Added Value of Breast MRI for Preoperative Diagnosis of Ductal Carcinoma In Situ: Diagnostic Performance on 362 Patients.

PubMed

Petrillo, Antonella; Fusco, Roberta; Petrillo, Mario; Triunfo, Flavia; Filice, Salvatore; Vallone, Paolo; Setola, Sergio Venanzio; Rubulotta, Mariarosaria; Di Bonito, Maurizio; Rinaldo, Massimo; D'Aiuto, Massimiliano; Brunetti, Arturo

2017-06-01

The purpose of this study was to evaluate the added value of breast magnetic resonance imaging (MRI) in preoperative diagnosis of ductal carcinoma in situ (DCIS). We reviewed our institution database of 3499 consecutive patients treated for breast cancer. A total of 362 patients with histologically proven DCIS were selected from the institutional database. Of these, 245 (67.7%) preoperatively underwent conventional imaging (CI) (mammography/ultrasonography) (CI group), and 117 (32.3%) underwent CI and dynamic MRI (CI + MRI group). The pathology of surgical specimens served as a reference standard. The Mann-Whitney U, χ 2 test, and Spearman correlation coefficient were performed. The CI + MRI group showed a sensitivity of 98.5% with an increase of 10.1% compared with the CI group to detect pure DCIS. Dynamic MRI identified 19.7% (n = 13) additional pure DCIS compared with CI. In the CI + MRI group, a single (1.5%) false negative was reported, whereas in the CI group, 11 (11.6%) false negatives were reported. Moreover, the CI + MRI group showed a sensitivity of 98.0% to detect DCIS + small invasive component. In this group, dynamic MRI identified 21.6% (n = 11) additional DCIS and a single (2.0%) false negative compared with the CI group, whereas in the CI group, 7 (4.7%) false negatives were reported. MRI and histopathologically measured lesion sizes, Breast Imaging Reporting and Data System MRI assessment categories, and enhancement signal intensity curve types showed a significant correlation. The MRI detection rate of DCIS increased significantly with increasing nuclear grade. Preoperative breast MRI showed a better accuracy then CI in preoperative diagnosis for both pure DCIS and DCIS + small invasive component with a precise assessment of lesion size. This can provide a more appropriate management of DCIS patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Optimizing MRI Logistics: Prospective Analysis of Performance, Efficiency, and Patient Throughput.

PubMed

Beker, Kevin; Garces-Descovich, Alejandro; Mangosing, Jason; Cabral-Goncalves, Ines; Hallett, Donna; Mortele, Koenraad J

2017-10-01

The objective of this study is to optimize MRI logistics through evaluation of MRI workflow and analysis of performance, efficiency, and patient throughput in a tertiary care academic center. For 2 weeks, workflow data from two outpatient MRI scanners were prospectively collected and stratified by value added to the process (i.e., value-added time, business value-added time, or non-value-added time). Two separate time cycles were measured: the actual MRI process cycle as well as the complete length of patient stay in the department. In addition, the impact and frequency of delays across all observations were measured. A total of 305 MRI examinations were evaluated, including body (34.1%), neurologic (28.9%), musculoskeletal (21.0%), and breast examinations (16.1%). The MRI process cycle lasted a mean of 50.97 ± 24.4 (SD) minutes per examination; the mean non-value-added time was 13.21 ± 18.77 minutes (25.87% of the total process cycle time). The mean length-of-stay cycle was 83.51 ± 33.63 minutes; the mean non-value-added time was 24.33 ± 24.84 minutes (29.14% of the total patient stay). The delay with the highest frequency (5.57%) was IV or port placement, which had a mean delay of 22.82 minutes. The delay with the greatest impact on time was MRI arthrography for which joint injection of contrast medium was necessary but was not accounted for in the schedule (mean delay, 42.2 minutes; frequency, 1.64%). Of 305 patients, 34 (11.15%) did not arrive at or before their scheduled time. Non-value-added time represents approximately one-third of the total MRI process cycle and patient length of stay. Identifying specific delays may expedite the application of targeted improvement strategies, potentially increasing revenue, efficiency, and overall patient satisfaction.

Effect of added mass on treadmill performance and pulmonary function.

PubMed

Walker, Rachel E; Swain, David P; Ringleb, Stacie I; Colberg, Sheri R

2015-04-01

Military personnel engage in strenuous physical activity and load carriage. This study evaluated the role of body mass and of added mass on aerobic performance (uphill treadmill exercise) and pulmonary function. Performance on a traditional unloaded run test (4.8 km) was compared with performance on loaded tasks. Subjects performed an outdoor 4.8-km run and 4 maximal treadmill tests wearing loads of 0, 10, 20, and 30 kg. Subjects' pulmonary function (forced expired volume in 1 second [FEV1], forced vital capacity [FVC], and maximal voluntary ventilation [MVV]) was tested with each load, and peak values of heart rate, oxygen consumption ((Equation is included in full-text article.)), ventilation (VE), and respiratory exchange ratio (RER) were measured during each treadmill test. Performance on the 4.8-km run was correlated with treadmill performance, measured as time to exhaustion (TTE), with the strength of the correlation decreasing with load (r = 0.87 for 0 kg to 0.76 for 30 kg). Body mass was not correlated with TTE, other than among men with the 30-kg load (r = 0.48). During treadmill exercise, all peak responses other than RER decreased with load. Pulmonary function measures (FEV1, FVC, and MVV) decreased with load. Body mass was poorly correlated with treadmill performance, but added mass decreased performance. The decreased performance may be in part because of decreased pulmonary function. Unloaded 4.8-km run performance was correlated to unloaded uphill treadmill performance, but less so as load increased. Therefore, traditional run tests may not be an effective means of evaluating aerobic performance for military field operations.

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

PubMed

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

2012-03-01

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

Wechsler Memory Scale-III Faces test performance in patients with mild cognitive impairment and mild Alzheimer's disease.

PubMed

Seelye, Adriana M; Howieson, Diane B; Wild, Katherine V; Moore, Mindy Milar; Kaye, Jeffrey A

2009-08-01

Little is known about the sensitivity of the Wechsler Memory Scale-Third Edition (WMS-III) Faces subtest to memory impairment associated with mild cognitive impairment (MCI). In this study, Faces performance was examined in 24 MCI patients, 46 mild Alzheimer's disease (AD) patients, and 98 elderly controls. We hypothesized that participants with diagnoses of MCI or AD would be impaired relative to controls on Faces. Analyses showed that AD participants performed significantly worse than MCI and intact participants, although there were no significant differences between MCI and intact participants. Data suggest that brain areas specialized for face recognition memory may be less affected by MCI and mild AD than regions specialized for verbal memory.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2001-06-26

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

Measuring Value Added in Higher Education: A Proposed Methodology for Developing a Performance Indicator Based on the Economic Value Added to Graduates

ERIC Educational Resources Information Center

Rodgers, Timothy

2007-01-01

The 2003 UK higher education White Paper suggested that the sector needed to re-examine the potential of the value added concept. This paper describes a possible methodology for developing a performance indicator based on the economic value added to graduates. The paper examines how an entry-quality-adjusted measure of a graduate's…

Next-Generation A/D Sampler ADS3000+ for VLBI2010

NASA Technical Reports Server (NTRS)

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

2010-01-01

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

Cognitive performance on Piagetian tasks by Alzheimer's disease patients.

PubMed

Thornbury, J M

1992-02-01

The purpose of this study was to examine cognitive abilities in Alzheimer's disease (AD) patients using Piaget's child developmental theory. Thirty elderly AD patients and 30 elderly control subjects were given two traditional Piagetian measures, the Infant Psychological Development Scale and the Concrete Operations Test. Half of the AD subjects (15) were in Piaget's sensorimotor or preoperational stages, while the remaining half of the AD subjects and all elderly control subjects were in Piaget's concrete operational stage, chi 2 [1, N = 60] = 17.42, p less than .001. If subsequent studies confirm that AD patients' cognitive characteristics are similar to Piaget's theoretical model, nursing care might be individualized based on mental competence, thus minimizing the commonly observed caregiver overestimation and underestimation of the AD patient's ability to understand and cooperate.

14 CFR 91.227 - Automatic Dependent Surveillance-Broadcast (ADS-B) Out equipment performance requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Automatic Dependent Surveillance-Broadcast... Dependent Surveillance-Broadcast (ADS-B) Out equipment performance requirements. (a) Definitions. For the..., Extended Squitter Automatic Dependent Surveillance-Broadcast (ADS-B) and Traffic Information Service...

14 CFR 91.227 - Automatic Dependent Surveillance-Broadcast (ADS-B) Out equipment performance requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Automatic Dependent Surveillance-Broadcast... Dependent Surveillance-Broadcast (ADS-B) Out equipment performance requirements. (a) Definitions. For the..., Extended Squitter Automatic Dependent Surveillance-Broadcast (ADS-B) and Traffic Information Service...

