduced in a previous paper [Y. Lin, A. Baumketner, S. Deng, Z. Xu, D. Jacobs, W. Cai, An image-based reaction field method for electrostatic interactions in molecular dynamics simulations of aqueous solutions, J. Chem. Phys. 131 (2009) 154103] and termed the Image-Charge Solvation Model (ICSM), is a hybrid electrostatic approach that combines the strengths of both explicit and implicit representations of the solvent. A multiple-image method is used to calculate reaction fields due to the implicit part while the Fast Multipole Method (FMM) is used to calculate the Coulomb interactions for all charges, including the explicit part. The integrated package is validated through test simulations of liquid water. The results are compared with those obtained by the Particle Mesh Ewald (PME) method that is built in the TINKER package. Timing performance of TINKER with the integrated ICSM is benchmarked on bulk water as a function of the size of the system. In particular, timing analysis results show that the ICSM outperforms the PME for sufficiently large systems with the break-even point at around 30,000 particles in the simulated system.

  1. 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.

  2. 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.

  3. A visible-light-excited fluorescence method for imaging protein crystals without added dyes.

    PubMed

    Lukk, Tiit; Gillilan, Richard E; Szebenyi, Doletha M E; Zipfel, Warren R

    2016-02-01

    Fluorescence microscopy methods have seen an increase in popularity in recent years for detecting protein crystals in screening trays. The fluorescence-based crystal detection methods have thus far relied on intrinsic UV-inducible tryptophan fluorescence, nonlinear optics or fluorescence in the visible light range dependent on crystals soaked with fluorescent dyes. In this paper data are presented on a novel visible-light-inducible autofluorescence arising from protein crystals as a result of general stabilization of conjugated double-bond systems and increased charge delocalization due to crystal packing. The visible-light-inducible autofluorescence serves as a complementary method to bright-field microscopy in beamline applications where accurate crystal centering about the rotation axis is essential. Owing to temperature-dependent chromophore stabilization, protein crystals exhibit tenfold higher fluorescence intensity at cryogenic temperatures, making the method ideal for experiments where crystals are cooled to 100 K with a cryostream. In addition to the non-damaging excitation wavelength and low laser power required for imaging, the method can also serve a useful role for differentiating protein crystals from salt crystals in screening trays.

  4. A visible-light-excited fluorescence method for imaging protein crystals without added dyes

    PubMed Central

    Lukk, Tiit; Gillilan, Richard E.; Szebenyi, Doletha M. E.; Zipfel, Warren R.

    2016-01-01

    Fluorescence microscopy methods have seen an increase in popularity in recent years for detecting protein crystals in screening trays. The fluorescence-based crystal detection methods have thus far relied on intrinsic UV-inducible tryptophan fluorescence, nonlinear optics or fluorescence in the visible light range dependent on crystals soaked with fluorescent dyes. In this paper data are presented on a novel visible-light-inducible autofluorescence arising from protein crystals as a result of general stabilization of conjugated double-bond systems and increased charge delocalization due to crystal packing. The visible-light-inducible autofluorescence serves as a complementary method to bright-field microscopy in beamline applications where accurate crystal centering about the rotation axis is essential. Owing to temperature-dependent chromophore stabilization, protein crystals exhibit tenfold higher fluorescence intensity at cryogenic temperatures, making the method ideal for experiments where crystals are cooled to 100 K with a cryostream. In addition to the non-damaging excitation wavelength and low laser power required for imaging, the method can also serve a useful role for differentiating protein crystals from salt crystals in screening trays. PMID:26937240

  5. 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.

  6. 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…

  7. Health multi-terminology portal: a semantic added-value for patient safety.

    PubMed

    Grosjean, Julien; Merabti, Tayeb; Dahamna, Badisse; Kergourlay, Ivan; Thirion, Benoit; Soualmia, Lina F; Darmoni, Stefan J

    2011-01-01

    Since the mid-90s, several quality-controlled health gateways were developed. In France, CISMeF is the leading health gateway. It indexes Internet resources from the main institutions, using the MeSH thesaurus and the Dublin Core metadata element set. Since 2005, the CISMeF Information System (IS) includes 24 health terminologies, classifications and thesauri for indexing and information retrieval. This work aims at creating a Health Multi-Terminology Portal (HMTP) and connect it to the CISMeF Terminology Database mainly for searching concepts and terms among all the health controlled vocabularies available in French (or in English and translated in French) and browsing it dynamically. To integrate the terminologies in the CISMeF IS, three steps are necessary: (1) designing a meta-model into which each terminology can be integrated, (2) developing a process to include terminologies into the HMTP, (3) building and integrating existing and new inter-terminology mappings into the HMTP. A total of 24 terminologies are included in the HMTP, with 575,300 concepts, 852,000 synonyms, 222,800 definitions and 1,180,000 relations. Heightteen of these terminologies are not included yet in the UMLS among them, some from the World Health Organization. Since January 2010, HMTP is daily used by CISMeF librarians to index in multi-terminology mode. A health multiterminology portal is a valuable tool helping the indexing and the retrieval of resources from a quality-controlled patient safety gateway. It can also be very useful for teaching or performing audits in terminology management.

  8. Omega 3 fatty acids induce a marked reduction of apolipoprotein B48 when added to fluvastatin in patients with type 2 diabetes and mixed hyperlipidemia: a preliminary report

    PubMed Central

    Valdivielso, Pedro; Rioja, José; García-Arias, Carlota; Sánchez-Chaparro, Miguel Angel; González-Santos, Pedro

    2009-01-01

    Backgorund Mixed hyperlipidemia is common in patients with diabetes. Statins, the choice drugs, are effective at reducing lipoproteins that contain apolipoprotein B100, but they fail to exert good control over intestinal lipoproteins, which have an atherogenic potential. We describe the effect of prescription omega 3 fatty acids on the intestinal lipoproteins in patients with type 2 diabetes who were already receiving fluvastatin 80 mg per day. Methods Patients with type 2 diabetes and mixed hyperlipidemia were recruited. Fasting lipid profile was taken when patients were treated with diet, diet plus 80 mg of fluvastatin and diet plus fluvastatin 80 mg and 4 g of prescription omega 3 fatty acids. The intestinal lipoproteins were quantified by the fasting concentration of apolipoprotein B48 using a commercial ELISA. Results The addition of 4 g of prescription omega 3 was followed by significant reductions in the levels of triglycerides, VLDL triglycerides and the triglyceride/HDL cholesterol ratio, and an increase in HDL cholesterol (P < 0.05). Fluvastatin induced a reduction of 26% in B100 (P < 0.05) and 14% in B48 (NS). However, the addition of omega 3 fatty acids enhanced this reduction to 32% in B100 (NS) and up to 36% in B48 (P < 0.05). Conclusion Our preliminary findings therefore suggest an additional benefit on postprandial atherogenic particles when omega 3 fatty acids are added to standard treatment with fluvastatin. PMID:19133114

  9. 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

  10. 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.

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

    PubMed Central

    Kim, Sioh; Seo, Jeongwon; Jeon, Younghoon

    2010-01-01

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

  12. Linagliptin added to sulphonylurea in uncontrolled type 2 diabetes patients with moderate-to-severe renal impairment.

    PubMed

    McGill, Janet B; Barnett, Anthony H; Lewin, Andrew J; Patel, Sanjay; Neubacher, Dietmar; von Eynatten, Maximilian; Woerle, Hans-Juergen

    2014-01-01

    Glucose-lowering treatment options are limited for uncontrolled type 2 diabetes mellitus (T2DM) patients with advanced stages of renal impairment (RI). This retrospective analysis evaluated glycaemic efficacy and tolerability of the dipeptidyl peptidase-4 inhibitor linagliptin added to sulphonylurea. Three randomized phase 3 studies (n = 619) including T2DM subjects with moderate or severe RI [estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m²] were analysed; only sulphonylurea-treated subjects who received additional linagliptin (n = 58) or placebo (n = 33) were evaluated. Linagliptin provided meaningful placebo-adjusted HbA1c reductions of -0.68% (95% confidence interval: -1.19, -0.17), -1.08% (-2.02, -0.14) and -0.62% (-1.25, 0.01) after 24, 18 and 12 weeks, respectively. There was a similar incidence of overall adverse events (linagliptin: 79.3%, placebo: 75.8%) and hypoglycaemia (linagliptin: 37.9%, placebo: 39.4%). Severe hypoglycaemia was more common with placebo (linagliptin: 1.7%, placebo: 6.1%). These data suggest that linagliptin is a safe and effective glucose-lowering treatment in T2DM patients with moderate-to-severe RI for whom sulphonylurea treatment is no longer sufficient.

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

    DOEpatents

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

    2012-01-17

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

  14. Added Sugars

    MedlinePlus

    ... need sugar to function properly. Added sugars contribute zero nutrients but many added calories that can lead to extra pounds or even obesity, thereby reducing heart health. If you think of your daily calorie needs as a budget, you want to “spend” ...

  15. 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,…

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

    PubMed Central

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

    2009-01-01

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

  17. 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.

  18. 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…

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

    PubMed

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

    2016-07-01

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

  20. Exenatide versus Insulin Lispro Added to Basal Insulin in a Subgroup of Korean Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Hardy, Elise; Han, Jenny

    2017-01-01

    Background The prevalence of type 2 diabetes mellitus (T2DM) and obesity is increasing in Korea. Clinical studies in patients with T2DM have shown that combining the glucagon-like peptide-1 receptor agonist exenatide twice daily with basal insulin is an effective glucose-lowering strategy. However, these studies were predominantly conducted in non-Asian populations. Methods We conducted a subgroup analysis of data from a multinational, 30-week, randomized, open-label trial to compare the effects of exenatide twice daily (n=10) or three times daily mealtime insulin lispro (n=13) among Korean patients with T2DM inadequately controlled (glycosylated hemoglobin [HbA1c] >7.0%) on metformin plus optimized insulin glargine. Results Exenatide twice daily and insulin lispro both reduced HbA1c (mean −1.5% and −1.0%, respectively; P<0.01 vs. baseline). Fasting glucose and weight numerically decreased with exenatide twice daily (−0.7 mmol/L and −0.7 kg, respectively) and numerically increased with insulin lispro (0.9 mmol/L and 1.0 kg, respectively). Minor hypoglycemia occurred in four patients receiving exenatide twice daily and three patients receiving insulin lispro. Gastrointestinal adverse events were the most common with exenatide twice daily treatment. Conclusion This analysis found treatment with exenatide twice daily improved glycemic control without weight gain in Korean patients with T2DM unable to achieve glycemic control on metformin plus basal insulin. PMID:28029018

  1. 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

  2. Adding Value.

    ERIC Educational Resources Information Center

    Orsini, Larry L.; Hudack, Lawrence R.; Zekan, Donald L.

    1999-01-01

    The value-added statement (VAS), relatively unknown in the United States, is used in financial reports by many European companies. Saint Bonaventure University (New York) has adapted a VAS to make it appropriate for not-for-profit universities by identifying stakeholder groups (students, faculty, administrators/support personnel, creditors, the…

  3. Inter-Method Reliability of School Effectiveness Measures: A Comparison of Value-Added and Regression Discontinuity Estimates

    ERIC Educational Resources Information Center

    Perry, Thomas

    2017-01-01

    Value-added (VA) measures are currently the predominant approach used to compare the effectiveness of schools. Recent educational effectiveness research, however, has developed alternative approaches including the regression discontinuity (RD) design, which also allows estimation of absolute school effects. Initial research suggests RD is a viable…

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

    PubMed

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

    2012-06-01

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

  5. 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…

  6. 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

  7. Engaging patients with heart failure into the design of health system interventions: Impact on research methods.

    PubMed

    Newhouse, Robin P; Johantgen, Meg; Thomas, Sue A; Trocky, Nina M; Dennison-Himmelfarb, Cheryl; Cheon, Jooyoung; Miller, Wanda; Gray, Tracy; Pruitt, Robin

    2017-02-19

    The purpose of this study was to engage patients with heart failure (HF) to assess if changes are needed in a research study design, methods and outcomes when transferring interventions used in urban/community hospitals to rural hospital settings. A qualitative structured interview was conducted with eight patients with a diagnosis of HF admitted to two rural hospitals. Patients validated the study design, measures and outcomes, but identified one area that should be added to the study protocol, symptom experience. Results validated that the intervention, methods and outcomes for the planned study were important, but modifications to the study protocol resulted. Patient engagement in the conceptualization of research is essential to guide patient-centered studies.

  8. 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.

  9. 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

  10. 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 Central

    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

  11. Adding dexmedetomidine to ropivacaine for lumbar plexus and sciatic nerve block for amputation of lower limb in high-risk patient-a case report.

    PubMed

    Wang, Chun-Guang; Ding, Yan-Ling; Han, Ai-Ping; Hu, Chang-Qing; Hao, Shi; Zhang, Fang-Fang; Li, Yong-Wang; Liu, Hu; Han, Zhe; Guo, De-Li; Zhang, Zhi-Qiang

    2015-01-01

    The ischemia necrosis of limb frequently requires surgery of amputation. Lumbar plexus and sciatic nerve block is an ideal intra-operative anesthetic and post-operative antalgic technique for patients of amputation, especially for high-risk patients who have severe cardio-cerebrovascular diseases. However, the duration of analgesia of peripheral nerve block is hardly sufficient to avoid the postoperative pain and the usage of opioids. In this case, a 79-year-old man, with multiple cerebral infarcts, congestive heart failure, atrial flutter and syncope, was treated with an above knee amputation because of ischemia necrosis of his left lower limb. Dexmedetomidine 1 μg/kg was added to 0.33% ropivacaine for lumbar plexus and sciatic nerve block in this case for intra-operative anesthesia and post-operative analgesia. The sensory function was blocked fully for surgery and the duration of analgesia maintained 26 hours with haemodynamic stability and moderate sedation. The patient did not complain pain and require any supplementary analgesics after surgery. This case showed that adding 1 μg/kg dexmedetomidine to ropivacaine for lumbar plexus and sciatic nerve block may be a feasible and safe technique for high-risk patients for lower limb surgery of amputation.

  12. Adding dexmedetomidine to ropivacaine for lumbar plexus and sciatic nerve block for amputation of lower limb in high-risk patient-a case report

    PubMed Central

    Wang, Chun-Guang; Ding, Yan-Ling; Han, Ai-Ping; Hu, Chang-Qing; Hao, Shi; Zhang, Fang-Fang; Li, Yong-Wang; Liu, Hu; Han, Zhe; Guo, De-Li; Zhang, Zhi-Qiang

    2015-01-01

    The ischemia necrosis of limb frequently requires surgery of amputation. Lumbar plexus and sciatic nerve block is an ideal intra-operative anesthetic and post-operative antalgic technique for patients of amputation, especially for high-risk patients who have severe cardio-cerebrovascular diseases. However, the duration of analgesia of peripheral nerve block is hardly sufficient to avoid the postoperative pain and the usage of opioids. In this case, a 79-year-old man, with multiple cerebral infarcts, congestive heart failure, atrial flutter and syncope, was treated with an above knee amputation because of ischemia necrosis of his left lower limb. Dexmedetomidine 1 μg/kg was added to 0.33% ropivacaine for lumbar plexus and sciatic nerve block in this case for intra-operative anesthesia and post-operative analgesia. The sensory function was blocked fully for surgery and the duration of analgesia maintained 26 hours with haemodynamic stability and moderate sedation. The patient did not complain pain and require any supplementary analgesics after surgery. This case showed that adding 1 μg/kg dexmedetomidine to ropivacaine for lumbar plexus and sciatic nerve block may be a feasible and safe technique for high-risk patients for lower limb surgery of amputation. PMID:26550393

  13. 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

  14. The use of the adding-doubling method for the optical optimization of planar luminescent down shifting layers for solar cells.

    PubMed

    Leyre, Sven; Cappelle, Jan; Durinck, Guy; Abass, Aimi; Hofkens, Johan; Deconinck, Geert; Hanselaer, Peter

    2014-05-05

    To enhance the efficiency of solar cells, a luminescent down shifting layer can be applied in order to adapt the solar spectrum to the spectral internal quantum efficiency of the semiconductor. Optimization of such luminescent down shifting layers benefits from quick and direct evaluation methods. In this paper, the potential of the adding-doubling method is investigated to simulate the optical behavior of an encapsulated solar cell including a planar luminescent down shifting layer. The results of the adding-doubling method are compared with traditional Monte Carlo ray tracing simulations. The average relative deviation is found to be less than 1.5% for the absorptance in the active layer and the reflectance from the encapsulated cell, while the computation time can be decreased with a factor 52. Furthermore, the adding-doubling method is adopted to investigate the suitability of the SrB4O7:5%Sm2 + ,5%Eu2 + phosphor as a luminescent down shifting material in combination with a Copper Indium Gallium Selenide solar cell. A maximum increase of 9.0% in the short-circuit current can be expected if precautions are taken to reduce the scattering by matching the refractive index of host material to the phosphor particles. To be useful as luminescent down shifting material, the minimal value of the quantum yield of the phosphor is determined to be 0.64.

  15. Patient Satisfaction With Postpartum Teaching Methods

    PubMed Central

    Wagner, Debra L.; Washington, Cynthia

    2016-01-01

    ABSTRACT Postpartum discharge instructions are a crucial part of a mother’s birth experience. Finding the method to provide those discharge instructions in a manner that increases the mother’s satisfaction with her hospital experience is important. This quasi-experimental study examined the relationship between new mothers’ interaction with nurses providing postpartum instructions by the traditional and class methods and their satisfaction with discharge teaching. The results indicated new mothers were satisfied with both methods of discharge teaching; however, they were more likely to report stronger agreement with overall satisfaction with the traditional method of discharge teaching than with attending the discharge class. PMID:27445450

  16. Patient Satisfaction With Postpartum Teaching Methods.

    PubMed

    Wagner, Debra L; Washington, Cynthia

    2016-01-01

    Postpartum discharge instructions are a crucial part of a mother's birth experience. Finding the method to provide those discharge instructions in a manner that increases the mother's satisfaction with her hospital experience is important. This quasi-experimental study examined the relationship between new mothers' interaction with nurses providing postpartum instructions by the traditional and class methods and their satisfaction with discharge teaching. The results indicated new mothers were satisfied with both methods of discharge teaching; however, they were more likely to report stronger agreement with overall satisfaction with the traditional method of discharge teaching than with attending the discharge class.

  17. 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

  18. Utility of adding Pneumocystis jirovecii DNA detection in nasopharyngeal aspirates in immunocompromised adult patients with febrile pneumonia.

    PubMed

    Guigue, Nicolas; Alanio, Alexandre; Menotti, Jean; Castro, Nathalie De; Hamane, Samia; Peyrony, Olivier; LeGoff, Jérôme; Bretagne, Stéphane

    2015-04-01

    Detection of viral and bacterial DNA in nasopharyngeal aspirates (NPAs) is now a routine practice in emergency cases of febrile pneumonia. We investigated whether Pneumocystis jirovecii DNA could also be detected in these cases by conducting retrospective screening of 324 consecutive NPAs from 324 adult patients (198 or 61% were immunocompromised) admitted with suspected pulmonary infections during the 2012 influenza epidemic season, using a real-time quantitative polymerase chain reaction (PCR) assay (PjqPCR), which targets the P. jirovecii mitochondrial large subunit ribosomal RNA gene. These NPAs had already been tested for 22 respiratory pathogens (18 viruses and 4 bacteria), but we found that 16 NPAs (4.9%) were PjqPCR-positive, making P. jirovecii the fourth most prevalent of the 23 microorganisms in the screen. Eleven of the 16 PjqPCR-positive patients were immunocompromised, and five had underlying pulmonary conditions. Nine NPAs were also positive for another respiratory pathogen. Six had PjqPCR-positive induced sputa less than 3 days after the NPA procedure, and five were diagnosed with pneumocystis pneumonia (four with chronic lymphoproliferative disorders and one AIDS patient). In all six available pairs quantification of P. jirovecii DNA showed fewer copies in NPA than in induced sputum and three PjqPCR-negative NPAs corresponded to PjqPCR-positive bronchoalveolar lavage fluids, underscoring the fact that a negative PjqPCR screen does not exclude a diagnosis of pneumocystosis. Including P. jirovecii DNA detection to the panel of microorganisms included in screening tests used for febrile pneumonia may encourage additional investigations or support use of anti-pneumocystis pneumonia prophylaxis in immunocompromised patients.

  19. 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.

  20. Large transport Jc in Sn-added SmFeAsO1-xFx tapes prepared by an ex situ PIT method

    NASA Astrophysics Data System (ADS)

    Wang, Chunlei; Yao, Chao; Lin, He; Zhang, Xianping; Zhang, Qianjun; Wang, Dongliang; Ma, Yanwei; Awaji, S.; Watanabe, K.; Tsuchiya, Y.; Sun, Y.; Tamegai, T.

    2013-07-01

    SmFeAsO1-xFx possesses the highest superconducting transition temperature (Tc) among the iron-based superconductors, with a very high upper critical field and critical current density (Jc). All these are desirable for practical applications. Although tremendous progress has been made in improving the Jc values for Sr(Ba)-122 tapes or wires [1-3], the transport Jc of Sm1111 tapes or wires is still very low. Here we report on large transport critical current densities observed in Sn-added SmFeAsO1-xFx/Fe tapes produced by an ex situ powder-in-tube (PIT) method. It was found that the loss of fluorine was reduced and the intergranular coupling was enhanced in the Sn-added samples. As a result, the onset and offset Tc values for 10 wt%, 20 wt% and 30 wt% Sn-added samples were 52 K and 35 K, 53 K and 39 K, and 54 K and 41.5 K, respectively. In particular, a transport Jc as large as 22 000 A cm-2 (Ic = 160 A) at 4.2 K under self-field was achieved in 30 wt% Sn-added specimens, which is the highest value reported so far for SmFeAsO1-xFx wires and tapes. Magneto-optical imaging further showed that there were large global currents over the whole sample, which is consistent with the results obtained by the four-probe method.

  1. Concentration of Donepezil in the Cerebrospinal Fluid of AD Patients: Evaluation of Dosage Sufficiency in Standard Treatment Strategy.

    PubMed

    Valis, Martin; Masopust, Jiri; Vysata, Oldrich; Hort, Jakub; Dolezal, Rafael; Tomek, Jiri; Misik, Jan; Kuca, Kamil; Karasova, Jana Zdarova

    2017-01-01

    Although some studies have described the pharmacokinetics and pharmacodynamics of donepezil in the peripheral compartment, studies focused on drug transport across the blood-brain barrier are still very rare. To our knowledge, the fluctuation in the cerebrospinal fluid concentration of donepezil after administration of the drug has not been described in the literature so far. We recruited 16 patients regularly taking a standard therapeutic dose of donepezil (10 mg per day). All patients (Caucasian race) were treated for at least three months with a stable dose of 10 mg per day prior to sample collection. Patients were divided into two groups depending on the time of plasma and cerebrospinal fluid sampling: 12 h (n = 9; 4 M/5F aged 78.68 ± 7.35 years) and 24 h (n = 7; 3 M/4F aged 77.14 ± 5.87 years) after donepezil administration. The cerebrospinal fluid sample was collected by standard lumbar puncture technique using a single-use traumatic needle. The samples were analysed on an Agilent 1260 Series liquid chromatograph comprising a degasser, a quaternary pump, a light-tight autosampler unit set, a thermostated column compartment, and a UV/VIS detector. Agilent ChemStation software, the statistical software Prism4, version 5.0 (GraphPad Software, USA), and IBM(®) SPSS(®) Statistics were used for the analysis of the results. The difference in plasma concentration of donepezil after 12 h (mean ± SEM; 39.99 ± 5.90 ng/ml) and after 24 h (29.38 ± 1.71 ng/ml) was nonsignificant. In contrast, the donepezil concentration in the cerebrospinal fluid was significantly higher in the 24-h interval (7.54 ± 0.55 ng/ml) compared with the 12-h interval (5.19 ± 0.83 ng/ml, which is ~70 % based on mean cerebrospinal fluid values). Based on these data, it is plausible to predict that donepezil might produce a stronger AChE inhibition in the brain at 24 h compared with 12 h following the administration. This information may help physicians

  2. 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…

  3. Effects of sitagliptin or metformin added to pioglitazone monotherapy in poorly controlled type 2 diabetes mellitus patients.

    PubMed

    Derosa, Giuseppe; Maffioli, Pamela; Salvadeo, Sibilla A T; Ferrari, Ilaria; Ragonesi, Pietro D; Querci, Fabrizio; Franzetti, Ivano G; Gadaleta, Gennaro; Ciccarelli, Leonardina; Piccinni, Mario N; D'Angelo, Angela; Cicero, Arrigo F G

    2010-06-01

    The aim of the study was to compare the effects of the addition of sitagliptin or metformin to pioglitazone monotherapy in poorly controlled type 2 diabetes mellitus patients on body weight, glycemic control, beta-cell function, insulin resistance, and inflammatory state parameters. One hundred fifty-one patients with uncontrolled type 2 diabetes mellitus (glycated hemoglobin [HbA(1c)] >7.5%) in therapy with pioglitazone 30 mg/d were enrolled in this study. We randomized patients to take pioglitazone 30 mg plus sitagliptin 100 mg once a day, or pioglitazone 15 mg plus metformin 850 mg twice a day. We evaluated at baseline and after 3, 6, 9, and 12 months these parameters: body weight, body mass index, HbA(1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), homeostasis model assessment beta-cell function index, fasting plasma proinsulin (Pr), Pr/FPI ratio, adiponectin, resistin (R), tumor necrosis factor-alpha (TNF-alpha), and high-sensitivity C-reactive protein. A decrease of body weight and body mass index was observed with metformin, but not with sitagliptin, at the end of the study. We observed a comparable significant decrease of HbA(1c), FPG, and PPG and a significant increase of homeostasis model assessment beta-cell function index compared with baseline in both groups without any significant differences between the 2 groups. Fasting plasma insulin, fasting plasma Pr, Pr/FPI ratio, and HOMA-IR values were decreased in both groups even if the values obtained with metformin were significantly lower than the values obtained with sitagliptin. There were no significant variations of ADN, R, or TNF-alpha with sitagliptin, whereas a significant increase of ADN and a significant decrease of R and TNF-alpha values were recorded with metformin. A significant decrease of high-sensitivity C-reactive protein value was obtained in both groups without any

  4. Adding hormonal therapy to chemotherapy and trastuzumab improves prognosis in patients with hormone receptor-positive and human epidermal growth factor receptor 2-positive primary breast cancer.

    PubMed

    Hayashi, Naoki; Niikura, Naoki; Yamauchi, Hideko; Nakamura, Seigo; Ueno, Naoto T

    2013-01-01

    Adjuvant hormonal therapy for hormone receptor (HR)-positive primary breast cancer patients and a human epidermal growth factor receptor 2 (HER2)-targeted agent for HER2-positive primary breast cancer patients are standard treatment. However, it is not well known whether adding hormonal therapy to the combination of preoperative or postoperative chemotherapy and HER2-targeted agent contributes any additional clinical benefit in patients with HR-positive/HER2-positive primary breast cancer regardless of cross-talk between HR and HER2. We retrospectively reviewed records from 897 patients with HR-positive/HER2-positive primary breast cancer with clinical stage I-III disease who underwent surgery between 1988 and 2009. We determined the overall survival (OS) and disease-free survival (DFS) rates according to whether they received hormonal therapy or not and according to the type of hormonal therapy, tamoxifen and aromatase inhibitor, they received. The median followup time was 52.8 months (range 1-294.6 months). Patients who received hormonal therapy with chemotherapy and trastuzumab (n = 128) had significantly higher OS and DFS rates than did those who received only chemotherapy and trastuzumab (n = 46) in log-rank analysis (OS 96.1 vs. 87.0 %, p = 0.023, DFS 86.7 vs. 78.3 %, p = 0.029). There was no statistical difference in OS or DFS between those given an aromatase inhibitor and those given tamoxifen. In multivariate analysis, receiving hormonal therapy in addition to the combination of chemotherapy and trastuzumab was the sole independent prognostic factor for DFS (hazard ratio 0.446; 95 % CI 0.200-0.992; p = 0.048), and there was a similar trend in OS. Our study supported that hormonal therapy, whether in the form of an aromatase inhibitor or tamoxifen, confers a survival benefit when added to chemotherapy and trastuzumab in patients with HR-positive/HER2-positive primary breast cancer. Adjuvant treatment without hormonal therapy is inferior for this patient

  5. Influence of Distillation Temperature in the Determination of Added Sulfites in Dehydrated Garlic Powders Using the Modified Optimized Monier-Williams Method.

    PubMed

    2016-04-08

    Influence of distillation temperature on the determination of added sulfites in dehydrated garlic originating from China and California using the modified optimized Monier-Williams method was evaluated. In the study, the temperature of the distillation was monitored and maintained from 90° to 95°C instead of boiling temperature (>95°C). Samples from 38 unsulfited dehydrated garlic powders were analyzed at the 90° to 95°C temperature and at boiling temperature (>95°C) at 94 m above sea level. At the boiling distillation temperature, 25 of the 38 unsulfited garlic samples had a positive result for sulfite content ranging from 10.2 to 14.1 ppm using the modified optimized Monier-Williams procedure. Maintaining distillation temperature between 90° and 95°C eliminated false-positive results for added sulfite and had an average spiked sulfite recovery of 95.6% with a coefficient of variation of 3.79%. Lowering of the distillation temperature decreases the possible acid hydrolysis of organosulfur compounds that can lead to positive added sulfite results in unsulfited dehydrated garlic samples.

  6. Adding diet and exercise counseling to the health promotion plan alleviates anthropometric and metabolic complications in patients with metabolic syndrome.

    PubMed

    Morita-Suzuki, S; Fujioka, Y; Mitsuoka, H; Tashiro, M; Harada, M

    2012-01-01

    We investigated the effects of individual (IC) and group (GC) diet and exercise counseling in men with metabolic syndrome. Participants received exercise instruction and exercise load was monitored. IC participants received individual diet counseling sessions and general consultations at baseline and monthly. GC participants received a group diet counseling session at baseline and general consultations at baseline and monthly. In the IC group, body mass index (BMI) percent body fat, waist circumference, diastolic blood pressure, low-density lipoprotein cholesterol, glycosylated hemoglobin A1c, and liver function levels were reduced significantly after 3 months, whereas in the GC group, waist circumference and levels of liver function were reduced. Exercise load was negatively correlated with change in BMI and waist circumference in the IC group, and positively correlated with changes in high-density lipoprotein cholesterol levels in all subjects and in the GC group. Diet and exercise counseling, especially IC, may benefit patients with metabolic syndrome.

  7. Orientifolded locally AdS3 geometries

    NASA Astrophysics Data System (ADS)

    Loran, F.; Sheikh-Jabbari, M. M.

    2011-01-01

    Continuing the analysis of [Loran F and Sheikh-Jabbari M M 2010 Phys. Lett. B 693 184-7], we classify all locally AdS3 stationary axi-symmetric unorientable solutions to AdS3 Einstein gravity and show that they are obtained by applying certain orientifold projection on AdS3, BTZ or AdS3 self-dual orbifold, respectively, O-AdS3, O-BTZ and O-SDO geometries. Depending on the orientifold fixed surface, the O-surface, which is either a space-like 2D plane or a cylinder, or a light-like 2D plane or a cylinder, one can distinguish four distinct cases. For the space-like orientifold plane or cylinder cases, these geometries solve AdS3 Einstein equations and are hence locally AdS3 everywhere except at the O-surface, where there is a delta-function source. For the light-like cases, the geometry is a solution to Einstein equations even at the O-surface. We discuss the causal structure for static, extremal and general rotating O-BTZ and O-SDO cases as well as the geodesic motion on these geometries. We also discuss orientifolding Poincaré patch AdS3 and AdS2 geometries as a way to geodesic completion of these spaces and comment on the 2D CFT dual to the O-geometries.

  8. 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.

  9. [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.

  10. Rationale, design and organisation of an efficacy and safety study of oxypurinol added to standard therapy in patients with NYHA class III - IV congestive heart failure.

    PubMed

    Freudenberger, Ronald S; Schwarz, Richard P; Brown, Joanne; Moore, Alan; Mann, Douglas; Givertz, Michael M; Colucci, Wilson S; Hare, Joshua M

    2004-11-01

    Oxypurinol, the active metabolite of allopurinol and a potent xanthine oxidase inhibitor (XOI), is under evaluation as a novel agent for the treatment of congestive heart failure (HF). Several lines of evidence provide the rationale for the hypothesis that XOIs will improve clinical outcomes in patients with HF. First, XOIs have unique positive inotropic effects, improving myocardial contraction and performance while simultaneously improving myocardial energy metabolism. Second, XOIs ameliorate endothelial dysfunction in humans with HF. Finally, XO activity is upregulated in the heart and vasculature of subjects with HF, which may in turn contribute to oxidative stress and/or increased uric acid levels. Together these findings form the rationale for the Controlled Efficacy and Safety Study of Oxypurinol Added to Standard Therapy in Patients with New York Heart Association (NYHA) class III - IV Congestive Heart Failure (OPT-CHF) trial (Food and Drug Administration IND 65,125), a Phase II - III prospective, randomised, double-blind, placebo-controlled trial, which will include patients with stable symptomatic HF in NYHA class III - IV congestive HF who are deemed clinically stable on a standard and appropriately maximised heart failure therapy regimen. The efficacy end point for OPT-CHF is a composite that incorporates measures of patient outcome and well-being.

  11. 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.

  12. 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.

  13. AdS-Carroll branes

    NASA Astrophysics Data System (ADS)

    Clark, T. E.; ter Veldhuis, T.

    2016-11-01

    Coset methods are used to determine the action of a co-dimension one brane (domain wall) embedded in (d + 1)-dimensional AdS space in the Carroll limit in which the speed of light goes to zero. The action is invariant under the non-linearly realized symmetries of the AdS-Carroll spacetime. The Nambu-Goldstone field exhibits a static spatial distribution for the brane with a time varying momentum density related to the brane's spatial shape as well as the AdS-C geometry. The AdS-C vector field dual theory is obtained.

  14. Rapid calculation of diffuse reflectance from a multilayered model by combination of the white Monte Carlo and adding-doubling methods

    PubMed Central

    Yoshida, Kenichiro; Nishidate, Izumi

    2014-01-01

    To rapidly derive a result for diffuse reflectance from a multilayered model that is equivalent to that of a Monte-Carlo simulation (MCS), we propose a combination of a layered white MCS and the adding-doubling method. For slabs with various scattering coefficients assuming a certain anisotropy factor and without absorption, we calculate the transition matrices for light flow with respect to the incident and exit angles. From this series of precalculated transition matrices, we can calculate the transition matrices for the multilayered model with the specific anisotropy factor. The relative errors of the results of this method compared to a conventional MCS were less than 1%. We successfully used this method to estimate the chromophore concentration from the reflectance spectrum of a numerical model of skin and in vivo human skin tissue. PMID:25426319

  15. Alternative method for the quantification by gas chromatography triacylglycerol class analysis of cocoa butter equivalent added to chocolate bars.

    PubMed

    Guyon, François; Destouesse, Sarah; Moustirats, Joëlle; Esclapez, Maryse; Salagoity, Marie-Hélène; Medina, Bernard

    2004-05-19

    Directive 2000/36/EC allows chocolate makers to add up to 5% of only six specific cocoa butter equivalents (CBEs) to cocoa butter (CB). A quantification method based on triacylglycerol (TAG) class analysis by gas chromatography with an unpolar column was set up for routine control purposes of chocolate bars. Mixtures of CBEs/CB were elaborated according to a Placket-Burman experiment design and analyzed by gas chromatography. A matrix was built with the normalized values of TAG classes (C50, C52, C54, and C56) of pure CBs of various origins, homemade CB/CBE mixtures (1 CB type), and mixtures containing CBE with CBs of various origins. A multivariate calibration equation was computed from this matrix using a partial least-squares regression technique. CBE addition can be detected at a minimum level of 2%, and the mathematical model allows its quantification with an uncertainty of 2% with respect to the cocoa butter fats. The model has also been applied for deconvolution and quantification of each CBE of a CBE mixture in chocolate bars.

  16. [Methods used in the hospital for patients' sleep improvement].

    PubMed

    Ryhänen, A; Kuivalainen, L; Meriläinen, P; Isola, A

    1998-01-01

    The purpose of this article is to describe methods used in the hospital for sleep improvement. The article is based on a study of patients' sleep in a Finnish hospital's medical or surgical ward. The patients of the Central Hospital of Northern Carelia's two medical and two surgical wards took part in the research. The data were collected by a structured questionnaire in May-June 1996. Of the replies of 181 patients, the results of 177 were taken to the final analysis. The data were analysed by statistical methods. The data and the results are presented in frequency and percent distributions. The most common method used by the patients to improve their sleep was to choose a good sleeping position. Other methods, which were often used, were reading, watching TV, having a snack, taking a warm shower or praying. The nurses were versatile in using the available methods of nursing for helping the patients to sleep. They informed the patients about their illnesses, nursing regime and the forthcoming operations, consoling and giving support to them. The nurses also organised sleep-supporting environment and gave painkillers and sleeping pills. About 60% of the researched patients were of the opinion, that sleeping tablets were prescribed too often. The patients themselves regarded the information and knowledge about their own treatment as the best way to improve their sleep.

  17. 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

  18. Distinct cerebral perfusion patterns in FTLD and AD

    PubMed Central

    Hu, W.T.; Wang, Z.; Lee, V.M.-Y.; Trojanowski, J.Q.; Detre, J.A.; Grossman, M.