14 CFR 91.227 - Automatic Dependent Surveillance-Broadcast (ADS-B) Out equipment performance requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Automatic Dependent Surveillance-Broadcast... Dependent Surveillance-Broadcast (ADS-B) Out equipment performance requirements. (a) Definitions. For the..., Extended Squitter Automatic Dependent Surveillance-Broadcast (ADS-B) and Traffic Information Service...

Memory Test Performance on Analogous Verbal and Nonverbal Memory Tests in Patients with Frontotemporal Dementia and Alzheimer's Disease.

PubMed

Baldock, Deanna; Miller, Justin B; Leger, Gabriel C; Banks, Sarah Jane

2016-01-01

Patients with frontotemporal dementia (FTD) typically have initial deficits in language or changes in personality, while the defining characteristic of Alzheimer's disease (AD) is memory impairment. Neuropsychological findings in the two diseases tend to differ, but can be confounded by verbal impairment in FTD impacting performance on memory tests in these patients. Twenty-seven patients with FTD and 102 patients with AD underwent a neuropsychological assessment before diagnosis. By utilizing analogous versions of a verbal and nonverbal memory test, we demonstrated differences in these two modalities between AD and FTD. Better differentiation between AD and FTD is found in a nonverbal memory test, possibly because it eliminates the confounding variable of language deficits found in patients with FTD. These results highlight the importance of nonverbal learning tests with multiple learning trials in diagnostic testing.

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

PubMed

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

2017-11-01

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

Value-Added Measures of Education Performance: Clearing Away the Smoke and Mirrors. Policy Brief 10-4

ERIC Educational Resources Information Center

Harris, Douglas N.

2010-01-01

In this policy brief, the author explores the problems with attainment measures when it comes to evaluating performance at the school level, and explores the best uses of value-added measures. These value-added measures, the author writes, are useful for sorting out-of-school influences from school influences or from teacher performance, giving…

75 FR 48552 - Automatic Dependent Surveillance-Broadcast (ADS-B) Out Performance Requirements To Support Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-11

...-29305; Amdt. No. 91-314] RIN 2120-AI92 Automatic Dependent Surveillance-Broadcast (ADS-B) Out... Surveillance- Broadcast (ADS-B) Out Performance Requirements To Support Air Traffic Control (ATC) Service..., Surveillance and Broadcast Services, AJE-6, Air Traffic Organization, Federal Aviation Administration, 800...

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2011-06-01

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

Self-reported quality of ADL task performance among patients with COPD exacerbations.

PubMed

Bendixen, Hans Jørgen; Wæhrens, Eva Ejlersen; Wilcke, Jon Torgny; Sørensen, Lisbeth Villemoes

2014-07-01

Patients suffering from chronic obstructive pulmonary disease (COPD) experience problems in the performance of activities of daily living (ADL) tasks. The objective was to examine the self-reported quality of ADL task performance among COPD patients, and to investigate whether age, gender, and routine COPD characteristics correlate with the self-reported ADL ability. Eighty patients admitted to hospital with COPD exacerbations participated. In a cross-sectional study, the patients' self-reported ADL ability was assessed using the ADL-Interview (ADL-I) instrument. Data concerning age, gender, and routine COPD characteristics were drawn from the patients' medical records. The patients reported being inefficient to markedly inefficient when performing ADL tasks within the personal hygiene, toileting, dressing, household, mobility, and transportation domains. While more than 90% of the participants reported increased effort and/or fatigue when performing the ADL tasks, up to 88% of the participants relied on help from others in the performance of general household chores like cooking and shopping. Self-reported ADL ability did not correlate with age, gender, or routine COPD characteristics. Decreased quality of ADL task performance seemed to be extremely common among COPD patients. Therefore, addressing the problems in individually tailored pulmonary rehabilitation programmes may be advantageous.

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…

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

PubMed

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

2015-11-01

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

What Are Error Rates for Classifying Teacher and School Performance Using Value-Added Models?

ERIC Educational Resources Information Center

Schochet, Peter Z.; Chiang, Hanley S.

2013-01-01

This article addresses likely error rates for measuring teacher and school performance in the upper elementary grades using value-added models applied to student test score gain data. Using a realistic performance measurement system scheme based on hypothesis testing, the authors develop error rate formulas based on ordinary least squares and…

Performance Analysis of Automatic Dependent Surveillance-Broadcast (ADS-B) and Breakdown of Anomalies

NASA Astrophysics Data System (ADS)

Tabassum, Asma

This thesis work analyzes the performance of Automatic Dependent Surveillance-Broadcast (ADS-B) data received from Grand Forks International Airport, detects anomalies in the data and quantifies the associated potential risk. This work also assesses severity associated anomalous data in Detect and Avoid (DAA) for Unmanned Aircraft System (UAS). The received data were raw and archived in GDL-90 format. A python module is developed to parse the raw data into readable data in a .csv file. The anomaly detection algorithm is based on Federal Aviation Administration's (FAA) ADS-B performance assessment report. An extensive study is carried out on two main types of anomalies, namely dropouts and altitude deviations. A dropout is considered when the update rate exceeds three seconds. Dropouts are of different durations and have a different level of risk depending on how much time ADS-B is unavailable as the surveillance system. Altitude deviation refers to the deviation between barometric and geometric altitude. Deviation ranges from 25 feet to 600 feet have been observed. As of now, barometric altitude has been used for separation and surveillance while geometric altitude can be used in cases where barometric altitude is not available. Many UAS might not have both sensors installed on board due to size and weight constrains. There might be a chance of misinterpretation of vertical separation specially while flying in National Airspace (NAS) if the ownship UAS and intruder manned aircraft use two different altitude sources for separation standard. The characteristics and agreement between two different altitudes is investigated with a regression based approach. Multiple risk matrices are established based on the severity of the DAA well clear. ADS-B is called the Backbone of FAA Next Generation Air Transportation System, NextGen. NextGen is the series of inter-linked programs, systems, and policies that implement advanced technologies and capabilities. ADS-B utilizes the

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

PubMed

Cline, Rebecca J Welch; Young, Henry J

2005-12-01

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

A Research on Performance Measurement Based on Economic Valued-Added Comprehensive Scorecard

NASA Astrophysics Data System (ADS)

Chen, Qin; Zhang, Xiaomei

With the development of economic, the traditional performance mainly rely on financial indicators could not satisfy the need of work. In order to make the performance measurement taking the best services for business goals, this paper proposed Economic Valued-Added Comprehensive Scorecard based on research of shortages and advantages of EVA and BSC .We used Analytic Hierarchy Process to build matrix to solve the weighting of EVA Comprehensive Scorecard. At last we could find the most influence factors for enterprise value forming the weighting.

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

PubMed

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

2011-08-01

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

Financial and health literacy predict incident AD dementia and AD pathology

PubMed Central

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

2017-01-01

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

Exploring the Potential of Value-Added Performance Measures to Affect the Quality of the Teacher Workforce

ERIC Educational Resources Information Center

Goldhaber, Dan

2015-01-01

The past decade has seen a tremendous amount of research on the use of value-added modeling to assess individual teachers, and a significant number of states and districts are now using, or plan to use, value added as a component of a teacher's summative performance evaluation. In this article, I explore the various mechanisms through which the…

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

PubMed

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

2018-05-13

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

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

NASA Astrophysics Data System (ADS)

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

2018-03-01

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

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

PubMed

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

2014-07-01

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

An enhanced performance through agent-based secure approach for mobile ad hoc networks

NASA Astrophysics Data System (ADS)

Bisen, Dhananjay; Sharma, Sanjeev

2018-01-01

This paper proposes an agent-based secure enhanced performance approach (AB-SEP) for mobile ad hoc network. In this approach, agent nodes are selected through optimal node reliability as a factor. This factor is calculated on the basis of node performance features such as degree difference, normalised distance value, energy level, mobility and optimal hello interval of node. After selection of agent nodes, a procedure of malicious behaviour detection is performed using fuzzy-based secure architecture (FBSA). To evaluate the performance of the proposed approach, comparative analysis is done with conventional schemes using performance parameters such as packet delivery ratio, throughput, total packet forwarding, network overhead, end-to-end delay and percentage of malicious detection.

Ad libitum vs. restricted fluid replacement on hydration and performance of military tasks.

PubMed

Nolte, Heinrich W; Noakes, Timothy D; Nolte, Kim

2013-02-01

The primary objective was to evaluate the effect of ad libitum vs. restricted fluid replacement protocol on hydration markers and performance in selected military tasks. The secondary objective was to determine if 300 ml x h(-1) could be considered a safe minimum fluid intake under the experimental conditions. Data were collected simulating a route march over 16 km. There were 57 subjects who participated in the study. The mean pre-exercise body mass of the ad libitum group was 70.4 +/- 13.3 (SD) kg compared to 69.3 +/- 8.9 kg in the restricted group. The mean total fluid intake of the ad libitum group was 2.1 +/- 0.9 L compared to 1.2 +/- 0.0 L in the restricted group. The ad libitum and restricted intake groups, respectively, lost a mean of 1.05 kg +/- 0.77 (1.5%) and 1.34 kg +/- 0.37 (1.9%). Calculated sweat rate was 608 +/- 93 ml x h(-1) compared to 762 +/- 162 ml x h(-1) in the ad libitum group. There were no significant differences for either urine specific gravity (USG) or urine osmolality (UOsm) before or after the exercise. It is not clear whether fluid intake and calculated sweat rates are causally related or explained by their codependence on a third variable; for example, the exercising metabolic rate. Thus, 300 ml x h(-1) intake could be considered a current safe minimum water intake for soldiers of similar mass under similar experimental conditions, namely similar exercise durations at equivalent exercise intensities in a moderate, dry climate.

The Effect of Summer on Value-Added Assessments of Teacher and School Performance

ERIC Educational Resources Information Center

Palardy, Gregory J.; Peng, Luyao

2015-01-01

This study examines the effects of including the summer period on value-added assessments (VAA) of teacher and school performance at the early grades. The results indicate that 40-62% of the variance in VAA estimates originates from the summer period, depending on the outcome (i.e., reading or math achievement gains). Furthermore, when summer is…

Associations between physical function, dual-task performance and cognition in patients with mild Alzheimer's disease.

PubMed

Sobol, Nanna Aue; Hoffmann, Kristine; Vogel, Asmus; Lolk, Annette; Gottrup, Hanne; Høgh, Peter; Hasselbalch, Steen G; Beyer, Nina

2016-11-01

Alzheimer's disease (AD) causes a gradual decline in cognition, limitations of dual-tasking and physical function leading to total dependence. Hence, information about the interaction between physical function, dual-task performance and cognition may lead to new treatment strategies with the purpose of preserving function and quality of life. The objective of this study was to investigate the associations between physical function, dual-task performance and cognition in community-dwelling patients with mild AD. Baseline results from 185 participants (50-90 years old) in the single blinded multicenter RCT 'ADEX' (Alzheimer's disease: the effect of physical exercise) were used. Assessments included tests of physical function: 400-m walk test, 10-m walk test, Timed Up and Go test and 30-s chair stand test; dual-task performance, i.e., 10-m walk while counting backwards from 50 or naming the months backwards; and cognition, i.e., Mini Mental State Examination, Symbol Digit Modalities Test, the Stroop Color and Word Test, and Lexical verbal fluency test. Results in the 30-s chair stand test correlated significantly with all tests of cognition (r = .208-.242) while the other physical function tests only randomly correlated with tests of cognition. Results in the dual-task counting backwards correlated significantly with results in all tests of cognition (r = .259-.388), which accounted for 7%-15% of the variation indicating that a faster time to complete dual-task performance was associated with better cognitive performance. The evidence of the associations between physical function, dual-task performance and cognition is important when creating new rehabilitation interventions to patients with mild AD.

Performance Analysis of Hierarchical Group Key Management Integrated with Adaptive Intrusion Detection in Mobile ad hoc Networks

DTIC Science & Technology

2016-04-05

applications in wireless networks such as military battlefields, emergency response, mobile commerce , online gaming, and collaborative work are based on the...www.elsevier.com/locate/peva Performance analysis of hierarchical group key management integrated with adaptive intrusion detection in mobile ad hoc...Accepted 19 September 2010 Available online 26 September 2010 Keywords: Mobile ad hoc networks Intrusion detection Group communication systems Group

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

PubMed

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

2014-02-01

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

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

PubMed

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

2015-01-01

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

Performance of patients with frontotemporal lobar degeneration on artistic tasks: A pilot study.

PubMed

Anauate, Maria Cristina; Bahia, Valéria Santoro; Nitrini, Ricardo; Radanovic, Marcia

2014-01-01

Several studies have addressed visuospatial and executive skills in artistic activities in Frontotemporal Lobar Degeneration (FTLD) and Alzheimer's disease (AD). To investigate the performance of FTLD patients compared to controls on two artistic tasks. Four FTLD patients with mean age of 57 (8.7) years and schooling of 12.2 (4.5) years plus 10 controls with mean age of 62.9 (8.6) years and schooling of 12.3 (4.6) years, were assessed using the Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and by a three-stage artistic protocol including visual observation, copying and collage, based on a Sisley painting. FTLD patients had lower scores than controls on Visuospatial Perception, Copy, Collage, Examiner's Observation, and Total, showing distinct patterns of performance according to FTLD sub-type: semantic PPA, nonfluent PPA and bvFTD. FTLD patients presented impairment in the visuospatial and executive skills required to perform artistic tasks. We demonstrated that the application of the instrument as a complimentary method for assessing cognitive skills in this group of patients is possible. Further studies addressing larger and more homogeneous samples of FTLD patients as well as other dementias are warranted.

Performance of patients with frontotemporal lobar degeneration on artistic tasks: A pilot study

PubMed Central

Anauate, Maria Cristina; Bahia, Valéria Santoro; Nitrini, Ricardo; Radanovic, Marcia

2014-01-01

Several studies have addressed visuospatial and executive skills in artistic activities in Frontotemporal Lobar Degeneration (FTLD) and Alzheimer's disease (AD). Objective To investigate the performance of FTLD patients compared to controls on two artistic tasks. Methods Four FTLD patients with mean age of 57 (8.7) years and schooling of 12.2 (4.5) years plus 10 controls with mean age of 62.9 (8.6) years and schooling of 12.3 (4.6) years, were assessed using the Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and by a three-stage artistic protocol including visual observation, copying and collage, based on a Sisley painting. Results FTLD patients had lower scores than controls on Visuospatial Perception, Copy, Collage, Examiner's Observation, and Total, showing distinct patterns of performance according to FTLD sub-type: semantic PPA, nonfluent PPA and bvFTD. Conclusion FTLD patients presented impairment in the visuospatial and executive skills required to perform artistic tasks. We demonstrated that the application of the instrument as a complimentary method for assessing cognitive skills in this group of patients is possible. Further studies addressing larger and more homogeneous samples of FTLD patients as well as other dementias are warranted. PMID:29213882

Position space analysis of the AdS (in)stability problem

NASA Astrophysics Data System (ADS)

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

2015-08-01

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

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

PubMed

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

2016-01-01

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

Neurocognitive performance in unmedicated patients with hoarding disorder.

PubMed

Sumner, Jennifer M; Noack, Carolyn G; Filoteo, J Vincent; Maddox, W Todd; Saxena, Sanjaya

2016-02-01

Hoarding disorder (HD) is an often incapacitating psychiatric illness associated with a wide range of neurocognitive abnormalities. Some prior neuropsychological studies have found executive dysfunction in HD, but no clear pattern has emerged. One potential reason for discrepant results in previous studies might be the inclusion of patients on psychotropic and other medications that can affect neurocognitive performance. Therefore, we examined neurocognitive functioning in medication-free HD patients. We also added a novel investigation of implicit learning, which has been found to be abnormal in obsessive-compulsive disorder (OCD) and related disorders. Twenty-six participants meeting the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) diagnostic criteria for HD and 23 normal controls were administered a battery of neuropsychological tests and symptom rating scales. All participants were free of psychotropic medications for at least 6 weeks prior to the study. HD participants showed no significant differences from normal controls on measures of verbal memory, attention, or executive functioning, including response inhibition, planning, organization, and decision making. However, HD participants demonstrated a trend toward less implicit learning and greater use of explicit learning strategies during perceptual categorization compared to normal controls. HD participants who used an implicit strategy performed significantly worse than controls who used an implicit strategy. Hoarding symptom severity was not associated with neurocognitive performance. HD patients may have a tendency to use explicit rather than implicit learning strategies for perceptual categorization but perform as well as normal controls on many other neurocognitive measures. Future studies should assess unmedicated participants and examine test strategies, not just outcomes. PsycINFO Database Record (c) 2016 APA, all rights reserved.

No added diagnostic value of non-phosphorylated tau fraction (p-taurel) in CSF as a biomarker for differential dementia diagnosis.

PubMed

Goossens, Joery; Bjerke, Maria; Struyfs, Hanne; Niemantsverdriet, Ellis; Somers, Charisse; Van den Bossche, Tobi; Van Mossevelde, Sara; De Vil, Bart; Sieben, Anne; Martin, Jean-Jacques; Cras, Patrick; Goeman, Johan; De Deyn, Peter Paul; Van Broeckhoven, Christine; van der Zee, Julie; Engelborghs, Sebastiaan

2017-07-14

The Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers Aβ 1-42 , t-tau, and p-tau 181 overlap with other diseases. New tau modifications or epitopes, such as the non-phosphorylated tau fraction (p-tau rel ), may improve differential dementia diagnosis. The goal of this study is to investigate if p-tau rel can improve the diagnostic performance of the AD CSF biomarker panel for differential dementia diagnosis. The study population consisted of 45 AD, 45 frontotemporal lobar degeneration (FTLD), 45 dementia with Lewy bodies (DLB), and 21 Creutzfeldt-Jakob disease (CJD) patients, and 20 cognitively healthy controls. A substantial subset of the patients was pathology-confirmed. CSF levels of Aβ 1-42 , t-tau, p-tau 181 , and p-tau rel were determined with commercially available single-analyte enzyme-linked immunosorbent assay (ELISA) kits. Diagnostic performance was evaluated by receiver operating characteristic (ROC) curve analyses, and area under the curve (AUC) values were compared using DeLong tests. The diagnostic performance of single markers as well as biomarker ratios was determined for each pairwise comparison of different dementia groups and controls. The addition of p-tau rel to the AD biomarker panel decreased its diagnostic performance when discriminating non-AD, FTLD, and DLB from AD. As a single marker, p-tau rel increased the diagnostic performance for CJD. No significant difference was found in AUC values with the addition of p-tau rel when differentiating between AD or non-AD dementias and controls. The addition of p-tau rel to the AD CSF biomarker panel failed to improve differentiation between AD and non-AD dementias.