    2010-01-01

    Objective: We examined the utility of distinguishing between patients with frontotemporal lobar degeneration (FTLD) and Alzheimer disease (AD) using quantitative cerebral blood flow (CBF) imaging with arterial spin labeled (ASL) perfusion MRI. Methods: Forty-two patients with FTLD and 18 patients with AD, defined by autopsy or CSF-derived biomarkers for AD, and 23 matched controls were imaged with a continuous ASL method to quantify CBF maps covering the entire brain. Results: Patients with FTLD and AD showed distinct patterns of hypoperfusion and hyperperfusion. Compared with controls, patients with FTLD showed significant hypoperfusion in regions of the frontal lobe bilaterally, and hyperperfusion in posterior cingulate and medial parietal/precuneus regions. Compared with controls, patients with AD showed significant hypoperfusion in the medial parietal/precuneus and lateral parietal cortex, and hyperperfusion in regions of the frontal lobe. Direct comparison of patient groups showed significant inferior, medial, and dorsolateral frontal hypoperfusion in FTLD, and significant hypoperfusion in bilateral lateral temporal-parietal and medial parietal/precuneus regions in AD. Conclusions: Doubly dissociated areas of hypoperfusion in FTLD and AD are consistent with areas of significant histopathologic burden in these groups. ASL is a potentially useful biomarker for distinguishing patients with these neurodegenerative diseases. GLOSSARY Aβ42 = β-amyloid1-42; AD = Alzheimer disease; ASL = arterial spin labeling; bvFTD = behavioral-variant frontotemporal dementia; cASL = continuous arterial spin labeling; CBS = corticobasal syndrome; CBF = cerebral blood flow; dACC = dorsal anterior cingulate cortex; dlPFC = dorsolateral prefrontal cortex; FDR = false detection rate; FTLD = frontotemporal lobar degeneration; GM = gray matter; iFC = inferior frontal cortex; MCI = mild cognitive impairment; MNI = Montreal Neurological Institute; mTC = middle temporal cortex; OFC

  19. [Combinative methods of treatment of patients with complicated urolithiasis].

    PubMed

    Kochetov, A G; Sitnikov, N V; Gvasaliia, B R; Sidorov, O V; Ponomarev, V K; Borshevetskiĭ, A A; Pavlov, D V

    2013-05-01

    The authors showed that urolithiasis is the second disease after inflammatory nonspecific kidney and urinary tract diseases and has a tendency to increase. 3-5% of patients suffer this disease, and 30-40% of all patients of urology in-patients department suffer nephrolithiasis. Introduction into clinical practice of modern minimally invasive treatment methods changed the paradigm of treatment of urolithiasis, especially coral type nephrolithiasis - cause of 15-50% of all renal calculi. The authors presented results of combinative treatment of 183 patients with different complicated forms of urolithiasis. The technique of percutaneous nephrolithotripsy (in supine position) was modified. It helped to reduce complications, time of surgery and radiation exposure. The effectiveness of simultaneous contact ureterolithotripsy and percutaneous nephrolithotripsy in patients with renal or ureters calculi, and simultaneous litholysis and distance lithotripsy in patients with metabolic disorders is shown. Combinative methods of treatment of complicated forms of urolithiasis are based on modern minimally invasive technologies and are very effective.

  20. Methods of measuring patient satisfaction in health care organizations.

    PubMed

    Ford, R C; Bach, S A; Fottler, M D

    1997-01-01

    Patient perceptions of the quality of services provided is a key factor (along with cost effectiveness) in determining a health care organization's competitive advantage and survival. This article examines the advantages, disadvantages, and problems associated with nine different methods of measuring patient satisfaction with service quality. The appropriateness of each of these techniques under different organizational conditions is also discussed. The article concludes with guidelines for measurement of patient satisfaction and implementation of managerial follow-up.

  1. Warped AdS3 black holes

    NASA Astrophysics Data System (ADS)

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

    2009-03-01

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

  2. Warped AdS3 black holes

    NASA Astrophysics Data System (ADS)

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

    2009-03-01

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

  3. Do patients on oral chemotherapy have sufficient knowledge for optimal adherence? A mixed methods study.

    PubMed

    Arber, A; Odelius, A; Williams, P; Lemanska, A; Faithfull, S

    2017-03-01

    A new treatment paradigm has emerged with many patients now receiving oral chemotherapy (OC) as first-line treatment for cancer. Treatment with OC has resulted in reduced hospital costs, more autonomy for patients but with added responsibilities for patient self-management. Little is known about patient's knowledge following patient education to enable optimal adherence with OC. A mixed methods study was carried out using a self-report questionnaire to patients on OC for multiple myeloma (MM) followed by semi-structured interviews with patients at home. Analysis identifies high rates of adherence (92.2%) with OC for MM. However, statistically significant knowledge deficits were identified, which were related to patient ethnicity and to gender. There is the potential for non-intentional non-adherence with OC due to deficits in knowledge of OC. Support at home needs to include primary care practitioners such as GPs, practice nurses and pharmacists so that timely support is easily accessible especially in the early phase of treatment.

  4. Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: a meta-analysis of randomized trials.

    PubMed

    Pöpping, Daniel M; Elia, Nadia; Marret, Emmanuel; Wenk, Manuel; Tramèr, Martin R

    2012-04-01

    Opioids are widely used as additives to local anesthetics for intrathecal anesthesia. Benefit and risk remain unclear. We systematically searched databases and bibliographies to February 2011 for full reports of randomized comparisons of any opioid added to any intrathecal local anesthetic with the local anesthetic alone in adults undergoing surgery (except cesarean section) and receiving single-shot intrathecal anesthesia without general anesthesia. We included 65 trials (3338 patients, 1932 of whom received opioids) published between 1983 and 2010. Morphine (0.05-2mg) and fentanyl (10-50 μg) added to bupivacaine were the most frequently tested. Duration of postoperative analgesia was prolonged with morphine (weighted mean difference 503 min; 95% confidence interval [CI] 315 to 641) and fentanyl (weighted mean difference 114 min; 95% CI 60 to 168). Morphine decreased the number of patients needing opioid analgesia after surgery and decreased pain intensity to the 12th postoperative hour. Morphine increased the risk of nausea (number needed to harm [NNH] 9.9), vomiting (NNH 10), urinary retention (NNH 6.5), and pruritus (NNH 4.4). Fentanyl increased the risk of pruritus (NNH 3.3). With morphine 0.05 to 0.5mg, the NNH for respiratory depression varied between 38 and 59 depending on the definition of respiratory depression chosen. With fentanyl 10 to 40 μg, the risk of respiratory depression was not significantly increased. For none of these effects, beneficial or harmful, was there evidence of dose-responsiveness. Consequently, minimal effective doses of intrathecal morphine and fentanyl should be sought. For intrathecal buprenorphine, diamorphine, hydromorphone, meperidine, methadone, pentazocine, sufentanil, and tramadol, there were not enough data to allow for meaningful conclusions.

  5. 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.

  6. What Do We Know about Using Value-Added to Compare Teachers Who Work in Different Schools? What We Know Series: Value-Added Methods and Applications. Knowledge Brief 10

    ERIC Educational Resources Information Center

    Raudenbush, Stephen

    2013-01-01

    This brief considers the problem of using value-added scores to compare teachers who work in different schools. The author focuses on whether such comparisons can be regarded as fair, or, in statistical language, "unbiased." An unbiased measure does not systematically favor teachers because of the backgrounds of the students they are…

  7. A method for working with displeased patients-blast.

    PubMed

    Steinman, Howard K

    2013-03-01

    Clinicians inevitably encounter patients with complaints and concerns about the quality of their care. This causes some to experience anxiety, fear, anger, resentment, guilt, and depression, especially when they believe they may have erred or caused harm. Lack of customer-service training and experience may contribute to these emotions. The "BLAST" technique is a complaint-resolution method that is useful in patient care and as a clinical teaching tool. The mnemonic stands for: Believe (what the patient is saying), Listen (actively, to assess and restate the patient's unmet expectations), Apologize (for the patient's unmet expectations), Satisfy (the patient), and Thank (the patient for expressing his/her concerns and providing a second chance to satisfy the patient). The technique appears to help clinicians become more at ease and confident when handling patient complaints. This may be especially helpful for clinicians who must routinely interact with post-treatment and post-procedure patients who commonly express surprise, concern, or complaints about their results and healing. BLAST may be an effective teaching tool enabling students, residents, and clinicians to become more comfortable and adept at working with displeased and concerned patients.

  8. 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

  9. Mystery cloud of AD 536

    NASA Technical Reports Server (NTRS)

    Stothers, R. B.

    1984-01-01

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

  10. 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.

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

    PubMed

    Niimi, Yukari; Ota, Katsumasa

    2017-02-01

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

  12. 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.

  13. 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.

  14. Assessment of methods for amino acid matrix selection and their use on empirical data shows that ad hoc assumptions for choice of matrix are not justified

    PubMed Central

    Keane, Thomas M; Creevey, Christopher J; Pentony, Melissa M; Naughton, Thomas J; Mclnerney, James O

    2006-01-01

    Background In recent years, model based approaches such as maximum likelihood have become the methods of choice for constructing phylogenies. A number of authors have shown the importance of using adequate substitution models in order to produce accurate phylogenies. In the past, many empirical models of amino acid substitution have been derived using a variety of different methods and protein datasets. These matrices are normally used as surrogates, rather than deriving the maximum likelihood model from the dataset being examined. With few exceptions, selection between alternative matrices has been carried out in an ad hoc manner. Results We start by highlighting the potential dangers of arbitrarily choosing protein models by demonstrating an empirical example where a single alignment can produce two topologically different and strongly supported phylogenies using two different arbitrarily-chosen amino acid substitution models. We demonstrate that in simple simulations, statistical methods of model selection are indeed robust and likely to be useful for protein model selection. We have investigated patterns of amino acid substitution among homologous sequences from the three Domains of life and our results show that no single amino acid matrix is optimal for any of the datasets. Perhaps most interestingly, we demonstrate that for two large datasets derived from the proteobacteria and archaea, one of the most favored models in both datasets is a model that was originally derived from retroviral Pol proteins. Conclusion This demonstrates that choosing protein models based on their source or method of construction may not be appropriate. PMID:16563161

  15. [Hemostasis management in multiple trauma patients--value of near-patient diagnostic methods].

    PubMed

    Jámbor, Csilla; Heindl, Bernhard; Spannagl, Michael; Rolfes, Caroline; Dinges, Gerhard Klaus; Frietsch, Thomas

    2009-03-01

    Massively transfused multiple trauma patients commonly develop a complex coagulopathy which needs immediate treatment. Near-patient diagnostic methods are available for the management of this coagulopathy and for the guidance of the therapeutic options with blood products and haemostatic drugs: conventional laboratory analysis methods adapted to the point-of-care (POC) situation (blood gas analysis, point of care PT, APTT and platelet count), and the complex whole blood methods used for near-patient coagulation monitoring (thromboelastometry and platelet function analysis). Based on the new Guidelines of the German Medical Association for the use of blood and plasma derivates, interventions with blood products and haemostatic drugs in multiple trauma patients are suggested. The diagnostic value of near-patient methods for coagulation monitoring is discussed.

  16. Comparison of three methods of recalling patients for influenza vaccination.

    PubMed

    McDowell, I; Newell, C; Rosser, W

    1986-11-01

    Despite recommendations supporting annual influenza vaccination for people aged 65 years or older, vaccination rates remain low. Several studies have evaluated the effect of sending mailed reminders, but few have compared alternative ways of reminding patients to receive the vaccine. In a randomized trial of 939 patients aged 65 years or older in four family practices carried out between Oct. 23 and Dec. 31, 1984, we compared three ways of reminding elderly patients to receive the vaccine: personal reminder by the physician, telephone reminder by the nurse and reminder by letter. The vaccination rates for the three groups were 22.9%, 37% and 35.1% respectively. No reminder was issued to a control group, and the rate was 9.8%. Some patients could not be reached by telephone, and some did not see the physician during the specified time. Among the patients whom the nurse actually contacted, the vaccination rate was 43.5%; the rate for patients whom the doctor actually saw was 45.1%. Overall, a telephone reminder by the nurse was the most effective method, and at an hourly salary of $16 or less this method would also be the most cost-effective. The reminders used in this study were automatically generated from a computerized medical record system. The study shows how a computerized system can be used to identify patients for whom preventive procedures are due.

  17. Qualitative Methods in Patient-Centered Outcomes Research.

    PubMed

    Vandermause, Roxanne; Barg, Frances K; Esmail, Laura; Edmundson, Lauren; Girard, Samantha; Perfetti, A Ross

    2016-09-14

    The Patient-Centered Outcomes Research Institute (PCORI), created to fund research guided by patients, caregivers, and the broader health care community, offers a new research venue. Many (41 of 50) first funded projects involved qualitative research methods. This study was completed to examine the current state of the science of qualitative methodologies used in PCORI-funded research. Principle investigators participated in phenomenological interviews to learn (a) how do researchers using qualitative methods experience seeking funding for, implementing and disseminating their work; and (b) how may qualitative methods advance the quality and relevance of evidence for patients? Results showed the experience of doing qualitative research in the current research climate as "Being a bona fide qualitative researcher: Staying true to research aims while negotiating challenges," with overlapping patterns: (a) researching the elemental, (b) expecting surprise, and (c) pushing boundaries. The nature of qualitative work today was explicitly described and is rendered in this article.

  18. 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.

  19. 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…

  20. Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

    PubMed Central

    Taibbi, Adele; Anastasi, Andrea; Lagalla, Roberto

    2017-01-01

    Purpose The aim of this study is to assess the role of contrast-enhanced ultrasonography (CEUS) in the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale ultrasonography (US). Methods Thirty-seven consecutive cancer patients (24 women and 13 men; age, 33 to 80 years; mean, 58.1 years) with geographic liver fatty deposition, but without any detectable focal liver lesion on greyscale US, underwent sulphur hexafluoride-enhanced US. Two readers reported by consensus the presence, size, and location of any detected lesion. All patients underwent magnetic resonance imaging (MRI) as a confirmatory study. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy were calculated. Results Seven focal liver lesions (size, 4 to 10 mm; mean, 6.1 mm) were detected in 4/37 patients (10.8%): four metastases (size, 5 to 10 mm; mean, 6.7 mm) were detected both by CEUS and MRI, with one hemangioma and two cysts (size range, 4 to 6 mm; mean, 5.3 mm) detected by MRI only. In 1/37 patients (2.7%), CEUS misdiagnosed geographic fatty change as three metastases. In 32/37 patients (86.5%), no lesions were detected. Sensitivity, specificity, PPV, NPV, and accuracy of CEUS were 100% (95% confidence Interval [CI], 1.000 to 1.000), 97.1% (95% CI, 0.914 to 1.027), 75%, 100%, and 97.3%, respectively. No statistically significant differences were found between CEUS and MRI in the detection of focal liver lesions (P=0.480), whereas both of them performed better than baseline US (P<0.001). Conclusion CEUS improves the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale US. PMID:28145108

  1. 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

  2. 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 .

  3. Oncology patients pose challenge in choosing birth control method.

    PubMed

    Neinstein, L S; Katz, B

    1985-04-01

    who are treated with either chemotherapy or radiation during the 1st trimester. Cancer patients should be provided with appropriate contraceptive counseling. Some patients are instructed by their physicians to avoid pregnancy for 1 year following chemotherapy. Pregnancies may also need to be timed so as not to interfere with the disease's management schedule. Counselors should help patients select an effective method, avoid oral contraceptives if the disease is hormonal dependent, and chose a method appropriate to the severity and prognosis of the disease. Consideration should be given to the risk of IUD failure if the patient is being treated with steroids. In addition, counselors should advise patients who received chemotherapy or radiation therapy during the 1st trimester to consider abortion.

  4. 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.

  5. Using mixed methods to identify factors influencing patient flow.

    PubMed

    Van Vaerenbergh, Cindy

    2009-11-01

    An effective method of identifying operational factors that influence patient flow can potentially lead to improvements and thus have huge benefits on the efficiency of hospital departments. This paper presents a new inductive mixed-method approach to identify operational factors that influence patient flow through an accident and emergency (A&E) department. Preliminary explorative observations were conducted, followed by semi-structured interviews with key stakeholders. A questionnaire survey of all medical, nursing, porter and clerical staff was then conducted. The observations provided factors for further exploration: skill-mix, long working hours, equipment availability, lack of orientation programmes, inefficient IT use and issues regarding communication structures. Interviewees highlighted several factors, including availability of medical supervision and senior nursing staff, nursing documentation issues, lack of morale due to overcrowding, personality differences and factors relating to the department layout. The questionnaire respondents strongly supported the importance of the previously identified factors. This paper demonstrates an effective mixed-method approach that can be replicated by other health-care managers to identify factors influencing patient flow. Further benefits include increased volume and quality of data, increased staff awareness for the influence of internal factors on patient flow and enhancing the evidence base for future decision making when prioritizing A&E projects.

  6. The Effects of Tocotrienols Added to Canola Oil on Microalbuminuria, Inflammation, and Nitrosative Stress in Patients with Type 2 Diabetes: A Randomized, Double-blind, Placebo-controlled Trial

    PubMed Central

    Haghighat, Neda; Vafa, Mohammadreza; Eghtesadi, Shahryar; Heidari, Iraj; Hosseini, Aghafatemeh; Rostami, Ali

    2014-01-01

    Background: Tocotrienols (T3) were neglected in the past; today, get attentions due to their antioxidant and none-antioxidant activity. The objective of this study was to evaluate the effects of the daily intake of 200 mg T3 added in canola oil over 8 weeks on microalbuminuria, inflammation, and nitrosative stress in type 2 diabetic patients. Methods: This study was a double-blinded, placebo-controlled, randomized trial. A total of 50 patients with T2DM and FBS >126 mg/dl treated by non-insulin hypoglycemic drugs were randomly assigned to receive either 15 ml T3-enriched canola oil (200 mg/day T3) or pure canola oil for 8 weeks. Urine microalbumin, volume and creatinine levels, serum hs-CRP, and nitric oxide (NO) levels were measured before and after intervention. Results: From 50 patients participated in this study, 44 completed the study. There were no significant differences in baseline characteristics, dietary intake, and physical activity between groups. Urine microalbumin and serum hs-CRP were declined significantly in T3-treated group. At the end of the study, patients who treated with T3 had lower urine microalbumin (11 (9, 25) vs. 22 (15, 39.75) nmol/dl, P = 0.003) and hs-CRP changes (−10.91 ± 15.5 vs. −9.88 ± 27.5 Pg/ml, P = 0.048) than control group. A non-significant decrease was also observed in serum NO level in T3-treated group with no changes in urine volume and creatinine levels. Conclusions: These findings indicate that T3 leads to ameliorate proteinuria and can protect the kidney against inflammation (hs-CRP) and nitrosative stress (NO). PMID:24932394

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

    PubMed Central

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

    2016-01-01

    Abstract 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:26417965

  8. Deliberative Engagement Methods for Patient-Centered Outcomes Research.

    PubMed

    Morain, Stephanie R; Whicher, Danielle M; Kass, Nancy E; Faden, Ruth R

    2017-04-03

    There is growing emphasis on eliciting and incorporating stakeholder perspectives into health research and public policy development. The deliberative engagement session (DES) method provides one approach to elicit informed preferences from patients and other stakeholders on policy issues. DES involves day-long interaction with participants, including short plenary presentations followed by small group discussion. While interest in DES methods is expanding, practical guidance for researchers on this method remains limited. In this paper, we describe the DES method and its contemporary relevance for health policy research, illustrate how to conduct a DES using an example of a recent patient-centered outcomes research (PCOR) study with which we were involved, and discuss strengths and challenges of using this approach. DES methods generate rich data, reduce the risk of eliciting uniformed preferences or non-attitudes, and increase the likelihood of eliciting informed, reflective preferences. However, they are resource-intensive, and thus generally require trading away a larger, more representative sample. Despite these limitations, the DES method, when carefully designed, is well-suited for engaging stakeholders in research on complex health policy issues.

  9. An Improved Colonoscopy Preparation Method and its Acceptability by Patients

    PubMed Central

    1995-01-01

    The author presents an improved method of preparation for colonoscopy that involved no dietary limitation on the patient until the day of the examination and that was shown by a randomized questionnaire evaluation to earn good patient tolerance and acceptance. Patients were given 10 mg of cisapride and 75 mg of sodium picosulfate before sleep on the day preceding the examination, and 50 g of magnesium citrate powder (MP) in 1,200 mL lukewarm water before the examination. It was divided into 600-mL portions and ingested slowly during two 30-minute periods. Ninety-five percent of patients classified the taste of a magnesium citrate powder laxative as palatable in the questionnaire given immediately after the procedure. Concerning the quantity, 79.4% replied that it was tolerable, 17.3% considered it somewhat excessive, and 3.3% replied that it was barely tolerable. No patient classified it as intolerable. Symptoms after taking laxatives and lukewarm water such as abdominal pain, nausea and abdominal fullness were observed in 3.8%, 4.4% and 5.6%, respectively, whereas there were no symptoms in 79% of patients. Body weight and serum K level showed a tendency to decrease, whereas the serum Mg level showed an increase before and after colonoscopy. The quality of colonic cleansing evaluated by colonoscopy was excellent, good, or fair in a total of 93.3%. No adverse effects were observed. It was concluded that this method is a clinically beneficial and well-tolerated preparation for colonic examinations. PMID:18493356

  10. 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.

  11. 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

  12. An AdS Crunch in Supergravity

    NASA Astrophysics Data System (ADS)

    Hertog, Thomas

    2004-12-01

    We review some properties of N=8 gauged supergravity in four dimensions with modified, but AdS invariant boundary conditions on the m2 = -2 scalars. There is a one-parameter class of asymptotic conditions on these fields and the metric components, for which the full AdS symmetry group is preserved. The generators of the asymptotic symmetries are finite, but acquire a contribution from the scalar fields. For a large class of such boundary conditions, we find there exist black holes with scalar hair that are specified by a single conserved charge. Since Schwarschild-AdS is a solution too for all boundary conditions, this provides an example of black hole non-uniqueness. We also show there exist solutions where smooth initial data evolve to a big crunch singularity. This opens up the possibility of using the dual conformal field theory to obtain a fully quantum description of the cosmological singularity, and we report on a preliminary study of this.

  13. Epidemiology and statistical methods in prediction of patient outcome.

    PubMed

    Bostwick, David G; Adolfsson, Jan; Burke, Harry B; Damber, Jan-Erik; Huland, Hartwig; Pavone-Macaluso, Michele; Waters, David J

    2005-05-01

    Substantial gaps exist in the data of the assessment of risk and prognosis that limit our understanding of the complex mechanisms that contribute to the greatest cancer epidemic, prostate cancer, of our time. This report was prepared by an international multidisciplinary committee of the World Health Organization to address contemporary issues of epidemiology and statistical methods in prostate cancer, including a summary of current risk assessment methods and prognostic factors. Emphasis was placed on the relative merits of each of the statistical methods available. We concluded that: 1. An international committee should be created to guide the assessment and validation of molecular biomarkers. The goal is to achieve more precise identification of those who would benefit from treatment. 2. Prostate cancer is a predictable disease despite its biologic heterogeneity. However, the accuracy of predicting it must be improved. We expect that more precise statistical methods will supplant the current staging system. The simplicity and intuitive ease of using the current staging system must be balanced against the serious compromise in accuracy for the individual patient. 3. The most useful new statistical approaches will integrate molecular biomarkers with existing prognostic factors to predict conditional life expectancy (i.e. the expected remaining years of a patient's life) and take into account all-cause mortality.

  14. 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.

  15. 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

  16. An acoustic method of automatically evaluating patient inhaler technique.

    PubMed

    Holmes, Martin S; D'Arcy, Shona; Costello, Richard W; Reilly, Richard B

    2013-01-01

    Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) affect millions of people worldwide. Inhalers are devices utilized to deliver medication in small doses directly to the airways in the treatment of asthma and COPD. Despite the proven effectiveness of inhaler medication in controlling symptoms, many patients suffer from technique errors leading to decreased levels of medication efficacy. This study employs a recording device attached to a commonly used dry powder inhaler (DPI) to obtain the acoustic signals of patients taking their inhaler medication. The audio files provide information on how a patient uses their inhaler over a period of one month. Manually listening to such a large quantity of audio files would be a time consuming and monotonous process and therefore an algorithm that could automatically carry out this task would be of great benefit. An algorithm was thus designed and developed to detect inhalation, exhalation and blister events in the audio signals, analyze the quantity of each event, the order in which the events took place and finally provide a score on the overall performance. The algorithm was tested on a dataset of 185 audio files obtained from five community dwelling asthmatic patients in real world environments. Evaluation of the algorithm on this dataset revealed that it had an accuracy of 92.8% in deciding the correct technique score compared to manual detection methods.

  17. IL-10 and IL-4 co-operate to normalize in vitro IgA production in IgA-deficient (IgAD) patients

    PubMed Central

    Marconi, M; Plebani, A; Avanzini, M A; Maccario, R; Pistorio, A; Duse, M; Stringa, M; Monafo, V

    1998-01-01

    In the present study we evaluated in vitro immunoglobulin production from IgAD individuals and healthy controls. Peripheral blood mononuclear cells (PBMC) from IgAD and controls were cultured with anti-CD40 MoAb presented on a CDw32-transfected fibroblast cell line (CD40 system) in the presence of IL-10, IL-2, IL-4, transforming growth factor-beta (TGF-β) alone as well as of IL-10 in combination with each of the other three cytokines. Only IL-10 added alone induced significant changes in baseline immunoglobulin production; marked increases in median supernatant levels of all three isotypes were observed in both groups. The most striking finding of this study was the synergizing effect of IL-4 on IgA production in the IgAD group when added with IL-10; median IgA supernatant level increased to a value superimposable on that found in the normal controls which remained about the same as when stimulated with IL-10 alone. The synergic effect of IL-4 and IL-10 was specific to the IgA isotype. PMID:9649225

  18. 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....

  19. Patient Care Appraisal as a Method of Continuing Education

    PubMed Central

    MacIntyre, Karen

    1982-01-01

    Patient care appraisal (PCA) is a type of medical audit specifically designed for educational purposes. It can be instituted in solo or group practices. A subject is selected (preferably a commonly treated condition), criteria for care are established (the most educational element of PCA), records of cases are searched to see if these criteria are met, results are reviewed, and corrective action is planned. A follow up audit is then done. This method of CME is currently under study at Dalhousie University's Division of Continuing Medical Education as a possible alternative to formal courses. PMID:20469392

  20. 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

  1. New anchoring method for tarsal tendon transfers in myelomeningocele patients.

    PubMed

    Tomonori, Kenmoku; Makoto, Kamegaya; Takashi, Saisu

    2007-12-01

    We describe a new anchoring method for tarsal tendon transfers in myelomeningocele patients to protect the sole of the foot from pressure sores and skin necrosis and to loosen the tension of the transferred tendon.Tendon transfer procedures were performed in 51 feet (33 patients) with myelomeningocele. We transferred tibialis anterior tendons to the second or third cuneiform in 19 with equinovarus deformities, and transferred tibialis anterior tendons to the calcaneus through the interosseous membrane in 32 with talipes calcaneus. Clinical results were evaluated with the muscle power of transferred tendons using manual muscle testing 6 months after surgery. The muscle test result was classified as good, fair, and poor.After passing the tendon through the bony hole, a 2.0-mm Kirschner wire was inserted from the sole to the tibia through the ankle joint at neutral. (It extended from the sole through the posterior cortex of the tibia.) The remaining part of the wire was bent and formed into a loop shaped like the Greek letter "zeta" (zeta). The thread was then tied to the loop of the wire as tightly as possible. In this way, there was no contact with the sole during anchoring, thus avoiding ulcers. In addition, the transferred tendon could be kept stable because the patient's ankle was fixed by the Kirschner wire.No cases of wound infection or skin necrosis of the sole occurred. In 49 of the 51 cases, transferred tendons were firmly anchored to tarsal bones. Muscle strength was good for 83%, fair for 13%, and poor for 4%. Consequently, 45 feet could obtain plantigrade pattern during their walking with shoe inserts or occasional use of ankle-foot orthoses.Our anchoring method has the advantage of protecting the sole of the foot from pressure sores and skin necrosis, as well as maintaining tension on the transferred tendon until it settles down in an anchor hole.

  2. Adding Maximum Standard Uptake Value of Primary Lesion and Lymph Nodes in 18F-Fluorodeoxyglucose PET Helps Predict Distant Metastasis in Patients with Nasopharyngeal Carcinoma

    PubMed Central

    Zhang, Yingjian; Hu, Chaosu

    2014-01-01

    Objective To find out the most valuable parameter of 18F-Fluorodeoxyglucose positron emission tomography for predicting distant metastasis in nasopharyngeal carcinoma. Methods From June 2007 through December 2010, 43 non-metastatic NPC patients who underwent 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) before radical Intensity-Modulated Radiation Therapy were enrolled and reviewed retrospectively. PET parameters including maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glucose (TLG) of both primary tumor and cervical lymph nodes were calculated. Total SUVmax were recorded as the sum of SUVmax of primary tumor and cervical lymph nodes. Total SUVmean, Total MTV and Total TLG were calculated in the same way as Total SUVmax. Results The median follow-up was 32 months (range, 23–68 months). Distant metastasis was the main pattern of treatment failure. Univariate analysis showed higher SUVmax, SUVmean, MTV, and TLG of primary tumor, Total SUVmax, Total MTV, Total TLG, and stage T3-4 were factors predicting for significantly poorer distant metastasis-free survival (p = 0.042, p = 0.008, p = 0.023, p = 0.023, p = 0.024, p = 0.033, p = 0.016, p = 0.015). In multivariate analysis, Total SUVmax was the independent predictive factor for distant metastasis (p = 0.046). Spearman Rank correlation analysis showed mediate to strong correlationship between Total SUVmax and SUVmax-T, and between Total SUVmax and SUVmax-N(Spearman coefficient:0.568 and 0.834;p = 0.000 and p = 0.000). Conclusions Preliminary results indicated that Total SUVmax was an independently predictive factor for distant metastasis in patients of nasopharyngeal carcinoma treated with Intensity-Modulated Radiation Therapy. PMID:25068373

  3. Adding Papillomacular Bundle Measurements to Standard Optical Coherence Tomography Does Not Increase Sensitivity to Detect Prior Optic Neuritis in Patients with Multiple Sclerosis

    PubMed Central

    Laible, Mona; Jarius, Sven; Schmidt-Bacher, Annette; Platten, Michael; Haas, Jürgen

    2016-01-01

    Purpose To improve the detection of retinal nerve fiber layer (RNFL) thinning in multiple sclerosis (MS), a special peripapillary ring scanning algorithm (N-site RNFL, N-RNFL) was developed for spectral domain optical coherence tomography (SD-OCT). In contrast to the standard protocol (ST-RNFL) scanning starts nasally, not temporally, and provides an additional sector of analysis, the papillomacular bundle (PMB). We aimed to ascertain whether the temporal RNFL differs between the two techniques, whether N-RNFL is more sensitive than ST-RNFL to detect previous optic neuritis (ON), and whether analyzing the PMB adds additional sensitivity. Furthermore, we investigated whether RNFL is associated with disease severity and/or disease duration. Methods We conducted a cross-sectional case-control study of 38 patients with MS, of whom 24 had a history of ON, and 40 healthy controls (HC). Subjects with ON within the previous 6 months were excluded. Records included clinical characteristics, visual evoked potentials (VEP), and SD-OCT in both techniques. Results In a total of 73 evaluable MS eyes, temporal N-RNFL was abnormal in 17.8%, temporal ST-RNFL in 19.2%, and the PMB-RNFL in 21.9%. In ON eyes, the sensitivity of temporal N-RNFL and ST-RNFL did not differ significantly (37.0%/33.3%, p = 0.556). The sensitivity of VEP was 85.2%. RNFL thickness was associated with disease severity in all eyes, with and without a history of ON, and with disease duration. Conclusion The two OCT techniques detected previous ON with similar sensitivity, but the sensitivity of VEPs was superior to that of both N-RNFL and ST-RNFL. Our results indicate that the widely used ST-RNFL technique is appropriate for peripapillary RNFL measurements in MS patients. PMID:27171375

  4. 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

  5. AdS2 holographic dictionary

    NASA Astrophysics Data System (ADS)

    Cvetič, Mirjam; Papadimitriou, Ioannis

    2016-12-01

    We construct the holographic dictionary for both running and constant dilaton solutions of the two dimensional Einstein-Maxwell-Dilaton theory that is obtained by a circle reduction from Einstein-Hilbert gravity with negative cosmological constant in three dimensions. This specific model ensures that the dual theory has a well defined ultraviolet completion in terms of a two dimensional conformal field theory, but our results apply qualitatively to a wider class of two dimensional dilaton gravity theories. For each type of solutions we perform holographic renormalization, compute the exact renormalized one-point functions in the presence of arbitrary sources, and derive the asymptotic symmetries and the corresponding conserved charges. In both cases we find that the scalar operator dual to the dilaton plays a crucial role in the description of the dynamics. Its source gives rise to a matter conformal anomaly for the running dilaton solutions, while its expectation value is the only non trivial observable for constant dilaton solutions. The role of this operator has been largely overlooked in the literature. We further show that the only non trivial conserved charges for running dilaton solutions are the mass and the electric charge, while for constant dilaton solutions only the electric charge is non zero. However, by uplifting the solutions to three dimensions we show that constant dilaton solutions can support non trivial extended symmetry algebras, including the one found by Compère, Song and Strominger [1], in agreement with the results of Castro and Song [2]. Finally, we demonstrate that any solution of this specific dilaton gravity model can be uplifted to a family of asymptotically AdS2 × S 2 or conformally AdS2 × S 2 solutions of the STU model in four dimensions, including non extremal black holes. The four dimensional solutions obtained by uplifting the running dilaton solutions coincide with the so called `subtracted geometries', while those obtained

  6. 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.

  7. 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.

  8. Evaluation and Validation of a Method for Determining Platelet Catecholamine in Patients with Obstructive Sleep Apnea and Arterial Hypertension

    PubMed Central

    Feres, Marcia C.; Cintra, Fatima D.; Rizzi, Camila F.; Mello-Fujita, Luciane; Lino de Souza, Altay A.; Tufik, Sergio; Poyares, Dalva

    2014-01-01

    Background Measurements of plasma and urinary catecholamine are susceptible to confounding factors that influence the results, complicating the interpretation of sympathetic nervous system (SNS) activity in the Obstructive sleep apnea (OSA) and arterial hypertension (HYP) conditions. Objective In this study, we validated a test for platelet catecholamine and compared the catecholamine levels (adrenaline and noradrenaline) in urine, plasma and platelets in patients with OSA and HYP compared with controls. Methods In the validation, 30 healthy, nonsmoking volunteers who were not currently undergoing treatment or medication were selected as the control group. One hundred fifty-four individuals (114 OSA, 40 non-OSA) were consecutively selected from the outpatient clinic of the Sleep Institute and underwent clinical, polysomnographic and laboratory evaluation, including the urinary, plasma and platelet levels of adrenaline (AD) and noradrenaline (NA). Patients were then allocated to groups according to the presence of OSA and/or hypertension. Results A logistic regression model, controlled for age and BMI, showed that urinary AD and urinary NA were risk factors in the OSA+HYP group and the HYP group; however, the model showed higher levels of platelet NA for OSA without HYP. After 1 year of CPAP (continuous upper airway pressure) treatment, patients (n = 9) presented lower levels of urinary NA (p = 0.04) and platelet NA (p = 0.05). Conclusion Urinary NA and AD levels were significantly associated with the condition of hypertension with and without OSA, whereas platelet NA with OSA without comorbidity. These findings suggest that platelet catecholamine levels might reflect nocturnal sympathetic activation in OSA patients without hypertension. PMID:24911183

  9. Added value of next generation gene panel analysis for patients with elevated methylmalonic acid and no clinical diagnosis following functional studies of vitamin B12 metabolism.

    PubMed

    Pupavac, Mihaela; Tian, Xia; Chu, Jordan; Wang, Guoli; Feng, Yanming; Chen, Stella; Fenter, Remington; Zhang, Victor W; Wang, Jing; Watkins, David; Wong, Lee-Jun; Rosenblatt, David S

    2016-03-01

    Next generation sequencing (NGS) based gene panel testing is increasingly available as a molecular diagnostic approach for inborn errors of metabolism. Over the past 40 years patients have been referred to the Vitamin B12 Clinical Research Laboratory at McGill University for diagnosis of inborn errors of cobalamin metabolism by functional studies in cultured fibroblasts. DNA samples from patients in which no diagnosis was made by these studies were tested by a NGS gene panel to determine whether any molecular diagnoses could be made. 131 DNA samples from patients with elevated methylmalonic acid and no diagnosis following functional studies of cobalamin metabolism were analyzed using the 24 gene extended cobalamin metabolism NGS based panel developed by Baylor Miraca Genetics Laboratories. Gene panel testing identified two or more variants in a single gene in 16/131 patients. Eight patients had pathogenic findings, one had a finding of uncertain significance, and seven had benign findings. Of the patients with pathogenic findings, five had mutations in ACSF3, two in SUCLG1 and one in TCN2. Thus, the NGS gene panel allowed for the presumptive diagnosis of 8 additional patients for which a diagnosis was not made by the functional assays.

  10. A novel method for radiotherapy patient identification using surface imaging.

    PubMed

    Wiant, David B; Verchick, Quinton; Gates, Percy; Vanderstraeten, Caroline L; Maurer, Jacqueline M; Hayes, T Lane; Liu, Han; Sintay, Benjamin J

    2016-03-08

    Performing a procedure on the wrong patient or site is one of the greatest errors that can occur in medicine. The addition of automation has been shown to reduce errors in many processes. In this work we explore the use of an automated patient identification process using optical surface imaging for radiotherapy treatments. Surface imaging uses visible light to align the patient to a reference surface in the treatment room. It is possible to evaluate the similarity between a daily set-up surface image and the reference image using distance to agreement between the points on the two surfaces. The higher the percentage overlapping points within a defined distance, the more similar the surfaces. This similarity metric was used to intercompare 16 left-sided breast patients. The reference surface for each patient was compared to 10 daily treatment surfaces for the same patient, and 10 surfaces from each of the other 15 patients (for a total of 160 comparisons per patient), looking at the percent of points overlapping. For each patient, the minimum same-patient similarity score was higher than the maximum different-patient score. For the group as a whole a threshold was able to classify correct and incorrect patients with high levels of accuracy. A 10-fold cross-validation using linear discriminant analysis gave cross-validation loss of 0.0074. An automated process using surface imaging is a feasible option to provide nonharmful daily patient identification verification using currently available technology.