Aerodynamic Influence of Added Surfaces on the Performance Characteristics of a Sports Car

NASA Astrophysics Data System (ADS)

Thangadurai, Murugan; Kumar, Rajesh; Rana, Subhas Chandra; Chatterjee, Dipankar

2018-05-01

External aerodynamics plays a vital role in designing high-speed vehicles since a reduction in drag and positive lift generation are principal concerns in vehicle aerodynamics to ensure superior performance, comfort, and vehicle stability. In the present study, the effect of added surfaces such as NACA 2412 wings and wedge type spoiler at the rear end of a sports car are examined in detail using three-dimensional numerical simulations substantiated with lab scale experiments. The simulations are performed by solving Reynolds-averaged Navier-Stokes equations with a realizable k-ɛ turbulence model using ANSYS Fluent software for Reynolds numbers 9.1 × 106, 1.37 × 107 and 1.82 × 107. The results obtained from simulations are validated with the experiments performed on a scale down model at the low-speed wind tunnel using a six component external pyramidal balance. The variation in the wake flow field of the vehicles with different added surfaces are demonstrated using pressure and velocity contours, velocity vectors at the rear end, and the turbulent kinetic energy distribution plots. It is observed that the positive lift coefficient of the base model is reduced drastically by incorporating a single wing at the rear end of the vehicle. The aerodynamics coefficients obtained from different configurations suggest that the two wing configuration has lesser drag than the wedge type spoiler though, the negative lift is higher with a wedge than the two wing configuration.

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

PubMed Central

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

2017-01-01

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

Hydrotherapy added to endurance training versus endurance training alone in elderly patients with chronic heart failure: a randomized pilot study.

PubMed

Caminiti, Giuseppe; Volterrani, Maurizio; Marazzi, Giuseppe; Cerrito, Anna; Massaro, Rosalba; Sposato, Barbara; Arisi, Arianna; Rosano, Giuseppe

2011-04-14

To assess if Hydrotherapy (HT) added to endurance training (ET) is more effective than ET alone in order to improve exercise tolerance of elderly male patients with chronic heart failure (CHF). Twenty-one male CHF patients, age 68+/-7 (mean+/-DS) years; ejection fraction 32+/-9. NYHA II-III were enrolled. Eleven pts were randomized to combined training (CT) group performing HT+ET and 10 patients to ET group (ET only). At baseline and after 24 weeks all patients underwent: 6-minute walking test (6MWT), assessment of quadriceps maximal voluntary contraction (MVC) and peak torque (PT), blood pressure and heart rate (HR), echocardiography and non-invasive hemodynamic evaluation. HT was performed 3 times/week in upright position at up to the xyphoid process at a temperature of 31°C. ET was performed 3 times/week. Exercise was well tolerated. No patients had adverse events. Distance at 6MWT improved in both groups (CT group: 150+/-32 m; ET group:105+/-28 m) with significant intergroup differences (p 0.001). On land diastolic BP and HR significantly decreased in the CT group while remained unchanged in the ET group (-11 mmHg+/-2, p 0.04; e - 12 bpm, p 0.03; respectively) CO and SV had a relative despite no significant increase in CT group TPR on land significantly decreased in CT group (-23+/-3 mmHg/l/m; p 0.01) while remained unchanged in ET group. Patients of CT group had no significant higher increase of both MVC and PT than ET group. CT training, significantly improves exercise tolerance and hemodynamic profile of patients with CHF. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Analysis of motor function in 6-month-old male and female 3xTg-AD mice.

PubMed

Stover, Kurt R; Campbell, Mackenzie A; Van Winssen, Christine M; Brown, Richard E

2015-03-15

The 3xTg-AD mouse has high validity as a model of Alzheimer's disease (AD) because it develops both amyloid beta plaques and neurofibrillary tangles. Human patients with AD typically develop motor deficits, which worsen as the disease progresses, but 3xTg-AD mice have been reported to show enhanced motor abilities. We investigated the motor behaviour phenotype of male and female 3xTg-AD and B6129SF2 wildtype mice on a battery of motor behaviours at 6 months of age. Compared to wildtype mice, the 3xTg-AD mice had enhanced motor performance on the Rotarod, but worse performance on the grid suspension task. In gait analysis 3xTg-AD mice had a longer stride length and made more foot slips on the balance beam than wildtype mice. There was no overall difference in voluntary wheel-running activity between genotypes, but there was a disruption in circadian activity rhythm in 3xTg-AD mice. In some motor tasks, such as the Rotarod and balance beam, females appeared to perform better than males, but this sex differences was accounted for by differences in body weight. Our results indicate that while the 3xTg-AD mice show enhanced performance on the Rotarod, they have poorer performance on other motor behaviour tasks, indicating that their motor behaviour phenotype is more complex than previously reported. The presence of the P301L transgene may explain the enhancement of Rotarod performance but the poorer performance on other motor behaviour tasks may be due to other transgenes. Copyright © 2014 Elsevier B.V. All rights reserved.

Neuropsychological test performance and prediction of functional capacities among Spanish-speaking and English-speaking patients with dementia.

PubMed

Loewenstein, D A; Rubert, M P; Argüelles, T; Duara, R

1995-03-01

Neuropsychological measures have been widely used by clinicians to assist them in making judgments regarding a cognitively impaired patient's ability to independently perform important activities of daily living. However, important questions have been raised concerning the degree to which neuropsychological instruments can predict a broad array of specific functional capacities required in the home environment. In the present study, we examined 127 English-speaking and 56 Spanish-speaking patients with Alzheimer's disease (AD) and determined the extent to which various neuropsychological measures and demographic variables were predictive of performance on functional measures administered within the clinical setting. Among English-speaking AD patients, Block Design and Digit-Span of the WAIS-R, as well as tests of language were among the strongest predictors of functional performance. For Spanish-speakers, Block Design, The Mini-Mental State Evaluation (MMSE) and Digit Span had the optimal predictive power. When stepwise regression was conducted on the entire sample of 183 subjects, ethnicity emerged as a statistically significant predictor variable on one of the seven functional tests (writing a check). Despite the predictive power of several of the neuropsychological measures for both groups, most of the variability in objective functional performance could not be explained in our regression models. As a result, it would appear prudent to include functional measures as part of a comprehensive neuropsychological evaluation for dementia.

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

PubMed

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

2017-10-16

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

A high performance, ad-hoc, fuzzy query processing system for relational databases

NASA Technical Reports Server (NTRS)

Mansfield, William H., Jr.; Fleischman, Robert M.

1992-01-01

Database queries involving imprecise or fuzzy predicates are currently an evolving area of academic and industrial research. Such queries place severe stress on the indexing and I/O subsystems of conventional database environments since they involve the search of large numbers of records. The Datacycle architecture and research prototype is a database environment that uses filtering technology to perform an efficient, exhaustive search of an entire database. It has recently been modified to include fuzzy predicates in its query processing. The approach obviates the need for complex index structures, provides unlimited query throughput, permits the use of ad-hoc fuzzy membership functions, and provides a deterministic response time largely independent of query complexity and load. This paper describes the Datacycle prototype implementation of fuzzy queries and some recent performance results.

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

PubMed

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

2016-02-03

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

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

PubMed Central

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

2012-01-01

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

Cognitive Styles, Demographic Attributes, Task Performance and Affective Experiences: An Empirical Investigation into Astrophysics Data System (ADS) Core Users

NASA Astrophysics Data System (ADS)

Tong, Rong

As a primary digital library portal for astrophysics researchers, SAO/NASA ADS (Astrophysics Data System) 2.0 interface features several visualization tools such as Author Network and Metrics. This research study involves 20 ADS long term users who participated in a usability and eye tracking research session. Participants first completed a cognitive test, and then performed five tasks in ADS 2.0 where they explored its multiple visualization tools. Results show that over half of the participants were Imagers and half of the participants were Analytic. Cognitive styles were found to have significant impacts on several efficiency-based measures. Analytic-oriented participants were observed to spent shorter time on web pages and apps, made fewer web page changes than less-Analytic-driving participants in performing common tasks, whereas AI (Analytic-Imagery) participants also completed their five tasks faster than non-AI participants. Meanwhile, self-identified Imagery participants were found to be more efficient in their task completion through multiple measures including total time on task, number of mouse clicks, and number of query revisions made. Imagery scores were negatively associated with frequency of confusion and the observed counts of being surprised. Compared to those who did not claimed to be a visual person, self-identified Imagery participants were observed to have significantly less frequency in frustration and hesitation during their task performance. Both demographic variables and past user experiences were found to correlate with task performance; query revision also correlated with multiple time-based measurements. Considered as an indicator of efficiency, query revisions were found to correlate negatively with the rate of complete with ease, and positively with several time-based efficiency measures, rate of complete with some difficulty, and the frequency of frustration. These results provide rich insights into the cognitive styles of ADS' core

Effects of adding a weekly eccentric-overload training session on strength and athletic performance in team-handball players.

PubMed

Sabido, Rafael; Hernández-Davó, Jose Luis; Botella, Javier; Navarro, Angel; Tous-Fajardo, Julio

2017-06-01

To investigate the influence of adding a weekly eccentric-overload training (EOT) session in several athletic performance's tests, 18 team-handball players were assigned either to an EOT (n = 11) or a Control (n = 7) group. Both groups continued to perform the same habitual strength training, but the EOT group added one session/week during a 7-week training programme consisting of four sets of eight repetitions for the bilateral half-squat and unilateral lunge exercises. The test battery included handball throwing velocity, maximum dynamic strength (1RM), countermovement jump (CMJ), 20 m sprint, triple hop for distance, and eccentric/concentric power in both the half-squat and lunge exercises. Data were analysed using magnitude-based inferences. Both groups improved their 1RM in the half squat, 20 m sprint time, and CMJ performance to a similar extent, but the EOT group showed a beneficial effect for both right [(42/58/0), possibly positive] and left [(99/1/0), very likely positive] triple hop for distance performance. In addition, the EOT group showed greater power output improvements in both eccentric and concentric phases of the half-squat (difference in percent of change ranging from 6.5% to 22.0%) and lunge exercises (difference in per cent of change ranging from 13.1% to 24.9%). Nevertheless, no group showed changes in handball throwing velocity. Selected variables related to team-handball performance (i.e. functional jumping performance, power output) can be improved by adding a single EOT session per week, highlighting the usefulness of this low-volume/high-intensity training when aiming at optimizing dynamic athletic performance.

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.

Exact microstate counting for dyonic black holes in AdS4

NASA Astrophysics Data System (ADS)

Benini, Francesco; Hristov, Kiril; Zaffaroni, Alberto

2017-08-01

We present a counting of microstates of a class of dyonic BPS black holes in AdS4 which precisely reproduces their Bekenstein-Hawking entropy. The counting is performed in the dual boundary description, that provides a non-perturbative definition of quantum gravity, in terms of a twisted and mass-deformed ABJM theory. We evaluate its twisted index and propose an extremization principle to extract the entropy, which reproduces the attractor mechanism in gauged supergravity.

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

PubMed

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

2012-07-02

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

Segmented strings in AdS 3

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

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

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

Segmented strings in AdS 3

DOE PAGES

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

2015-11-17

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

Adding value to laboratory medicine: a professional responsibility.

PubMed

Beastall, Graham H

2013-01-01

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

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

ERIC Educational Resources Information Center

Smith, Mark Joseph

2016-01-01

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

Evaluating driving performance of outpatients with Alzheimer disease.

PubMed

Cox, D J; Quillian, W C; Thorndike, F P; Kovatchev, B P; Hanna, G

1998-01-01

Alzheimer disease (AD) is a progressive disease, with multiple physiologic, psychologic, and social implications. A critical issue in its management is when to recommend restrictions on autonomous functioning, such as driving an automobile. This study evaluates driving performance of patients with AD and its relation to patient scores on the Mini-Mental State Exam (MMSE). This study compared 29 outpatients with probable AD with 21 age-matched control participants on an interactive driving simulator to determine how the two groups differed and how such differences related to mental status. Patients with AD (1) were less likely to comprehend and operate the simulator cognitively, (2) drove off the road more often, (3) spent more time driving considerably slower than the posted speed limit, (4) spent less time driving faster than the speed limit, (5) applied less brake pressure in stop zones, (6) spent more time negotiating left turns, and (7) drove more poorly overall. There were no observed differences between AD patients and the control group in terms of crossing the midline and driving speed variability. Among the AD patients, those who could not drive the simulator because of confusion and disorientation (n = 10) had lower MMSE scores and drove fewer miles annually. Those AD patients who had stopped driving also scored lower on their MMSE but did not perform more poorly on the driving simulator. Factor analysis revealed five driving factors associated with AD, explaining 93 percent of the variance. These five factors correctly classified 27 (85 percent) of 32 AD patients compared with the control group. Of the 15 percent who were improperly classified, there were three false positives (control participants misclassified as AD patients) and two false negatives (AD patients misclassified as control participants). The computed total driving score correlated significantly with MMSE scores (r = -.403, P = 0.011). Driving simulators can provide an objective means of

Performance Improvement in Geographic Routing for Vehicular Ad Hoc Networks

PubMed Central

Kaiwartya, Omprakash; Kumar, Sushil; Lobiyal, D. K.; Abdullah, Abdul Hanan; Hassan, Ahmed Nazar

2014-01-01

Geographic routing is one of the most investigated themes by researchers for reliable and efficient dissemination of information in Vehicular Ad Hoc Networks (VANETs). Recently, different Geographic Distance Routing (GEDIR) protocols have been suggested in the literature. These protocols focus on reducing the forwarding region towards destination to select the Next Hop Vehicles (NHV). Most of these protocols suffer from the problem of elevated one-hop link disconnection, high end-to-end delay and low throughput even at normal vehicle speed in high vehicle density environment. This paper proposes a Geographic Distance Routing protocol based on Segment vehicle, Link quality and Degree of connectivity (SLD-GEDIR). The protocol selects a reliable NHV using the criteria segment vehicles, one-hop link quality and degree of connectivity. The proposed protocol has been simulated in NS-2 and its performance has been compared with the state-of-the-art protocols: P-GEDIR, J-GEDIR and V-GEDIR. The empirical results clearly reveal that SLD-GEDIR has lower link disconnection and end-to-end delay, and higher throughput as compared to the state-of-the-art protocols. It should be noted that the performance of the proposed protocol is preserved irrespective of vehicle density and speed. PMID:25429415

Performance improvement in geographic routing for Vehicular Ad Hoc Networks.

PubMed

Kaiwartya, Omprakash; Kumar, Sushil; Lobiyal, D K; Abdullah, Abdul Hanan; Hassan, Ahmed Nazar

2014-11-25

Geographic routing is one of the most investigated themes by researchers for reliable and efficient dissemination of information in Vehicular Ad Hoc Networks (VANETs). Recently, different Geographic Distance Routing (GEDIR) protocols have been suggested in the literature. These protocols focus on reducing the forwarding region towards destination to select the Next Hop Vehicles (NHV). Most of these protocols suffer from the problem of elevated one-hop link disconnection, high end-to-end delay and low throughput even at normal vehicle speed in high vehicle density environment. This paper proposes a Geographic Distance Routing protocol based on Segment vehicle, Link quality and Degree of connectivity (SLD-GEDIR). The protocol selects a reliable NHV using the criteria segment vehicles, one-hop link quality and degree of connectivity. The proposed protocol has been simulated in NS-2 and its performance has been compared with the state-of-the-art protocols: P-GEDIR, J-GEDIR and V-GEDIR. The empirical results clearly reveal that SLD-GEDIR has lower link disconnection and end-to-end delay, and higher throughput as compared to the state-of-the-art protocols. It should be noted that the performance of the proposed protocol is preserved irrespective of vehicle density and speed.

Does adding clinical data to administrative data improve agreement among hospital quality measures?

PubMed

Hanchate, Amresh D; Stolzmann, Kelly L; Rosen, Amy K; Fink, Aaron S; Shwartz, Michael; Ash, Arlene S; Abdulkerim, Hassen; Pugh, Mary Jo V; Shokeen, Priti; Borzecki, Ann

2017-09-01

Hospital performance measures based on patient mortality and readmission have indicated modest rates of agreement. We examined if combining clinical data on laboratory tests and vital signs with administrative data leads to improved agreement with each other, and with other measures of hospital performance in the nation's largest integrated health care system. We used patient-level administrative and clinical data, and hospital-level data on quality indicators, for 2007-2010 from the Veterans Health Administration (VA). For patients admitted for acute myocardial infarction (AMI), heart failure (HF) and pneumonia we examined changes in hospital performance on 30-d mortality and 30-d readmission rates as a result of adding clinical data to administrative data. We evaluated whether this enhancement yielded improved measures of hospital quality, based on concordance with other hospital quality indicators. For 30-d mortality, data enhancement improved model performance, and significantly changed hospital performance profiles; for 30-d readmission, the impact was modest. Concordance between enhanced measures of both outcomes, and with other hospital quality measures - including Joint Commission process measures, VA Surgical Quality Improvement Program (VASQIP) mortality and morbidity, and case volume - remained poor. Adding laboratory tests and vital signs to measure hospital performance on mortality and readmission did not improve the poor rates of agreement across hospital quality indicators in the VA. Efforts to improve risk adjustment models should continue; however, evidence of validation should precede their use as reliable measures of quality. Published by Elsevier Inc.