  11. Is there a benefit to adding rituximab to CHOP in the overall survival of patients with B-cell non-Hodgkin's lymphoma in a developing country?

    PubMed

    Ruiz-Delgado, Guillermo J; Gómez-Almaguer, David; Tarín-Arzaga, Luz C; Cantú-Rodriguez, Olga G; Urdaneta, Carlos Alarcón; Rodríguez-Morales, Uxmal; Calderón-Garcia, Jackeline; Fernández-Vargas, Omar; Montes-Montiel, Maryel; Sánchez-Cárdenas, Mónica; Ruiz-Argüelles, Guillermo J

    2012-07-01

    Rituximab (R) has changed the prognosis of patients with non-Hodgkin's lymphoma (NHL) in developed countries, but its role has not been analyzed in underprivileged circumstances. One hundred and two patients with NHL treated in a developing country were analyzed: 28 patients with follicular lymphoma (FL) and 74 with diffuse large B-cell lymphoma (DLCL). Patients were treated upfront with either cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or R-CHOP; the decision to employ R depending solely on the ability of patients to defray it. In DLCL, 42 were given CHOP and 32 R-CHOP, whereas in FL, 19 were given CHOP and 9 R-CHOP. The impact of the addition of R was found to be clearer in FL than in DLCL. In patients with DLCL, the overall survival (OS) was 87% at 80 months for those treated with R-CHOP and 84% at 145 months for those treated with CHOP (not significant). In patients with FL, the OS was 89% at 88 months for those treated with R-CHOP and 71% at 92 months for those treated with CHOP (P = 0··05). In a multivariate analysis, other variables which were identified to be associated with the OS were IPI and number of cycles in DLCL. It is concluded that R produced a mild positive impact in the OS of patients with FL, but not in those with DLCL. Since the addition of R results in a 36-fold increase in treatment costs, these observations may be important to decide therapeutic approaches in NHL patients living in underprivileged circumstances.

  12. AD(H)D.

    PubMed

    Harrison, Christopher; Charles, Janice; Britt, Helena

    2008-06-01

    The BEACH program (Bettering the Evaluation and Care of Health) shows that management of attention deficit (hyperactivity) disorder (AD(H)D) was rare in general practice, occurring only six times per 1,000 encounters with children aged 5-17 years, between April 2000 and December 2007. This suggests that general practitioners manage AD(H)D about 46,000 times for this age group nationally each year.

  13. 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.

  14. Knowledge Base Methods of Obtaining Preference of Dental Patients

    NASA Astrophysics Data System (ADS)

    Chang, Chi-Chang; Li, Ya-Hsin; Chen, Yi-Fen; Liao, Kuo-Hsiung

    The purpose of this study was to explore the dental patients' preferred roles in Taiwan. A convenience sample of 66 patients, 26 recruited from one dental clinic, and 40 from one medical center, were interviewed and their preferences for participation in treatment decision making were established using a measurement tool designed to elicit decision-making preferences. Patients' preferences for participation in treatment decision making were established using Control Preference Scale (CPS) tool. In addition, Unfolding theory provided a means of analyzing the data so that the degree of control preferred by each patient could be established. This study found that nearly 70% clinic patients perceived passive role in treatment decision making whereas 50% patients in medical centre. Further, the collaborative role was most commonly preferred, but an active role was more commonly perceived in clinics than in medical centre. Finally, the implications of the results for patient participation are discussed.

  15. Aspects of warped AdS3/CFT2 correspondence

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  16. 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.

  17. 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.

  18. A novel method to enhance polychlorinated dibenzo-p-dioxins and dibenzofurans removal by adding bio-solution in EAF dust treatment plant.

    PubMed

    Li, Hsing-Wang; Lee, Wen-Jhy; Tsai, Perng-Jy; Mou, Jin-Luh; Chang-Chien, Guo-Ping; Yang, Kuen-Thyr

    2008-01-15

    In order to understand the effect of different amounts of powder-activated carbon (PAC) injection and bio-solution (NOE-7F) addition on the removal efficiencies of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in a fly ash treatment plant with Waelz rotary kiln process, the PCDD/F concentrations in the stack flue gasses were measured and discussed. In the amount of 20, 40 and 50 kg/h PAC injection, the removal efficiencies of PCDD/Fs in the stack flue gas were 86, 96 and 97%, respectively. While adding more amounts of PAC did enhance the removal efficiencies, the reduction fractions of low chlorinated PCDD/F congeners were much higher than those of highly chlorinated PCDD/F congeners. Particularly, a lower amount of PAC injection (20 kg/h), not only cannot remove highly chlorinated PCDD/Fs, but also the carbon surface of the PAC can act as a precursor for the formation promotion of highly chlorinated PCDD/F congeners. The addition of NOE-7F in the raw materials had the dechlorination effect on the PCDD/F removal and mainly inhibited highly chlorinated PCDD/F formation. The combination of both PAC injection and NOE-7F addition has a high potential for practical application.

  19. 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.

  20. Adding a Time-Series Design Element to the Success Case Method to Improve Methodological Rigor: An Application for Nonprofit Program Evaluation

    ERIC Educational Resources Information Center

    Coryn, Chris L. S.; Schroter, Daniela C.; Hanssen, Carl E.

    2009-01-01

    Brinkerhoff's Success Case Method (SCM) was developed with the specific purpose of assessing the impact of organizational interventions (e.g., training and coaching) on business goals by analyzing extreme groups using case study techniques and storytelling. As an efficient and cost-effective method of evaluative inquiry, SCM is attractive in other…

  1. Planning for ambulatory care: simple methods for improving patient flow.

    PubMed

    Schuh, S E; Tolins, I; Westphal, M C; Miller, M C

    1977-06-01

    A combined patient flow and work sampling study was done at the Ambulatory Pediatric Service of the Medical University of South Carolina. The biggest problem was that almost two thirds of the patient's time was spent waiting to see the doctor. Reasons for delay included too few examining rooms, the single block appointment system, and design of the facility.

  2. Extension of the Inverse Adding-Doubling Method to the Measurement of Wavelength-Dependent Absorption and Scattering Coefficients of Biological Samples

    SciTech Connect

    Baba, Justin S; Allegood, Marcus S

    2008-01-01

    Light interaction with biological tissue can be described using three parameters: the scattering and absorption coefficients (us and ua), 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 specific wavelengths, and simultaneously, would be beneficial for a variety of different biomedical applications. The goal of this project was to take a user-defined g-value and determine the remaining two parameters for a specified wavelength range for an integrating sphere with a collimated white light input source system. 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 computation of the optical properties based on the output from the IAD code. To allow data to be passed efficiently 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 and determination of the absorption and scattering coefficients showed excellent agreement with theory for wavelengths were the user inputted single g-value was sufficiently precise. Future improvements entail providing for multi-wavelength g-value entry to extend the accuracy of results to encompass the complete system multispectral range. Ultimately, the data collection process and algorithms developed through this effort will be used to study actual biological tissues for the purpose of deriving and refining models for light-tissue interactions.

  3. 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.

  4. Validation of nutritional risk index method against patient-generated subjective global assessment in screening malnutrition in colorectal cancer patients

    PubMed Central

    Faramarzi, Elnaz; Mohammad-Zadeh, Mohammad; Nasirimotlagh, Behnam

    2013-01-01

    Objective To validate malnutrition screening tool of nutrition risk index (NRI) against patient-generated subjective global assessment (PG-SGA) as a gold standard tool in colorectal cancer patients before radiotherapy. Methods Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA (gold standard method) and NRI. Serum albumin levels of patients were determined by colorimetric method. A contingency table was used to determine the sensitivity, specificity, and predictive value of the NRI in screening patients at risk of malnutrition, in comparison with the PG-SGA in patients before radiotherapy. Results The findings of PG-SGA and NRI showed that 52% and 45% of patients in our study were moderately or severely malnourished respectively. The NRI had a sensitivity of 66% and a specificity of 60% against PG-SGA. The positive predictive value was 64% and the negative predicative value was 62%. The agreement between NRI and PG-SGA was statistically insignificant (kappa =0.267; P>0.05). Conclusions The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer. Moreover, NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer. It seems that the combination of anthropometric, laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients. PMID:24255578

  5. 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.

  6. The Massive Wave Equation in Asymptotically AdS Spacetimes

    NASA Astrophysics Data System (ADS)

    Warnick, C. M.

    2013-07-01

    We consider the massive wave equation on asymptotically AdS spaces. We show that the timelike F behaves like a finite timelike boundary, on which one may impose the equivalent of Dirichlet, Neumann or Robin conditions for a range of (negative) mass parameter which includes the conformally coupled case. We demonstrate well posedness for the associated initial-boundary value problems at the H 1 level of regularity. We also prove that higher regularity may be obtained, together with an asymptotic expansion for the field near F. The proofs rely on energy methods, tailored to the modified energy introduced by Breitenlohner and Freedman. We do not assume the spacetime is stationary, nor that the wave equation separates.

  7. 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.

  8. [Rapid analysis of added ingredients in heroin].

    PubMed

    Wang, Ji-fen; Yu, Jing; Guo, Xin; Sun, Xing-long; Wang, Ding-fang

    2011-07-01

    The method of rapid analysis of added ingredients in heroin was studied in the present paper. Adding sucrose, fructose, glucose, starch, caffeine and phenacetin to heroin with a certain percentage, the changes in the infrared spectrum with the concentration of heroin increasing and the detection limit of the additives were determined. Whether or not heroin can be detected in the sample with high concentration of added ingredients was studied using Raman spectroscopy. Similarly, in high purity of heroin, whether or not Raman spectroscopy can detect the added ingredients was tested. Through systematic experiments, the results showed that: using infrared spectroscopy and Raman spectroscopy to test the added ingredients of heroin is a rapid and effective method. Each has both advantages and disadvantages. We should select the appropriate method according to the actual cases.

  9. Adding and Deleting Images

    EPA Pesticide Factsheets

    Images are added via the Drupal WebCMS Editor. Once an image is uploaded onto a page, it is available via the Library and your files. You can edit the metadata, delete the image permanently, and/or replace images on the Files tab.

  10. 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…

  11. ADS in a Nutshell

    NASA Astrophysics Data System (ADS)

    Demleitner, M.; Eichhorn, G.; Grant, C. S.; Accomazzi, A.; Murray, S. S.; Kurtz, M. J.

    1999-05-01

    The bibliographic databases maintained by the NASA Astrophysics Data System are updated approximately biweekly with records gathered from over 125 sources all over the world. Data are either sent to us electronically, retrieved by our staff via semi-automated procedures, or entered in our databases through supervised OCR procedures. PERL scripts are run on the data to convert them from their incoming format to our standard format so that they can be added to the master database at SAO. Once new data has been added, separate index files are created for authors, objects, title words, and text word, allowing these fields to be searched for individually or in combination with each other. During the indexing procedure, discipline-specific knowledge is taken into account through the use of rule-based procedures performing string normalization, context-sensitive word translation, and synonym and stop word replacement. Once the master text and index files have been updated at SAO, an automated procedure mirrors the changes in the database to the ADS mirror site via a secure network connection. The use of a public domain software tool called rsync allows incremental updating of the database files, with significant savings in the amount of data being transferred. In the past year, the ADS Abstract Service databases have grown by approximately 30%, including 50% growth in Physics, 25% growth in Astronomy and 10% growth in the Instrumentation datasets. The ADS Abstract Service now contains over 1.4 million abstracts (475K in Astronomy, 430K in Physics, 510K in Instrumentation, and 3K in Preprints), 175,000 journal abstracts, and 115,000 full text articles. In addition, we provide links to over 40,000 electronic HTML articles at other sites, 20,000 PDF articles, and 10,000 postscript articles, as well as many links to other external data sources.

  12. 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.

  13. 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.

  14. “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

  15. 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.

  16. Myofeedback: a new method of teaching breathing exercises in emphysematous patients.

    PubMed

    Johnston, R; Lee, K

    1976-07-01

    The diaphragm of the emphysematous patient is low and limited in its excursions, producing an increased functional residual capacity and decreased pulmonary ventilation. This report describes our experiences with a new technique for 1) the training of abdominal-diaphragmatic (A-D) breathing and 2) the relaxation of accessory respiratory muscles in emphysematous patients. Abdominal muscle contraction during expiration has been shown to increase diaphragmatic excursions and, hence, pulmonary ventilation. Use of this technique has been limited, however, because of the difficulty in learning this breathing pattern. Through continuous audio and visual feedback of myoelectric potentials (myofeedback) from abdominal muscles, 12 patients learned A-D breathing. The lower rectus abdominis muscle was found to be the most suitable muscle for obtaining the myoelectric potentials. Similarly, by providing the patients with myofeedback from their accessory muscles, they decreased the use of these muscles, thus increasing their respiratory efficiency. With myofeedback, patients appear to learn new breathing patterns effectively and in fewer sessions than with conventional procedures.

  17. Reproducibility of 2 methods to locate centric relation in healthy individuals and TMD patients.

    PubMed

    Zonnenberg, A J J; Mulder, J

    2012-12-01

    No conclusive evidence exists for any maxillomandibular relationship as the preferable treatment position. Measurement reliability of 2 different methods to attempt to locate centric relation in control and TMD patients was assessed to determine if both methods lead to the same position. A group of 27 controls and 91 TMD patients were examined using the Research Diagnostic Criteria for TMD (RDC/TMD). Three patient groups were recruited: 27 patients with myofascial pain (MYO), 34 patients with disc displacement without reduction (ID), and 30 patients with osteoarthritis (OA). For each study participant centric relation was located with chinpoint guidance and a technique with a leaf gauge, for the controls once, for all TMD patients before and after stabilization splint treatment. The mixed model procedure revealed no significant differences between the methods, the patient groups and the time interval. However the patient groups at baseline and conclusion of treatment differed significantly from the controls. The percentage of patients (15.9%) having a coincident split-cast result for both methods was significantly smaller (P < 0.001) than the corresponding percentage (85.2%) of controls. After splint treatment, the percentage of coincident split-casts increased from 15.9% to 76.8%. Both methods are reproducible techniques to locate centric relation for control and TMD patients. However, the leaf gauge provides the clinician a different centric relation position in TMD patients than chinpoint guidance does.

  18. 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).

  19. Effect of adding aluminum ion on the structural, optical, electrical and magnetic properties of terbium doped yttrium iron garnet nanoparticles films prepared by sol-gel method

    NASA Astrophysics Data System (ADS)

    Aldbea, Ftema W.; Ibrahim, N. B.; Yahya, M.

    2014-12-01

    Tb0.8Y2.2AlyFe5-yO12 nanoparticle films with y = 0.0, 0.2, 0.4, 0.6, 0.8 and 1.0 were prepared by a sol-gel method for potential use as a magnetic sensor and in magneto-optical applications. The films were deposited onto quartz substrate, followed by annealing at 900 °C in air for 2 h. X-ray diffractometry results confirmed the formation of a pure garnet structure. The lattice parameter decreased with increasing Al3+ content due to the substitution of Al3+ ions with the larger Fe3+ ions. The grain size of the films decreased up to y = 0.6. This variation is discussed based on the stress on the grain surface. The films observed to be transparent between 76 and 92% in the visible and infrared regions. The films demonstrated a strong absorption of 104 cm-1 caused by the charge transfer transition in the UV region. The absorption edge shifts to lower wavelengths at higher Al contents of 0.8 and 1 due to electronic transitions. The conductivity of films increased with increasing of Al content due to the increasing in free carrier concentration. The saturation magnetization at room temperature decreased with increasing Al3+ content, whereas the coercivity increased markedly at y = 0.6.

  20. 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.

  1. Focal right inferotemporal atrophy in AD with disproportionate visual constructive impairment

    PubMed Central

    Boxer, A.L.; Kramer, J.H.; Du, A.-T.; Schuff, N.; Weiner, M.W.; Miller, B.L.; Rosen, H.J.

    2009-01-01

    Objective To explore the structural neuroimaging correlates of visual constructive impairment in patients with mild to moderate Alzheimer disease (AD). Background There is considerable heterogeneity in the non-memory cognitive deficits associated with AD. Structural neuroimaging with MRI is an important diagnostic tool that is gaining acceptance as a surrogate measure of brain pathology in AD treatment trials. Most MRI measurements have focused on medial temporal lobe or global cortical atrophy, which may not reflect some important clinical features of AD. Methods Thirty-two patients with probable AD were stratified into two groups based on their relative performance on a visual constructive task, the copy of a modified Rey-Osterrieth figure (Rey). The two groups did not differ in basic demographic features or in neuropsychological performance, other than on the visual constructive task. MRI measurements of hippocampal volume, cortical gray matter volume, and focal cortical gray matter loss were performed in the patients and a group of 71 age-matched, normal controls. Results Both groups showed significant, bilateral hippocampal as well as cortical gray matter volume loss relative to controls. The more spatially impaired AD group (SAD) had more right than left cortical gray matter loss, whereas the opposite was true in the less spatially impaired group (NSAD). The SAD group had significantly less gray matter in the right inferior temporal gyrus relative to the NSAD group. Atrophy of this region was correlated with performance on the Rey task in all patients with AD. Conclusions Right inferotemporal atrophy may serve as a neuroimaging marker of visual constructive impairment in mild to moderate AD. Heterogeneous cortical atrophy is a common feature of AD. PMID:14663029

  2. 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…

  3. 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.…

  4. 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.

  5. 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

  6. Neurosonological Examination: A Non-Invasive Approach for the Detection of Cerebrovascular Impairment in AD

    PubMed Central

    Urbanova, Barbora; Tomek, Ales; Mikulik, Robert; Magerova, Hana; Horinek, Daniel; Hort, Jakub

    2014-01-01

    There has been a growing interest in vascular impairment associated with Alzheimer’s disease (AD). This interest was stimulated by the findings of higher incidence of vascular risk factors in AD. Signs of vascular impairment were investigated notably in the field of imaging methods. Our aim was to explore ultrasonographic studies of extra- and intracranial vessels in patients with AD and mild cognitive impairment (MCI) and define implications for diagnosis, treatment, and prevention of the disease. The most frequently studied parameters with extracranial ultrasound are intima-media thickness in common carotid artery, carotid atherosclerosis, and total cerebral blood flow. The transcranial ultrasound concentrates mostly on flow velocities, pulsatility indices, cerebrovascular reserve capacity, and cerebral microembolization. Studies suggest that there is morphological and functional impairment of cerebral circulation in AD compared to healthy subjects. Ultrasound as a non-invasive method could be potentially useful in identifying individuals in a higher risk of progression of cognitive decline. PMID:24478651

  7. 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%).

  8. AdS4/CFT3 squashed, stretched and warped

    NASA Astrophysics Data System (ADS)

    Klebanov, Igor R.; Klose, Thomas; Murugan, Arvind

    2009-03-01

    We use group theoretic methods to calculate the spectrum of short multiplets around the extremum of Script N = 8 gauged supergravity potential which possesses Script N = 2 supersymmetry and SU(3) global symmetry. Upon uplifting to M-theory, it describes a warped product of AdS4 and a certain squashed and stretched 7-sphere. We find quantum numbers in agreement with those of the gauge invariant operators in the Script N = 2 superconformal Chern-Simons theory recently proposed to be the dual of this M-theory background. This theory is obtained from the U(N) × U(N) theory through deforming the superpotential by a term quadratic in one of the superfields. To construct this model explicitly, one needs to employ monopole operators whose complete understanding is still lacking. However, for the U(2) × U(2) gauge theory we make a proposal for the form of the monopole operators which has a number of desired properties. In particular, this proposal implies enhanced symmetry of the U(2) × U(2) ABJM theory for k = 1,2; it makes its similarity to and subtle difference from the BLG theory quite explicit.

  9. Supersymmetry of AdS and flat IIB backgrounds

    NASA Astrophysics Data System (ADS)

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

    2015-02-01

    We present a systematic description of all warped AdS n × w M 10- n and IIB backgrounds and identify the a priori number of supersymmetries N preserved by these solutions. In particular, we find that the AdS n backgrounds preserve for n ≤ 4 and for 4 < n ≤ 6 supersymmetries and for suitably restricted. In addition under some assumptions required for the applicability of the maximum principle, we demonstrate that the Killing spinors of AdS n backgrounds can be identified with the zero modes of Dirac-like operators on M 10- n establishing a new class of Lichnerowicz type theorems. Furthermore, we adapt some of these results to backgrounds with fluxes by taking the AdS radius to infinity. We find that these backgrounds preserve for 2 < n ≤ 4 and for 4 < n ≤ 7 supersymmetries. We also demonstrate that the Killing spinors of AdS n × w M 10- n do not factorize into Killing spinors on AdS n and Killing spinors on M 10- n .

  10. [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,…

  11. 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.

  12. AdS3 Solutions of IIB Supergravity

    SciTech Connect

    Kim, Nakwoo

    2005-12-02

    We consider pure D3-brane configurations of IIB string theory which lead to supergravity solutions containing an AdS3 factor. They can provide new examples of AdS3/CFT2 examples on D3-branes whose worldvolume is partially compactified. When the internal 7 dimensional space is non-compact, they are related to fluctuations of higher dimensional AdS/CFT duality examples, thus dual to the BPS operators of D = 4 superconformal field theories. We find that supersymmetry requires the 7 dimensional space is warped Hopf-fibration of (real) 6 dimensional Kahler manifolds.

  13. A simple method for the quantification of portosystemic shunting (PSS) in patients with portal hypertension.

    PubMed

    Bödvarsson, A; Verdegaal, W P; Slaats, E H; Geraedts, A A; Kehrer, D F; Silberbusch, J

    1993-12-01

    Portosystemic shunting (PSS) was evaluated in 32 patients with chronic liver disease by the rectal administration of iodine-123 I-amphetamine (IMP method), a radionuclide which is rapidly absorbed from the sigmoid and extracted by liver and lungs. Simultaneous measurement of pulmonary and hepatic uptake supplies a shunt fraction (SF) as an index of PSS. The IMP method was compared with the ammonia tolerance test (NH3TT), and there proved to be a significant correlation between these two methods (r = 0.75, p < 0.001). Assuming that an increase of > 7 mumol/l in arterial ammonia concentration after NH3TT represents PSS, the IMP method had a sensitivity of 0.93. When fasting (NH3) was > 50 mumol/l, all patients showed pathological PSS with either method, but this was also the case in 50% of patients with normal basal arterial ammonia. There was also a significant correlation between the IMP method and the Child-Pugh classification (r = 0.75, p < 0.001). Endoscopy in 28 patients revealed absence of varices in 11, of whom, however, 7 (64%) had an increased SF and although all 15 patients with ascites had increased SF, this was also the case in 12 of the 17 patients without ascites. In conclusion, PSS evaluation using IMP is a non-invasive, sensitive method without patient discomfort which might be used in the staging and follow-up of chronic liver disease.

  14. 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

  15. 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.

  16. Value Added in English Schools

    ERIC Educational Resources Information Center

    Ray, Andrew; McCormack, Tanya; Evans, Helen

    2009-01-01

    Value-added indicators are now a central part of school accountability in England, and value-added information is routinely used in school improvement at both the national and the local levels. This article describes the value-added models that are being used in the academic year 2007-8 by schools, parents, school inspectors, and other…

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

    NASA Astrophysics Data System (ADS)

    Čubrović, Mihailo; Zaanen, Jan; Schalm, Koenraad

    2011-10-01

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

  18. Is cytoimmunological monitoring a safe follow-up method for heart transplantation patients?

    PubMed Central

    Gunay, Celalettin; Oz, Bilgehan Savas; Arslan, Mehmet

    2014-01-01

    The aim of the study The aim of the study is to show the effects of cytoimmunological monitoring and its role in the patient's follow-up period after heart transplantation. Material and methods Between 2002 and 2009, 8 patients underwent heart transplantation at Gulhane Military Medical Academy Hospital. Seven patients were male. The average age was 43 ± 12 years. Donor hearts were implanted orthotopically in all patients. The patients were then subjected to cytoimmunological monitoring and endomyocardial biopsy. 431 laboratory blood tests were carried out for all patients to analyze their cytoimmunological profiles and diagnose a possible infection or rejection. Results The total and average follow-up periods were 17.5 patient years and 30 ± 36 months (1-120 months), respectively. The first patient had two rejection episodes in 3 months. A viral infection was diagnosed in the third patient, who had painful muscle spasms in both lower limbs and the CD4/CD8 ratio was below 0.4. In the fourth patient, the CD4/CD8 ratio suddenly increased and a urinary infection was diagnosed. Only one patient passed away in the early period (less than 30 days). Four patients died because of an infection or hemodynamic deterioration within three months. Conclusions Cytoimmunological monitoring is a simple and effective technique of evaluating the patient's immunological profile. It may provide an adjunctive laboratory test and may decrease the number of endomyocardial biopsies. PMID:26336394

  19. [The effectiveness of physical therapy methods (Bobath and motor relearning program) in rehabilitation of stroke patients].

    PubMed

    Krutulyte, Grazina; Kimtys, Algimantas; Krisciūnas, Aleksandras

    2003-01-01

    The purpose of this study was to examine whether two different physiotherapy regimes caused any differences in outcome in the rehabilitation after stroke. We examined 240 patients with stroke. Examination was carried out at the Rehabilitation Center of Kaunas Second Clinical Hospital. Patients were divided into 2 groups: Bobath method was applied to the first (I) group (n=147), motor relearning program (MRP) method was applied to the second (II) group (n=93). In every group of patients we established samples according to sex, age, hospitalization to rehab unit as occurrence of CVA degree of disorder (hemiplegia, hemiparesis). The mobility of patients was evaluated according to European Federation for Research in Rehabilitation (EFRR) scale. Activities of daily living were evaluated by Barthel index. Analyzed groups were evaluated before physical therapy. When preliminary analysis was carried out it proved no statically reliable differences between analyzed groups (reliability 95%). The same statistical analysis was carried out after physical therapy. The results of differences between patient groups were compared using chi(2) method. Bobath method was applied working with the first group of patients. The aim of the method is to improve quality of the affected body side's movements in order to keep both sides working as harmoniously as possible. While applying this method at work, physical therapist guides patient's body on key-points, stimulating normal postural reactions, and training normal movement pattern. MRP method was used while working with the second group patients. This method is based on movement science, biomechanics and training of functional movement. Program is based on idea that movement pattern shouldn't be trained; it must be relearned. CONCLUSION. This study indicates that physiotherapy with task-oriented strategies represented by MRP, is preferable to physiotherapy with facilitation/inhibition strategies, such the Bobath programme, in the

  20. Using Computational Approaches to Improve Risk-Stratified Patient Management: Rationale and Methods

    PubMed Central

    Stone, Bryan L; Sakaguchi, Farrant; Sheng, Xiaoming; Murtaugh, Maureen A

    2015-01-01

    Background Chronic diseases affect 52% of Americans and consume 86% of health care costs. A small portion of patients consume most health care resources and costs. More intensive patient management strategies, such as case management, are usually more effective at improving health outcomes, but are also more expensive. To use limited resources efficiently, risk stratification is commonly used in managing patients with chronic diseases, such as asthma, chronic obstructive pulmonary disease, diabetes, and heart disease. Patients are stratified based on predicted risk with patients at higher risk given more intensive care. The current risk-stratified patient management approach has 3 limitations resulting in many patients not receiving the most appropriate care, unnecessarily increased costs, and suboptimal health outcomes. First, using predictive models for health outcomes and costs is currently the best method for forecasting individual patient’s risk. Yet, accuracy of predictive models remains poor causing many patients to be misstratified. If an existing model were used to identify candidate patients for case management, enrollment would miss more than half of those who would benefit most, but include others unlikely to benefit, wasting limited resources. Existing models have been developed under the assumption that patient characteristics primarily influence outcomes and costs, leaving physician characteristics out of the models. In reality, both characteristics have an impact. Second, existing models usually give neither an explanation why a particular patient is predicted to be at high risk nor suggestions on interventions tailored to the patient’s specific case. As a result, many high-risk patients miss some suitable interventions. Third, thresholds for risk strata are suboptimal and determined heuristically with no quality guarantee. Objective The purpose of this study is to improve risk-stratified patient management so that more patients will receive the

  1. ADS Based on Linear Accelerators

    NASA Astrophysics Data System (ADS)

    Pan, Weimin; Dai, Jianping

    An accelerator-driven system (ADS), which combines a particle accelerator with a subcritical core, is commonly regarded as a promising device for the transmutation of nuclear waste, as well as a potential scheme for thorium-based energy production. So far the predominant choice of the accelerator for ADS is a superconducting linear accelerator (linac). This article gives a brief overview of ADS based on linacs, including the motivation, principle, challenges and research activities around the world. The status and future plan of the Chinease ADS (C-ADS) project will be highlighted and discussed in depth as an example.

  2. AdS spacetimes from wrapped D3-branes

    NASA Astrophysics Data System (ADS)

    Gauntlett, Jerome P.; MacConamhna, Oisín A. P.

    2007-12-01

    We derive a geometrical characterization of a large class of AdS3 and AdS2 supersymmetric spacetimes in type IIB supergravity with non-vanishing five-form flux using G-structures. These are obtained as special cases of a class of supersymmetric spacetimes with an {{\\bb R}}^{1,1} or {{\\bb R}} (time) factor that are associated with D3 branes wrapping calibrated two or three cycles, respectively, in manifolds with SU(2), SU(3), SU(4) and G2 holonomy. We show how two explicit AdS solutions, previously constructed in gauged supergravity, satisfy our more general G-structure conditions. For each explicit solution, we also derive a special holonomy metric which, although singular, has an appropriate calibrated cycle. After analytic continuation, some of the classes of AdS spacetimes give rise to known classes of BPS bubble solutions with {{\\bb R}}\\times {\\it SO}(4)\\times {\\it SO}(4), {{\\bb R}}\\times {\\it SO}(4)\\times U(1) and {{\\bb R}}\\times {\\it SO}(4) symmetry. These have 1/2, 1/4 and 1/8 supersymmetry, respectively. We present a new class of 1/8 BPS geometries with {{\\bb R}}\\times {\\it SU}(2) symmetry, obtained by analytic continuation of the class of AdS spacetimes associated with D3-brane wrapped on associative three cycles.

  3. 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)

  4. 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

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

    PubMed

    Paula, Fabiana Martins de; 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

    2016-09-22

    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.

  6. 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…

  7. 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

  8. [Detection of mycobacteria tuberculosis in patients with urogenital tuberculosis by PCR method].

    PubMed

    Dochviri, T Z; Katsitadze, V A; Khosiashvili, G Z; Chigogidze, T G

    2005-02-01

    The study was carried out in hospital patients as well as in outpatients at the National Centre of Tuberculosis and Lung Diseases of Georgia (2002-2004). The group consisting of 32 patients with tuberculosis of urogenital system has been studied (newly detected forms). Except clinical laboratory, culture and X-ray contrast methods, two additional methods were used in testing of this group of patients. The examination of their urine, at the same time, was carried out by the Polymerase Chain Reaction method in order to detect Kochi bacillus and by three-time bacterioscopy of urine for acid resistant bacteria. Mycobacterium tuberculosis in urine has been detected in 26 (81,25%) patients by PCR method, and by urine bacterioscopy--acid fast bacilli (AFB+) in 18 (56,25%) patients. The histo-morphological investigation of specimens obtained by surgery confirmed the TB diagnosis in all patients. This study on patients suspected of Tuberculosis of genital-urinary system gives us an opportunity to update the diagnostic algorithm by including the modern molecular methods. This algorithm will help in timely detection of Tuberculosis, in selection of adequate therapy and in prevention of the further progression of the disease.

  9. Revisiting the thermodynamic relations in AdS /CMT models

    NASA Astrophysics Data System (ADS)

    Hyun, Seungjoon; Park, Sang-A.; Yi, Sang-Heon

    2017-03-01

    Motivated by the recent unified approach to the Smarr-like relation of anti-de Sitter (AdS) planar black holes in conjunction with the quasilocal formalism on conserved charges, we revisit the quantum statistical and thermodynamic relations of hairy AdS planar black holes. By extending the previous results, we identify the hairy contribution in the bulk and show that the holographic computation can be improved so that it is consistent with the bulk computation. We argue that the first law can be retained in its universal form and that the relation between the on-shell renormalized Euclidean action and its free energy interpretation in gravity may also be undeformed even with the hairy contribution in hairy AdS black holes.

  10. Solutions of free higher spins in AdS

    NASA Astrophysics Data System (ADS)

    Lü, H.; Shao, Kai-Nan

    2011-11-01

    We consider free massive and massless higher integer spins in AdS backgrounds in general D dimensions. We obtain the solutions corresponding to the highest-weight state of the spin-ℓ representations of the SO (2 , D - 1) isometry groups. The solution for the spin-ℓ field is expressed recursively in terms of that for the spin- (ℓ - 1). Thus starting from the explicit spin-0, all the higher-spin solutions can be obtained. These solutions allow us to derive the generalized Breitenlohner-Freedman bound, and analyze the asymptotic falloffs. In particular, solutions with negative mass square in general have falloffs slower than those of the Schwarzschild AdS black holes in the AdS boundaries.

  11. [Immunoassay methods used to diagnose patients poisoned with psychoactive substances--analytical and interpretation problems].

    PubMed

    Gomółka, Ewa; Hydzik, Piotr; Madej, Teresa; Łata, Stanisław; Rojek, Sebastian

    2012-01-01

    Diagnostics of patients poisoned with psychoactive substances is usually performed by immunoenzymatic methods. The results obtained by the methods are not reliable. A few percent of results can be "false positive" or "false negative". The purpose of the paper was to present cases of "false positive" THC and amphetamine derivatives results obtained in urine of patients treated in Departments of Toxicology in Krakow and in Tarnow. Confirmation tests gave negative results. Interpretation of results obtained by immunoassay methods should include possibility of "false" result. The physician should consider verification of the results and refer confirmation by reference methods.

  12. Recommendations for CSF AD biomarkers in the diagnostic evaluation of dementia.

    PubMed

    Simonsen, Anja Hviid; Herukka, Sanna-Kaisa; Andreasen, Niels; Baldeiras, Ines; Bjerke, Maria; Blennow, Kaj; Engelborghs, Sebastiaan; Frisoni, Giovanni B; Gabryelewicz, Tomasz; Galluzzi, Samantha; Handels, Ron; Kramberger, Milica G; Kulczyńska, Agnieszka; Molinuevo, Jose Luis; Mroczko, Barbara; Nordberg, Agneta; Oliveira, Catarina Resende; Otto, Markus; Rinne, Juha O; Rot, Uroš; Saka, Esen; Soininen, Hilkka; Struyfs, Hanne; Suardi, Silvia; Visser, Pieter Jelle; Winblad, Bengt; Zetterberg, Henrik; Waldemar, Gunhild

    2017-03-01

    This article presents recommendations, based on the Grading of Recommendations, Assessment, Development, and Evaluation method, for the clinical application of cerebrospinal fluid (CSF) amyloid-β1-42, tau, and phosphorylated tau in the diagnostic evaluation of patients with dementia. The recommendations were developed by a multidisciplinary working group based on the available evidence and consensus from focused discussions for (i) identification of Alzheimer's disease (AD) as the cause of dementia, (ii) prediction of rate of decline, (iii) cost-effectiveness, and (iv) interpretation of results. The working group found sufficient evidence to support a recommendation to use CSF AD biomarkers as a supplement to clinical evaluation, particularly in uncertain and atypical cases, to identify or exclude AD as the cause of dementia. Because of insufficient evidence, it was uncertain whether CSF AD biomarkers outperform imaging biomarkers. Operational recommendations for the interpretation of ambiguous CSF biomarker results were also provided.

  13. Diffusion and chaos from near AdS2 horizons

    NASA Astrophysics Data System (ADS)

    Blake, Mike; Donos, Aristomenis

    2017-02-01

    We calculate the thermal diffusivity D = κ/c ρ and butterfly velocity v B in holographic models that flow to AdS2 × R d fixed points in the infra-red. We show that both these quantities are governed by the same irrelevant deformation of AdS2 and hence establish a simple relationship between them. When this deformation corresponds to a universal dilaton mode of dimension Δ = 2 then this relationship is always given by D = v B 2 /(2 πT).

  14. Heart cells with regenerative potential from pediatric patients with end stage heart failure: a translatable method to enrich and propagate.

    PubMed

    Steele, Ann; Boucek, Robert J; Jacobs, Jeffrey Phillip; Steele, Peter; Asante-Korang, Alfred; Chamizo, Wilfredo; Steele, Jasmine; Chai, Paul J; Quintessenza, James A

    2012-01-01

    Background. Human cardiac-derived progenitor cells (hCPCs) have shown promise in treating heart failure (HF) in adults. The purpose of this study was to describe derivation of hCPCs from pediatric patients with end-stage HF. Methods. At surgery, discarded right atrial tissues (hAA) were obtained from HF patients (n = 25; hAA-CHF). Minced tissues were suspended in complete (serum-containing) DMEM. Cells were selected for their tissue migration and expression of stem cell factor receptor (hc-kit). Characterization of hc-kit(positive) cells included immunohistochemical screening with a panel of monoclonal antibodies. Results. Cells, including phase-bright cells identified as hc-kit(positive), spontaneously emigrated from hAA-CHF in suspended explant cultures (SEC) after Day 7. When cocultured with tissue, emigrated hc-kit(positive) cells proliferated, first as loosely attached clones and later as multicellular clusters. At Day 21~5% of cells were hc-kit(positive). Between Days 14 and 28 hc-kit(positive) cells exhibited mesodermal commitment (GATA-4(positive) and NKX2.5(positive)); then after Day 28 cardiac lineages (flk-1(positive), smooth muscle actin(positive), troponin-I(positive), and myosin light chain(positive)). Conclusions. C-kit(positive) hCPCs can be derived from atrial tissue of pediatric patients with end-stage HF. SEC is a novel culture method for derivation of migratory hc-kit(positive) cells that favors clinical translation by reducing the need for exogenously added factors to expand hCPCs in vitro.

  15. Heart Cells with Regenerative Potential from Pediatric Patients with End Stage Heart Failure: A Translatable Method to Enrich and Propagate

    PubMed Central

    Steele, Ann; Boucek, Robert J.; Jacobs, Jeffrey Phillip; Steele, Peter; Asante-Korang, Alfred; Chamizo, Wilfredo; Steele, Jasmine; Chai, Paul J.; Quintessenza, James A.

    2012-01-01

    Background. Human cardiac-derived progenitor cells (hCPCs) have shown promise in treating heart failure (HF) in adults. The purpose of this study was to describe derivation of hCPCs from pediatric patients with end-stage HF. Methods. At surgery, discarded right atrial tissues (hAA) were obtained from HF patients (n = 25; hAA-CHF). Minced tissues were suspended in complete (serum-containing) DMEM. Cells were selected for their tissue migration and expression of stem cell factor receptor (hc-kit). Characterization of hc-kitpositive cells included immunohistochemical screening with a panel of monoclonal antibodies. Results. Cells, including phase-bright cells identified as hc-kitpositive, spontaneously emigrated from hAA-CHF in suspended explant cultures (SEC) after Day 7. When cocultured with tissue, emigrated hc-kitpositive cells proliferated, first as loosely attached clones and later as multicellular clusters. At Day 21~5% of cells were hc-kitpositive. Between Days 14 and 28 hc-kitpositive cells exhibited mesodermal commitment (GATA-4positive and NKX2.5positive); then after Day 28 cardiac lineages (flk-1positive, smooth muscle actinpositive, troponin-Ipositive, and myosin light chainpositive). Conclusions. C-kitpositive hCPCs can be derived from atrial tissue of pediatric patients with end-stage HF. SEC is a novel culture method for derivation of migratory hc-kitpositive cells that favors clinical translation by reducing the need for exogenously added factors to expand hCPCs in vitro. PMID:22936950

  16. 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 instructional…

  17. A novel method for the management of patients with heparin-induced thrombocytopaenia during cardiac surgery.

    PubMed

    Mishra, Pankaj Kumar; Chnaris, Asterinos; Mohammed, Fayaz; Luckraz, Heyman

    2014-06-01

    A 63-year old, male patient presented with prosthetic valve endocarditis and developed heparin-induced thrombocytopaenia (HIT) following heparin administration for continuous veno-venous haemofiltration. Use of cardiopulmonary bypass in patients suffering from heparin-induced thrombocytopaenia is difficult and challenging. We report a novel method that allows heparin use in patients diagnosed with HIT using Multiplate platelet analyser and iloprost. Platelet function analysis is complex, poorly standardized and time consuming. Multiplate platelet analyser represents a convenient, safe, reliable and rapid system that allows the assessment of platelet dysfunction. It allows objective demonstration of platelet inhibition before administration of heparin, allowing safe establishment of cardiopulmonary bypass in patients suffering from HIT.

  18. 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

  19. Unconstrained Respiration Measurement and Respiratory Arrest Detection Method by Dynamic Threshold in Transferring Patients by Stretchers

    NASA Astrophysics Data System (ADS)

    Kurihara, Yosuke; Watanabe, Kajiro; Kobayashi, Kazuyuki; Tanaka, Hiroshi

    General anesthesia used for surgical operations may cause unstable conditions of the patients after the operations, which could lead to respiratory arrests. Under such circumstances, nurses could fail in finding the change of the conditions, and other malpractices could also occur. It is highly possible that such malpractices may occur while transferring a patient from ICU to the room using a stretcher. Monitoring the change in the blood oxygen saturation concentration and other vital signs to detect a respiratory arrest is not easy when transferring a patient on a stretcher. Here we present several noise reduction system and algorithm to detect respiratory arrests in transferring a patient, based on the unconstrained air pressure method that the authors presented previously. As the result, when the acceleration level of the stretcher noise was 0.5G, the respiratory arrest detection ratio using this novel method was 65%, while that with the conventional method was 0%.

  20. Method for quality control of laboratory tests using histograms of daily patient data.

    PubMed

    Okada, M

    1990-01-01

    A method for controlling the quality of laboratory tests is proposed. Histograms of patients' daily results which fall within reference ranges of healthy individuals are used for estimating accuracy and precision of measurements. For the determination of accuracy, three methods are evaluated; computing an average of patients' results; determining the location of the peak of the histogram; approximating the histogram by an Erland distribution and determining the peak of the distribution. For precision control, standard deviations are calculated from patient data. We applied these methods to serum aspartate aminotransferase (AST or SGOT) and total cholesterol of patients in a general hospital. Averages, peaks of approximated Erland distribution, and standard deviations were found to be useful to daily quality control in laboratories of large hospitals.

  1. Typicality Mediates Performance during Category Verification in Both Ad-hoc and Well-defined Categories

    PubMed Central

    Sandberg, Chaleece; Sebastian, Rajani; Kiran, Swathi

    2012-01-01

    Background The typicality effect is present in neurologically intact populations for natural, ad-hoc, and well-defined categories. Although sparse, there is evidence of typicality effects in persons with chronic stroke aphasia for natural and ad-hoc categories. However, it is unknown exactly what influences the typicality effect in this population. Aims The present study explores the possible contributors to the typicality effect in persons with aphasia by analyzing and comparing data from both normal and language-disordered populations, from persons with aphasia with more semantic impairment versus those with less semantic impairment, and from two types of categories with very different boundary structure (ad-hoc vs. well-defined). Methods and procedures A total of 40 neurologically healthy adults (20 older, 20 younger) and 35 persons with aphasia (20 LSI (less-semantically impaired) patients, 15 MSI (more-semantically impaired) patients) participated in the study. Participants completed one of two tasks: either category verification for ad-hoc categories or category verification for well-defined categories. Outcomes and Results Neurologically healthy participants showed typicality effects for both ad-hoc and well-defined categories. MSI patients showed a typicality effect for well-defined categories, but not for ad-hoc categories, whereas LSI patients showed a typicality effect for ad-hoc categories, but not for well-defined categories. Conclusions These results suggest that the degree of semantic impairment mediates the typicality effect in persons with aphasia depending on the structure of the category. PMID:22261305

  2. Effects of auditing patient safety in hospital care: design of a mixed-method evaluation

    PubMed Central

    2013-01-01

    Background Auditing of patient safety aims at early detection of risks of adverse events and is intended to encourage the continuous improvement of patient safety. The auditing should be an independent, objective assurance and consulting system. Auditing helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluating and improving the effectiveness of risk management, control, and governance. Audits are broadly conducted in hospitals, but little is known about their effects on the behaviour of healthcare professionals and patient safety outcomes. This study was initiated to evaluate the effects of patient safety auditing in hospital care and to explore the processes and mechanisms underlying these effects. Methods and design Our study aims to evaluate an audit system to monitor and improve patient safety in a hospital setting. We are using a mixed-method evaluation with a before-and-after study design in eight departments of one university hospital in the period October 2011–July 2014. We measure several outcomes 3 months before the audit and 15 months after the audit. The primary outcomes are adverse events and complications. The secondary outcomes are experiences of patients, the standardised mortality ratio, prolonged hospital stay, patient safety culture, and team climate. We use medical record reviews, questionnaires, hospital administrative data, and observations to assess the outcomes. A process evaluation will be used to find out which components of internal auditing determine the effects. Discussion We report a study protocol of an effect and process evaluation to determine whether auditing improves patient safety in hospital care. Because auditing is a complex intervention targeted on several levels, we are using a combination of methods to collect qualitative and quantitative data about patient safety at the patient, professional, and department levels. This study is relevant for hospitals that want to

  3. Black hole formation in AdS Einstein-Gauss-Bonnet gravity

    NASA Astrophysics Data System (ADS)

    Deppe, Nils; Kolly, Allison; Frey, Andrew R.; Kunstatter, Gabor

    2016-10-01

    AdS spacetime has been shown numerically to be unstable against a large class of arbitrarily small perturbations. In [1], the authors presented a preliminary study of the effects on stability of changing the local dynamics by adding a Gauss-Bonnet term to the Einstein action. Here we provide further details as well as new results with improved numerical methods. In particular, we elucidate new structure in Choptuik scaling plots. We also provide evidence of chaotic behavior at the transition between immediate horizon formation and horizon formation after the matter pulse reflects from the AdS conformal boundary. Finally, we present data suggesting the formation of naked singularities in spacetimes with ADM mass below the algebraic bound for black hole formation.

  4. A sensitive HPLC method for the quantification of free and total p-cresol in patients with chronic renal failure.

    PubMed

    De Smet, R; David, F; Sandra, P; Van Kaer, J; Lesaffer, G; Dhondt, A; Lameire, N; Vanholder, R

    1998-11-01

    Para-cresol (4-methylphenol) is a volatile phenolic compound which is retained in chronic renal failure. Several recent studies suggest that p-cresol interferes with various biochemical and physiological functions at concentrations currently observed in uremia. Only a few methods are available for the determination of p-cresol concentration in serum. In addition, these methods have only been used for the determination of total p-cresol. In particular, the evolution of free (non-protein bound) p-cresol is of concern, because conceivably this is the biologically active fraction. The concentration of free p-cresol, is, however, markedly lower than that of total p-cresol, in view of its important protein binding. We report a method enabling the measurement of total and free p-cresol concentration in serum of healthy controls and uremic patients. Deproteinization, extraction and HPLC procedure are efficient, without interference of other protein bound ligands and/or precursors of p-cresol or phenol. By means of spiking experiments, the measurement of the UV absorbance over the 200-400 nm wavelength range, and capillary gas chromatography-mass spectrometry, the considered compound is identified as p-cresol. With a fluorescence detection at 284/310 nm as extinction/emission wavelengths the detection limit of p-cresol is 1.3 micromol/l (0.14 microg/ml). Recovery of added p-cresol to normal serum is 95.4+/-4.1%. For free p-cresol and total p-cresol determinations, intra-assay and day-to-day variation co-efficients are 3.2%, 4.2%, 6.9% and 7.3%, respectively. Compared to healthy controls, the serum p-cresol levels are 7-10 times higher in continuous ambulatory peritoneal dialysis patients (CAPD), uremic outpatients, and hemodialysis patients: 8.6+/-3.0 vs. 62.0+/-19.5, 87.8+/-31.7 and 88.7+/-49.3 micromol/l (0.93+/-0.32 vs. 6.70+/-2.11, 9.49+/-3.43, and 9.60+/-5.30 microg/ml) (p<0.05), respectively. The difference is even more important if free p-cresol is considered. This

  5. 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.

  6. Coset construction of AdS particle dynamics

    NASA Astrophysics Data System (ADS)

    Heinze, Martin; Jorjadze, George; Megrelidze, Luka

    2017-01-01

    We analyze the dynamics of the AdSN+1 particle realized on the coset SO(2, N)/SO (1,N). Hamiltonian reduction provides the physical phase space in terms of the coadjoint orbit obtained by boosting a timelike element of 𝔰𝔬(2, N). We show equivalence of this approach to geometric quantization and to the SO(N) covariant oscillator description, for which the boost generators entail a complicated operator ordering. As an alternative scheme, we introduce dual oscillator variables and derive their algebra at the classical and the quantum levels. This simplifies the calculations of the commutators for the boost generators and leads to unitary irreducible representations of 𝔰𝔬(2, N) for all admissible values of the mass parameter. We furthermore discuss an SO(N) covariant supersymmetric extension of the oscillator quantization, with its realization for superparticles in AdS2 and AdS3 given by recent works.

  7. AdS5 backgrounds with 24 supersymmetries

    NASA Astrophysics Data System (ADS)

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

    2016-06-01

    We prove a non-existence theorem for smooth AdS 5 solutions with connected, compact without boundary internal space that preserve strictly 24 supersymmetries. In particular, we show that D = 11 supergravity does not admit such solutions, and that all such solutions of IIB supergravity are locally isometric to the AdS 5 × S 5 maximally supersymmetric background. Furthermore, we prove that (massive) IIA supergravity also does not admit such solutions, provided that the homogeneity conjecture for massive IIA supergravity is valid. In the context of AdS/CFT these results imply that if gravitational duals for strictly mathcal{N}=3 superconformal theories in 4-dimensions exist, they are either singular or their internal spaces are not compact.

  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. [Comparative characteristic of methods for operative treatment of patients suffering varicocele].

    PubMed

    Boĭko, M I; Pasiechnikov, S P; Boĭko, O M

    2014-04-01

    Efficacy and security of treatment of varicocele constitute a complex issues in urology, necessitating the additional investigations conduction. The results of surgical treatment of 280 patients, suffering left-sided varicocele and operated using three different methods--retroperitoneal varicocelectomy, laparoscopic varicocelectomy and subinguinal microsurgical varicocelectomy (SMV)--were analyzed. The advantages and faults of these methods were estimated, basing on the recurrence rate, complications by hidrocele occurrence and changes in the patients quality of life. SMV was determined as most effective and secure method of varicocele correction. The data obtained may be useful for choice of tactics for the disease treatment.

  10. [Rehabilitation of patients after total endoprosthesis replacement of hip joint by the method of functional electrostimulation].

    PubMed

    Oskanian, T L; Solopova, I A; Grishin, A A; Sidorov, V D

    2008-01-01

    Patients after total endoprosthesis replacement of hip joint underwent method of functional electrostimulation (FES) with the purpose to recovery correct walking stereotype, to increase leisured muscle strength, to prevent secondary coxarthrosis development via stimulation or relaxation of muscles, and for analgesia of joints and pain zones at walking. Results of treatment of 143 patients received rehabilitation course of FES (15 procedures of 30 minutes) were compared with results of treatment of 54 patients received traditional methods. It is shown that FES is effective method of rehabilitation because it makes possible to improve muscle strength significantly, to eliminate or reduce motor deficit, to decrease pain syndrome, to form correct walking stereotype, and to perform early prophylaxis of secondary coxarthrosis on contralateral side. The main advantage of proposed method of nonmedicamental influence is better clinic-biomechanical result without use of drugs.

  11. Methods for Incorporating Patient Preferences for Treatments of Depression in Community Mental Health Settings.

    PubMed

    Crits-Christoph, Paul; Gallop, Robert; Diehl, Caroline K; Yin, Seohyun; Gibbons, Mary Beth Connolly

    2016-06-22

    We developed three methods (rating, ranking, and discrete choice) for identifying patients' preferred depression treatments based on their prioritization of specific treatment attributes (e.g., medication side effects, psychotherapy characteristics) at treatment intake. Community mental health patients with depressive symptoms participated in separate studies of predictive validity (N = 193) and short-term (1-week) stability (N = 40). Patients who received non-preferred initial treatments (based on the choice method) switched treatments significantly more often than those who received preferred initial treatments. Receiving a non-preferred treatment at any point (based on rating and choice methods) was a significant predictor of longer treatment duration. All three methods demonstrated good short-term stability.

  12. Accuracy of Conventional Diagnostic Methods for Identifying Structural Changes in Patients with Focal Epilepsy

    PubMed Central

    Dakaj, Nazim; Kruja, Jera; Jashari, Fisnik; Boshnjaku, Dren; Shatri, Nexhat; Zeqiraj, Kamber

    2016-01-01

    Background: Epilepsy is a neurological disorder characterized by abnormal firing of nerve impulses in the brain. Aim: This study aims to investigate the frequency of appearance of pathological changes in conventional examination methods (electroencephalography–EEG, brain computerized tomography -CT or brain magnetic resonance imaging – MRI) in patients with epilepsy, and relationship between clinical manifestations and localization of changes in CT or MRI. Methods: In this study we have included 110 patients with focal epilepsy who fulfilled the inclusion criteria out of 557 initially diagnosed patients. Detailed clinical examination together with brain imaging (CT and MRI) and electroencephalography examination was performed. We have evaluated the accuracy of each diagnostic method to localize the epileptic focus. Diagnosis of epilepsy was determined by the ILAE (International League Against Epilepsy) criteria of the year 1989, and classification of epileptic seizures was made according to the ILAE classification 2010. Results: Electroencephalography presented changes in 60.9% of patients; brain CT in 42.1%, and MRI in 78% of the patients. The results of our study showed that clinical manifestations were not always conveyed with pathological changes in conventional examining methods performed. Of the total of 79 patients with changes in imaging (8 with changes in CT and 71 in MRI), 79.7% presented a clinical picture compatible with the region in which morphological changes were found, while in 20.3% of patients the presented morphological changes were not aligned with the clinical picture. Conclusion: In patients with epilepsy, conventional examination methods do not always find pathological changes, while clinical manifestations of epilepsy did not always coincide with the location of changes in imaging. Further studies are needed to see if there is clear border between focal and generalized epilepsy. PMID:28077892

  13. Myelodysplastic Syndromes (MDS) and autoimmune disorders (AD): cause or consequence?

    PubMed

    Braun, Thorsten; Fenaux, Pierre

    2013-12-01

    Myelodysplastic Syndromes (MDS) and Chronic Myelomonocytic Leukemia (CMML) are frequently associated with clinical manifestations of autoimmune disorders (AD) and inflammatory response of the immune system. AD accompanying MDS and CMML include vasculitis, seronegative polyarthritis and neutrophilic dermatosis. Rare AD including relapsing polychondritis is strongly associated with MDS as in a high proportion of those patients MDS is diagnosed during disease course. Antinuclear antibodies (ANA) are frequently found among MDS patients without clinical manifestation of AD. In a subset of patients, MDS and resulting cytopenias appear to be the consequence of auto reactive immunologic activity and may respond to immunosuppressive treatment (IST). Increased release of inflammatory cytokines like tumor necrosis factor-(TNF)-α and interferon (IF)-γ triggers apoptosis of myeloid precursor cells leading to cytopenias. Impaired function of immune cells including cytotoxic, regulatory (Treg), helper (Th17) T cells and NK cells also appears to predict response to IST, outcome and occurrence of AD.

  14. 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.

  15. 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

  16. 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…

  17. 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…

  18. "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…

  19. 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

  20. Concept Mapping as a Method to Engage Patients in Clinical Quality Improvement

    PubMed Central

    LaNoue, Marianna; Mills, Geoffrey; Cunningham, Amy; Sharbaugh, Adam

    2016-01-01

    Patient engagement has become a primary care research and practice priority. Little guidance exists, however, on how best to engage patients in primary care practice improvement, or how to measure the impact of their engagement. We present an overview of group concept mapping as a method for engaging patients in primary care practice improvement. We detail the group concept mapping process as a tool for use in primary care practice improvement, research, and evaluation, and we present resources to enable researchers and practice leaders to use this tool in practice improvement. To illustrate the method, we present a practice-based quality improvement project conducted with patients and staff at a large urban academic primary care practice. PMID:27401427

  1. 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.

  2. Polynya Signature Simulation Method polynya area in comparison to AMSR-E 89 GHz sea-ice concentrations in the Ross Sea and off the Adélie Coast, Antarctica, for 2002-05: first results

    NASA Astrophysics Data System (ADS)

    Kern, Stefan; Spreen, Gunnar; Kaleschke, Lars; de La Rosa, Sara; Heygster, Georg

    2007-10-01

    The Polynya Signature Simulation Method (PSSM) is applied to Special Sensor Microwave/Imager observations from different Defense Meteorological Satellite Program spacecraft for 2002-05 to analyze the polynya area in the Ross Sea (Ross Ice Shelf polynya (RISP) and Terra Nova Bay polynya (TNBP)) and off the Adélie Coast (Mertz Glacier polynya (MGP)), Antarctica, on a sub-daily scale. The RISP and the MGP exhibit similar average total polynya areas. Major area changes (>10 000 km2; TNPB: >2000 km2) occur over a range of 2-3 to 20 days in all regions. Sub-daily area changes are largest for the MGP (5800 km2) and smallest for the TNBP (800 km2), underlining the persistence of the forcing of the latter. ARTIST sea-ice (ASI) algorithm concentration maps obtained using 89 GHz Advanced Microwave Scanning Radiometer (AMSR-E) data are compared to PSSM maps, yielding convincing agreement in the average, similarly detailed winter polynya distribution. Average ASI algorithm ice concentrations take values of 25-40% and 65-80% for the PSSM open-water and thin-ice class, respectively. The discrepancy with expected values (0% and 100%) can be explained by the different spatial resolution and frequency used by the methods. A new land mask and a mask to flag icebergs are introduced. Comparison of PSSM maps with thermal ice thickness based on AVHRR infrared temperature and ECMWF ERA-40 data suggests an upper thickness limit for the PSSM thin-ice class of 20-25 cm.

  3. Mellin Amplitudes for Supergravity on AdS5×S5

    NASA Astrophysics Data System (ADS)

    Rastelli, Leonardo; Zhou, Xinan

    2017-03-01

    We revisit the calculation of holographic correlation functions in type-IIB supergravity on AdS5×S5 . Results for four-point functions simplify drastically when expressed in Mellin space. We conjecture a compact formula for the four-point functions of one-half Bogomol'nyi-Prasad-Sommerfield single-trace operators of arbitrary weight. Our methods rely on general consistency conditions and eschew detailed knowledge of the supergravity effective action.

  4. Disease Awareness and Management Behavior of Patients with Atopic Dermatitis: A Questionnaire Survey of 313 Patients

    PubMed Central

    Kim, Jung Eun; Lee, Young Bok; Lee, Ji Hyun; Kim, Hye Sung; Lee, Kyung Ho; Park, Young Min; Lee, Jun Young

    2015-01-01

    Background Patients with atopic dermatitis (AD) should be relatively well informed about the disorder to control their condition and prevent flare-ups. Thus far, there is no accurate information about the disease awareness levels and therapeutic behavior of AD patients. Objective To collect data on patients' knowledge about AD and their behavior in relation to seeking information about the disease and its treatment. Methods We performed a questionnaire survey on the disease awareness and self-management behavior of AD patients. A total of 313 patients and parents of patients with AD who had visited the The Catholic University of Korea, Catholic Medical Center between November 2011 and October 2012 were recruited. We compared the percentage of correct answers from all collected questionnaires according to the demographic and disease characteristics of the patients. Results Although dermatologists were the most frequent disease information sources and treatment providers for the AD patients, a significant proportion of participants obtained information from the Internet, which carries a huge amount of false medical information. A considerable number of participants perceived false online information as genuine, especially concerning complementary and alternative medicine treatments of AD, and the adverse effects of steroids. Some questions on AD knowledge had significantly different answers according to sex, marriage status, educational level, type of residence and living area, disease duration, disease severity, and treatment history with dermatologists. Conclusion Dermatologists should pay more attention to correcting the common misunderstandings about AD to reduce unnecessary social/economic losses and improve treatment compliance. PMID:25673930

  5. Non-Invasive Methods to Diagnose Fungal Infections in Pediatric Patients with Hematologic Disorders

    PubMed Central

    Badiee, Parisa; Hashemizadeh, Zahra; Ramzi, Mani; Karimi, Mohammad; Mohammadi, Rasoul

    2016-01-01

    Background Invasive fungal infection (IFIs) is a major infectious complication in immunocompromised patients. Early diagnosis and initiation of antifungal therapy is important to achieve the best outcome. Objectives The current study aimed to investigate the incidence of IFIs and evaluate the diagnostic performance of non-invasive laboratory tests: serologic (β-D-glucan, galactomannan) and molecular (nested polymerase chain reaction) tests to diagnose fungal infections in hematologic pediatric patients. Patients and Methods In a cross-sectional study from October 2014 to January 2015, 321 blood samples of 62 pediatric patients with hematologic disorders and at high risk for fungal infections were analyzed. Non-invasive tests including the Platelia Aspergillus enzyme immunoassay (EIA) to detect galactomannan antigen, Glucatell for β–D–glucan and nested PCR to detect Candida and Aspergillus species-specific DNA were used in a weekly screening strategy. Results Twenty six patients (42%) were considered as proven and probable IFIs, including 3 (5%) proven and 23 (37%) probable cases. Eighteen patients (29%) were considered as possible cases. The sensitivity, specificity, positive and negative predictive values for galactomannan test in 26 patients with proven and probable fungal infections were 94.4%, 100%, 100% and 94.7%; for β-D-glucan test 92.3%, 77.7%, 85%, 87.5% and for nested-PCR were 84.6%, 88.8%, 91.7% and 80%, respectively. Conclusions The rate of IFIs in pediatric patients with hematologic disorders is high, and sample collection from the sterile sites cannot be performed in immunocompromised patients. Detection of circulating fungal cell wall components and DNA in the blood using non-invasive methods can offer diagnostic help in patients with suspected IFIs. Their results should be interpreted in combination with clinical, radiological and microbiological findings. PMID:28138379

  6. Similarity measure between patient traces for clinical pathway analysis: problem, method, and applications.

    PubMed

    Huang, Zhengxing; Dong, Wei; Duan, Huilong; Li, Haomin

    2014-01-01

    Clinical pathways leave traces, described as event sequences with regard to a mixture of various latent treatment behaviors. Measuring similarities between patient traces can profitably be exploited further as a basis for providing insights into the pathways, and complementing existing techniques of clinical pathway analysis (CPA), which mainly focus on looking at aggregated data seen from an external perspective. Most existing methods measure similarities between patient traces via computing the relative distance between their event sequences. However, clinical pathways, as typical human-centered processes, always take place in an unstructured fashion, i.e., clinical events occur arbitrarily without a particular order. Bringing order in the chaos of clinical pathways may decline the accuracy of similarity measure between patient traces, and may distort the efficiency of further analysis tasks. In this paper, we present a behavioral topic analysis approach to measure similarities between patient traces. More specifically, a probabilistic graphical model, i.e., latent Dirichlet allocation (LDA), is employed to discover latent treatment behaviors of patient traces for clinical pathways such that similarities of pairwise patient traces can be measured based on their underlying behavioral topical features. The presented method provides a basis for further applications in CPA. In particular, three possible applications are introduced in this paper, i.e., patient trace retrieval, clustering, and anomaly detection. The proposed approach and the presented applications are evaluated via a real-world dataset of several specific clinical pathways collected from a Chinese hospital.

  7. Vaccination of high-risk patients for influenza. A comparison of telephone and mail reminder methods.

    PubMed

    Brimberry, R

    1988-04-01

    During the 1984-1985 influenza season two study groups were used to compare telephone and letter reminder methods with a control group that received no reminder to determine which was the most effective strategy to increase influenza vaccination rates among the high-risk patient population of a university-based family practice. Seven hundred eighty-seven high-risk patients were randomly assigned to one of the three study groups: a mailed-reminder group, a telephone-reminder group, and a control group. Vaccination rates for both reminder methods were significantly higher than for the control group (P less than .02), and if successfully contacted, the telephone-reminder group had a significantly better vaccination rate than the mailed-reminder group (P less than .05). If successful telephone contact can be made, this reminder method is more effective than a letter reminder to increase influenza vaccination rates among high-risk patients.

  8. A deformation of AdS5 × S5

    NASA Astrophysics Data System (ADS)

    Gauntlett, Jerome P.; Gutowski, Jan B.; Suryanarayana, Nemani V.

    2004-11-01

    We analyse a one-parameter family of supersymmetric solutions of type IIB supergravity that includes AdS5 × S5. For small values of the parameter the solutions are causally well behaved, but beyond a critical value closed timelike curves (CTCs) appear. The solutions are holographically dual to {\\cal N}=4 supersymmetric Yang Mills theory on a non-conformally flat background with non-vanishing R-currents. We compute the holographic energy momentum tensor for the spacetime and show that it remains finite even when the CTCs appear. The solutions, as well as the uplift of some recently discovered AdS5 black-hole solutions, are shown to preserve precisely two supersymmetries.

  9. Supersymmetric AdS_6 solutions of type IIB supergravity

    NASA Astrophysics Data System (ADS)

    Kim, Hyojoong; Kim, Nakwoo; Suh, Minwoo

    2015-10-01

    We study the general requirement for supersymmetric AdS_6 solutions in type IIB supergravity. We employ the Killing spinor technique and study the differential and algebraic relations among various Killing spinor bilinears to find the canonical form of the solutions. Our result agrees precisely with the work of Apruzzi et al. (JHEP 1411:099, 2014), which used the pure spinor technique. Hoping to identify the geometry of the problem, we also computed four-dimensional theory through the dimensional reduction of type IIB supergravity on AdS_6. This effective action is essentially a non-linear sigma model with five scalar fields parametrizing {SL}(3,{R})/{SO}(2,1), modified by a scalar potential and coupled to Einstein gravity in Euclidean signature. We argue that the scalar potential can be explained by a subgroup CSO(1,1,1) subset {SL}(3,{R}) in a way analogous to gauged supergravity.

  10. Universal isolation in the AdS landscape

    NASA Astrophysics Data System (ADS)

    Danielsson, U. H.; Dibitetto, G.; Vargas, S. C.

    2016-12-01

    We study the universal conditions for quantum nonperturbative stability against bubble nucleation for pertubatively stable AdS vacua based on positive energy theorems. We also compare our analysis with the preexisting ones in the literature carried out within the thin-wall approximation. The aforementioned criterion is then tested in two explicit examples describing massive type IIA string theory compactified on S3 and S3×S3, respectively. The AdS landscape of both classes of compactifications is known to consist of a set of isolated points. The main result is that all critical points respecting the Breitenlohner-Freedman (BF) bound also turn out be stable at a nonperturbative level. Finally, we speculate on the possible universal features that may be extracted from the above specific examples.

  11. Tachyon inflation in an AdS braneworld with backreaction

    NASA Astrophysics Data System (ADS)

    Bilić, Neven; Dimitrijevic, Dragoljub D.; Djordjevic, Goran S.; Milosevic, Milan

    2017-02-01

    We analyze the inflationary scenario based on the tachyon field coupled with the radion of the second Randall-Sundrum model (RSII). The tachyon Lagrangian is derived from the dynamics of a 3-brane moving in the five-dimensional bulk. The AdS5 geometry of the bulk is extended to include the radion. Using the Hamiltonian formalism we find four nonlinear field equations supplemented by the modified Friedmann equations of the RSII braneworld cosmology. After a suitable rescaling we reduce the parameters of our model to only one free parameter related to the brane tension and the AdS5 curvature. We solve the equations numerically assuming a reasonably wide range of initial conditions determined by physical considerations. Varying the free parameter and initial conditions we confront our results with the Planck 2015 data.

  12. Ambitwistors, oscillators and massless fields on AdS5

    NASA Astrophysics Data System (ADS)

    Uvarov, D. V.

    2016-11-01

    Positive energy unitary irreducible representations of SU (2 , 2) can be constructed with the aid of bosonic oscillators in (anti)fundamental representation of SU(2)L × SU(2)R that are closely related to Penrose twistors. Starting with the correspondence between the doubleton representations, homogeneous functions on projective twistor space and on-shell generalized Weyl curvature SL (2 , C) spinors and their low-spin counterparts, we study in the similar way the correspondence between the massless representations, homogeneous functions on ambitwistor space and, via the Penrose transform, with the gauge fields on Minkowski boundary of AdS5. The possibilities of reconstructing massless fields on AdS5 and some applications are also discussed.

  13. Generalised structures for N=1 AdS backgrounds

    NASA Astrophysics Data System (ADS)

    Coimbra, André; Strickland-Constable, Charles

    2016-11-01

    We expand upon a claim made in a recent paper [arXiv:1411.5721] that generic minimally supersymmetric AdS backgrounds of warped flux compactifications of Type II and M theory can be understood as satisfying a straightforward weak integrability condition in the language of {E}_{d(d)}× {R}+ generalised geometry. Namely, they are spaces admitting a generalised G-structure set by the Killing spinor and with constant singlet generalised intrinsic torsion.

  14. Methods and results of local treatment of brain metastases in patients with breast cancer

    PubMed Central

    Pluta, Elżbieta; Walasek, Tomasz; Blecharz, Paweł; Jakubowicz, Jerzy; Mituś, Jerzy W.

    2017-01-01

    This article presents methods and results of surgical treatment and radiation therapy of brain metastases in breast cancer patients (brain metastases from breast cancer BMF-BC). Based on the literature data, it was shown that patients with single BMF-BC, aged less than 65 years, with Karnofsky score (KPS) of 70 or more and with cured or controlled extracranial disease are the best candidates to surgical treatment. Irrespective of the extracranial disease control status, there are indications for surgery in patients with symptomatic mass effect (tumour diameter larger than 3 cm) and patients with obstructive hydrocephalus from their BMF-BC. Stereotactic radiosurgery (SRS) has some advantages over surgery, with similar effectiveness: it may be used in the treatment of lesions inaccessible to surgery, the number of lesion is not a limiting factor if each lesion is small (< 3) and adequate doses can be delivered, it is not contraindicated in patients with active extracranial disease, it does not interfere with ongoing systemic treatment, and it does not require general anaesthesia or hospitalisation. A disadvantage of SRS, as compared to whole brain radiotherapy (WBRT), in patients with BMF-BC is the possibility of subsequent development of new lesion in the non-irradiated field. Thus the majority of the BMF-BC patients are not good candidates to surgery or SRS; WBRT alone or combined with a systemic treatment still plays a major role in the treatment of these patients. PMID:28239278

  15. [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.

  16. On information loss in AdS3/CFT2

    DOE PAGES

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

    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

  17. Shock Wave Collisions and Thermalization in AdS_5

    NASA Astrophysics Data System (ADS)

    Kovchegov, Y. V.

    We study heavy ion collisions at strong 't Hooft coupling usingAdS/CFT correspondence. According to the AdS/CFT dictionary heavy ion collisions correspond to gravitational shock wave collisions in AdS_5. We construct the metric in the forward light cone after the collision perturbatively through expansion of Einstein equations in graviton exchanges. We obtain an analytic expression for the metric including all-order graviton exchanges with one shock wave, while keeping the exchanges with another shock wave at the lowest order. We read off the corresponding energy-momentum tensor of the produced medium. Unfortunately this energy-momentum tensor does not correspond to ideal hydrodynamics, indicating that higher order graviton exchanges are needed to construct the full solution of the problem. We also show that shock waves must completely stop almost immediately after the collision in AdS_5, which, on the field theory side, corresponds to complete nuclear stopping due to strong coupling effects, likely leading to Landau hydrodynamics. Finally, we perform trapped surface analysis of the shock wave collisions demonstrating that a bulk black hole, corresponding to ideal hydrodynamics on the boundary, has to be created in such collisions, thus constructing a proof of thermalization in heavy ion collisions at strong coupling.

  18. 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

  19. Neutrophil Gelatinase-Associated Lipocalin and its Receptors in Alzheimer’s Disease (AD) Brain Regions: Differential Findings in AD with and without Depression

    PubMed Central

    Dekens, Doortje W.; Naudé, Petrus J.W.; Engelborghs, Sebastiaan; Vermeiren, Yannick; Van Dam, Debby; Oude Voshaar, Richard C.; Eisel, Ulrich L.M.; De Deyn, Peter P.

    2016-01-01

    Co-existing depression worsens Alzheimer’s disease (AD) pathology. Neutrophil gelatinase-associated lipocalin (NGAL) is a newly identified (neuro)inflammatory mediator in the pathophysiologies of both AD and depression. This study aimed to compare NGAL levels in healthy controls, AD without depression (AD–D), and AD with co-existing depression (AD+D) patients. Protein levels of NGAL and its receptors, 24p3R and megalin, were assessed in nine brain regions from healthy controls (n = 19), AD–D (n = 19), and AD+D (n = 21) patients. NGAL levels in AD–D patients were significantly increased in brain regions commonly associated with AD. In the hippocampus, NGAL levels were even further increased in AD+D subjects. Unexpectedly, NGAL levels in the prefrontal cortex of AD+D patients were comparable to those in controls. Megalin levels were increased in BA11 and amygdala of AD+D patients, while no changes in 24p3R were detected. These findings indicate significant differences in neuroimmunological regulation between AD patients with and without co-existing depression. Considering its known effects, elevated NGAL levels might actively promote neuropathological processes in AD with and without depression. PMID:27716662

  20. Mysterious zero in AdS5×S5 supergravity

    NASA Astrophysics Data System (ADS)

    Bars, Itzhak

    2002-11-01

    It is shown that all the states in AdS5×S5 supergravity have zero eigenvalue for all Casimir eigenvalues of its symmetry group SU(2,2|4). To compute this zero in supergravity we refine the oscillator methods for studying the lowest weight unitary representations of SU(N,M|R+S). We solve the reduction problem when one multiplies an arbitrary number of super-doubletons. This enters in the computation of the Casimir eigenvalues of the lowest weight representations. We apply the results to SU(2,2|4) that classifies the Kaluza-Klein towers of ten-dimensional type IIB supergravity compactified on AdS5×S5. We show that the vanishing of the SU(2,2|4) Casimir eigenvalues for all the states is indeed a group-theoretical fact in AdS5×S5 supergravity. By the AdS-CFT correspondence, it is also a fact for gauge invariant states of super-Yang-Mills theory with four supersymmetries in four dimensions. This nontrivial and mysterious zero is very interesting because it is predicted as a straightforward consequence of the fundamental local Sp(2) symmetry in 2T-physics. Via the 2T-physics explanation of this zero we find a global indication that these special supergravity and super-Yang-Mills theories hide a twelve-dimensional structure with (10,2) signature.

  1. 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.

  2. Bortezomib Added to Daunorubicin and Cytarabine During Induction Therapy and to Intermediate-Dose Cytarabine for Consolidation in Patients With Previously Untreated Acute Myeloid Leukemia Age 60 to 75 Years: CALGB (Alliance) Study 10502

    PubMed Central

    Attar, Eyal C.; Johnson, Jeffrey L.; Amrein, Philip C.; Lozanski, Gerard; Wadleigh, Martha; DeAngelo, Daniel J.; Kolitz, Jonathan E.; Powell, Bayard L.; Voorhees, Peter; Wang, Eunice S.; Blum, William; Stone, Richard M.; Marcucci, Guido; Bloomfield, Clara D.; Moser, Barry; Larson, Richard A.