The Impact of Student Composition on Schools' Value-Added Performance: A Comparison of Seven Empirical Studies

ERIC Educational Resources Information Center

Timmermans, Anneke C.; Thomas, Sally M.

2015-01-01

In many countries, policy makers struggle with the development of value-added indicators of school performance for educational accountability purposes and in particular with the choice whether school context measured in the form of student composition variables should be included. This study investigates differences between 7 empirical studies…

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

PubMed

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

2017-01-01

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

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.

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.

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

PubMed

Harju, E J; Larmi, T K

1985-01-01

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

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

PubMed Central

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

2010-01-01

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

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

PubMed

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

2016-09-01

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

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

PubMed

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

2016-10-01

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

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%).

AdS 2 holographic dictionary

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

Cvetic, Mirjam; Papadimitriou, Ioannis

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

AdS 2 holographic dictionary

DOE PAGES

Cvetic, Mirjam; Papadimitriou, Ioannis

2016-12-02

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

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

PubMed

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

2012-02-01

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

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

PubMed

Mendez, Mario F

2012-11-01

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

Driving Simulator Performance in Patients with Possible and Probable Alzheimer’s Disease

PubMed Central

Stein, Anthony C.; Dubinsky, Richard M.

2011-01-01

Drivers with more advanced stages of Alzheimer’s disease (AD) have been previously associated with an increased rate of motor vehicle accidents. Drivers suffering from early AD are also involved in, and may even cause motor vehicle accidents with greater frequency than “normal” drivers. Consequently there is considerable public concern regarding traffic safety issues for those with AD and subsequently for society, but there has been little research in understanding whether deterioration in driving ability is progressive, or has a sudden onset once the disease has reached a certain severity. The purpose of this study was to identify possible degradation in simulated driving performance that may occur at the earliest stages of AD, and compare these decrements to a control group of normal drivers. Using a single blind design, seventeen AD subjects, eight at a Clinical Dementia Rating (CDR) of 0.5 (possible AD) and nine at a CDR of 1 (probable AD), were compared to 63 cognitively normal, elderly controls. All subjects were trained to drive a computerized interactive driving simulator and then tested on a 19.3 km (12 mile) test course. The AD subjects demonstrated impaired driving performance when compared to the controls. The simulated driving performance of the CDR 1 AD subjects was so degraded that it would be regarded as unsafe by standard assessment criteria. The CDR 0.5 subjects made similar errors, suggesting that driving impairment may occur at the earliest stages of the disease. Further work will be necessary to determine the significance of these findings. PMID:22105407

Adiabatic pumping solutions in global AdS

NASA Astrophysics Data System (ADS)

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

2017-05-01

We construct a family of very simple stationary solutions to gravity coupled to a massless scalar field in global AdS. They involve a constantly rising source for the scalar field at the boundary and thereby we name them pumping solutions. We construct them numerically in D = 4. They are regular and, generically, have negative mass. We perform a study of linear and nonlinear stability and find both stable and unstable branches. In the latter case, solutions belonging to different sub-branches can either decay to black holes or to limiting cycles. This observation motivates the search for non-stationary exactly timeperiodic solutions which we actually construct. We clarify the role of pumping solutions in the context of quasistatic adiabatic quenches. In D = 3 the pumping solutions can be related to other previously known solutions, like magnetic or translationally-breaking backgrounds. From this we derive an analytic expression.

The role of color in the implicit memory performance of healthy older adults and individuals with Alzheimer's disease.

PubMed

Lloyd-Jones, Toby J

2005-01-01

Although the Alzheimer's disease (AD) patients in this study were severely impaired in recognition performance, their naming performance demonstrated normal priming across transformations in object color. This is evidence for preserved implicit shape-based memory performance in AD patients. For colored-object decision, healthy older adult control participants but not AD patients showed priming for new associations between previously encountered object shapes and colors. The author argues, on the basis of this colored object decision performance, that the deficits present in AD do not allow shape and color to be integrated to form a novel unitized representation that can be used to benefit cognitive performance. 2005 APA

Declining financial capacity in patients with mild Alzheimer disease: a one-year longitudinal study.

PubMed

Martin, Roy; Griffith, H Randall; Belue, Katherine; Harrell, Lindy; Zamrini, Edward; Anderson, Britt; Bartolucci, Alfred; Marson, Daniel

2008-03-01

The objective of this study was to investigate change over time in financial abilities in patients with mild Alzheimer disease (AD). The authors conducted a prospective 1-year longitudinal study at a large southern U.S. metropolitan-area medical school university. Participants included healthy older adults (N=63) and patients with mild AD (N=55). The authors conducted a standardized performance measure of financial capacity. Performance was assessed on 18 financial tasks, nine domains of financial activity, and overall financial capacity. Capacity outcomes classifications (capable, marginally capable, or incapable) for domains and overall performance were made using cut scores referenced to comparison group performance. At baseline, patients with mild AD performed significantly below healthy older adults on 16 of 18 tasks, on all nine domains, and on overall financial capacity. At one-year follow up, comparison group performance was stable on all variables. In contrast, patients with mild AD showed substantial declines in overall financial capacity, on eight of nine domains, and on 12 of 18 tasks. Similarly, the proportion of the mild AD group classified as marginally capable and incapable increased substantially over one year for the two overall scores and for five financial domains. Financial capacity is already substantially impaired in patients with mild AD at baseline and undergoes rapid additional decline over one year. Relative to the comparison group, overall financial capacity performance in the AD group declined 10%, from approximately 80% of the comparison group performance at baseline to 70% at follow up. Financial skills showed differential rates of decline on both simple and complex tasks. Of clinical and public policy interest was the declining judgment of patients with mild AD regarding simple fraud schemes. The study supports the importance of prompt financial supervision and planning for patients newly diagnosed with AD.

The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings.

PubMed

Roberts, Nicole K; Williams, Reed G; Schwind, Cathy J; Sutyak, John A; McDowell, Christopher; Griffen, David; Wall, Jarrod; Sanfey, Hilary; Chestnut, Audra; Meier, Andreas H; Wohltmann, Christopher; Clark, Ted R; Wetter, Nathan

2014-02-01

Communication breakdowns and care coordination problems often cause preventable adverse patient care events, which can be especially acute in the trauma setting, in which ad hoc teams have little time for advanced planning. Existing teamwork curricula do not address the particular issues associated with ad hoc emergency teams providing trauma care. Ad hoc trauma teams completed a preinstruction simulated trauma encounter and were provided with instruction on appropriate team behaviors and team communication. Teams completed a postinstruction simulated trauma encounter immediately afterward and 3 weeks later, then completed a questionnaire. Blinded raters rated videotapes of the simulations. Participants expressed high levels of satisfaction and intent to change practice after the intervention. Participants changed teamwork and communication behavior on the posttest, and changes were sustained after a 3-week interval, though there was some loss of retention. Brief training exercises can change teamwork and communication behaviors on ad hoc trauma teams. Copyright © 2014 Elsevier Inc. All rights reserved.

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

PubMed

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

2012-10-01

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

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

PubMed

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

2016-01-01

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

Different Effects of Adding White Noise on Cognitive Performance of Sub-, Normal and Super-Attentive School Children

PubMed Central

Helps, Suzannah K.; Bamford, Susan; Sonuga-Barke, Edmund J. S.; Söderlund, Göran B. W.

2014-01-01

Objectives Noise often has detrimental effects on performance. However, because of the phenomenon of stochastic resonance (SR), auditory white noise (WN) can alter the “signal to noise” ratio and improve performance. The Moderate Brain Arousal (MBA) model postulates different levels of internal “neural noise” in individuals with different attentional capacities. This in turn determines the particular WN level most beneficial in each individual case–with one level of WN facilitating poor attenders but hindering super-attentive children. The objective of the present study is to find out if added WN affects cognitive performance differently in children that differ in attention ability. Methods Participants were teacher-rated super- (N = 25); normal- (N = 29) and sub-attentive (N = 36) children (aged 8 to 10 years). Two non-executive function (EF) tasks (a verbal episodic recall task and a delayed verbal recognition task) and two EF tasks (a visuo-spatial working memory test and a Go-NoGo task) were performed under three WN levels. The non-WN condition was only used to control for potential differences in background noise in the group testing situations. Results There were different effects of WN on performance in the three groups-adding moderate WN worsened the performance of super-attentive children for both task types and improved EF performance in sub-attentive children. The normal-attentive children’s performance was unaffected by WN exposure. The shift from moderate to high levels of WN had little further effect on performance in any group. Significance The predicted differential effect of WN on performance was confirmed. However, the failure to find evidence for an inverted U function challenges current theories. Alternative explanations are discussed. We propose that WN therapy should be further investigated as a possible non-pharmacological treatment for inattention. PMID:25393410

Different effects of adding white noise on cognitive performance of sub-, normal and super-attentive school children.