    2013-01-01

    Purpose The purpose of this study was to determine remission induction frequency when bortezomib was combined with daunorubicin and cytarabine in previously untreated older adults with acute myeloid leukemia (AML) and safety of bortezomib in combination with consolidation chemotherapy consisting of intermediate-dose cytarabine (Int-DAC). Patients and Methods Ninety-five adults (age 60 to 75 years; median, 67 years) with previously untreated AML (including therapy-related and previous myelodysplastic syndrome) received bortezomib 1.3 mg/m2 intravenously (IV) on days 1, 4, 8, and 11 with daunorubicin 60 mg/m2 on days 1 through 3 and cytarabine 100 mg/m2 by continuous IV infusion on days 1 through 7. Patients who achieved complete remission (CR) received up to two courses of consolidation chemotherapy with cytarabine 2 gm/m2 on days 1 through 5 with bortezomib. Three cohorts with escalating dose levels of bortezomib were tested (0.7, 1.0, and 1.3 mg/m2). Dose-limiting toxicities were assessed during the first cycle of consolidation. The relationship between cell surface expression of CD74 and clinical outcome was assessed. Results Frequency of CR was 65% (62 of 95), and 4% of patients (four of 95) achieved CR with incomplete platelet recovery (CRp). Eleven patients developed grade 3 sensory neuropathy. Bortezomib plus Int-DAC proved tolerable at the highest dose tested. Lower CD74 expression was associated with CR/CRp (P = .04) but not with disease-free or overall survival. Conclusion The addition of bortezomib to standard 3 + 7 daunorubicin and cytarabine induction chemotherapy for AML resulted in an encouraging remission rate. The maximum tested dose of bortezomib administered in combination with Int-DAC for remission consolidation was 1.3 mg/m2 and proved tolerable. Further testing of this regimen is planned. PMID:23129738

  3. Design and fabrication of facial prostheses for cancer patient applying computer aided method and manufacturing (CADCAM)

    NASA Astrophysics Data System (ADS)

    Din, Tengku Noor Daimah Tengku; Jamayet, Nafij; Rajion, Zainul Ahmad; Luddin, Norhayati; Abdullah, Johari Yap; Abdullah, Abdul Manaf; Yahya, Suzana

    2016-12-01

    Facial defects are either congenital or caused by trauma or cancer where most of them affect the person appearance. The emotional pressure and low self-esteem are problems commonly related to patient with facial defect. To overcome this problem, silicone prosthesis was designed to cover the defect part. This study describes the techniques in designing and fabrication for facial prosthesis applying computer aided method and manufacturing (CADCAM). The steps of fabricating the facial prosthesis were based on a patient case. The patient was diagnosed for Gorlin Gotz syndrome and came to Hospital Universiti Sains Malaysia (HUSM) for prosthesis. The 3D image of the patient was reconstructed from CT data using MIMICS software. Based on the 3D image, the intercanthal and zygomatic measurements of the patient were compared with available data in the database to find the suitable nose shape. The normal nose shape for the patient was retrieved from the nasal digital library. Mirror imaging technique was used to mirror the facial part. The final design of facial prosthesis including eye, nose and cheek was superimposed to see the result virtually. After the final design was confirmed, the mould design was created. The mould of nasal prosthesis was printed using Objet 3D printer. Silicone casting was done using the 3D print mould. The final prosthesis produced from the computer aided method was acceptable to be used for facial rehabilitation to provide better quality of life.

  4. 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

  5. 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…

  6. The generalized added mass revised

    NASA Astrophysics Data System (ADS)

    De Wilde, Juray

    2007-05-01

    The reformulation of the generalized or apparent added mass presented by De Wilde [Phys. Fluids 17, 113304 (2005)] neglects the presence of a drag-type force in the gas and solid phase momentum equations. Reformulating the generalized added mass accounting for the presence of a drag-type force, an apparent drag force appears next to the apparent distribution of the filtered gas phase pressure gradient over the phases already found by De Wilde in the above-cited reference. The reformulation of the generalized added mass and the evaluation of a linear wave propagation speed test then suggest a generalized added mass type closure approach to completely describe filtered gas-solid momentum transfer, that is, including both the filtered drag force and the correlation between the solid volume fraction and the gas phase pressure gradient.

  7. Strongyloidiasis detected by the agar plate culture method among patients infected by HIV.

    PubMed

    Urdez-Hernández, E; Jiménez-Galán, S; Antonio-Manríquez, M; DE León-Juárez, E A; Terrazas-Estrada, J J; Hernández-García, M C; García-Zaldívar, P; Estrada-Aguilera, A

    1999-10-01

    To evaluate the rate of strongyloidiasis among HIV/AIDS patients, stools and duodenal juice were examined using the agar plate culture method. From January to June 1993, a total of 60 HIV/AIDS patients were required for duodenal aspirate and three serial samples of freshly passed stools. Stools and duodenal aspirate were dispensed on an agar plate culture; after incubation at 28 degrees C during 48 h, screening of plates was made at 10 x. The presence of furrows and worms of short buccal chamber and prominent genital primordium were positive for Strongyloides stercoralis. Most patients were men (91.7%); their mean age, of 33.9 years (SD +/- 10.6); their median CD4(+) T-cells count, of 105/microL (range of 12 to 646). S. stercoralis was detected in three patients (5%). In duodenal juice, the three patients showed the parasite, but in feces, only two (3.3%). In these two individuals, the worms were found in feces by agar culture and Faust's concentration method. The rate of S. stercoralis in feces of HIV/AIDS individuals (3.3%) by agar culture method was similar to that formerly reported from the general Mexican population (2.9%) using standard concentration procedures. Hence, in this immunocompromised population of a low prevalence city, there was no advantage to using an agar plate culture for strongyloidiasis.

  8. 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.

  9. Symptoms and fear in heart failure patients approaching end of life: a mixed methods study

    PubMed Central

    Abshire, Martha; Xu, Jiayun; Himmelfarb, Cheryl Dennison; Davidson, Patricia; Sulmasy, Daniel; Kub, Joan; Hughes, Mark; Nolan, Marie

    2015-01-01

    Aims and Objectives The purpose of this study was to consider how fear and symptom experience are perceived in patients with heart failure at the end of life. Background Heart failure is a burdensome condition and mortality rates are high globally. There is substantive literature describing suffering and unmet needs but description of the experience of fear and the relationship with symptom burden is limited. Design A convergent mixed methods design was used. Methods Data from the McGill Quality of Life Questionnaire (n = 55) were compared to data from in-depth interviews (n = 5). Results Patients denied fear when asked directly, but frequently referred to moments of being afraid when they were experiencing symptoms. In addition, patients reported few troublesome symptoms on the survey, but mentioned many more symptoms during interviews. Conclusions These data not only identify the relationship between psychological issues and symptom experience but also elucidate the benefit of a mixed method approach in describing such experiences from the perspective of the patient. Future research should examine relationships between and among symptom experience, fear and other psychological constructs across the illness trajectory. Relevance to Clinical Practice Conversations about the interaction of symptom burden and fear can lead to both a more robust assessment of symptoms and lead to patient centred interventions. PMID:26404121

  10. 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

  11. AD-1 aircraft in flight

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The Ames-Dryden (AD)-1 was a research aircraft designed to investigate the concept of an oblique (or pivoting) wing. The movie clip runs about 17 seconds and has two air-to-air views of the AD-1. The first shot is from slightly above as the wing pivots to 60 degrees. The other angle is almost directly below the aircraft when the wing is fully pivoted.

  12. 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

  13. Method for patient-specific finite element modeling and simulation of deep brain stimulation.

    PubMed

    Aström, Mattias; Zrinzo, Ludvic U; Tisch, Stephen; Tripoliti, Elina; Hariz, Marwan I; Wårdell, Karin

    2009-01-01

    Deep brain stimulation (DBS) is an established treatment for Parkinson's disease. Success of DBS is highly dependent on electrode location and electrical parameter settings. The aim of this study was to develop a general method for setting up patient-specific 3D computer models of DBS, based on magnetic resonance images, and to demonstrate the use of such models for assessing the position of the electrode contacts and the distribution of the electric field in relation to individual patient anatomy. A software tool was developed for creating finite element DBS-models. The electric field generated by DBS was simulated in one patient and the result was visualized with isolevels and glyphs. The result was evaluated and it corresponded well with reported effects and side effects of stimulation. It was demonstrated that patient-specific finite element models and simulations of DBS can be useful for increasing the understanding of the clinical outcome of DBS.

  14. [Correction of psycho-emotional state by the biofeedback method in patients with metabolic syndrome].

    PubMed

    Koichubekov, B K; Shaikhin, A M; Tabagari, S I; Sorokina, M A; Omarbekova, N K

    2014-11-01

    Metabolic syndrome is one of the important clinical problems of medicine. The aim of this study was to demonstrate the efficacy of heart rate variability biofeedback method in correction of mental and emotional state in patients with metabolic syndrome. For this task was set to study the dynamics of indicators of mental and emotional stress by biofeedback based hardware-software complex "Amblyocor" in patients with metabolic syndrome. Course of heart rate variability biofeedback passed 10 patients with the metabolic syndrome. During biofeedback sessions conducted tests that assess psycho-emotional state by 5 characters. Data processing was performed using software package «Statistica 8.0» and showed a statistically significant decrease in indicators of mental and emotional stress, that demonstrates the effectiveness of biofeedback in the correction of mental and emotional stress in patients with metabolic syndrome.

  15. 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.

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

    DOE PAGES

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

    2016-01-25

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

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

    SciTech Connect

    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 existing results for the relevant conformal blocks in arbitrary dimension.

  18. Supersymmetric AdS5 solutions of type IIB supergravity without D3 branes

    NASA Astrophysics Data System (ADS)

    Couzens, Christopher

    2017-01-01

    We analyse the most general bosonic supersymmetric solutions of type IIB supergravity whose metrics are warped products of five-dimensional anti-de Sitter space (AdS5) with a five-dimensional Riemannian manifold M 5, where the five-form flux vanishes, while all remaining fluxes are allowed to be non-vanishing consistent with SO(4,2) symmetry. This completes the program of classifying all supersymmetric solutions of ten and eleven-dimensional supergravity with an AdS5 factor. We investigate the supersymmetry conditions in some special cases, and demonstrate how these are satisfied by a solution originally found in [13], utilising the method of non-Abelian T-duality.

  19. 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

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

    PubMed

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

    2015-02-01

    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.

  1. [Between mind and body. Psychologicall methods for patients with musculoskeletal pain].

    PubMed

    Jabłońska-Brzozowska, Judyta

    2016-01-01

    According to the currently prevailing trends in medicine in restoring the psychosomatic unity of human, it is important to ask the question about the function and role of psychology in the rehabilitation of patients with chronic musculoskeletal disorder, MSD. In this article authors present the theoretical basis of psychical and body rehabilitation of patients with MSD. In the first part of this article, problem of the prevalence of MSD in population, its biological, psychological and social components and its impact on the economy of the country, have been discussed. Secondly, there was a focus on the mental representation of the body and its role as a psychophysical integrating unit. The following sections discuss therapeutic methods, like cognitive-behavioral therapy and chosen body work methods as complex rehabilitation of patients with musculoskeletal pain.

  2. Recommendations for a Mixed Methods Approach to Evaluating the Patient-Centered Medical Home

    PubMed Central

    Goldman, Roberta E.; Parker, Donna R.; Brown, Joanna; Walker, Judith; Eaton, Charles B.; Borkan, Jeffrey M.

    2015-01-01

    PURPOSE There is a strong push in the United States to evaluate whether the patient-centered medical home (PCMH) model produces desired results. The explanatory and contextually based questions of how and why PCMH succeeds in different practice settings are often neglected. We report the development of a comprehensive, mixed qualitative-quantitative evaluation set for researchers, policy makers, and clinician groups. METHODS To develop an evaluation set, the Brown Primary Care Transformation Initiative convened a multidisciplinary group of PCMH experts, reviewed the PCMH literature and evaluation strategies, developed key domains for evaluation, and selected or created methods and measures for inclusion. RESULTS The measures and methods in the evaluation set (survey instruments, PCMH meta-measures, patient outcomes, quality measures, qualitative interviews, participant observation, and process evaluation) are meant to be used together. PCMH evaluation must be sufficiently comprehensive to assess and explain both the context of transformation in different primary care practices and the experiences of diverse stakeholders. In addition to commonly assessed patient outcomes, quality, and cost, it is critical to include PCMH components integral to practice culture transformation: patient and family centeredness, authentic patient activation, mutual trust among practice employees and patients, and transparency, joy, and collaboration in delivering and receiving care in a changing environment. CONCLUSIONS This evaluation set offers a comprehensive methodology to enable understanding of how PCMH transformation occurs in different practice settings. This approach can foster insights about how transformation affects critical outcomes to achieve meaningful, patient-centered, high-quality, and cost-effective sustainable change among diverse primary care practices. PMID:25755039

  3. Methods for Evaluating Practice Change Toward a Patient-Centered Medical Home

    PubMed Central

    Jaén, Carlos Roberto; Crabtree, Benjamin F.; Palmer, Raymond F.; Ferrer, Robert L.; Nutting, Paul A.; Miller, William L.; Stewart, Elizabeth E.; Wood, Robert; Davila, Marivel; Stange, Kurt C.

    2010-01-01

    PURPOSE Understanding the transformation of primary care practices to patient-centered medical homes (PCMHs) requires making sense of the change process, multilevel outcomes, and context. We describe the methods used to evaluate the country’s first national demonstration project of the PCMH concept, with an emphasis on the quantitative measures and lessons for multimethod evaluation approaches. METHODS The National Demonstration Project (NDP) was a group-randomized clinical trial of facilitated and self-directed implementation strategies for the PCMH. An independent evaluation team developed an integrated package of quantitative and qualitative methods to evaluate the process and outcomes of the NDP for practices and patients. Data were collected by an ethnographic analyst and a research nurse who visited each practice, and from multiple data sources including a medical record audit, patient and staff surveys, direct observation, interviews, and text review. Analyses aimed to provide real-time feedback to the NDP implementation team and lessons that would be transferable to the larger practice, policy, education, and research communities. RESULTS Real-time analyses and feedback appeared to be helpful to the facilitators. Medical record audits provided data on process-of-care outcomes. Patient surveys contributed important information about patient-rated primary care attributes and patient-centered outcomes. Clinician and staff surveys provided important practice experience and organizational data. Ethnographic observations supplied insights about the process of practice development. Most practices were not able to provide detailed financial information. CONCLUSIONS A multimethod approach is challenging, but feasible and vital to understanding the process and outcome of a practice development process. Additional longitudinal follow-up of NDP practices and their patients is needed. PMID:20530398

  4. Cost-Effectiveness Analysis of Helicobacter pylori Diagnostic Methods in Patients with Atrophic Gastritis

    PubMed Central

    Shimbo, Takuro; Ohde, Sachiko; Fukui, Tsuguya

    2017-01-01

    Background. There are several diagnostic methods for Helicobacter pylori (H. pylori) infection. A cost-effective analysis is needed to decide on the optimal diagnostic method. The aim of this study was to determine a cost-effective diagnostic method in patients with atrophic gastritis (AG). Methods. A decision-analysis model including seven diagnostic methods was constructed for patients with AG diagnosed by esophagogastroduodenoscopy. Expected values of cost and effectiveness were calculated for each test. Results. If the prevalence of H. pylori in the patients with AG is 85% and CAM-resistant H. pylori is 30%, histology, stool H. pylori antigen (SHPAg), bacterial culture (BC), and urine H. pylori antibody (UHPAb) were dominated by serum H. pylori IgG antibody (SHPAb), rapid urease test (RUT), and urea breath test (UBT). Among three undominated methods, the incremental cost-effective ratios (ICER) of RUT versus SHPAb and UBT versus RUT were $214 and $1914, respectively. If the prevalence of CAM-sensitive H. pylori was less than 55%, BC was not dominated, but its H. pylori eradication success rate was 0.86. Conclusions. RUT was the most cost-effective at the current prevalence of CAM-resistant H. pylori. BC could not be selected due to its poor effectiveness even if CAM-resistant H. pylori was more than 45%. PMID:28337217

  5. Alliance for aging research AD biomarkers work group: structural MRI.

    PubMed

    Jack, Clifford R

    2011-12-01

    Biomarkers of Alzheimer's disease (AD) are increasingly important. All modern AD therapeutic trials employ AD biomarkers in some capacity. In addition, AD biomarkers are an essential component of recently updated diagnostic criteria for AD from the National Institute on Aging--Alzheimer's Association. Biomarkers serve as proxies for specific pathophysiological features of disease. The 5 most well established AD biomarkers include both brain imaging and cerebrospinal fluid (CSF) measures--cerebrospinal fluid Abeta and tau, amyloid positron emission tomography (PET), fluorodeoxyglucose (FDG) positron emission tomography, and structural magnetic resonance imaging (MRI). This article reviews evidence supporting the position that MRI is a biomarker of neurodegenerative atrophy. Topics covered include methods of extracting quantitative and semiquantitative information from structural MRI; imaging-autopsy correlation; and evidence supporting diagnostic and prognostic value of MRI measures. Finally, the place of MRI in a hypothetical model of temporal ordering of AD biomarkers is reviewed.

  6. Video elicitation interviews: a qualitative research method for investigating physician-patient interactions.

    PubMed

    Henry, Stephen G; Fetters, Michael D

    2012-01-01

    We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants' associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specific events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, high-quality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care.

  7. 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…

  8. 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.

  9. Effectiveness of new sedation and rehabilitation methods for critically ill patients receiving mechanical ventilation

    PubMed Central

    Yamashita, Kouji; Takami, Akiyoshi; Wakayama, Saichi; Makino, Misato; Takeyama, Yoshihiro

    2017-01-01

    [Purpose] The purpose of this study was to investigate the effects of new sedation management methods and cooperation between nurses and physical therapists on the duration of mechanical ventilation and hospitalization. [Subjects and Methods] Patients who had been treated at the study hospital 2 years before and after the implementation of the new methods were analyzed retrospectively and classified into a “control group” and an “intervention group”, respectively. Both groups were analyzed and subsequently compared regarding the effects of the new sedation and cooperative rehabilitation. [Results] A total of 70 patients met the inclusion criteria and were divided evenly into the two groups. No significant differences were found between the groups in age, APACHE II score, or duration of stay in hospital. On the other hand, significant decreases were seen in the duration of sedation and intubation, mechanical ventilation, and stay in the emergency ward, as well as time until standing. In addition, after intervention, three patients undergoing ventilator treatment were able to be ambulated. [Conclusion] These results suggest that the new sedation and cooperative rehabilitation methods for critically ill patients were effective in the early stage of treatment and shortened the duration of stay in the ward. PMID:28210060

  10. 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…

  11. 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

  12. 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

  13. Development and validation of an enantioselective HPLC-UV method using Chiralpak AD-H to quantify (+)- and (-)-torcetrapib enantiomers in hamster plasma--application to a pharmacokinetic study.

    PubMed

    Trivedi, Ravi Kumar; Dubey, P K; Mullangi, Ramesh; Srinivas, Nuggehally R

    2007-10-01

    A chiral selective, accurate and reproducible high-performance liquid chromatographic (HPLC) method was developed and validated for direct separation of individual enantiomers of torcetrapib (TTB) [(+)-TTB and (-)-TTB]. TTB enantiomers and IS were extracted from a small aliquot of plasma (100 microL) by simple liquid-liquid extraction using acetonitrile as extraction solvent. The enantiomers were resolved on Chiralpak AD-H (250 mm x 4.6 mm, 5 microm) with the mobile phase consisting of n-hexane:isopropyl alcohol (IPA) in the ratio of 95:5 (v/v). The eluate was monitored using an UV detector set at 254 nm. Baseline separation of the TTB enantiomers and the internal standard (IS, DRL-17859), free from endogenous interferences was achieved. The resolution factor between the enantiomers was optimized and found to be not less than five. During method development, the IPA content in the mobile phase was optimized for separation of peaks of interest. Additionally, both flow rate and column temperature were optimized for an improved baseline separation of the enantiomers. Ratio of peak area of each enantiomer to IS was used for quantification of plasma samples. Nominal retention times of (+)-TTB, (-)-TTB and IS were 9.4, 13.8 and 17.5 min, respectively. The standard curves for TTB enantiomers were linear (r(2)>0.999) in the concentration range 0.1-10 microg/mL for each enantiomer. Absolute recovery, when compared to neat standards, was 88.7-90.0% for TTB enantiomers and 100% for IS from the hamster plasma. The lower limit of quantification (LLOQ) for each enantiomer of TTB was 0.1 microg/mL. The inter-day precisions were in the range of 4.57-6.32 and 5.66-11.0% for (+)-TTB and (-)-TTB, respectively. The intra-day precisions were in the range of 1.60-7.36 and 2.76-13.6% for (+)-TTB and (-)-TTB, respectively. Accuracy in the measurement of quality control (QC) samples was in the range of 95.6-109% and 92.7-108% for (+)-TTB and (-)-TTB, respectively. Both enantiomers were

  14. Evaluation of two methods for continuous cardiac output assessment during exercise in chronic heart failure patients.

    PubMed

    Kemps, Hareld M C; Thijssen, Eric J M; Schep, Goof; Sleutjes, Boudewijn T H M; De Vries, Wouter R; Hoogeveen, Adwin R; Wijn, Pieter F F; Doevendans, Pieter A F M

    2008-12-01

    The purpose of this study was to evaluate the accuracy of two techniques for the continuous assessment of cardiac output in patients with chronic heart failure (CHF): a radial artery pulse contour analysis method that uses an indicator dilution method for calibration (LiDCO) and an impedance cardiography technique (Physioflow), using the Fick method as a reference. Ten male CHF patients (New York Heart Association class II-III) were included. At rest, cardiac output values obtained by LiDCO and Physioflow were compared with those of the direct Fick method. During exercise, the continuous Fick method was used as a reference. Exercise, performed on a cycle ergometer in upright position, consisted of two constant-load tests at 30% and 80% of the ventilatory threshold and a symptom-limited maximal test. Both at rest and during exercise LiDCO showed good agreement with reference values [bias +/- limits of agreement (LOA), -1% +/- 28% and 2% +/- 28%, respectively]. In contrast, Physioflow overestimated reference values both at rest and during exercise (bias +/- LOA, 48% +/- 60% and 48% +/- 52%, respectively). Exercise-related within-patient changes of cardiac output, expressed as a percent change, showed for both techniques clinically acceptable agreement with reference values (bias +/- LOA: 2% +/- 26% for LiDCO, and -2% +/- 36% for Physioflow, respectively). In conclusion, although the limits of agreement with the Fick method are pretty broad, LiDCO provides accurate measurements of cardiac output during rest and exercise in CHF patients. Although Physioflow overestimates cardiac output, this method may still be useful to estimate relative changes during exercise.

  15. 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

  16. 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.

  17. 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

  18. Heavy quark potential from deformed AdS5 models

    NASA Astrophysics Data System (ADS)

    Zhang, Zi-qiang; Hou, De-fu; Chen, Gang

    2017-04-01

    In this paper, we investigate the heavy quark potential in some holographic QCD models. The calculation relies on a modified renormalization scheme mentioned in a previous work of Albacete et al. After studying the heavy quark potential in Pirner-Galow model and Andreev-Zakharov model, we extend the discussion to a general deformed AdS5 case. It is shown that the obtained potential is negative definite for all quark-antiquark separations, differs from that using the usual renormalization scheme.

  19. The AdS central charge in string theory

    NASA Astrophysics Data System (ADS)

    Troost, Jan

    2011-11-01

    We evaluate the vacuum expectation value of the central charge operator in string theory in an AdS3 vacuum. Our calculation provides a rare non-zero one-point function on a spherical worldsheet. The evaluation involves the regularization both of a worldsheet ultraviolet divergence (associated to the infinite volume of the conformal Killing group), and a space-time infrared divergence (corresponding to the infinite volume of space-time). The two divergences conspire to give a finite result, which is the classical general relativity value for the central charge, corrected in bosonic string theory by an infinite series of tree level higher derivative terms.

  20. Internal structure of charged AdS black holes

    NASA Astrophysics Data System (ADS)

    Bhattacharjee, Srijit; Sarkar, Sudipta; Virmani, Amitabh

    2016-06-01

    When an electrically charged black hole is perturbed, its inner horizon becomes a singularity, often referred to as the Poisson-Israel mass inflation singularity. Ori constructed a model of this phenomenon for asymptotically flat black holes, in which the metric can be determined explicitly in the mass inflation region. In this paper we implement the Ori model for charged AdS black holes. We find that the mass function inflates faster than the flat space case as the inner horizon is approached. Nevertheless, the mass inflation singularity is still a weak singularity: Although spacetime curvature becomes infinite, tidal distortions remain finite on physical objects attempting to cross it.

  1. 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

  2. Methods for testing automatic mode switching in patients implanted with DDD(R) pacemakers.

    PubMed

    Lau, Chu-Pak; Mascia, Franco; Corbucci, Giorgio; Padeletti, Luigi

    2004-01-01

    The assessment of automatic mode switching (AMS) algorithms is impossible in vivo, due to a low chance of seeing the patient at the onset of a spontaneous episode of atrial fibrillation (AF). As the induction of AF to test AMS has clinical concerns, three alternative and non-invasive techniques may be proposed for this purpose: myopotentials, chest wall stimulation, and an external supraventricular arrhythmia simulator. The first method is simple and does not require additional equipment, even though in some patients adequate signals cannot be generated with a soft effort such as handgrip or hand compression. The main advantage of the chest wall stimulation method is the possibility that it be performed in every implanting center, since it is based on the use of standard devices for cardiac stimulation. The method based on the external supraventricular arrhythmia simulator allows the most detailed of the ECG traces, but it needs a dedicated electronic device.

  3. Nasogastric tube insertion in anesthetized and intubated patients: a new and reliable method

    PubMed Central

    2012-01-01

    Background The “Rusch” intubation stylet is used to make endotracheal tube intubation easy. We designed this study to evaluate the usage of this equipment in the guidance of nasogastric tube (NGT) insertion. Methods A total of 103 patients, aged 23 to 70 years, undergoing gastrointestinal or hepatic surgeries that required intraoperative NGT insertions were enrolled into our study. The patients were randomly allocated to the control group (Group C) or the stylet group (Group S) according to a computerized, random allocation software program. In the control group, the NGT was inserted with the patient’s head in an intubating position. In the stylet group, the NGT was inserted with the assistance of a “Rusch” intubation stylet tied together at the tips by a slipknot. The success rates of the two methods, the durations of the insertions, and the occurrences of complications were recorded. All of the failed cases in the control group were subjected to the new technique used in the stylet group, and the successful rescue rate was also evaluated. Results Successful insertions were recorded for 52/53 patients (98.1%) in Group S and for 32/50 patients (64%) in Group C. The mean insertion times were 39.5 ± 19.5 seconds in Group C and 40.3 ± 23.2 seconds in Group S. Successful rescues of failure cases in Group C were achieved in 17/18 patients (94.4%) with the assistance of a “Rusch” intubation stylet. Conclusions The “Rusch” intubation stylet-guided method is reliable with a high success rate of NGT insertion in anesthetized and intubated patients. Trial registration Institutional Review Board of Chang Gung Memorial Hospital (IRB: 98-2669B) and Australian New Zealand Clinical Trials Registry (ACTRN12611000423910) PMID:22853453

  4. A patient-specific Monte Carlo dose-calculation method for photon beams.

    PubMed

    Wang, L; Chui, C S; Lovelock, M

    1998-06-01

    A patient-specific, CT-based, Monte Carlo dose-calculation method for photon beams has been developed to correctly account for inhomogeneity in the patient. The method employs the EGS4 system to sample the interaction of radiation in the medium. CT images are used to describe the patient geometry and to determine the density and atomic number in each voxel. The user code (MCPAT) provides the data describing the incident beams, and performs geometry checking and energy scoring in patient CT images. Several variance reduction techniques have been implemented to improve the computation efficiency. The method was verified with measured data and other calculations, both in homogeneous and inhomogeneous media. The method was also applied to a lung treatment, where significant differences in dose distributions, especially in the low-density region, were observed when compared with the results using an equivalent pathlength method. Comparison of the DVHs showed that the Monte Carlo calculated plan predicted an underdose of nearly 20% to the target, while the maximum doses to the cord and the heart were increased by 25% and 33%, respectively. These results suggested that the Monte Carlo method may have an impact on treatment designs, and also that it can be used as a benchmark to assess the accuracy of other dose calculation algorithms. The computation time for the lung case employing five 15-MV wedged beams, with an approximate field size of 13 X 13 cm and the dose grid size of 0.375 cm, was less than 14 h on a 175-MHz computer with a standard deviation of 1.5% in the high-dose region.

  5. [Methods of the use of ketorolac tromethamine in patients during the early postoperative period].

    PubMed

    Lebedeva, R N; Maiachkin, R B; Nikoda, V V; Rusina, O V; Broun, N K; Molochnikov, I O

    1997-01-01

    Analgesia with nonsteroid antiinflammatory drugs (NSAID) becomes a pressing problem today. One such drug is ketorolak tromethamine (KT), characterized by expressed analgesic activity comparable with that of opioid analgesics morphine or promedol. Our purpose was to assess KT efficacy in analgesia performed by different methods, including analgesia controlled by the patient (ACP) after surgery. In medium severe and strong pain KT was used in group I (n = 60) "as needed" in a dose of 30 mg up to 3-4 times a day, in group 2 (n = 12) by the ACP method, in group 3 (n = 16) KT was incessantly infused in a daily dose of up to 120 mg, and in group 4 (n = 11) KT was injected 3-4 times a day in a dose of 30 mg in combination with morphine ACP. The results indicate a high efficacy of KT: 83% after a single injection. Combined use of KT and promedol decreased the dose by 40-50%. Side effects were observed in 15% of patients: most often it was a sense of fever and sweating (in 4% of patients), nausea and vomiting (in 2%), insomnia (in 2%). ACP and planned injections in a daily dose of 90-120 mg is the optimal method of analgesia in patients after extensive surgical interventions.

  6. 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

  7. 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.

  8. A simple method to predict response to immunosuppressive therapy in patients with myelodysplastic syndrome.

    PubMed

    Saunthararajah, Yogen; Nakamura, Ryotaro; Wesley, Robert; Wang, Qiong J; Barrett, A John

    2003-10-15

    Immunosuppression with antithymocyte globulin (ATG) or cyclosporine (CSA) can be used to treat the cytopenia associated with myelodysplastic syndrome (MDS). Previously, we identified HLA-DR15, younger age, and shorter duration of red cell transfusion dependence as pretreatment variables that correlate significantly with a response. Using these pretreatment variables we have devised a simple method to prospectively identify patients with low or high probabilities of response to immunosuppression. The ability of this system to predict response was confirmed in a separate cohort of 23 patients with MDS treated with immunosuppression.

  9. 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.

  10. 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.

  11. A method to determine the planar dose distributions in patient undergone radiotherapy

    NASA Astrophysics Data System (ADS)

    Cilla, S.; Viola, P.; Augelli, B. G.; D'Onofrio, G.; Grimaldi, L.; Craus, M.; Digesù, C.; Deodato, F.; Macchia, G.; Morganti, A. G.; Fidanzio, A.; Azario, L.; Piermattei, A.

    2008-06-01

    A 2D-array equipped with 729 vented plane parallel ion-chambers has been calibrated as a portal dose detector for radiotherapy in vivo measurements. The array has been positioned by a radiographic film stand at 120 cm from the source orthogonal to the radiotherapy beam delivered with the gantry angle at 180°. The collision between the 2D-array and the patient's couch have been avoided. In this work, using the measurements of the portal detector, we present a method to reconstruct the dose variations in the patient treated with step and shoot intensity-modulated beams (IMRT) for head-neck tumours. For this treatment morphological changes often occur during the fractionated therapy. In a first step an in-house software supplied the comparison between the measured portal dose and the one computed by a commercial treatment planning system within the field of view of the computed tomography (CT) scanner. For each patient, the percentage Pγ of chambers, where the comparison is in agreement within a selected acceptance criteria, was determined 8 times. At the first radiotherapy fraction the γ-index analysis supplied Pγ values of about 95%, within acceptance criteria in terms of dose-difference, ΔD, and distance-agreement, Δd, that was equal to 5% and 4 mm, respectively. These acceptance criteria were taken into account for small errors in the patient's set-up reproducibility and for the accuracy of the portal dose calculated by the treatment planning system (TPS) in particular when the beam was attenuated by inhomogeneous tissues and the shape of the head-neck body contours were irregular. During the treatment, some patients showed a reduction of the Pγ below 90% because due to radiotherapy treatment there was a change of the patient's morphology. In a second step a method, based on dosimetric measurements that used standard phantoms, supplied the percentage dose variations in a coronal plane of the patient using the percentage dose variations measured by the 2D

  12. Posterior AD-Type Pathology: Cognitive Subtypes Emerging from a Cluster Analysis

    PubMed Central

    Cappa, Antonella; Ciccarelli, Nicoletta; Silveri, Maria Caterina

    2014-01-01

    Background. “Posterior shift” of the neuropathological changes of Alzheimer's disease (AD) produces a syndrome (posterior cortical atrophy) (PCA) dominated by high-level visual deficits. Objective. To explore in patients with AD-type pathology whether a data-driven analysis (cluster analysis) based on neuropsychological findings resulted in the emergence of different subgroups of patients; in particular to find out whether it was possible to identify patients with visuospatial deficits consistent with the hypothesis that PCA is a “dorsal stream” syndrome or, rather, whether there were subgroups of patients with different types of impairment within the high-level visual domain. Methods. 23 PCA and 16 DAT patients were studied. By a principal component analysis performed on a wide range of neuropsychological tasks, 15 variables were obtained that loaded onto five main factors (memory, language, perceptual, visuospatial, and calculation) which entered a hierarchical cluster analysis. Results. Four clusters of cognitive impairment emerged: visuospatial/perceptual, memory, perceptual/calculation, and language. Only in the first cluster a visuospatial deficit clearly emerged. Conclusions. AD pathology produces not only variants dominated by memory (DAT) and, to a lesser extent, visuospatial deficit (PCA), but also other distinct syndromic subtypes with disorders in visual perception and language which reflect a different vulnerability of specific functional networks. PMID:24994944

  13. 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.

  14. Primordial fluctuations from complex AdS saddle points

    SciTech Connect

    Hertog, Thomas; Woerd, Ellen van der E-mail: ellen@itf.fys.kuleuven.be

    2016-02-01

    One proposal for dS/CFT is that the Hartle-Hawking (HH) wave function in the large volume limit is equal to the partition function of a Euclidean CFT deformed by various operators. All saddle points defining the semiclassical HH wave function in cosmology have a representation in which their interior geometry is part of a Euclidean AdS domain wall with complex matter fields. We compute the wave functions of scalar and tensor perturbations around homogeneous isotropic complex saddle points, turning on single scalar field matter only. We compare their predictions for the spectra of CMB perturbations with those of a different dS/CFT proposal based on the analytic continuation of inflationary universes to real asymptotically AdS domain walls. We find the predictions of both bulk calculations agree to first order in the slow roll parameters, but there is a difference at higher order which, we argue, is a signature of the HH state of the fluctuations.

  15. AdS nonlinear instability: moving beyond spherical symmetry

    NASA Astrophysics Data System (ADS)

    Dias, Óscar J. C.; Santos, Jorge E.

    2016-12-01

    Anti-de Sitter (AdS) is conjectured to be nonlinear unstable to a weakly turbulent mechanism that develops a cascade towards high frequencies, leading to black hole formation (Dafermos and Holzegel 2006 Seminar at DAMTP (University of Cambridge) available at https://dpmms.cam.ac.uk/~md384/ADSinstability.pdf, Bizon and Rostworowski 2011 Phys. Rev. Lett. 107 031102). We give evidence that the gravitational sector of perturbations behaves differently from the scalar one studied by Bizon and Rostworowski. In contrast with Bizon and Rostworowski, we find that not all gravitational normal modes of AdS can be nonlinearly extended into periodic horizonless smooth solutions of the Einstein equation. In particular, we show that even seeds with a single normal mode can develop secular resonances, unlike the spherically symmetric scalar field collapse studied by Bizon and Rostworowski. Moreover, if the seed has two normal modes, more than one resonance can be generated at third order, unlike the spherical collapse of Bizon and Rostworowski. We also show that weak turbulent perturbative theory predicts the existence of direct and inverse cascades, with the former dominating the latter for equal energy two-mode seeds.

  16. Strings on AdS wormholes and nonsingular black holes

    NASA Astrophysics Data System (ADS)

    Lü, H.; Vázquez-Poritz, Justin F.; Zhang, Zhibai

    2015-01-01

    Certain AdS black holes in the STU model can be conformally scaled to wormhole and black hole backgrounds which have two asymptotically AdS regions and are completely free of curvature singularities. While there is a delta-function source for the dilaton, classical string probes are not sensitive to this singularity. According to the AdS/CFT correspondence, the dual field theory lives on the union of the disjoint boundaries. For the wormhole background, causal contact exists between the two boundaries and the structure of certain correlation functions is indicative of an interacting phase for which there is a coupling between the degrees of freedom living at each boundary. The nonsingular black hole describes an entangled state in two non-interacting identical conformal field theories. By studying the behavior of open strings on these backgrounds, we extract a number of features of the ‘quarks’ and ‘anti-quarks’ that live in the field theories. In the interacting phase, we find that there is a maximum speed with which the quarks can move without losing energy, beyond which energy is transferred from a quark in one field theory to a quark in the other. We also compute the rate at which moving quarks within entangled states lose energy to the two surrounding plasmas. While a quark-antiquark pair within a single field theory exhibits Coulomb interaction for small separation, a quark in one field theory exhibits spring-like confinement with an anti-quark in the other field theory. For the entangled states, we study how the quark-antiquark screening length depends on temperature and chemical potential.