PubMed

Helps, Suzannah K; Bamford, Susan; Sonuga-Barke, Edmund J S; Söderlund, Göran B W

2014-01-01

Noise often has detrimental effects on performance. However, because of the phenomenon of stochastic resonance (SR), auditory white noise (WN) can alter the "signal to noise" ratio and improve performance. The Moderate Brain Arousal (MBA) model postulates different levels of internal "neural noise" in individuals with different attentional capacities. This in turn determines the particular WN level most beneficial in each individual case-with one level of WN facilitating poor attenders but hindering super-attentive children. The objective of the present study is to find out if added WN affects cognitive performance differently in children that differ in attention ability. Participants were teacher-rated super- (N = 25); normal- (N = 29) and sub-attentive (N = 36) children (aged 8 to 10 years). Two non-executive function (EF) tasks (a verbal episodic recall task and a delayed verbal recognition task) and two EF tasks (a visuo-spatial working memory test and a Go-NoGo task) were performed under three WN levels. The non-WN condition was only used to control for potential differences in background noise in the group testing situations. There were different effects of WN on performance in the three groups-adding moderate WN worsened the performance of super-attentive children for both task types and improved EF performance in sub-attentive children. The normal-attentive children's performance was unaffected by WN exposure. The shift from moderate to high levels of WN had little further effect on performance in any group. The predicted differential effect of WN on performance was confirmed. However, the failure to find evidence for an inverted U function challenges current theories. Alternative explanations are discussed. We propose that WN therapy should be further investigated as a possible non-pharmacological treatment for inattention.

Cognitive and neuropathologic correlates of Stroop Color-Word Test performance in Alzheimer's disease.

PubMed

Bondi, Mark W; Serody, Adam B; Chan, Agnes S; Eberson-Shumate, Sonja C; Delis, Dean C; Hansen, Lawrence A; Salmon, David P

2002-07-01

The Stroop Color-Word Test (SCWT; C. Golden, 1978) was examined in 59 patients with probable Alzheimer's disease (AD) and in 51 demographically comparable normal control (NC) participants. AD patients produced significantly larger Stroop interference effects than NC participants, and level of dementia severity significantly influenced SCWT performance. Principal-components analyses demonstrated a dissociation in the factor structure of the Stroop trials between NC participants and AD patients, suggesting that disruption of semantic knowledge and speeded verbal processing in AD may be a major contributor to impairment on the incongruent trial. Results of clinicopathologic correlations in an autopsy-confirmed AD subgroup further suggest the invocation of a broad network of integrated cortical regions and executive and language processes underlying successful SCWT performance.

Patient opinions regarding 'pay for performance for patients'.

PubMed

Long, Judith A; Helweg-Larsen, Marie; Volpp, Kevin G

2008-10-01

Pay for performance (P4P) programs have shown only modest improvements in outcomes and do not target patient behaviors. Many large employers and payers are turning to pay for performance for patients (P4P4P) to reduce health costs and improve the health of their covered populations. How these programs may be perceived by patients is unknown. To assess patients' opinion of the acceptability of P4P4P. Cross-sectional self-administered survey. Patients in waiting rooms in two university-based primary care clinics. Participants were asked their opinions about paying people to quit smoking, lose weight, control their blood pressure, or control their diabetes. Respondents were split on whether P4P4P is desirable. Thirty-six to 42% thought it was a good/excellent idea to pay smokers to quit smoking, obese people to lose weight, people with hypertension to control their blood pressure, or people with diabetes to control their blood sugar, while 41-44% of the sample thought it was a bad/very bad idea. Smokers and patients who were obese endorsed P4P4P more favorably as a means to achieving tobacco cessation and weight loss than their non-smoking and non-obese counterparts. Acceptance of paying patients for performance by the general population is equivocal. Establishing the efficacy of paying patients for performance may help it gain wider acceptance.

Brain correlates of performance in a free/cued recall task with semantic encoding in Alzheimer disease.

PubMed

Lekeu, Françoise; Van der Linden, Martial; Chicherio, Christian; Collette, Fabienne; Degueldre, Christian; Franck, Georges; Moonen, Gustave; Salmon, Eric

2003-01-01

The goal of this study was to explore in patients with Alzheimer's disease (AD) the brain correlates of free and cued recall performance using an adaptation of the procedure developed by Grober and Buschke (1987). This procedure, which ensures semantic processing and coordinates encoding and retrieval, has been shown to be very sensitive to an early diagnosis of AD. Statistical parametric mapping (SPM 99) was used to establish clinicometabolic correlations between performance at free and cued verbal recall and resting brain metabolism in 31 patients with AD. Results showed that patient's score on free recall correlated with metabolic activity in right frontal regions (BA 10 and BA 45), suggesting that performance reflected a strategic retrieval attempt. Poor retrieval performance was tentatively attributed to a loss of functional correlation between frontal and medial temporal regions in patients with AD compared with elderly controls. Performance on cued recall was correlated to residual metabolic activity in bilateral parahippocampal regions (BA 36), suggesting that performance reflected retrieval of semantic associations, without recollection in AD. In conclusion, this study demonstrates that the diagnostic sensitivity for Alzheimer's disease of the cued recall performance in the Grober and Buschke procedure (1987) depends on the activity of parahippocampal regions, one of the earliest targets of the disease. Moreover, the results suggest that the poor performance of patients with AD during free and cued recall is related to a decreased connectivity between parahippocampal regions and frontal areas.

Can Value-Added Measures of Teacher Performance Be Trusted?

ERIC Educational Resources Information Center

Guarino, Cassandra M.; Reckase, Mark D.; Wooldridge, Jeffrey M.

2015-01-01

We investigate whether commonly used value-added estimation strategies produce accurate estimates of teacher effects under a variety of scenarios. We estimate teacher effects in simulated student achievement data sets that mimic plausible types of student grouping and teacher assignment scenarios. We find that no one method accurately captures…

Assessing the Potential of Using Value-Added Estimates of Teacher Job Performance for Making Tenure Decisions. Working Paper 31

ERIC Educational Resources Information Center

Goldhaber, Dan; Hansen, Michael

2010-01-01

Reforming teacher tenure is an idea that appears to be gaining traction with the underlying assumption being that one can infer to a reasonable degree how well a teacher will perform over her career based on estimates of her early-career effectiveness. Here we explore the potential for using value-added models to estimate performance and inform…

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

PubMed

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

2017-05-01

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

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

Diagnostic performance of the atopy patch test with inhalant allergens.

PubMed

Fuiano, N; Diddi, G; Delvecchio, M; Incorvaia, C

2015-01-01

This study evaluated the diagnostic performance of the atopy patch test (APT) compared with skin prick testing (SPT) and in vitro IgE measurement in a large group of patients with atopic dermatitis (AD) with or without respiratory symptoms (RS). The study included 521 patients (292 males, 229 females; age, 0.5-18 years; median age, 6 years) with AD and RS with different clinical presentations: current AD, 47 patients (Group A); current AD and RS, 72 patients (Group B), past AD and RS, 69 patients (Group C); and RS only, 280 patients (Group D). Fifty-three healthy individuals served as controls. All participants underwent the APT, SPT, and CAP/RAST with the most common inhalant allergens. The presence of a control group allowed calculation of specificity and positive and negative predictive values. A significant difference was found for a positive APT versus both SPT and CAP/RAST (P < .0001) but not for SPT versus CAP/RAST. The differences for APT were significant in all group comparisons except group B vs C and group C vs D. In the control group, the APT was positive in 2% of cases (specificity of 96.2%), SPT was positive in 6% of cases (specificity of 88.4%), and CAP/RAST was positive in 4% of cases (specificity of 92.5%). In young patients sensitized to inhalant allergens with AD in addition to RS, the APT has a superior diagnostic performance to SPT and in vitro IgE measurement.

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

PubMed

Szklaruk, Janio; Kaya, Diana; Wei, Wei

2018-02-01

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

AdVance male sling

PubMed Central

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

2017-01-01

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

An Evaluation of Empirical Bayes' Estimation of Value- Added Teacher Performance Measures. Working Paper #31. Revised

ERIC Educational Resources Information Center

Guarino, Cassandra M.; Maxfield, Michelle; Reckase, Mark D.; Thompson, Paul; Wooldridge, Jeffrey M.

2014-01-01

Empirical Bayes' (EB) estimation is a widely used procedure to calculate teacher value-added. It is primarily viewed as a way to make imprecise estimates more reliable. In this paper we review the theory of EB estimation and use simulated data to study its ability to properly rank teachers. We compare the performance of EB estimators with that of…

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

PubMed

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

2014-02-01

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

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

PubMed Central

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

2009-01-01

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

Influence of controlled encoding and retrieval facilitation on memory performance in patients with different profiles of mild cognitive impairment.