  17. 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

  18. The Taiwanese method for providing patients data from multiple hospital EHR systems.

    PubMed

    Jian, Wen-Shan; Wen, Hsyien-Chia; Scholl, Jeremiah; Shabbir, Syed Abdul; Lee, Peisan; Hsu, Chien-Yeh; Li, Yu-Chuan

    2011-04-01

    Personal Health Record (PHR) systems are growing in popularity and are receiving increased attention from the Biomedical Informatics research community. Information Collection is one PHR research topic and includes system functionality that helps patients retrieve their data from external sources. One of the most potentially useful external sources of information is the data stored in patients' EHRs at medical institutions. PHR systems that support Information Collection from EHR systems are thus interesting to investigate. In this paper we present PHR system that allows patients to receive data from 10 participating hospitals in Taiwan via a USB flash memory device. The overall design goals and architecture for the system are presented. Based on our experiences in designing and implementing the system we propose a three step method for accomplishing Information Collection from EHR systems at medical institutions for similar PHR systems in the future.

  19. Carbon footprint of patient journeys through primary care: a mixed methods approach

    PubMed Central

    Andrews, Elizabeth; Pearson, David; Kelly, Charlotte; Stroud, Laura; Rivas Perez, Martin

    2013-01-01

    Background The NHS has a target of cutting its carbon dioxide (CO2) emissions by 80% below 1990 levels by 2050. Travel comprises 17% of the NHS carbon footprint. This carbon footprint represents the total CO2 emissions caused directly or indirectly by the NHS. Patient journeys have previously been planned largely without regard to the environmental impact. The potential contribution of ‘avoidable’ journeys in primary care is significant. Aim To investigate the carbon footprint of patients travelling to and from a general practice surgery, the issues involved, and potential solutions for reducing patient travel. Design and setting A mixed methods study in a medium-sized practice in Yorkshire. Method During March 2012, 306 patients completed a travel survey. GIS maps of patients’ travel (modes and distances) were produced. Two focus groups (12 clinical and 13 non-clinical staff) were recorded, transcribed, and analysed using a thematic framework approach. Results The majority (61%) of patient journeys to and from the surgery were made by car or taxi; main reasons cited were ‘convenience’, ‘time saving’, and ‘no alternative’ for accessing the surgery. Using distances calculated via ArcGIS, the annual estimated CO2 equivalent carbon emissions for the practice totalled approximately 63 tonnes. Predominant themes from interviews related to issues with systems for booking appointments and repeat prescriptions; alternative travel modes; delivering health care; and solutions to reducing travel. Conclusion The modes and distances of patient travel can be accurately determined and allow appropriate carbon emission calculations for GP practices. Although challenging, there is scope for identifying potential solutions (for example, modifying administration systems and promoting walking) to reduce ‘avoidable’ journeys and cut carbon emissions while maintaining access to health care. PMID:23998839

  20. Validation of an LC-MS/MS Method for Urinary Lactulose and Mannitol Quantification: Results in Patients with Irritable Bowel Syndrome

    PubMed Central

    Gervasoni, Jacopo; Schiattarella, Arcangelo; Giorgio, Valentina; Primiano, Aniello; Russo, Consuelo; Tesori, Valentina; Urbani, Andrea; Zuppi, Cecilia

    2016-01-01

    Aim. Lactulose/mannitol ratio is used to assess intestinal barrier function. Aim of this work was to develop a robust and rapid method for the analysis of lactulose and mannitol in urine by liquid chromatography coupled to tandem mass spectrometry. Lactulose/mannitol ratio has been measured in pediatric patients suffering from irritable bowel syndrome. Methods. Calibration curves and raffinose, used as internal standard, were prepared in water : acetonitrile 20 : 80. Fifty μL of urine sample was added to 450 μL of internal standard solution. The chromatographic separation was performed using a Luna NH2 column operating at a flow rate of 200 μL/min and eluted with a linear gradient from 20% to 80% water in acetonitrile. Total run time is 9 minutes. The mass spectrometry operates in electrospray negative mode. Method was fully validated according to European Medicine Agency guidelines. Results and Conclusions. Linearity ranged from 10 to 1000 mg/L for mannitol and 2.5 to 1000 mg/L for lactulose. Imprecision in intra- and interassay was lower than 15% for both analytes. Accuracy was higher than 85%. Lactulose/mannitol ratio in pediatric patients is significantly higher than that measured in controls. The presented method, rapid and sensitive, is suitable in a clinical laboratory. PMID:28070137

  1. Patient-specific dose calculation methods for high-dose-rate iridium-192 brachytherapy

    NASA Astrophysics Data System (ADS)

    Poon, Emily S.

    In high-dose-rate 192Ir brachytherapy, the radiation dose received by the patient is calculated according to the AAPM Task Group 43 (TG-43) formalism. This table-based dose superposition method uses dosimetry parameters derived with the radioactive 192Ir source centered in a water phantom. It neglects the dose perturbations caused by inhomogeneities, such as the patient anatomy, applicators, shielding, and radiographic contrast solution. In this work, we evaluated the dosimetric characteristics of a shielded rectal applicator with an endocavitary balloon injected with contrast solution. The dose distributions around this applicator were calculated by the GEANT4 Monte Carlo (MC) code and measured by ionization chamber and GAFCHROMIC EBT film. A patient-specific dose calculation study was then carried out for 40 rectal treatment plans. The PTRAN_CT MC code was used to calculate the dose based on computed tomography (CT) images. This study involved the development of BrachyGUI, an integrated treatment planning tool that can process DICOM-RT data and create PTRAN_CT input initialization files. BrachyGUI also comes with dose calculation and evaluation capabilities. We proposed a novel scatter correction method to account for the reduction in backscatter radiation near tissue-air interfaces. The first step requires calculating the doses contributed by primary and scattered photons separately, assuming a full scatter environment. The scatter dose in the patient is subsequently adjusted using a factor derived by MC calculations, which depends on the distances between the point of interest, the 192Ir source, and the body contour. The method was validated for multicatheter breast brachytherapy, in which the target and skin doses for 18 patient plans agreed with PTRAN_CT calculations better than 1%. Finally, we developed a CT-based analytical dose calculation method. It corrects for the photon attenuation and scatter based upon the radiological paths determined by ray tracing

  2. Evaluating community pharmacy practice in Qatar using simulated patient method:acute gastroenteritis management

    PubMed Central

    Ibrahim, Mohamed I.; Palaian, Subish; Al-Sulaiti, Fatima; El-Shami, Somia

    2016-01-01

    Objective: To evaluate Qatari pharmacists’ prescribing, labeling, dispensing and counseling practices in response to acute community-acquired gastroenteritis. Methods: The simulated patient method was used in this study. Thirty pharmacies in Doha were randomly selected and further randomized into two groups: Face-to-Face (n=15) vs. Telephone-call (n=15) per simulated patient; 2 simulated patients were involved. Prescribing, labeling, dispensing and counseling practices were assessed. Data analysis was performed using Mann-Whitney and chi square tests at alpha=0.05. Results: Most pharmacists prescribed and dispensed medicines (96%), including antimicrobials (43.9%), antidiarrheals (36%), antiemetics (5.1%) and antipyretics (3%). Counseling practices were poor (62.1% in the face-to-face group vs 70% in the telephone-call group did not counsel simulated patients about the dispensed medicines; p-value=0.50). In more than one-third of the encounters, at least one labeling parameter was missing. The duration of each interaction in minutes was not significantly different between the groups [median (IQR); 3(4.25) in the face-to-face group versus 2(0.25) in the telephone-call group; p-value=0.77]. No significant differences in prescribing or dispensing behaviors were present between groups (p-value>0.05). Conclusion: Qatar community pharmacists’ labeling, dispensing, and counseling practices were below expectation, thus urging the need for continuous professional development. PMID:28042351

  3. 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.

  4. Methods to assess performance of models estimating risk of death in intensive care patients: a review.

    PubMed

    Cook, D A

    2006-04-01

    Models that estimate the probability of death of intensive care unit patients can be used to stratify patients according to the severity of their condition and to control for casemix and severity of illness. These models have been used for risk adjustment in quality monitoring, administration, management and research and as an aid to clinical decision making. Models such as the Mortality Prediction Model family, SAPS II, APACHE II, APACHE III and the organ system failure models provide estimates of the probability of in-hospital death of ICU patients. This review examines methods to assess the performance of these models. The key attributes of a model are discrimination (the accuracy of the ranking in order of probability of death) and calibration (the extent to which the model's prediction of probability of death reflects the true risk of death). These attributes should be assessed in existing models that predict the probability of patient mortality, and in any subsequent model that is developed for the purposes of estimating these probabilities. The literature contains a range of approaches for assessment which are reviewed and a survey of the methodologies used in studies of intensive care mortality models is presented. The systematic approach used by Standards for Reporting Diagnostic Accuracy provides a framework to incorporate these theoretical considerations of model assessment and recommendations are made for evaluation and presentation of the performance of models that estimate the probability of death of intensive care patients.

  5. A new hierarchical method for inter-patient heartbeat classification using random projections and RR intervals

    PubMed Central

    2014-01-01

    Background The inter-patient classification schema and the Association for the Advancement of Medical Instrumentation (AAMI) standards are important to the construction and evaluation of automated heartbeat classification systems. The majority of previously proposed methods that take the above two aspects into consideration use the same features and classification method to classify different classes of heartbeats. The performance of the classification system is often unsatisfactory with respect to the ventricular ectopic beat (VEB) and supraventricular ectopic beat (SVEB). Methods Based on the different characteristics of VEB and SVEB, a novel hierarchical heartbeat classification system was constructed. This was done in order to improve the classification performance of these two classes of heartbeats by using different features and classification methods. First, random projection and support vector machine (SVM) ensemble were used to detect VEB. Then, the ratio of the RR interval was compared to a predetermined threshold to detect SVEB. The optimal parameters for the classification models were selected on the training set and used in the independent testing set to assess the final performance of the classification system. Meanwhile, the effect of different lead configurations on the classification results was evaluated. Results Results showed that the performance of this classification system was notably superior to that of other methods. The VEB detection sensitivity was 93.9% with a positive predictive value of 90.9%, and the SVEB detection sensitivity was 91.1% with a positive predictive value of 42.2%. In addition, this classification process was relatively fast. Conclusions A hierarchical heartbeat classification system was proposed based on the inter-patient data division to detect VEB and SVEB. It demonstrated better classification performance than existing methods. It can be regarded as a promising system for detecting VEB and SVEB of unknown patients in

  6. Separating Growth from Value Added

    ERIC Educational Resources Information Center

    Yeagley, Raymond

    2007-01-01

    This article discusses Rochester's two academic models that offer different tools for different purposes--measuring individual learning and measuring what affects learning. The main focus of currently available growth measures is formative assessment--providing data to inform instructional planning. Value-added assessment is not a student…

  7. Adding Value to Indiana's Commodities.

    ERIC Educational Resources Information Center

    Welch, Mary A., Ed.

    1995-01-01

    Food processing plants are adding value to bulk and intermediate products to sell overseas. The Asian Pacific Rim economies constituted the largest market for consumer food products in 1993. This shift toward consumer food imports in this area is due to more women working outside the home, the internationalization of populations, and dramatic…

  8. Courtship American Style: Newspaper Ads

    ERIC Educational Resources Information Center

    Cameron, Catherine; And Others

    1977-01-01

    This study investigated an increasing social phenomenon--newspaper advertising for dating or marital partners--in terms of the bargaining process involved. Content analysis of personal ads in a popular "respectable" singles newspaper revealed a pattern of offers and requests reminiscent of a heterosexual stock market. (Author)

  9. 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…

  10. 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.

  11. Supersymmetry Properties of AdS Supergravity Backgrounds

    NASA Astrophysics Data System (ADS)

    Beck, Samuel; Gutowski, Jan; Papadopoulos, George

    2017-01-01

    Anti-de Sitter supergravity backgrounds are of particular interest in light of the AdS/CFT correspondence, which relates them to dual conformal field theories on the boundary of the anti-de Sitter space. We have investigated the forms of the supersymmetries these backgrounds preserve by solving the Killing spinor equations on the anti-de Sitter components of these spaces. We have found that a supersymmetric AdSn background necessarily preserves 2⌊n/2⌋ k supersymmetries for n <= 4 and 2 ⌊n/2 ⌋ + 1 k supersymmetries for 4 < n <= 7 , k ∈N> 0 . Additionally, we have found that the Killing spinors of each background are exactly the zeroes of a Dirac-like operator constructed from the Killing spinor equations.

  12. On jordanian deformations of AdS5 and supergravity

    NASA Astrophysics Data System (ADS)

    Hoare, Ben; van Tongeren, Stijn J.

    2016-10-01

    We consider various homogeneous Yang-Baxter deformations of the {{AdS}}5× {{{S}}}5 superstring that can be obtained from the η-deformed superstring and related models by singular boosts. The jordanian deformations we obtain in this way behave similarly to the η-deformed model with regard to supergravity: T dualizing the classical sigma model it is possible to find corresponding solutions of supergravity, which, however, have dilatons that prevent T dualizing back. Hence the backgrounds of these jordanian deformations are not solutions of supergravity. Still, they do satisfy a set of recently found modified supergravity equations which implies that the corresponding sigma models are scale invariant. The abelian models that we obtain by singular boosts do directly correspond to solutions of supergravity. In addition to our main results we consider contraction limits of our main example, which do correspond to supergravity solutions.

  13. 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

  14. Acoustic method respiratory rate monitoring is useful in patients under intravenous anesthesia.

    PubMed

    Ouchi, Kentaro; Fujiwara, Shigeki; Sugiyama, Kazuna

    2017-02-01

    Respiratory depression can occur during intravenous general anesthesia without tracheal intubation. A new acoustic method for respiratory rate monitoring, RRa(®) (Masimo Corp., Tokyo, Japan), has been reported to show good reliability in post-anesthesia care and emergency units. The purpose of this study was to investigate the reliability of the acoustic method for measurement of respiratory rate during intravenous general anesthesia, as compared with capnography. Patients with dental anxiety undergoing dental treatment under intravenous anesthesia without tracheal intubation were enrolled in this study. Respiratory rate was recorded every 30 s using the acoustic method and capnography, and detectability of respiratory rate was investigated for both methods. This study used a cohort study design. In 1953 recorded respiratory rate data points, the number of detected points by the acoustic method (1884, 96.5 %) was significantly higher than that by capnography (1682, 86.1 %) (P < 0.0001). In the intraoperative period, there was a significant difference in the LOA (95 % limits of agreement of correlation between difference and average of the two methods)/ULLOA (under the lower limit of agreement) in terms of use or non-use of a dental air turbine (P < 0.0001). In comparison between capnography, the acoustic method is useful for continuous monitoring of respiratory rate in spontaneously breathing subjects undergoing dental procedures under intravenous general anesthesia. However, the acoustic method might not accurately detect in cases in with dental air turbine.

  15. Black patients with binge-eating disorder: Comparison of different assessment methods.

    PubMed

    Lydecker, Janet A; White, Marney A; Grilo, Carlos M

    2016-10-01

    The Eating Disorder Examination (EDE) is a well-established assessment instrument, but requires substantial training and administration time. The Eating Disorder Examination Questionnaire (EDE-Q) is the corresponding self-report survey, which does not have these demands. Research has shown concordance between these 2 assessment methods, but samples have lacked racial diversity. The current study examined the concordance of the EDE-Q and EDE in a sample of Black patients with binge-eating disorder (BED) and a matched sample of White patients. Participants were 238 (Black n = 119, White n = 119) treatment-seeking adults with DSM-IV-TR-defined BED. Participants completed the EDE-Q, and trained doctoral-level clinicians assessed participants for BED and eating-disorder psychopathology using the Structured Clinical Interview for DSM-IV Disorders and the Eating Disorder Examination (EDE) interview. The EDE-Q and EDE yielded significantly correlated frequencies of binge eating and eating-disorder psychopathology subscales. The EDE-Q yielded significantly lower frequencies of binge eating and higher scores on 3 of 4 subscales (not dietary restraint). Similar patterns of concordance between the EDE-Q and EDE were found for an alternative brief version of the instruments. Patterns of convergence and divergence between the EDE-Q and EDE observed in Black patients with BED are generally consistent with findings derived from the matched White sample: overall, scores are correlated but higher on the self-report compared with interview assessment methods. Clinicians assessing patients with BED should be aware of this overall pattern, and be aware that this pattern is similar in Black patients with BED with the notable exception of dietary restraint. (PsycINFO Database Record

  16. A Comprehensive Method for Predicting Fatal Liver Failure of Patients With Liver Cancer Resection

    PubMed Central

    Li, Jiangfa; Lei, Biao; Nie, Xingju; Lin, Linku; Tahir, Syed Abdul; Shi, Wuxiang; Jin, Junfei; He, Songqing

    2015-01-01

    Abstract There are many methods to assess liver function, but none of them has been verified as fully effective. The purpose of this study is to establish a comprehensive method evaluating perioperative liver reserve function (LRF) in patients with primary liver cancer (PLC). In this study, 310 PLC patients who underwent liver resection were included. The cohort was divided into a training set (n = 235) and a validation set (n = 75). The factors affecting postoperative liver dysfunction (POLD) during preoperative, intraoperative, and postoperative periods were confirmed by logistic regression analysis. The equation for calculating the preoperative liver functional evaluation index (PLFEI) was established; the cutoff value of PLFEI determined through analysis by receiver-operating characteristic curve was used to predict postoperative liver function. The data showed that body mass index, international normalized ratio, indocyanine green (ICG) retention rate at 15 minutes (ICGR15), ICG elimination rate, standard remnant liver volume (SRLV), operative bleeding volume (OBV), blood transfusion volume, and operative time were statistically different (all P < 0.05) between 2 groups of patients with and without POLD. The relationship among PLFEI, ICGR15, OBV, and SRLV is expressed as an equation of “PLFEI = 0.181 × ICGR15 + 0.001 × OBV − 0.008 × SRLV.” The cutoff value of PLFEI to predict POLD was −2.16 whose sensitivity and specificity were 90.3% and 73.5%, respectively. However, when predicting fatal liver failure (FLF), the cutoff value of PLFEI was switched to −1.97 whose sensitivity and specificity were 100% and 68.8%, respectively. PLFEI will be a more comprehensive, sensitive, and accurate index assessing perioperative LRF in liver cancer patients who receive liver resection. And keeping PLFEI <−1.97 is a safety margin for preventing FLF in PLC patients who underwent liver resection. PMID:25929924

  17. A comprehensive method for predicting fatal liver failure of patients with liver cancer resection.

    PubMed

    Li, Jiangfa; Lei, Biao; Nie, Xingju; Lin, Linku; Tahir, Syed Abdul; Shi, Wuxiang; Jin, Junfei; He, Songqing

    2015-05-01

    There are many methods to assess liver function, but none of them has been verified as fully effective. The purpose of this study is to establish a comprehensive method evaluating perioperative liver reserve function (LRF) in patients with primary liver cancer (PLC).In this study, 310 PLC patients who underwent liver resection were included. The cohort was divided into a training set (n = 235) and a validation set (n = 75). The factors affecting postoperative liver dysfunction (POLD) during preoperative, intraoperative, and postoperative periods were confirmed by logistic regression analysis. The equation for calculating the preoperative liver functional evaluation index (PLFEI) was established; the cutoff value of PLFEI determined through analysis by receiver-operating characteristic curve was used to predict postoperative liver function.The data showed that body mass index, international normalized ratio, indocyanine green (ICG) retention rate at 15 minutes (ICGR15), ICG elimination rate, standard remnant liver volume (SRLV), operative bleeding volume (OBV), blood transfusion volume, and operative time were statistically different (all P < 0.05) between 2 groups of patients with and without POLD. The relationship among PLFEI, ICGR15, OBV, and SRLV is expressed as an equation of "PLFEI = 0.181 × ICGR15 + 0.001 × OBV - 0.008 × SRLV." The cutoff value of PLFEI to predict POLD was -2.16 whose sensitivity and specificity were 90.3% and 73.5%, respectively. However, when predicting fatal liver failure (FLF), the cutoff value of PLFEI was switched to -1.97 whose sensitivity and specificity were 100% and 68.8%, respectively.PLFEI will be a more comprehensive, sensitive, and accurate index assessing perioperative LRF in liver cancer patients who receive liver resection. And keeping PLFEI <-1.97 is a safety margin for preventing FLF in PLC patients who underwent liver resection.

  18. A hypercoagulable and hypofibrinolytic state is detectable by global methods in patients with retinal vein occlusion.

    PubMed

    Cellai, Anna Paola; Lami, Donatella; Fedi, Sandra; Marcucci, Rossella; Mannini, Lucia; Cenci, Caterina; Rogolino, Angela; Sodi, Andrea; Menchini, Ugo; Abbate, Rosanna; Prisco, Domenico

    2012-09-01

    The pathogenesis of retinal vein occlusion (RVO), has not been well understood. Recent data have shown the efficacy of an anticoagulant therapy with LMWHs in the treatment of acute RVO suggesting the presence of a hypercoagulable state in these patients. New global tests for detection of hypercoagulability and hypofibrinolysis have become available and their application might improve the knowledge of the pathophysiology of RVO and, potentially, its treatment. The aim of our study was to evaluate coagulation and fibrinolytic alterations by two global tests in RVO patients: Endogenous Thrombin Potential (ETP) and Clot Lysis Time (CLT), respectively. We studied 81 RVO patients (40 males; median age 61 years) and a control group matched for age and sex. The ETP was measured by functional chromogenic assay and expressed as the time until thrombin burst (LagTime), Time to peak (T(max)), Peak amount of thrombin generation (C(max)) and ETP. CLT was determined by a plasma-based, tissue factor-induced clot lysis assay. C(max), ETP and CLT values were significantly higher in RVO patients than in controls (C(max)p = 0.010; ETP p < 0.001; CLT p < 0.001) and remained significantly associated with the disease at the multivariate analysis adjusted for cardiovascular risk factors. Our results indicate that -beyond the assay of different parameters associated with clotting activation and lysis- global methods might allow us to easily detect the presence of hypercoagulability and hypofibrinolysis in RVO patients. Further studies should assess the possible clinical value of our data in the management of RVO patients.

  19. 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:…

  20. 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.

  1. Beyond finite elements: a comprehensive, patient-specific neurosurgical simulation utilizing a meshless method.

    PubMed

    Miller, K; Horton, A; Joldes, G R; Wittek, A

    2012-10-11

    To be useful in clinical (surgical) simulations, a method must use fully nonlinear (both geometric and material) formulations to deal with large (finite) deformations of tissues. The method must produce meaningful results in a short time on consumer hardware and not require significant manual work while discretizing the problem domain. In this paper, we showcase the Meshless Total Lagrangian Explicit Dynamics Method (MTLED) which meets these requirements, and use it for computing brain deformations during surgery. The problem geometry is based on patient-specific MRI data and includes the parenchyma, tumor, ventricles and skull. Nodes are distributed automatically through the domain rendering the normally difficult problem of creating a patient-specific computational grid a trivial exercise. Integration is performed over a simple, regular background grid which does not need to conform to the geometry boundaries. Appropriate nonlinear material formulation is used. Loading is performed by displacing the parenchyma surface nodes near the craniotomy and a finite frictionless sliding contact is enforced between the skull (rigid) and parenchyma. The meshless simulation results are compared to both intraoperative MRIs and Finite Element Analysis results for multiple 2D sections. We also calculate Hausdorff distances between the computed deformed surfaces of the ventricles and those observed intraoperatively. The difference between previously validated Finite Element results and the meshless results presented here is less than 0.2mm. The results are within the limits of neurosurgical and imaging equipment accuracy (~1 mm) and demonstrate the method's ability to fulfill all of the important requirements for surgical simulation.

  2. Reduction of Deterministic Thinking Among Cancer Patients as a New Method to Increase Psychosocial Adjustments

    PubMed Central

    Younesi, Seyyed Jalal; Mirafzal, Akramsadat; Tooyserkani, Mahdieh

    2012-01-01

    Background Deterministic thinking is one of the major cognitive distortions. This type of thinking ignores any possibility in making a conclusion about events. Any consequence of an event may be thought as: 2×2= 4. Equality is a dominant factor among all conclusions of this kind of distortion. Distortion emerges in cognitive rigidity in the mind and could be the source of all distortions. Cognitive rigidity is a main reason for depression and other psychosocial maladjustments. Methods Challenging distortion was discussed as a new method for improving psychological conditions of cancer patients. Adapting the cultural base of the method, distortion is explained as a destructive factor which ruins the balance of fear and hope, the two important signs of faith in Islamic perspective. Results The consequence of challenging distortion to reduce depression and anxiety has been explained based on the Islamic Culture. Conclusion For the first time, in this study, it was proposed that how this method can be used in the treatment of psychological disorders of cancer patients. PMID:25628825

  3. 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.

  4. Orbits of the visual binaries ADS 8814 and ADS 8065 from observations along a short arc

    NASA Astrophysics Data System (ADS)

    Kiselev, A. A.; Kiyaeva, O. V.; Romanenko, L. G.; Gorynya, N. A.

    2012-07-01

    The orbits of the visual binaries ADS 8814 and ADS 8065 are determined for the first time. The orbits were calculated using the parameters of the apparent motion, based on position observations along short arcs obtained on the 26-inch refrector of the Pulkovo Observatory, supplemented with radial-velocity observations for the stellar components in both pairs obtained on the 1-m telescope of the Simeiz Section of the Crimean Astrophysical Observatory. All previous visual and photographic observations of these stars after 1832 were also taken into account. The orbit of ADS 8814 was refined using the differential-correction method. The orbital periods of these two stars are about 800 and 6000 years, respectively. The mass estimates derived for the known parallaxes from the Hipparcos catalog correspond to the spectral types of these stars. The polar vectors of the obtained orbits in Galactic coordinates are also given.

  5. Assesment of inflammatory response intensity in early postoperative period in patients after hernioplasty operated on with classic stoppa method and videoscopic TEP method.

    PubMed

    Libiszewski, Michał; Drozda, Rafał; Białecki, Jacek; Wieloch, Maria; Hedayati, Masoud; Kuzdak, Krzysztof; Kołomecki, Krzysztof

    2011-09-01

    THE AIM OF THE STUDY was comparison of inflammatory response intensity through estimation of CRP, IL-6 and WBC concentration in blood serum in patients before and after inguinal hernia operations with Stoppa and TEP method. MATERIAL AND METHODS. The study involoved 117 patients operated on inguinal hernia between 2006-2008. The patients were divided into two groups. In the first group (group I - 56) Stopp'a method was used, in the second (group II - 61) TEP method. The patients selection was coincidental. All examined patients were men between 25-75 years old (mean age 54.3). Moreover, the operation's time, state of postoperative wound, the average hospitalization time and intensity of pain were estimated. The observations were directed over two weeks after operation. RESULTS. The inflammatory response estimated with CRP, IL-6 concentration in blood serum was considerably higher in patients operated with Stoppa method. There wasn't observed a relevant difference in increase of white blood cells' concentration in both groups. Moreover, the patients operated on with TEP method experienced lower pain. In group, operated on with Stoppa method, 3 cases of wound healing complications were observed. The operation's time was considerably shorter in the first group. The hospitalization time, was considerably shorter in patients operated on with videoscopic method. CONCLUSIONS. The operation of inguinal hernia with TEP technique in comparison with Stopp'a method is connected with considerably lower inflammatory response of organism, what directly involve with postoperative pain abridgment and reduction of hospitalization time. Moreover it may have influence on frequency of postoperative complications related with wound healing.

  6. Autonomic function assessment in Parkinson's disease patients using the kernel method and entrainment techniques.

    PubMed

    Kamal, Ahmed K

    2007-01-01

    The experimental procedure of lowering and raising a leg while the subject is in the supine position is considered to stimulate and entrain the autonomic nervous system of fifteen untreated patients with Parkinson's disease and fifteen age and sex matched control subjects. The assessment of autonomic function for each group is achieved using an algorithm based on Volterra kernel estimation. By applying this algorithm and considering the process of lowering and raising a leg as stimulus input and the Heart Rate Variability signal (HRV) as output for system identification, a mathematical model is expressed as integral equations. The integral equations are considered and fixed for control subjects and Parkinson's disease patients so that the identification method reduced to the determination of the values within the integral called kernels, resulting in an integral equations whose input-output behavior is nearly identical to that of the system in both healthy subjects and Parkinson's disease patients. The model for each group contains the linear part (first order kernel) and quadratic part (second order kernel). A difference equation model was employed to represent the system for both control subjects and patients with Parkinson's disease. The results show significant difference in first order kernel(impulse response) and second order kernel (mesh diagram) for each group. Using first order kernel and second order kernel, it is possible to assess autonomic function qualitatively and quantitatively in both groups.

  7. Manual muscle testing: a method of measuring extremity muscle strength applied to critically ill patients.

    PubMed

    Ciesla, Nancy; Dinglas, Victor; Fan, Eddy; Kho, Michelle; Kuramoto, Jill; Needham, Dale

    2011-04-12

    Survivors of acute respiratory distress syndrome (ARDS) and other causes of critical illness often have generalized weakness, reduced exercise tolerance, and persistent nerve and muscle impairments after hospital discharge. Using an explicit protocol with a structured approach to training and quality assurance of research staff, manual muscle testing (MMT) is a highly reliable method for assessing strength, using a standardized clinical examination, for patients following ARDS, and can be completed with mechanically ventilated patients who can tolerate sitting upright in bed and are able to follow two-step commands. (7, 8) This video demonstrates a protocol for MMT, which has been taught to ≥ 43 research staff who have performed >800 assessments on >280 ARDS survivors. Modifications for the bedridden patient are included. Each muscle is tested with specific techniques for positioning, stabilization, resistance, and palpation for each score of the 6-point ordinal Medical Research Council scale. Three upper and three lower extremity muscles are graded in this protocol: shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion. These muscles were chosen based on the standard approach for evaluating patients for ICU-acquired weakness used in prior publications. (1,2).

  8. Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications.

    PubMed

    Sanches, Ana Cláudia Soncini; Góes, Cassiana Regina de; Bufarah, Marina Nogueira Berbel; Balbi, André Luiz; Ponce, Daniela

    2016-10-01

    Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE) of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis. The nutritional needs of this population are therefore complex, and determining the resting energy expenditure is essential to adjust the nutritional supply and to plan a proper diet, ensuring that energy requirements are met and avoiding complications associated with overfeeding and underfeeding. Several evaluation methods of EE in this population have been described, but all of them have limitations. Such methods include direct calorimetry, doubly labeled water, indirect calorimetry (IC), various predictive equations, and, more recently, the rule of thumb (kcal/kg of body weight). Currently, IC is considered the gold standard.

  9. A novel method to correct for pitch and yaw patient setup errors in helical tomotherapy

    SciTech Connect

    Boswell, Sarah A.; Jeraj, Robert; Ruchala, Kenneth J.; Olivera, Gustavo H.; Jaradat, Hazim A.; James, Joshua A.; Gutierrez, Alonso; Pearson, Dave; Frank, Gary; Mackie, T. Rock

    2005-06-15

    An accurate means of determining and correcting for daily patient setup errors is important to the cancer outcome in radiotherapy. While many tools have been developed to detect setup errors, difficulty may arise in accurately adjusting the patient to account for the rotational error components. A novel, automated method to correct for rotational patient setup errors in helical tomotherapy is proposed for a treatment couch that is restricted to motion along translational axes. In tomotherapy, only a narrow superior/inferior section of the target receives a dose at any instant, thus rotations in the sagittal and coronal planes may be approximately corrected for by very slow continuous couch motion in a direction perpendicular to the scanning direction. Results from proof-of-principle tests indicate that the method improves the accuracy of treatment delivery, especially for long and narrow targets. Rotational corrections about an axis perpendicular to the transverse plane continue to be implemented easily in tomotherapy by adjustment of the initial gantry angle.

  10. Skin Characteristics in Patients with Pityriasis Versicolor Using Non-Invasive Method, MPA5

    PubMed Central

    Park, Hyun Jung; Lee, Yang Won; Choe, Yong Beom

    2012-01-01

    Background Skin pigmentary changes of pityriasis versicolor may occur as either hyperpigmented or hypopigmented lesions, depending on the outcome of interactions between Malassezia yeasts and the skin, such as lipoperoxidation process, stimulus of inflammatory cell to melanocytes, and increased thickness of keratin layer. Objective To investigate skin characteristic factors that enhance the susceptibility to Malassezia yeasts and provoke different color changes of pityriasis versicolor patients. Methods To clarify these factors, we investigated the skin characteristics of pityriasis versicolor patients, using a non-invasive method known as MPA 5® (Courage and Khazaka, Germany). A total of 90 normal healthy subjects and 30 pityriasis versicolor patients were included in this study. Results Both hyperpigmented and hypopigmented pityriasis versicolor skin lesions showed higher humidity, increased sebum excretion rate and increased transepidermal water loss (TEWL) values than normal healthy subjects. But no significant difference of specific Malassezia yeasts species between hyperpigmented and hypopigmented skin lesions was evident. Conclusion These results indicate that higher humidity and increased sebum level provide a better growing environment of Malassezia yeasts in the skin, leading to the assumption that interaction between Malassezia yeasts and skin barrier materials makes disruption of skin barrier causing increased TEWL. PMID:23197911

  11. Realizing "value-added" metrology

    NASA Astrophysics Data System (ADS)

    Bunday, Benjamin; Lipscomb, Pete; Allgair, John; Patel, Dilip; Caldwell, Mark; Solecky, Eric; Archie, Chas; Morningstar, Jennifer; Rice, Bryan J.; Singh, Bhanwar; Cain, Jason; Emami, Iraj; Banke, Bill, Jr.; Herrera, Alfredo; Ukraintsev, Vladamir; Schlessinger, Jerry; Ritchison, Jeff

    2007-03-01

    The conventional premise that metrology is a "non-value-added necessary evil" is a misleading and dangerous assertion, which must be viewed as obsolete thinking. Many metrology applications are key enablers to traditionally labeled "value-added" processing steps in lithography and etch, such that they can be considered integral parts of the processes. Various key trends in modern, state-of-the-art processing such as optical proximity correction (OPC), design for manufacturability (DFM), and advanced process control (APC) are based, at their hearts, on the assumption of fine-tuned metrology, in terms of uncertainty and accuracy. These trends are vehicles where metrology thus has large opportunities to create value through the engineering of tight and targetable process distributions. Such distributions make possible predictability in speed-sorts and in other parameters, which results in high-end product. Additionally, significant reliance has also been placed on defect metrology to predict, improve, and reduce yield variability. The necessary quality metrology is strongly influenced by not only the choice of equipment, but also the quality application of these tools in a production environment. The ultimate value added by metrology is a result of quality tools run by a quality metrology team using quality practices. This paper will explore the relationships among present and future trends and challenges in metrology, including equipment, key applications, and metrology deployment in the manufacturing flow. Of key importance are metrology personnel, with their expertise, practices, and metrics in achieving and maintaining the required level of metrology performance, including where precision, matching, and accuracy fit into these considerations. The value of metrology will be demonstrated to have shifted to "key enabler of large revenues," debunking the out-of-date premise that metrology is "non-value-added." Examples used will be from critical dimension (CD

  12. [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.

  13. 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.

  14. A magnetic nanoparticles-based method for DNA extraction from the saliva of stroke patients

    PubMed Central

    Yi, Li; Huang, Ying; Wu, Ting; Wu, Jun

    2013-01-01

    C677T polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene is a risk factor for stroke, suggesting that widespread detection could help to prevent stroke. DNA from 70 stroke patients and 70 healthy controls was extracted from saliva using a magnetic nanoparticles-based method and from blood using conventional methods. Real-time PCR results revealed that the C677T polymorphism was genotyped by PCR using DNA extracted from both saliva and blood samples. The genotype results were confirmed by gene sequencing, and results for saliva and blood samples were consistent. The mutation TT genotype frequency was significantly higher in the stroke group than in controls. Homocysteine levels were significantly higher than controls in both TT genotype groups. Therefore, this noninvasive magnetic nanoparticles-based method using saliva samples could be used to screen for the MTHFR C677T polymorphism in target populations. PMID:25206624

  15. 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.

  16. 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.

  17. 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.

  18. The "stegosaurus" dressing: a simple and effective method of securing skin grafts in the burn patient.

    PubMed

    Fullerton, J K; Smith, C E; Milner, S M

    2000-10-01

    Skin grafts are vulnerable to shear stress, infection, and hematoma formation during the postoperative period, all of which reduce graft survival. Various methods of dressing application and materials have been described in the literature to try and prevent graft loss. The authors report the use of the "stegosaurus dressing" (Eggcrate Pad) in 6 patients to secure skin grafts. Patients chosen were those who were either noncompliant or who sustained burns in unfavorable anatomic sites. All grafts demonstrated complete take without infection and hematoma formation. This foam dressing provides an even pressure to the recipient bed, absorbs drainage, and protects the graft from shearing. It also demonstrates the versatility to be used in difficult nonburn skin graft areas. The stegosaurus dressing is easy to apply, inexpensive, and provides a very secure dressing over the skin graft.

  19. Evaluation of serum antioxidant activity in patients with liver pathology by the chemiluminescent method.

    PubMed

    Titov, V N; Sazhina, N N

    2014-12-01

    Total antioxidant activity of the serum in patients with liver pathology was assessed by two chemiluminescent methods based on different models of free radical oxidation: Hb-H2O2-luminol and ABAP-luminol. Comparative analysis showed a significant, but not high correlation of the results (r=0.798), which can be explained by different mechanisms of induction of free radicals and effects of various serum components (proteins and bilirubin) on the initiation process. The influence of aphysiological concentration of analyzed values manifested in the Hb-H2O2 model. Disagreement between the results of measurements was more pronounced in patients with abnormally high serum bilirubin content. The results suggested that ABAP-luminol chemiluminescent model is more preferable for evaluation of antioxidant activity in clinical practice.

  20. [Proprioceptive neuromuscular facilitation method of therapeutic rehabilitation in the treatment of patients with Parkinson disease].

    PubMed

    Mirek, Elzbieta; Chwała, Wiesław; Longawa, Krystyna; Rudzińska, Monika; Adamkiewicz, Paweł; Szczudlik, Andrzej

    2003-01-01

    Planning and verification of progress of efficacious physiotherapeutic effect on Parkinson's disease depends notably on the right identification of areas and scope of dysfunction of motoric systems. Biomechanical evaluation of motoric organ disability made by means of three-dimensional motion analysis using the "Vicon" system can make it considerably easier. A sample of three patients (two women and one man of average age of sixty-four) with idiopathic parkinsonism has been examined for the purpose of this evaluation. Based upon results of the three-dimensional motion analysis of these patients, dominant individual movement disorders were determined and individual therapeutic rehabilitation using the PNF method was planned. Within therapy, using the PNF method, they applied special techniques using motor patterns for the pelvis, upper and lower limbs in order to improve movement through an approach of assessed parameters to the biomechanical standard. After three weeks of therapy, specific characteristics of gait were examined again. On the basis of research results before therapy, it was found that these patients had none or limited scope of plantar flexion of feet, excessive dorsal flexion of feet, lengthened duration of stance phase, considerable excessive external rotation of shanks and excessive anteversion of the pelvis during gait cycle. Also big differences in values for spatiotemporal parameters (such as walking speed and frequency, stride length and time of single limb support) between the patients and healthy people were observed. After therapy, there has not been a marked variability in the scope of angular changes to the above-mentioned dysfunction. Only proportions between the duration of stance phase and swing phase have improved noticeably, so that they have directly resulted in better rhythm of gait. They have considerably approached the standards of frequency and speed (p = 0.05). However, stride length and duration of single limb support has not

  1. Echocardiographic Parameters as Life Quality Predictors in Patients After Myocardial Infarction Treated with Different Methods

    PubMed Central

    Dzubur, Alen; Mekic, Mevludin; Pesto, Senad; Nabil, Naser

    2016-01-01

    Introduction: Cardiovascular diseases are the leading cause of death in most countries. The aim was to examine the quality of life and to determine the differences in the quality of life in patients one year after myocardial infarction and the relationship between quality of life and echocardiographic parameters in these patients. Material and Methods: The research was a prospective, clinical, epidemiological study and was conducted at the Clinic of Cardiology, University Clinical Center Sarajevo (UCCS). The research was conducted on a sample of 160 patients who had acute myocardial infarction, which are based on the therapeutic procedures divided into four groups. The average age in the total sample was 54.9±8.8 years (range 37-76 years). The research was conducted one year after myocardial infarction (I group of subjects) or 12 months after PCI therapeutic procedures (II and III group of respondents) or coronary artery bypass surgery (IV group of respondents). Results: Comparison of the mean scores of scales in SF-36 questionnaire showed that the highest total score had patients in the group II 67.3±15.2, and the lowest in the group I 57.8±21.4. The increase in ejection fraction leads to a statistically significant increase in quality of life scores at all subscales, in all groups, so that EF has the greatest impact on the quality of life in all respondents. Statistically significant differences in the effects of mitral regurgitation in particular groups have been recorded only in the case of the mental health scale. Conclusions: Ejection fraction has the greatest impact on the quality of life in all patients, regardless of the type of medical treatment. PMID:28210012

  2. A New Method for Predicting Patient Survivorship Using Efficient Bayesian Network Learning

    PubMed Central

    Jiang, Xia; Xue, Diyang; Brufsky, Adam; Khan, Seema; Neapolitan, Richard

    2014-01-01

    The purpose of this investigation is to develop and evaluate a new Bayesian network (BN)-based patient survivorship prediction method. The central hypothesis is that the method predicts patient survivorship well, while having the capability to handle high-dimensional data and be incorporated into a clinical decision support system (CDSS). We have developed EBMC_Survivorship (EBMC_S), which predicts survivorship for each year individually. EBMC_S is based on the EBMC BN algorithm, which has been shown to handle high-dimensional data. BNs have excellent architecture for decision support systems. In this study, we evaluate EBMC_S using the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) dataset, which concerns breast tumors. A 5-fold cross-validation study indicates that EMBC_S performs better than the Cox proportional hazard model and is comparable to the random survival forest method. We show that EBMC_S provides additional information such as sensitivity analyses, which covariates predict each year, and yearly areas under the ROC curve (AUROCs). We conclude that our investigation supports the central hypothesis. PMID:24558297

  3. Ensuring Privacy When Integrating Patient-Based Datasets: New Methods and Developments in Record Linkage

    PubMed Central

    Brown, Adrian P.; Ferrante, Anna M.; Randall, Sean M.; Boyd, James H.; Semmens, James B.

    2017-01-01

    In an era where the volume of structured and unstructured digital data has exploded, there has been an enormous growth in the creation of data about individuals that can be used for understanding and treating disease. Joining these records together at an individual level provides a complete picture of a patient’s interaction with health services and allows better assessment of patient outcomes and effectiveness of treatment and services. Record linkage techniques provide an efficient and cost-effective method to bring individual records together as patient profiles. These linkage procedures bring their own challenges, especially relating to the protection of privacy. The development and implementation of record linkage systems that do not require the release of personal information can reduce the risks associated with record linkage and overcome legal barriers to data sharing. Current conceptual and experimental privacy-preserving record linkage (PPRL) models show promise in addressing data integration challenges. Enhancing and operationalizing PPRL protocols can help address the dilemma faced by some custodians between using data to improve quality of life and dealing with the ethical, legal, and administrative issues associated with protecting an individual’s privacy. These methods can reduce the risk to privacy, as they do not require personally identifying information to be shared. PPRL methods can improve the delivery of record linkage services to the health and broader research community. PMID:28303240

  4. 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.

  5. Connective tissue anomalies in patients with spontaneous cervical artery dissection

    PubMed Central

    Giossi, Alessia; Ritelli, Marco; Costa, Paolo; Morotti, Andrea; Poli, Loris; Del Zotto, Elisabetta; Volonghi, Irene; Chiarelli, Nicola; Gamba, Massimo; Bovi, Paolo; Tomelleri, Giampaolo; Carletti, Monica; Checcarelli, Nicoletta; Meneghetti, Giorgio; Morra, Michele; Chinaglia, Mauro; De Giuli, Valeria; Colombi, Marina; Padovani, Alessandro

    2014-01-01

    Objective: To investigate the prevalence of connective tissue abnormalities in patients with spontaneous cervical artery dissections (sCeAD). Methods: We systematically assessed clinically detectable signs of connective tissue aberration in a series of consecutive patients with sCeAD and of age- and sex-matched patients with ischemic stroke unrelated to CeAD (non-CeAD IS) by a standard examination protocol including 68 items, and performed extensive molecular investigation for hereditary connective tissue disorders in all patients with sCeAD. Results: The study group included 84 patients with sCeAD (mean age, 44.5 ± 7.8 years; 66.7% men) and 84 patients with non-CeAD IS. None of the patients with sCeAD met clinical or molecular diagnostic criteria for established hereditary connective tissue disorder. Connective tissue abnormalities were detected more frequently in the group of patients with sCeAD than in the group of those with non-CeAD IS (mean number of pathologic findings, 4.5 ± 3.5 vs 1.9 ± 2.3; p < 0.001). Eighty-one patients (96.4%) in the sCeAD group had at least one detectable sign compared with 55 patients (66.7%) in the group with non-CeAD IS (p < 0.001). Skeletal, ocular, and skin abnormalities, as well as craniofacial dysmorphisms, were the clinical signs more strongly associated with sCeAD. Signs suggesting connective tissue abnormality were also more frequently represented in patients with sCeAD than in patients with traumatic CeAD (28.6%, p < 0.001; mean number of pathologic findings, 1.7 ± 3.7, p = 0.045). Conclusions: Connective tissue abnormalities are frequent in patients with sCeAD. This reinforces the hypothesis that systemic aberrations of the connective tissue might be implicated in the pathogenesis of the disease. PMID:25355826

  6. Self-image of the Patients with Head and Neck Cancer: A Mixed Method Research

    PubMed Central

    Nayak, Shalini G; Pai, Mamatha Shivananda; George, Linu Sara

    2016-01-01

    Aim: The aim of the study was to assess the self-image of the patients with head and neck cancers (HNCs) by using a mixed method research. Subjects and Methods: A mixed method approach and triangulation design was used with the aim of assessing the self-image of the patients with HNCs. Data was gathered by using self-administered self-image scale and structured interview. Nested sampling technique was adopted. Sample size for quantitative approach was 54 and data saturation was achieved with seven subjects for qualitative approach. Institutional Ethical Committee clearance was obtained. Results: The results of the study showed that 30 (56%) subjects had positive self-image and 24 (44%) had negative self-image. There was a moderate positive correlation between body image and integrity (r = 0.430, P = 0.001), weak positive correlation between body image and self-esteem (r = 0.270, P = 0.049), and no correlation between self-esteem and integrity (r = 0.203, P = 0.141). The participants also scored maximum (24/24) in the areas of body image and self-esteem. Similar findings were also observed in the phenomenological approach. The themes evolved were immaterial of outer appearance and desire of good health to all. Conclusion: The illness is long-term and impacts the individual 24 h a day. Understanding patients’ self-concept and living experiences of patients with HNC is important for the health care professionals to improve the care. PMID:27559264

  7. Novel esophageal speech therapy method in total laryngectomized patients: biofeedback by intraesophageal impedance.

    PubMed

    Şahin, M; Ogut, M F; Vardar, R; Kirazli, T; Engin, E Z; Bor, S

    2016-01-01

    The loss of the best communication port after total laryngectomy surgery makes speech rehabilitation an important goal. Our aim was to improve the quality of esophageal speech (ES) using online esophageal multichannel intra-luminal impedance (MII) as a new biofeedback method. Twenty-six total laryngectomized patients were included. Before ES therapy, an esophageal motility test was carried out. MII catheters were placed in all subjects who were then randomized into two groups. Group 1 included 13 cases, who were retrained according to the classical method. Group 2 included 13 cases, who were retrained according to the simplified animation of air movements within the esophagus and upper stomach resulting from the modifications of intra-esophageal air kinetics gained by MII. The level of speech proficiency was evaluated relative to pretraining levels using perceptual scales in the third and sixth months. Acoustic voice was analyzed. The number of syllables read per minute and the intelligibility of monosyllabic and dissyllabic words were calculated. In this study, MII was used for the first time in alaryngeal speech rehabilitation as a biofeedback method; an overall sufficient speech level was achieved by 68.4% at the end of therapy, whereas attendance was 90%. A statistically significant improvement was found in both groups in terms of ES level compared with the pretraining period although there was no significant difference between groups. Although we did not observe the expected difference between groups suggested by our hypothesis, MII may be used as an objective tool to show patients how to swallow and regurgitate air during training, and may thus expedite ES therapy both for the speech therapist and the patient in the future.

  8. 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.

  9. 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

  10. 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

    2016-09-09

    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.

  11. 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

  12. Antibiotics for acute respiratory tract infections: a mixed-methods study of patient experiences of non-medical prescriber management

    PubMed Central

    Courtenay, Molly; Rowbotham, Samantha; Lim, Rosemary; Deslandes, Rhian; Hodson, Karen; MacLure, Katie; Peters, Sarah; Stewart, Derek

    2017-01-01

    Objective To (1) explore patients' expectations and experiences of nurse and pharmacist non-medical prescriber-led management of respiratory tract infections (RTIs), (2) examine whether patient expectations for antibiotics affect the likelihood of receiving them and (3) understand factors influencing patient satisfaction with RTI consultations. Design Mixed methods. Setting Primary care. Participants Questionnaires from 120 patients and follow-up interviews with 22 patients and 16 nurse and pharmacist non-medical prescribers (NMPs). Results Patients had multiple expectations of their consultation with 43% expecting to be prescribed an antibiotic. There was alignment between self-reported patient expectations and those perceived by NMPs. Patient expectations for non-antibiotic strategies, such as education to promote self-management, were associated with receipt of those strategies, whereas patient expectations for an antibiotic were not associated with receipt of these medications. ‘Patient-centred’ management strategies (including reassurance and providing information) were received by 86.7% of patients. Regardless of patients' expectations or the management strategy employed, high levels of satisfaction were reported for all aspects of the consultation. Taking concerns seriously, conducting a physical examination, communicating the treatment plan, explaining treatment decisions and lack of time restrictions were each reported to contribute to patient satisfaction. Conclusions NMPs demonstrate an understanding of patient expectations of RTI consultations and use a range of non-antibiotic management strategies, particularly those resembling a patient-centred approach. Overall, patients' expectations were met and prescribers were not unduly influenced by patient expectations for an antibiotic. Patients were satisfied with the consultation, indicating that strategies used by NMPs were acceptable. However, the lower levels of satisfaction among patients who

  13. A simple method to assess freezing of gait in Parkinson's disease patients.

    PubMed

    Popovic, M B; Djuric-Jovicic, M; Radovanovic, S; Petrovic, I; Kostic, V

    2010-09-01

    Freezing of gait (FOG) can be assessed by clinical and instrumental methods. Clinical examination has the advantage of being available to most clinicians; however, it requires experience and may not reveal FOG even for cases confirmed by the medical history. Instrumental methods have an advantage in that they may be used for ambulatory monitoring. The aim of the present study was to describe and evaluate a new instrumental method based on a force sensitive resistor and Pearson's correlation coefficient (Pcc) for the assessment of FOG. Nine patients with Parkinson's disease in the "on" state walked through a corridor, passed through a doorway and made a U-turn. We analyzed 24 FOG episodes by computing the Pcc between one "regular/normal" step and the rest of the steps. The Pcc reached ±1 for "normal" locomotion, while correlation diminished due to the lack of periodicity during FOG episodes. Gait was assessed in parallel with video. FOG episodes determined from the video were all detected with the proposed method. The computed duration of the FOG episodes was compared with those estimated from the video. The method was sensitive to various types of freezing; although no differences due to different types of freezing were detected. The study showed that Pcc analysis permitted the computerized detection of FOG in a simple manner analogous to human visual judgment, and its automation may be useful in clinical practice to provide a record of the history of FOG.

  14. Clinical Efficacy of Subcutaneous Allergen Immunotherapy in Patients with Atopic Dermatitis

    PubMed Central

    Kim, Myoung-Eun; Kwon, Byul; Cho, Su-Mi; Ahn, Areum

    2016-01-01

    Purpose The clinical usefulness of subcutaneous allergen immunotherapy (SCIT) in the treatment of atopic dermatitis (AD) is still controversial. We analyzed the clinical efficacy of SCIT in patients with AD and the clinical characteristics of patients showing a favorable clinical response to the treatment. Materials and Methods Two hundred and fifty one patients with AD sensitized to house dust mite (HDM) were treated by SCIT using HDM extract. The clinical severity of AD was measured using the standardized clinical severity scoring system for AD (SCORAD) at baseline and 12 months. A favorable clinical response to SCIT was defined as a decrease in SCORAD value at 12 months greater than 50% compared to baseline value. Severe AD was defined as a baseline SCORAD value above 50. Results A favorable clinical response to SCIT was observed in 73.6% of patients. The proportion of patients showing a favorable clinical response to SCIT was significantly higher in patients with severe AD (90.6%) than patients with mild to moderated AD (63.7%) (p<0.001). Patients with severe AD showing a favorable clinical response had a significantly shorter duration of AD (12.3±8.5 years; mean±SD) than patients with severe AD showing no significant clinical response (20.6±10.9 years) (p<0.05) at baseline. Conclusion SCIT could be a clinically useful therapeutic option for patients with severe AD sensitized to HDM. Early initiation of SCIT might provide a favorable clinical outcome in patients with severe AD sensitized to HDM. PMID:27593870

  15. [Fiber bronchoscopy and bronchoalveolar lavage in patients with asthma. A description of the method].

    PubMed

    Pedersen, B; Dahl, R

    1989-11-27

    Fiber bronchoscopy under local anaesthesia is an examination procedure frequently employed in the remainder of Scandinavia, Europe and USA. It requires only few resources and the costs are considerably less than fiber bronchoscopy under general anaesthesia. Bronchoalveolar lavage (BAL) in connection with fiber bronchoscopy is rapidly undertaken but analysis of the material obtained requires considerable time. A method of induction of local anaesthesia, performance of BAL and preparation of the washings obtained is described. Fiber bronchoscopy and BAL are considered to be safe examination procedures in patients with mild asthma in a stable phase. The examination is only associated with slight discomfort for the patients, who will frequently accept repeated investigations, and complications are rare. BAL is a valuable examination procedure in research and the results have increased the knowledge of mechanisms in a series of interstitial pulmonary diseases. Future investigations of the humoral and cellular components in BAL fluid in asthmatic patients will contribute to increase knowledge of the pathological mechanisms in asthmatic disease.

  16. Interobserver Reliability of Four Diagnostic Methods Using Traditional Korean Medicine for Stroke Patients

    PubMed Central

    Lee, Ju Ah; Kang, Byoung-Kab; Alraek, Terje

    2014-01-01

    Objective. The aim of this study is to evaluate the consistency of pattern identification (PI), a set of diagnostic indicators used by traditional Korean medicine (TKM) clinicians. Methods. A total of 168 stroke patients who were admitted into oriental medical university hospitals from June 2012 through January 2013 were included in the study. Using the PI indicators, each patient was independently diagnosed by two experts from the same department. Interobserver consistency was assessed by simple percentage agreement as well as by kappa and AC1 statistics. Results. Interobserver agreement on the PI indicators (for all patients) was generally high: pulse diagnosis signs (AC1 = 0.66–0.89); inspection signs (AC1 = 0.66–0.95); listening/smelling signs (AC1 = 0.67–0.88); and inquiry signs (AC1 = 0.62–0.94). Conclusion. In four examinations, there was moderate agreement between the clinicians on the PI indicators. To improve clinician consistency (e.g., in the diagnostic criteria used), it is necessary to analyze the reasons for inconsistency and to improve clinician training. PMID:25574181

  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. 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

  19. 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 Hyoun; 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. PACS numbers: 87.56.Fc, 87.53.Bn, 87.53.Kn, 87.53.Ly, 87.55.Gh.

  20. 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

    2015-09-08

    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.

  1. Manufacture of patient-specific vascular replicas for endovascular simulation using fast, low-cost method

    NASA Astrophysics Data System (ADS)

    Kaneko, Naoki; Mashiko, Toshihiro; Ohnishi, Taihei; Ohta, Makoto; Namba, Katsunari; Watanabe, Eiju; Kawai, Kensuke

    2016-12-01

    Patient-specific vascular replicas are essential to the simulation of endovascular treatment or for vascular research. The inside of silicone replica is required to be smooth for manipulating interventional devices without resistance. In this report, we demonstrate the fabrication of patient-specific silicone vessels with a low-cost desktop 3D printer. We show that the surface of an acrylonitrile butadiene styrene (ABS) model printed by the 3D printer can be smoothed by a single dipping in ABS solvent in a time-dependent manner, where a short dip has less effect on the shape of the model. The vascular mold is coated with transparent silicone and then the ABS mold is dissolved after the silicone is cured. Interventional devices can pass through the inside of the smoothed silicone vessel with lower pushing force compared to the vessel without smoothing. The material cost and time required to fabricate the silicone vessel is about USD $2 and 24 h, which is much lower than the current fabrication methods. This fast and low-cost method offers the possibility of testing strategies before attempting particularly difficult cases, while improving the training of endovascular therapy, enabling the trialing of new devices, and broadening the scope of vascular research.

  2. Manufacture of patient-specific vascular replicas for endovascular simulation using fast, low-cost method

    PubMed Central

    Kaneko, Naoki; Mashiko, Toshihiro; Ohnishi, Taihei; Ohta, Makoto; Namba, Katsunari; Watanabe, Eiju; Kawai, Kensuke

    2016-01-01

    Patient-specific vascular replicas are essential to the simulation of endovascular treatment or for vascular research. The inside of silicone replica is required to be smooth for manipulating interventional devices without resistance. In this report, we demonstrate the fabrication of patient-specific silicone vessels with a low-cost desktop 3D printer. We show that the surface of an acrylonitrile butadiene styrene (ABS) model printed by the 3D printer can be smoothed by a single dipping in ABS solvent in a time-dependent manner, where a short dip has less effect on the shape of the model. The vascular mold is coated with transparent silicone and then the ABS mold is dissolved after the silicone is cured. Interventional devices can pass through the inside of the smoothed silicone vessel with lower pushing force compared to the vessel without smoothing. The material cost and time required to fabricate the silicone vessel is about USD $2 and 24 h, which is much lower than the current fabrication methods. This fast and low-cost method offers the possibility of testing strategies before attempting particularly difficult cases, while improving the training of endovascular therapy, enabling the trialing of new devices, and broadening the scope of vascular research. PMID:27976687

  3. 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.

  4. Manufacture of patient-specific vascular replicas for endovascular simulation using fast, low-cost method.

    PubMed

    Kaneko, Naoki; Mashiko, Toshihiro; Ohnishi, Taihei; Ohta, Makoto; Namba, Katsunari; Watanabe, Eiju; Kawai, Kensuke

    2016-12-15

    Patient-specific vascular replicas are essential to the simulation of endovascular treatment or for vascular research. The inside of silicone replica is required to be smooth for manipulating interventional devices without resistance. In this report, we demonstrate the fabrication of patient-specific silicone vessels with a low-cost desktop 3D printer. We show that the surface of an acrylonitrile butadiene styrene (ABS) model printed by the 3D printer can be smoothed by a single dipping in ABS solvent in a time-dependent manner, where a short dip has less effect on the shape of the model. The vascular mold is coated with transparent silicone and then the ABS mold is dissolved after the silicone is cured. Interventional devices can pass through the inside of the smoothed silicone vessel with lower pushing force compared to the vessel without smoothing. The material cost and time required to fabricate the silicone vessel is about USD $2 and 24 h, which is much lower than the current fabrication methods. This fast and low-cost method offers the possibility of testing strategies before attempting particularly difficult cases, while improving the training of endovascular therapy, enabling the trialing of new devices, and broadening the scope of vascular research.

  5. FLiGS Score: A New Method of Outcome Assessment for Lip Carcinoma–Treated Patients

    PubMed Central

    Grassi, Rita; Toia, Francesca; Di Rosa, Luigi; Cordova, Adriana

    2015-01-01

    Background: Lip cancer and its treatment have considerable functional and cosmetic effects with resultant nutritional and physical detriments. As we continue to investigate new treatment regimens, we are simultaneously required to assess postoperative outcomes to design interventions that lessen the adverse impact of this disease process. We wish to introduce Functional Lip Glasgow Scale (FLiGS) score as a new method of outcome assessment to measure the effect of lip cancer and its treatment on patients’ daily functioning. Methods: Fifty patients affected by lip squamous cell carcinoma were recruited between 2009 and 2013. Patients were asked to fill the FLiGS questionnaire before surgery, 1 month, 6 months, and 1 year after surgery. The subscores were used to calculate a total FLiGS score of global oral disability. Statistical analysis was performed to test validity and reliability. Results: FLiGS scores improved significantly from preoperative to 12 months postoperative values (P = 0.000). Statistical evidence of validity was provided through rs (Spearman correlation coefficient) that resulted >0.30 for all surveys and for which P < 0.001. FLiGS score reliability was shown through examination of internal consistency and test-retest reliability. Conclusions: FLiGS score is a simple way of assessing functional impairment related to lip cancer before and after surgery; it is sensitive, valid, reliable, and clinically relevant: it provides useful information to orient the physician in the postoperative management and in the rehabilitation program. PMID:26034652

  6. Prevalence and correlates of suicide ideation in patients with COPD: a mixed methods study

    PubMed Central

    Fleehart, Sara; Fan, Vincent S; Nguyen, Huong Q; Lee, Jungeun; Kohen, Ruth; Herting, Jerald R; Matute-Bello, Gustavo; Adams, Sandra G; Pagalilauan, Genevieve; Borson, Soo

    2014-01-01

    Purpose The purpose of this study was to examine the prevalence and correlates of suicidal ideation (SI) in patients with stable moderate to very severe chronic obstructive pulmonary disease (COPD). Patients and methods We conducted an exploratory mixed methods analysis of data from participants in a longitudinal observational study of depression in COPD. We measured depression with the Patient Health Questionnaire-9 (PHQ-9), which includes an item on SI. We compared participants with and without SI in relation to sociodemographics, symptoms, anxiety, and healthcare resource use with independent t-tests and chi-square tests. Content analysis was performed on qualitative data gathered during a structured SI safety assessment. Results Of 202 participants, 121 (60%) had depressive symptoms (PHQ ≥6); 51 (25%) had a PHQ-9 ≥10, indicating a high likelihood of current major depression; and 22 (11%) reported SI. Compared to the 99 depressed participants without SI, those with SI were more likely to be female (59% vs 27%, P=0.004); had worse dyspnea (P=0.009), depression (P<0.001), and anxiety (P=0.003); and were also more likely to have received treatment for depression and/or anxiety (82% vs 40%, P<0.001) and more hospitalizations for COPD exacerbations (P=0.03) but had similar levels of airflow obstruction and functioning than participants without SI. Themes from the qualitative analysis among those with SI included current or prior adverse life situations, untreated or partially treated complex depression, loss of a key relationship, experience of illness and disability, and poor communication with providers. Conclusion Our findings suggest that current SI is common in COPD, may occur disproportionately in women, can persist despite mental health treatment, and has complex relationships with both health and life events. Adequate management of SI in COPD may therefore require tailored, comprehensive treatment approaches that integrate medical and mental health

  7. Electromyographic response to exercise in cardiac transplant patients: a new method for anaerobic threshold determination?

    PubMed

    Lucía, A; Vaquero, A F; Pérez, M; Sánchez, O; Sánchez, V; Gómez, M A; Chicharro, J L

    1997-06-01

    The purpose of this study was to investigate the possible use of integrated surface electromyography (iEMG) in cardiac transplant patients (CTPs) as a new noninvasive determinant of the metabolic response to exercise by studying the relationship between the iEMG threshold (iEMGT) and other more conventional methods for anaerobic threshold (AT) determination, such as the lactate threshold (LT) and the ventilatory threshold (VT). Thirteen patients (age: 57+/-7 years, mean+/-SD; height: 163+/-7 cm; body mass: 70.5+/-8.6 kg; posttransplant time: 87+/-49 weeks) were selected as subjects. Each of them performed a ramp protocol on a cycle ergometer (starting at 0 W, the workload was increased in 10 W/min). During the tests, gas exchange data, blood lactate levels, and iEMG of the vastus lateralis were collected to determine VT, LT, and iEMGT, respectively. The results evidenced no significant difference between mean values of VT, LT, or iEMGT, when expressed either as oxygen uptake (11.1+/-2.4, 11.7+/-2.3, and 11.0+/-2.8 mL/kg/min, respectively) or as percent maximum oxygen uptake (61.6+/-7.5, 62.2+/-7.7, and 59.6+/-8.2%, respectively). In conclusion, our findings suggest that iEMG might be used as a complementary, noninvasive method for AT determination in CTPs. In addition, since the aerobic impairment of these patients is largely due to peripheral limitation, determination of iEMGT could be used to assess the effectiveness of an exercise rehabilitation program to improve muscle aerobic capacity in CTPs.

  8. The inside outs of AdS3/CFT2: exact AdS wormholes with entangled CFT duals

    NASA Astrophysics Data System (ADS)

    Mandal, Gautam; Sinha, Ritam; Sorokhaibam, Nilakash

    2015-01-01

    We present the complete family of solutions of 3D gravity (Λ < 0) with two asymptotically AdS exterior regions. The solutions are constructed from data at the two boundaries, which correspond to two independent and arbitrary stress tensors T R , , and T L , . The two exteriors are smoothly joined on to an interior region through a regular horizon. We find CFT duals of these geometries which are entangled states of two CFT's. We compute correlators between general operators at the two boundaries and find perfect agreement between CFT and bulk calculations. We calculate and match the CFT entanglement entropy (EE) with the holographic EE which involves geodesics passing through the wormhole. We also compute a holographic, non-equilibrium entropy for the CFT using properties of the regular horizon. The construction of the bulk solutions here uses an exact version of Brown-Henneaux type diffeomorphisms which are asymptotically nontrivial and transform the CFT states by two independent unitary operators on the two sides. Our solutions provide an infinite family of explicit examples of the ER=EPR relation of Maldacena and Susskind [1].

  9. [IMPROVEMENT AND CHOICE OF COLOSTOMY METHOD IN THE TREATMENT OF PATIENTS, SUFFERING AN ACUTE OBTURATIVE IMPASSABILITY OF LARGE BOWEL].

    PubMed

    Kustryo, V I; Langazo, O V

    2015-11-01

    Colostomy was done in 49 patients, suffering an acute obturative impassability of large bowel (AOILB). In 28 patients (1st group) colostomy was conducted in accordance to standard method; in 21 (2nd group)--in accordance to the method, proposed by us. Application of the method proposed for surgical treatment of AOILB have guaranteed a reduction of postoperative paracolostomal complications rate in 6.8 times, of postoperative lethality--in 2.2 times, duration of the patient stationary treatment--in 1.4 times, the rate of dressings and the dressing material expanses--in 10 times.

  10. Police officer competence in handling Alzheimer's cases: The roles of AD knowledge, beliefs, and exposure.

    PubMed

    Sun, Fei; Gao, Xiang; Brown, Hillary; Winfree, L Thomas

    2017-01-01

    This study seeks to understand the level of police officer competence for providing assistance during interactions with patients of Alzheimer's disease (AD), and to reveal the roles their knowledge of AD, beliefs of AD, and previous exposure to patients with AD play in influencing these competence levels. Data were collected from police officers in two Phoenix metropolitan-area police departments through focus group discussions and survey. Four focus groups comprised of 27 police officers discussed their perceptions of AD and challenges of dealing with individuals with AD. Building on the findings from the focus groups, an online survey ( n = 228) examined police officer AD knowledge, as well as their experience and competence in the handling of AD cases. Police participants had fair knowledge of AD with an average 71.8% accuracy rate. More AD knowledge ( B = 0.29) and higher levels of education ( B = 0.85) were associated with higher levels of competence of recognizing AD-related behaviors. Low levels of discomfort interacting with AD patients ( B = -0.75) and having a family member of dementia ( B = 1.32) were related to higher levels of competence of reacting appropriately to an AD patient. The findings suggest that information about the best practices for dealing with community residents with AD needs to be made available to police officers. To ensure a dementia-friendly environment, aging service providers need to reach out to local law enforcement departments and provide training that promotes AD knowledge, decreases AD-related stigma, and increases competence of handing dementia cases in a way that fits the policing culture.

  11. Comparison of three cooling methods for burn patients: A randomized clinical trial.

    PubMed

    Cho, Young Soon; Choi, Young Hwan

    2016-10-01

    Tap water may not be readily available in numerous places as a first aid for burns and, therefore, tea tree oil products are recommended alternatives. Our aim in this study was to compare the cooling effects of three burn-cooling methodologies, running tap water, Burnshield(®), and Burn Cool Spray(®), and suggest indications for each cooling method. This randomized, controlled, study enrolled patients with burns who used the emergency service of Seoul Bestian Hospital from June 2015 to October 2015. The allocation of the cooling methods was randomly generated using a computer. We cooled the burn wounds by applying one of the three methods and measured the skin surface temperature and pain level using a visual analog scale (VAS) scoring. Ninety-six patients were enrolled in this study. The variability in the median(IQR) skin temperatures of the three groups was from 33.5°C (31.5-35.0) to 28.7°C (25.9-30.9), 33.8°C (32.0-35.4) to 33.2°C (30.5-35.0), and 34.0°C (32.0-35.1) to 34.4°C (32.7-35.6) for the tap water, Burn Cool Spray(®), and Burnshield(®), respectively. The variability of the mean VAS pain scores was 6.9 to 4.8 (tap water), 5.6 to 4.5 (Burn Cool Spray(®)), and 5.5 to 3.3 (Burnshield(®)). The reduction of skin surface temperature by tap water was significantly greater than that by the other two methods. All three methods reduced the VAS pain score after 20min of treatment (p<0.001). The tap water had a similar effect to that of the Burn Cool Spray(®) but significantly better than that of Burnshield(®). There was a significant difference in the skin surface temperature and VAS pain score reduction (p=0.014 and p=0.007, respectively) between the groups cooled by tap water below and above 24°C. The patients who visited the center within 30min showed a significantly higher skin temperature than those who came after 30min did (p=0.033). Tap water and Burn Cool Spray(®) reduced the skin surface temperature, but the Burnshield(®) slightly

  12. Emotional Working Memory in Alzheimer's Disease Patients

    PubMed Central

    Satler, Corina; Tomaz, Carlos

    2011-01-01

    Background Few studies have assessed whether emotional content affects processes supporting working memory in Alzheimer disease (AD) patients. Methods We assessed 22 AD patients and 40 elderly controls (EC) with a delayed matching and non-matching to sample task (DMST/DNMST), and a spatial-delayed recognition span task (SRST; unique/varied) using emotional stimuli. Results AD patients showed decreased performance on both tasks compared with EC. With regard to the valence of the stimuli, we did not observe significant performance differences between groups in the DMST/DNMST. However, both groups remembered a larger number of negative than positive or neutral pictures on unique SRST. Conclusion The results suggest that AD patients show a relative preservation of working memory for emotional information, particularly for negative stimuli. PMID:22163239

  13. 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.

  14. Beyond Adding Years to Life: Health-related Quality-of-life and Functional Outcomes in Patients with Severe Aortic Valve Stenosis at High Surgical Risk Undergoing Transcatheter Aortic Valve Replacement

    PubMed Central

    Deutsch, Marcus-André; Bleiziffer, Sabine; Elhmidi, Yacine; Piazza, Nicolo; Voss, Bernhard; Lange, Ruediger; Krane, Markus

    2013-01-01

    Aortic valve stenosis (AVS) is the most frequent acquired valvular heart disease in western industrialized countries and its prevalence considerably increases with age. Once becoming symptomatic severe AVS has a very poor prognosis. Progressive and rapid symptom deterioration leads to an impairment of functional status and compromised healthrelated quality-of-life (HrQoL) simultaneously. Until recently, surgical aortic valve replacement (SAVR) has been the only effective treatment option for improving symptoms and prolonging survival. Transcatheter aortic valve replacement (TAVR) emerged as an alternative treatment modality for those patients with severe symptomatic AVS in whom the risk for SAVR is considered prohibitive or too high. TAVR has gained clinical acceptance with almost startling rapidity and has even quickly become the standard of care for the treatment of appropriately selected individuals with inoperable AVS during recent years. Typically, patients currently referred for and treated by TAVR are elderly with a concomitant variable spectrum of multiple comorbidities, disabilities and limited life expectancy. Beyond mortality and morbidity, the assessment of HrQoL is of paramount importance not only to guide patient-centered clinical decision-making but also to judge this new treatment modality. As per current evidence, TAVR significantly improves HrQoL in high-surgical risk patients with severe AVS with sustained effects up to two years when compared with optimal medical care and demonstrates comparable benefits relative to SAVR. Along with a provision of a detailed overview of the current literature regarding functional and HrQoL outcomes in patients undergoing TAVR, this review article addresses specific considerations of the HrQoL aspect in the elderly patient and finally outlines the implications of HrQoL outcomes for medico-economic deliberations. PMID:24313648

  15. AD, the ALICE diffractive detector

    NASA Astrophysics Data System (ADS)

    Tello, Abraham Villatoro

    2017-03-01

    ALICE is one of the four large experiments at the CERN Large Hadron Collider (LHC). As a complement to its Heavy-Ion physics program, ALICE started during Run 1 of LHC an extensive program dedicated to the study of proton-proton diffractive processes. In order to optimize its trigger efficiencies and purities in selecting diffractive events, the ALICE Collaboration installed a very forward AD detector during the Long Shut Down 1 of LHC. This new forward detector system consists of two stations made of two layers of scintillator pads, one station on each side of the interaction point. With this upgrade, ALICE has substantially increased its forward physics coverage, including the double rapidity gap based selection of central production, as well as the measurements of inclusive diffractive cross sections.

  16. Evaluation of model-based methods in estimating respiratory mechanics in the presence of variable patient effort.

    PubMed

    Redmond, Daniel P; Chiew, Yeong Shiong; Major, Vincent; Chase, J Geoffrey

    2016-09-23

    Monitoring of respiratory mechanics is required for guiding patient-specific mechanical ventilation settings in critical care. Many models of respiratory mechanics perform poorly in the presence of variable patient effort. Typical modelling approaches either attempt to mitigate the effect of the patient effort on the airway pressure waveforms, or attempt to capture the size and shape of the patient effort. This work analyses a range of methods to identify respiratory mechanics in volume controlled ventilation modes when there is patient effort. The models are compared using 4 Datasets, each with a sample of 30 breaths before, and 2-3 minutes after sedation has been administered. The sedation will reduce patient efforts, but the underlying pulmonary mechanical properties are unlikely to change during this short time. Model identified parameters from breathing cycles with patient effort are compared to breathing cycles that do not have patient effort. All models have advantages and disadvantages, so model selection may be specific to the respiratory mechanics application. However, in general, the combined method of iterative interpolative pressure reconstruction, and stacking multiple consecutive breaths together has the best performance over the Dataset. The variability of identified elastance when there is patient effort is the lowest with this method, and there is little systematic offset in identified mechanics when sedation is administered.

  17. A liquid biopsy-based method for the detection and quantification of circulating tumor cells in surgical osteosarcoma patients

    PubMed Central

    Zhang, Haoqiang; Gao, Peng; Xiao, Xin; Heger, Michal; Geng, Lei; Fan, Bo; Yuan, Yulin; Huang, Chen; Chen, Guojing; Liu, Yao; Hu, Yongchen; Yu, Xiuchun; Wu, Sujia; Wang, Ling; Wang, Zhen

    2017-01-01

    A method for the enumeration and quantification of osteosarcoma (OS) circulating tumor cells (CTCs) is currently not available. A correlation between the number of CTCs and progression-free survival (PFS) has been established for other cancers, but not for OS CTCs. A method was therefore developed for CTC quantification in OS and validated in a prospective cohort of surgical patients with primary and recurrent/metastatic OS (N=23). Human OS cells, acting as CTCs, were enumerated from spiked human peripheral blood (PB) following erythrocyte and leukocyte depletion. The OS cells were quantified microscopically based on aneuploidy and a CK18−/CD45− phenotype. Aneuploidy was assayed by fluorescence in situ hybridization (FISH) using fluorescence-labeled alpha-satellite probes for the centromeres of chromosome (CEP 8). CK18 and CD45 phenotyping was performed with immunocytochemistry. HOS cells in spiked PB could be effectively retrieved with the FISH-based enumeration method, which was subsequently employed in an OS patient cohort. PB of recurrent/metastatic OS patients contained more CTCs than the PB of primary OS patients. OS patients with ≥2 CTCs per 7.5 ml of PB had worse PFS than patients whose PB contained <2 CTCs. In 2 cases, CTCs were present in PB of OS patients with negative X-ray and chest CT scans. In conclusion, our method was able to quantitate CTCs in liquid biopsies of OS patients. The number of CTCs has diagnostic and prognostic value. PMID:28350107

  18. A liquid biopsy-based method for the detection and quantification of circulating tumor cells in surgical osteosarcoma patients.

    PubMed

    Zhang, Haoqiang; Gao, Peng; Xiao, Xin; Heger, Michal; Geng, Lei; Fan, Bo; Yuan, Yulin; Huang, Chen; Chen, Guojing; Liu, Yao; Hu, Yongchen; Yu, Xiuchun; Wu, Sujia; Wang, Ling; Wang, Zhen

    2017-03-08

    A method for the enumeration and quantification of osteosarcoma (OS) circulating tumor cells (CTCs) is currently not available. A correlation between the number of CTCs and progression-free survival (PFS) has been established for other cancers, but not for OS CTCs. A method was therefore developed for CTC quantification in OS and validated in a prospective cohort of surgical patients with primary and recurrent/metastatic OS (N=23). Human OS cells, acting as CTCs, were enumerated from spiked human peripheral blood (PB) following erythrocyte and leukocyte depletion. The OS cells were quantified microscopically based on aneuploidy and a CK18-/CD45- phenotype. Aneuploidy was assayed by fluorescence in situ hybridization (FISH) using fluorescence-labeled alpha-satellite probes for the centromeres of chromosome (CEP 8). CK18 and CD45 phenotyping was performed with immunocytochemistry. HOS cells in spiked PB could be effectively retrieved with the FISH-based enumeration method, which was subsequently employed in an OS patient cohort. PB of recurrent/metastatic OS patients contained more CTCs than the PB of primary OS patients. OS patients with ≥2 CTCs per 7.5 ml of PB had worse PFS than patients whose PB contained <2 CTCs. In 2 cases, CTCs were present in PB of OS patients with negative X-ray and chest CT scans. In conclusion, our method was able to quantitate CTCs in liquid biopsies of OS patients. The number of CTCs has diagnostic and prognostic value.

  19. 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.

  20. Effectiveness of laparoscopic gonadectomy using abdominal wall lift method on Turner's syndrome patients with 45, X/46, XY mosaicism.

    PubMed

    Nakano, H; Kawashima, M; Okada, S; Igarashi, T; Nakata, M; Ogino, M

    2001-04-01

    We present a Turner's syndrome patient with a 45, X/46, XY mosaicism who underwent a prophylactic laparoscopic gonadectomy using the abdominal wall lift method. The patient was a 14-year-old phenotypic girl who was referred for an examination of primary amenorrhea. She had already been found to have Turner's syndrome with 45, X/46, XY mosaicism. After an extensive discussion with the patient and her family regarding her high risk for developing a gonadoblastoma, a laparoscopic bilateral salpingo-oophorectomy using the abdominal wall-life method was performed. Laparoscopy using the abdominal wall lift method has an advantage over CO2 pneumoperitoneum method for patients with Turner's syndrome when it is difficult to intubate because of a webbed neck or a shortened trachea.

  1. Supervised Wavelet Method to Predict Patient Survival from Gene Expression Data

    PubMed Central

    Farhadian, Maryam; Lisboa, Paulo J. G.; Moghimbeigi, Abbas; Mahjub, Hossein

    2014-01-01

    In microarray studies, the number of samples is relatively small compared to the number of genes per sample. An important aspect of microarray studies is the prediction of patient survival based on their gene expression profile. This naturally calls for the use of a dimension reduction procedure together with the survival prediction model. In this study, a new method based on combining wavelet approximation coefficients and Cox regression was presented. The proposed method was compared with supervised principal component and supervised partial least squares methods. The different fitted Cox models based on supervised wavelet approximation coefficients, the top number of supervised principal components, and partial least squares components were applied to the data. The results showed that the prediction performance of the Cox model based on supervised wavelet feature extraction was superior to the supervised principal components and partial least squares components. The results suggested the possibility of developing new tools based on wavelets for the dimensionally reduction of microarray data sets in the context of survival analysis. PMID:25538955

  2. Evaluation of oral mucosa epithelium in type II diabetic patients by an exfoliative cytology method.

    PubMed

    Jajarm, Hassan Hosseinpour; Mohtasham, Nooshin; Moshaverinia, Maryam; Rangiani, Afsaneh

    2008-09-01

    Diabetes mellitus is a common metabolic disease that causes chronic hyperglycemia and disturbances in carbohydrate, lipid, and protein metabolism. Although diabetes can cause considerable cellular changes, this field has attracted little research. We therefore decided to evaluate the quantitative and qualitative changes in oral epithelial cells using an exfoliative cytology method. In 30 control individuals and 30 patients with type II diabetes, smears were obtained from two distinct oral sites: the buccal mucosa and tongue dorsum. The oral smears were stained using Papanicolaou solution. Quantitative and qualitative changes were evaluated in each slide. For this purpose, 50 clearly defined cells in each slide were microscopically evaluated, and photographs were subjected to computerized morphometric analysis. Cytoplasmic and nuclear areas in the diabetic group were significantly higher than in the control group. The cytoplasmic/nuclear ratio was lower in the control group. At both smear sites, the proportion of cells with nuclear changes was higher in the diabetic group. Diabetes mellitus can cause alterations in the oral epithelium that are detectable with this exfoliative cytology method. The method may be viable in evaluating this disease.

  3. 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

  4. 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

  5. Timing, method and discontinuation of hydrocortisone administration for septic shock patients

    PubMed Central

    Ibarra-Estrada, Miguel A; Chávez-Peña, Quetzalcóatl; Reynoso-Estrella, Claudia I; Rios-Zermeño, Jorge; Aguilera-González, Pável E; García-Soto, Miguel A; Aguirre-Avalos, Guadalupe

    2017-01-01

    AIM To characterize the prescribing patterns for hydrocortisone for patients with septic shock and perform an exploratory analysis in order to identify the variables associated with better outcomes. METHODS This prospective cohort study included 59 patients with septic shock who received stress-dose hydrocortisone. It was performed at 2 critical care units in academic hospitals from June 1st, 2015, to July 31st, 2016. Demographic data, comorbidities, medical management details, adverse effects related to corticosteroids, and outcomes were collected after the critical care physician indicated initiation of hydrocortisone. Univariate comparison between continuous and bolus administration of hydrocortisone was performed, including multivariate analysis, as well as Kaplan-Meier analysis to compare the proportion of shock reversal at 7 d after presentation. Receiver operating characteristic (ROC) curves determined the best cut-off criteria for initiation of hydrocortisone associated with the highest probability of shock reversal. We addressed the effects of the taper strategy for discontinuation of hydrocortisone, noting risk of shock relapse and adverse effects. RESULTS All-cause 30-d mortality was 42%. Hydrocortisone was administered as a continuous infusion in 54.2% of patients; time to reversal of shock was 49 h longer in patients who were given a bolus administration [59 h (range, 47.5-90.5) vs 108 h (range, 63.2-189); P = 0.001]. The maximal dose of norepinephrine after initiation of hydrocortisone was lower in patients on continuous infusion [0.19 μg/kg per minute (range, 0.11-0.28 μg)] compared with patients who were given bolus [0.34 μg/kg per minute (range, 0.16-0.49); P = 0.004]. Kaplan-Meier analysis revealed a higher proportion of shock reversal at 7 d in patients with continuous infusion compared to those given bolus (83% vs 63%; P = 0.004). There was a good correlation between time to initiation of hydrocortisone and time to reversal of shock (r = 0

  6. 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.

  7. 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.

  8. A Novel Rapid MALDI-TOF-MS-Based Method for Measuring Urinary Globotriaosylceramide in Fabry Patients.

    PubMed

    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. Graphical Abstract ᅟ.

  9. [Medical care to patients with remote consequences of traumatic craniocerebral injury using methods of reflexology].

    PubMed

    Parnikoza, T P

    2012-01-01

    Head injury--is an important medical and social problem. In recent years Ukraine prevalence rate of patients with TBI is growing and now is 4-4,2 cases per 100 thousand population. In 50-80% or 2 of the 3 victims formed long-term consequences of closed head injuries that occur with frequent decompensation states with a temporary disability, often (11-12% of patients) have a strong disability. Use in osnovnovnomu acupuncture points of general application, segmental acupuncture points in the head, neck and scalp area. Treatment ought to be lengthy, with mnohorazovym conducting repeated courses. Most often, the following AND: VB(XI)20, VB(XI)21, T(XII)14, T(XII)20, GI(II)11, GI(II)15, GI(II)10, IG(VI)3, IG(VI)15, IG(VI)16, TR(X)5, TR(X)9, C(V)5, MC(IX)5, MC(IX)6, V(VII)40, V(VII)62, VB(XI)34, VB(XI)30, E(III)36, RP(IV)6. Take Effect braking method.

  10. Simple and effective method to lower body core temperatures of hyperthermic patients.

    PubMed

    O'Connor, John P

    2017-01-30

    Hyperthermia is a potentially life threatening scenario that may occur in patients due to accompanying morbidities, exertion, or exposure to dry and arid environmental conditions. In particular, heat stroke may result from environmental exposure combined with a lack of thermoregulation. Key clinical findings in the diagnosis of heatstroke are (1) a history of heat stress or exposure, (2) a rectal temperature greater than 40 °C, and (3) central nervous system dysfunction (altered mental state, disorientation, stupor, seizures, or coma) (Prendergast and Erickson, 2014 [1]). In these patients, it is important to bring the body's core temperature down to acceptable levels in a short period of time to avoid tissue/organ injury or death (Yoder, 2001; Casa et al., 2007 [2,3]). A number of potential approaches, both non-invasive and invasive, may be used to lower the temperature of these individuals. Non-invasive techniques generally include: evaporative cooling, ice water immersion, whole-body ice packing, strategic ice packing, and convective cooling. Invasive approaches may include gastric lavage or peritoneal lavage (Schraga and Kates [4]). The efficacy of these methods vary and select treatment approaches may be unsuitable for specific individuals (Schraga and Kates [4]). In this work, the effectiveness of radiation cooling of individuals as a stand-alone treatment and comparisons with existing noninvasive techniques are presented.

  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. GPU-accelerated Lattice Boltzmann method for anatomical extraction in patient-specific computational hemodynamics

    NASA Astrophysics Data System (ADS)

    Yu, H.; Wang, Z.; Zhang, C.; Chen, N.; Zhao, Y.; Sawchuk, A. P.; Dalsing, M. C.; Teague, S. D.; Cheng, Y.

    2014-11-01

    Existing research of patient-specific computational hemodynamics (PSCH) heavily relies on software for anatomical extraction of blood arteries. Data reconstruction and mesh generation have to be done using existing commercial software due to the gap between medical image processing and CFD, which increases computation burden and introduces inaccuracy during data transformation thus limits the medical applications of PSCH. We use lattice Boltzmann method (LBM) to solve the level-set equation over an Eulerian distance field and implicitly and dynamically segment the artery surfaces from radiological CT/MRI imaging data. The segments seamlessly feed to the LBM based CFD computation of PSCH thus explicit mesh construction and extra data management are avoided. The LBM is ideally suited for GPU (graphic processing unit)-based parallel computing. The parallel acceleration over GPU achieves excellent performance in PSCH computation. An application study will be presented which segments an aortic artery from a chest CT dataset and models PSCH of the segmented artery.

  13. ADVANCED MR IMAGING METHODS FOR PLANNING AND MONITORING RADIATION THERAPY IN PATIENTS WITH HIGH GRADE GLIOMA

    PubMed Central

    Lupo, Janine M.; Nelson, Sarah J.

    2016-01-01

    This review explores how the integration of advanced imaging methods with high quality anatomic images significantly improves the characterization, target definition, assessment of response to therapy, and overall management of patients with high-grade glioma. Metrics derived from diffusion, perfusion, and susceptibility weighted MR imaging in conjunction with MR spectroscopic imaging, allows us to characterize regions of edema, hypoxia, increased cellularity, and necrosis within heterogeneous tumor and surrounding brain tissue. Quantification of such measures may provide a more reliable initial representation of tumor delineation and response to therapy than changes in the contrast enhancing or T2 lesion alone and have a significant impact on targeting resection, planning radiation, and assessing treatment effectiveness. In the long-term, implementation of these imaging methodologies can also aid in the identification of recurrent tumor and its differentiation from treatment-related confounds and facilitate the detection of radiation-induced vascular injury in otherwise normal appearing brain tissue. PMID:25219809

  14. 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.

  15. 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

  16. A mixed methods study of student perceptions of using standardized patients for learning and evaluation

    PubMed Central

    Giesbrecht, Edward M; Wener, Pamela F; Pereira, Gisèle M

    2014-01-01

    Background Educators recognize the value of using standardized patients (SPs) when teaching and evaluating clinical skills in rehabilitation entry-to-practice education programs but have published little supporting evidence and have yet to evaluate programmatic SP use from a student perspective. This study explored occupational and physical therapy students’ perceptions of SP use in their professional education. Methods Recruiting current and graduated students, we conducted a two-phase mixed-methods sequential-explanatory study integrating data from a quantitative survey (phase 1) and qualitative focus groups with representative students (phase 2). Quantitative data were used to direct the second phase and informed selection of a purposive sample to participate in four focus groups (N=12). Results The 24-item online survey obtained a 32% response rate (N=167). Mean ratings were high, but significant differences were found between the four subsections of Teaching, SP Experience, Feedback, and Evaluation (P=0.000). Secondary analyses revealed significant differences based on sex, program, and age. Qualitative analysis revealed that students found SP use especially helpful earlier in their program to bridge classroom teaching and clinical practice. Students in the occupational and physical therapy programs approached SP interactions differently in terms of the authenticity, personal investment, and value of SP feedback. Educator feedback was perceived as reflective of technical skill, and SP feedback reflective of therapeutic value, which students prioritized differently. Students identified a preferential continuum of options for learning and practicing skills, ranging from peers and instructors through SPs to actual patients. Conclusion SPs were perceived as most useful early on in the professional education program, serving to bolster self-confidence and prepare students for clinical fieldwork. Discipline-specific differences impact the perception of SP use and

  17. Expression profiles for macrophage alternative activation genes in AD and in mouse models of AD

    PubMed Central

    Colton, Carol A; Mott, Ryan T; Sharpe, Hayley; Xu, Qing; Van Nostrand, William E; Vitek, Michael P

    2006-01-01

    Background Microglia are associated with neuritic plaques in Alzheimer disease (AD) and serve as a primary component of the innate immune response in the brain. Neuritic plaques are fibrous deposits composed of the amyloid beta-peptide fragments (Abeta) of the amyloid precursor protein (APP). Numerous studies have shown that the immune cells in the vicinity of amyloid deposits in AD express mRNA and proteins for pro-inflammatory cytokines, leading to the hypothesis that microglia demonstrate classical (Th-1) immune activation in AD. Nonetheless, the complex role of microglial activation has yet to be fully explored since recent studies show that peripheral macrophages enter an "alternative" activation state. Methods To study alternative activation of microglia, we used quantitative RT-PCR to identify genes associated with alternative activation in microglia, including arginase I (AGI), mannose receptor (MRC1), found in inflammatory zone 1 (FIZZ1), and chitinase 3-like 3 (YM1). Results Our findings confirmed that treatment of microglia with anti-inflammatory cytokines such as IL-4 and IL-13 induces a gene profile typical of alternative activation similar to that previously observed in peripheral macrophages. We then used this gene expression profile to examine two mouse models of AD, the APPsw (Tg-2576) and Tg-SwDI, models for amyloid deposition and for cerebral amyloid angiopathy (CAA) respectively. AGI, MRC1 and YM1 mRNA levels were significantly increased in the Tg-2576 mouse brains compared to age-matched controls while TNFα and NOS2 mRNA levels, genes commonly associated with classical activation, increased or did not change, respectively. Only TNFα mRNA increased in the Tg-SwDI mouse brain. Alternative activation genes were also identified in brain samples from individuals with AD and were compared to age-matched control individuals. In AD brain, mRNAs for TNFα, AGI, MRC1 and the chitinase-3 like 1 and 2 genes (CHI3L1; CHI3L2) were significantly increased

  18. 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.

  19. Emerging technologies for the prevention of dental caries. Are current methods of prevention sufficient for the high risk patient?

    PubMed Central

    Bretz, Walter A; Rosa, Odila P S

    2011-01-01

    Fluorides and chlorhexidine are technologies that are 65 and 40 yeas old, respectively. This overview argues that current methods of caries prevention are not effective for the high caries risk patient. In this review examples, arguments and recommendations are provided to address the high caries risk patient that include: failure of comprehensive chemical modalities treatments to address the high caries risk patient; ecological alteration - would this be an effective approach?; and biomaterials and oral microbiome research to address the high caries risk patient. PMID:21726223

  20. Kinetic Chemiluminescence as a Method for Oxidative Stress Evaluation in Examinations of Patients with Type 2 Diabetes Mellitus.

    PubMed

    Proskurnina, E V; Polimova, A M; Sozarukova, M M; Prudnikova, M A; Ametov, A S; Vladimirov, Yu A

    2016-05-01

    We propose a new approach to evaluation of oxidative stress based on kinetic chemiluminescence: measurement of antioxidant and pro-oxidant activities of the plasma. The study included 50 patients with type 2 diabetes mellitus receiving peroral hypoglycemic therapy. In addition to the above parameters, the levels of TBA-reactive products, inflammation markers, clotting parameters, and biochemical values were studied. The new method provides information on oxidative stress in patients with type 2 diabetes mellitus irrespective of the clinical and laboratory values. The use of this method in complex with the clinical, laboratory, and instrumental studies allows comprehensive evaluation of patient's status for the diagnosis and choice of therapy.

  1. The New York Times ad.

    PubMed

    Hunt, M E; Kissling, F

    1993-01-01

    Feminization of patriarchal institutions is necessary in order to eliminate the exclusivity and mutuality of hierarchical, gender, class, and race stratification. The aim of this paper is to explain the history and activities surrounding the New York Times ad on Sunday, October 7, 1984 (the Catholic Statement on Pluralism and Abortion signed by Barbara Ferraro and Patricia Hussey of the Sisters of Note Dame de Namur, Rose Dominic Trapasso of the Maryknoll Sisters, and 67 other signers). The significance of this ad for Roman Catholic feminists and suggestions for new models of relationships between feminists is given. The Statement was written by Daniel Maguire and Frances Kissling and reviewed by 20 Roman Catholic ethicists. A sponsoring committee of early signers sought other support. Catholics for a Free Choice sponsored the funding for circulation of the Statement among professional societies, but not necessarily canonical communities. Publication of the entire statement in the Times was at the height of the presidential campaign. Conservative Bishops Bernard Law of Boston and John O'Connor of Boston publicly denounced Ferraro's position. The first institutional church response came on November 14, 1984, and stated that the Statement was personal opinion and contradictory to clear and constant church teachings about abortion. On November 30, 1984, Cardinal Jean Jerome Hamer of the Congregation for Religious and Secular Institutes responded to most presidents of canonical communities to request a public retraction from signers under threat of dismissal. The issue was obedience to the church. Several members of the canonical community and priests published retractions; negotiations with the Vatican began. Freedom of conscience and empowerment of canonical communities, as agents of their own lives, were given as reasons for the challenge to paternalism. The response was that women were subject to obedience within their communities and had taken public vows and were

  2. Acute vertebral fracture after spinal fusion: a case report illustrating the added value of single-source dual-energy computed tomography to magnetic resonance imaging in a patient with spinal Instrumentation.

    PubMed

    Fuchs, M; Putzier, M; Pumberger, M; Hermann, K G; Diekhoff, T

    2016-09-01

    Magnetic resonance imaging (MRI) is degraded by metal-implant-induced artifacts when used for the diagnostic assessment of vertebral compression fractures in patients with instrumented spinal fusion. Dual-energy computed tomography (DECT) offers a promising supplementary imaging tool in these patients. This case report describes an 85-year-old woman who presented with a suspected acute vertebral fracture after long posterior lumbar interbody fusion. This is the first report of a vertebral fracture that showed bone marrow edema on DECT; however, edema was missed by an MRI STIR sequence owing to metal artifacts. Bone marrow assessment using DECT is less susceptible to metal artifacts than MRI, resulting in improved visualization of vertebral edema in the vicinity of fused vertebral bodies.

  3. Intracellular Signaling and Desmoglein 2 Shedding Triggered by Human Adenoviruses Ad3, Ad14, and Ad14P1

    PubMed Central

    Wang, Hongjie; Ducournau, Corinne; Saydaminova, Kamola; Richter, Maximilian; Yumul, Roma; Ho, Martin; Carter, Darrick; Zubieta, Chloé

    2015-01-01

    ABSTRACT We recently discovered that desmoglein 2 (DSG2) is a receptor for human adenovirus species B serotypes Ad3, Ad7, Ad11, and Ad14. Ad3 is considered to be a widely distributed human pathogen. Ad3 binding to DSG2 triggers the transient opening of epithelial junctions. Here, we further delineate the mechanism that leads to DSG2-mediated epithelial junction opening in cells exposed to Ad3 and recombinant Ad3 fiber proteins. We identified an Ad3 fiber knob-dependent pathway that involves the phosphorylation of mitogen-activated protein (MAP) kinases triggering the activation of the matrix-metalloproteinase ADAM17. ADAM17, in turn, cleaves the extracellular domain of DSG2 that links epithelial cells together. The shed DSG2 domain can be detected in cell culture supernatant and also in serum of mice with established human xenograft tumors. We then extended our studies to Ad14 and Ad14P1. Ad14 is an important research and clinical object because of the recent appearance of a new, more pathogenic strain (Ad14P1). In a human epithelial cancer xenograft model, Ad14P1 showed more efficient viral spread and oncolysis than Ad14. Here, we tested the hypothesis that a mutation in the Ad14P1 fiber knob could account for the differences between the two strains. While our X-ray crystallography studies suggested an altered three-dimensional (3D) structure of the Ad14P1 fiber knob in the F-G loop region, this did not significantly change the fiber knob affinity to DSG2 or the intracellular signaling and DSG2 shedding in epithelial cancer cells. IMPORTANCE A number of widely distributed adenoviruses use the epithelial junction protein DSG2 as a receptor for infection and lateral spread. Interaction with DSG2 allows the virus not only to enter cells but also to open epithelial junctions which form a physical barrier to virus spread. Our study elucidates the mechanism beyond virus-triggered junction opening with a focus on adenovirus serotype 3. Ad3 binds to DSG2 with its fiber

  4. Condom ads promote illicit sex.

    PubMed

    Kippley, J F

    1994-01-01

    Written in 1987, this opinion was republished in the wake of US President Bill Clinton's AIDS prevention media campaign promoting condom use which began January 1994, targeted at young adults aged 18-25. The author staunchly opposes condom use even though he admits that people do not consider abstinence from sex to be a serious option for the prevention of HIV/STD infection. He believes that there is no moral use of sex with a condom and that condoms have always been a sign of immorality, be it prostitution, adultery, fornication, or marital contraception. Likewise, the author laments the success enjoyed by Planned Parenthood in achieving the social acceptance of marital contraception and sex outside of marriage. The complete social acceptance of homosexual activity, however, remains to be achieved. Magazines, newspapers, and television receive income in exchange for publishing or airing advertisements. Finding offensive advertisements which promote the use of condoms against HIV infection, the author recommends writing letters of complaint to the responsible media sources. If the television stations or publications in question continue to advertise condoms to the public, stop watching them or end one's subscriptions to the particular printed media. Such action taken collectively among many individuals will reduce product sales and income, and potentially sway corporate policy against condom ads.

  5. 16 CFR 460.18 - Insulation ads.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INSULATION § 460.18 Insulation ads. (a) If your ad gives an R-value, you must give the type of insulation and... your ad gives a price, you must give the type of insulation, the R-value at a specific thickness, the... you give the price per square foot, you do not have to give the coverage area. (c) If your ad...

  6. 16 CFR 460.18 - Insulation ads.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INSULATION § 460.18 Insulation ads. (a) If your ad gives an R-value, you must give the type of insulation and... your ad gives a price, you must give the type of insulation, the R-value at a specific thickness, the... you give the price per square foot, you do not have to give the coverage area. (c) If your ad...

  7. Myths & Facts about Value-Added Analysis

    ERIC Educational Resources Information Center

    TNTP, 2011

    2011-01-01

    This paper presents myths as well as facts about value-added analysis. These myths include: (1) "Value-added isn't fair to teachers who work in high-need schools, where students tend to lag far behind academically"; (2) "Value-added scores are too volatile from year-to-year to be trusted"; (3) "There's no research behind value-added"; (4) "Using…

  8. Thermodynamic geometry and phase transitions of dyonic charged AdS black holes

    NASA Astrophysics Data System (ADS)

    Chaturvedi, Pankaj; Das, Anirban; Sengupta, Gautam

    2017-02-01

    We investigate phase transitions and critical phenomena of four dimensional dyonic charged AdS black holes in the framework of thermodynamic geometry. In a mixed canonical-grand canonical ensemble with a fixed electric charge and varying magnetic charge these black holes exhibit a liquid-gas like first order phase transition culminating in a second order critical point similar to the van der Waals gas. We show that the thermodynamic scalar curvature R for these black holes follow our proposed geometrical characterization of the R-crossing Method for the first order liquid-gas like phase transition and exhibits a divergence at the second order critical point. The pattern of R crossing and divergence exactly corresponds to those of a van der Waals gas described by us in an earlier work.

  9. Mouse Mammary Intraductal (MIND) Method for Transplantation of Patient Derived Primary DCIS Cells and Cell Lines

    PubMed Central

    Kittrell, Frances; Valdez, Kelli; Elsarraj, Hanan; Hong, Yan; Medina, Daniel; Behbod, Fariba

    2016-01-01

    The MIND method involves intraductal injection of patient derived ductal carcinoma in situ (DCIS) cells and DCIS cell lines (MCF10DCIS.COM and SUM225) inside the mouse mammary ducts [Video 1 and Figure 1 in Behbod et al. (2009)]. This method mimics the normal environment of DCIS and facilitates study of the natural progression of human DCIS, i.e., their initial growth as carcinoma in situ within the ducts, followed by invasion into the stroma through the myoepithelial cell layer and basement membrane (Behbod et al., 2009; Valdez et al., 2011). In order to demonstrate that transplantation procedure is successful, the transplanted mammary glands may be excised as early as two weeks following intraductal injection of cells followed by Hematoxylin and Eosin (H&E) staining and/or immunofluorescence staining using human specific cytokeratin 5 and/or 19 [please see Figures 2–4 in Behbod et al. (2009)]. Additionally, the presence of trypan blue inside the mouse mammary ducts immediately following intraductal injection is the best indicator that the injection was successful (Video 1 starting at 4:33 sec). PMID:27446983

  10. Estimation model of life insurance claims risk for cancer patients by using Bayesian method

    NASA Astrophysics Data System (ADS)

    Sukono; Suyudi, M.; Islamiyati, F.; Supian, S.

    2017-01-01

    This paper discussed the estimation model of the risk of life insurance claims for cancer patients using Bayesian method. To estimate the risk of the claim, the insurance participant data is grouped into two: the number of policies issued and the number of claims incurred. Model estimation is done using a Bayesian approach method. Further, the estimator model was used to estimate the risk value of life insurance claims each age group for each sex. The estimation results indicate that a large risk premium for insured males aged less than 30 years is 0.85; for ages 30 to 40 years is 3:58; for ages 41 to 50 years is 1.71; for ages 51 to 60 years is 2.96; and for those aged over 60 years is 7.82. Meanwhile, for insured women aged less than 30 years was 0:56; for ages 30 to 40 years is 3:21; for ages 41 to 50 years is 0.65; for ages 51 to 60 years is 3:12; and for those aged over 60 years is 9.99. This study is useful in determining the risk premium in homogeneous groups based on gender and age.

  11. "Not just little adults": qualitative methods to support the development of pediatric patient-reported outcomes.

    PubMed

    Arbuckle, Rob; Abetz-Webb, Linda

    2013-01-01

    The US FDA and the European Medicines Agency (EMA) have issued incentives and laws mandating clinical research in pediatrics. While guidances for the development and validation of patient-reported outcomes (PROs) or health-related quality of life (HRQL) measures have been issued by these agencies, little attention has focused on pediatric PRO development methods. With reference to the literature, this article provides an overview of specific considerations that should be made with regard to the development of pediatric PRO measures, with a focus on performing qualitative research to ensure content validity. Throughout the questionnaire development process it is critical to use developmentally appropriate language and techniques to ensure outcomes have content validity, and will be reliable and valid within narrow age bands (0-2, 3-5, 6-8, 9-11, 12-14, 15-17 years). For qualitative research, sample sizes within those age bands must be adequate to demonstrate saturation while taking into account children's rapid growth and development. Interview methods, interview guides, and length of interview must all take developmental stage into account. Drawings, play-doh, or props can be used to engage the child. Care needs to be taken during cognitive debriefing, where repeated questioning can lead a child to change their answers, due to thinking their answer is incorrect. For the PROs themselves, the greatest challenge is in measuring outcomes in children aged 5-8 years. In this age range, while self-report is generally more valid, parent reports of observable behaviors are generally more reliable. As such, 'team completion' or a parent-administered child report is often the best option for children aged 5-8 years. For infants and very young children (aged 0-4 years), patient rating of observable behaviors is necessary, and, for adolescents and children aged 9 years and older, self-reported outcomes are generally valid and reliable. In conclusion, the development of PRO

  12. New Features in the ADS Abstract Service

    NASA Technical Reports Server (NTRS)

    Eichhorn, Guenther; Accomazzi, Alberto; Grant, Carolyn S.; Kurtz, Michael J.; Henneken, Edwin A.; Thompson, Donna M.; Murray, Stephen S.

    2005-01-01

    The NASA-ADS Abstract Service provides a sophisticated search capability for the literature in Astronomy, Planetary Sciences, Physics/Geophysics, and Space Instrumentation. The ADS is funded by NASA and access to the ADS services is free to anybody world-wide without restrictions. It allows the user to search the literature by author, title, and abstract text.

  13. Weighing the Claims in Diet Ads

    MedlinePlus

    ... página en español Weighing the Claims in Diet Ads Related Items Weight Loss Challenge Diet Ads and ... control Information Network .  The Truth Behind Weight Loss Ads Claims to watch out for include: Lose weight ...

  14. Anatomically constrained region deformation for the automated segmentation of the hippocampus and the amygdala: Method and validation on controls and patients with Alzheimer's disease.

    PubMed

    Chupin, Marie; Mukuna-Bantumbakulu, A Romain; Hasboun, Dominique; Bardinet, Eric; Baillet, Sylvain; Kinkingnéhun, Serge; Lemieux, Louis; Dubois, Bruno; Garnero, Line

    2007-02-01

    We describe a new algorithm for the automated segmentation of the hippocampus (Hc) and the amygdala (Am) in clinical Magnetic Resonance Imaging (MRI) scans. Based on homotopically deforming regions, our iterative approach allows the simultaneous extraction of both structures, by means of dual competitive growth. One of the most original features of our approach is the deformation constraint based on prior knowledge of anatomical features that are automatically retrieved from the MRI data. The only manual intervention consists of the definition of a bounding box and positioning of two seeds; total execution time for the two structures is between 5 and 7 min including initialisation. The method is evaluated on 16 young healthy subjects and 8 patients with Alzheimer's disease (AD) for whom the atrophy ranged from limited to severe. Three aspects of the performances are characterised for validating the method: accuracy (automated vs. manual segmentations), reproducibility of the automated segmentation and reproducibility of the manual segmentation. For 16 young healthy subjects, accuracy is characterised by mean relative volume error/overlap/maximal boundary distance of 7%/84%/4.5 mm for Hc and 12%/81%/3.9 mm for Am; for 8 Alzheimer's disease patients, it is 9%/84%/6.5 mm for Hc and 15%/76%/4.5 mm for Am. We conclude that the performance of this new approach in data from healthy and diseased subjects in terms of segmentation quality, reproducibility and time efficiency compares favourably with that of previously published manual and automated segmentation methods. The proposed approach provides a new framework for further developments in quantitative analyses of the pathological hippocampus and amygdala in MRI scans.

  15. What are the decision-making preferences of patients in vascular surgery? A mixed-methods study

    PubMed Central

    Santema, T B Katrien; Stoffer, E Anniek; Kunneman, Marleen; Koelemay, Mark J W; Ubbink, Dirk T

    2017-01-01

    Objectives Shared decision-making (SDM) has been advocated as the preferred method of choosing a suitable treatment option. However, patient involvement in treatment decision-making is not yet common practice in the field of vascular surgery. The aim of this mixed-methods study was to explore patients' decision-making preferences and to investigate which facilitators and barriers patients perceive as important for the application of SDM in vascular surgery. Design and setting Patients were invited to participate after visiting the vascular surgical outpatient clinic of an Academic Medical Center in the Netherlands. A treatment decision was made during the consultation for an abdominal aortic aneurysm or peripheral arterial occlusive disease. Patients filled in a number of questionnaires (quantitative part) and a random subgroup of patients participated in an in-depth interview (qualitative part). Results A total of 67 patients participated in this study. 58 per cent of them (n=39) indicated that they preferred a shared role in decision-making. In more than half of the patients (55%; n=37) their preferred role was in disagreement with what they had experienced. 31 per cent of the patients (n=21) preferred a more active role in the decision-making process than they had experienced. Patients indicated a good patient–doctor relationship as an important facilitator for the application of SDM. Conclusions The vast majority of vascular surgical patients preferred, but did not experience a shared role in the decision-making process, although the concept of SDM was insufficiently clear to some patients. This emphasises the importance of explaining the concept of SDM and implementing it in the clinical encounter. PMID:28188153

  16. 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.

  17. 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

  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. Constructs of burden of illness in older patients with breast cancer: a comparison of measurement methods.

    PubMed Central

    Mandelblatt, J S; Bierman, A S; Gold, K; Zhang, Y; Ng, J H; Maserejan, N; Hwang, Y T; Meropol, N J; Hadley, J; Silliman, R A

    2001-01-01

    OBJECTIVE. The burden of illness can influence treatment decisions, but there are limited data comparing the performance of different illness burden measures. We assessed the correlations between five previously validated measures of illness burden and global health and physical function and evaluated how each measure correlates with breast cancer treatment patterns in older women. DATA SOURCE: A cohort of 718 women > 67 years with early-stage breast cancer formed the study group. STUDY DESIGN/DATA COLLECTION METHODS: The study made a cross-sectional comparison of illness burden measures (Charlson index, Index of Co-existent Diseases, cardiopulmonary burden of illness, patient-specific life expectancy, and disease counts) and physical function and self-rated global health status. Data were collected from records and patient interviews. PRINCIPAL FINDINGS: All of the measures were significantly correlated with each other and with physical function and self-rated health (p < .001). After controlling for age and stage, life expectancy had the largest effect on surgical treatment, followed by self-rated physical function and health; life expectancy was also independent of physical function. For instance, women with higher life expectancy and better self-rated physical function and health were more likely to receive breast conservation and radiation than sicker women. Women with higher physical functioning were more likely to receive adjuvant chemotherapy than women with lower functioning. CONCLUSIONS: Several measures of illness burden were associated with breast cancer therapy, but each measure accounted for only a small amount of variance in treatment patterns. Future work is needed to develop and validate measures of burden of illness that are feasible, comprehensive, and relevant for diverse clinical and health services objectives. PMID:11775669

  20. Antidepressant adherence patterns in older patients: use of a clustering method on a prescription database.

    PubMed

    Braunstein, David; Hardy, Amélie; Boucherie, Quentin; Frauger, Elisabeth; Blin, Olivier; Gentile, Gaétan; Micallef, Joëlle

    2017-04-01

    According to the World Health Organization, depression will become the second most important cause of disability worldwide by 2020. Our objective was to identify patterns of adherence to antidepressant treatments in older patients using several indicators of adherence and to characterize these patterns in terms of medication exposure. We conducted a retrospective cohort study using the French National Health Insurance reimbursement database. Incident antidepressant users aged more than 65 were included from July 1, 2010, to June 30, 2011, and followed up for 18 months. Antidepressant and other psychotropic drugs (opioids, benzodiazepines, antipsychotics, anti-epileptics) were recorded. Adherence to antidepressant treatment was assessed by several measures including proportion of days covered, discontinuation periods, persistence of treatment, and doses dispensed. Patients were classified according to their adherence patterns using a mixed clustering method. We identified five groups according to antidepressant adherence. One group (n = 7505, 26.9%) was fully adherent with regard to guidelines on antidepressant use. Two patterns of nonadherent users were identified: irregular but persistent users (n = 5131, 18.4%) and regular but nonpersistent users (n = 9037, 32.4%). Serotonin reuptake inhibitors were the most frequently dispensed antidepressant class (70.6%), followed by other antidepressants (43.3%, mainly serotonin-norepinephrine reuptake inhibitors and tianeptine) and tricyclic antidepressants (TCAs) (13.4%). Nonadherent users more frequently had a dispensing of TCA, opioid, and anti-epileptic medication than adherent users. Health policies to improve adherence to antidepressant treatment may require better training of physicians and pharmacists, insisting on the important role of the continuation period of antidepressant treatment.

  1. Historical Literature in the ADS

    NASA Astrophysics Data System (ADS)

    Eichhorn, G.; Kurtz, M. J.; Accomazzi, A.; Grant, C. S.

    1997-12-01

    The Astrophysics Data System at h