PubMed

Perri, Roberta; Monaco, Marco; Fadda, Lucia; Serra, Laura; Marra, Camillo; Caltagirone, Carlo; Bruni, Amalia C; Curcio, Sabrina; Bozzali, M; Carlesimo, Giovanni A

2015-01-01

Memory tests able to differentiate encoding and retrieval processes from the memoranda storing ones should be used to differentiate patients in a very early phase of AD. In fact, individuals with mild cognitive impairment (MCI) can be characterized by two different memory profiles: a pure amnestic one (with poor learning and retrieval and poor improvement when encoding is assisted and retrieval is facilitated) and a dysexecutive one (with inefficient encoding and/or poor retrieval strategies and improvement with assisted encoding and retrieval). The amnestic profile characterizes subjects affected by medio-temporal atrophy typical of AD. In this study, a Grober-Buschke memory procedure was used to evaluate normal controls and MCI patients with different cognitive profiles: pure amnestic (aMCIsd), amnestic plus other cognitive impairments (aMCImd) and non-amnestic (naMCI). An index of sensitivity of cueing (ISC) measured the advantage passing from free to cued recall. Results showed that both strategic and consolidation abilities were impaired in the aMCIsd and aMCImd groups and were preserved in the naMCI group. aMCImd, however, compensated the memory deficit with assisted encoding and retrieval, but aMCIsd performed very poorly. When MCI subjects were defined according to the ISC value, subjects with poor ISC were primarily in the aMCIsd group and, to a lesser extent, in the aMCImd group and the naMCI group. Finally, patients with a poor ISC showed cerebral atrophy documented in the precocious phase of AD and the retrosplenial cerebral areas seemed to be the most useful areas for identifying patients in the early phase of AD.

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

Effects of bilingualism on the age of onset and progression of MCI and AD: evidence from executive function tests.

PubMed

Bialystok, Ellen; Craik, Fergus I M; Binns, Malcolm A; Ossher, Lynn; Freedman, Morris

2014-03-01

Previous articles have reported that bilingualism is associated with a substantial delay in the onset of both Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). The present study reports results from 74 MCI patients and 75 AD patients; approximately half of the patients in each group were bilingual. All patients were interviewed to obtain details of their language use, onset of their condition, and lifestyle habits. Patients performed three executive function (EF) tests from the D-KEFS battery (Trails, Color-Word Interference, Verbal Fluency) on 3 occasions over a period of approximately 1 year. Results replicated the finding that bilingual patients are several years older than comparable monolinguals at both age of symptom onset and date of first clinic visit. This result could not be attributed to language group differences in such lifestyle variables as diet, smoking, alcohol consumption, physical activity, or social activity. On the first testing occasion, performance on the EF tasks was generally comparable between the language groups, contesting arguments that bilinguals wait longer before attending the clinic. Finally, EF performance tended to decline over the 3 sessions, but no differences were found between monolinguals and bilinguals in the rate of decline. PsycINFO Database Record (c) 2014 APA, all rights reserved.

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

PubMed

Klein, U; Nowak, A J

1999-01-01

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

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

PubMed

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

2016-12-01

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

SAO/NASA ADS at SAO: ADS Browse Service

Science.gov Websites

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

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

PubMed

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

2016-03-01

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

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

Tensionless string spectra on AdS3

NASA Astrophysics Data System (ADS)

Gaberdiel, Matthias R.; Gopakumar, Rajesh

2018-05-01

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

Functional neuroanatomy of sustained memory encoding performance in healthy aging and in Alzheimer's disease.

PubMed

Weis, Susanne; Leube, Dirk; Erb, Michael; Heun, Reinhard; Grodd, Wolfgang; Kircher, Tilo

2011-07-01

The aim of our study was to examine brain networks involved with sustaining memory encoding performance in healthy aging and in Alzheimer's disease (AD). Since different brain regions are affected by degradation in these two conditions, it might be conceivable that different compensation mechanisms occur to keep up memory performance in aging and in AD. Using an event-related functional magnetic resonance imaging (FMRI) design and a correlation analysis, 8 patients suffering from AD and 29 elderly control subjects were scanned while they studied a list of words for a subsequent memory test. Individual performance was assessed on the basis of a subsequent recognition test, and brain regions were identified where functional activations during study correlated with memory performance. In both groups, successful memory encoding performance was significantly correlated with the activation of the right frontal cortex. Furthermore, in healthy controls, there was a significant correlation of memory performance and the activation of the left medial and lateral temporal lobe. In contrast, in AD patients, increasing memory performance goes along with increasing activation of the hippocampus and a bilateral brain network including the frontal and temporal cortices. Our data show that in healthy aging and in AD, common and distinct compensatory mechanisms are employed to keep up a certain level of memory performance. Both in healthy aging and in patients with AD, an increased level of monitoring and control processes mediated by the (right) frontal lobe seems to be necessary to maintain a certain level of memory performance. In addition, memory performance in healthy older subjects seems to rely on an increased effort in encoding item-specific semantic and contextual information in lateral areas of the (left) temporal lobe. In AD patients, on the other hand, the maintenance of memory performance is related to an increase of activation of the (left) hippocampus in conjunction

Creative group performances to assess core competencies in a first-year patient-centered medicine course.

PubMed

Terregino, Carol A; Saks, Norma S

2010-02-15

A novel assessment of systems-based practice and practice-based learning and improvement learning objectives, implemented in a first-year patient-centered medicine course, is qualitatively described. Student learning communities were asked to creatively demonstrate a problem and solution for health care delivery. Skits, filmed performances, plays, and documentaries were chosen by the students. Video recordings were reviewed for themes and the presence of course competencies. All performances demonstrated not only the index competencies of team work and facilitation of the learning of others, but many other core objectives of the course. The assignment was rated positively both by the faculty and the students, and has been added to the assessment modalities of the course.

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

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

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

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

AD HOC Networks for the Autonomous Car

NASA Astrophysics Data System (ADS)

Ron, Davidescu; Negrus, Eugen

2017-10-01

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

AdS7/CFT6 with orientifolds

NASA Astrophysics Data System (ADS)

Apruzzi, Fabio; Fazzi, Marco

2018-01-01

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

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

PubMed

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

2016-06-01

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

Two Virasoro symmetries in stringy warped AdS 3

DOE PAGES

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

2014-12-02

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

Two Virasoro symmetries in stringy warped AdS 3

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

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

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

Analysis of Pervasive Mobile Ad Hoc Routing Protocols

NASA Astrophysics Data System (ADS)

Qadri, Nadia N.; Liotta, Antonio

Mobile ad hoc networks (MANETs) are a fundamental element of pervasive networks and therefore, of pervasive systems that truly support pervasive computing, where user can communicate anywhere, anytime and on-the-fly. In fact, future advances in pervasive computing rely on advancements in mobile communication, which includes both infrastructure-based wireless networks and non-infrastructure-based MANETs. MANETs introduce a new communication paradigm, which does not require a fixed infrastructure - they rely on wireless terminals for routing and transport services. Due to highly dynamic topology, absence of established infrastructure for centralized administration, bandwidth constrained wireless links, and limited resources in MANETs, it is challenging to design an efficient and reliable routing protocol. This chapter reviews the key studies carried out so far on the performance of mobile ad hoc routing protocols. We discuss performance issues and metrics required for the evaluation of ad hoc routing protocols. This leads to a survey of existing work, which captures the performance of ad hoc routing algorithms and their behaviour from different perspectives and highlights avenues for future research.

Phases of global AdS black holes

NASA Astrophysics Data System (ADS)

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

2016-06-01

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

Minocycline added to subcutaneous interferon β-1a in multiple sclerosis: randomized RECYCLINE study.

PubMed

Sørensen, P S; Sellebjerg, F; Lycke, J; Färkkilä, M; Créange, A; Lund, C G; Schluep, M; Frederiksen, J L; Stenager, E; Pfleger, C; Garde, E; Kinnunen, E; Marhardt, K

2016-05-01

Combining different therapies may improve disease control in patients with relapsing-remitting multiple sclerosis (RRMS). This study assessed the efficacy and safety of minocycline added to subcutaneous (sc) interferon (IFN) β-1a therapy. This was a double-blind, randomized, placebo-controlled multicentre study. Within 3 months (±1 month) of starting sc IFN β-1a 44 μg three times weekly, patients with RRMS were randomized to minocycline 100 mg twice daily or placebo, added to sc IFN β-1a, for 96 weeks. The primary efficacy endpoint was the time to first qualifying relapse. Secondary efficacy endpoints were the annualized relapse rate for qualifying relapses, the number of new/enlarging T2-weighted lesions and change in brain volume [magnetic resonance imaging (MRI) was performed only in a few selected centres]. In addition, a number of tertiary efficacy endpoints were assessed. One hundred and forty-nine patients received minocycline and 155 received placebo; MRI data were available for 23 and 27 patients, respectively. The time to first qualifying relapse did not differ significantly for minocycline versus placebo (hazard ratio 0.85; 95% confidence interval 0.53, 1.35; log-rank = 0.50; P = 0.48). There were no statistically significant differences between the two groups on other efficacy endpoints, although some numerical trends in favour of minocycline were observed. No unexpected adverse events were reported, but more patients discontinued because of adverse events with minocycline versus placebo. Minocycline showed no statistically significant beneficial effect when added to sc IFN β-1a therapy. © 2016 EAN.

New massive gravity and AdS(4) counterterms.

PubMed

Jatkar, Dileep P; Sinha, Aninda

2011-04-29

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

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.

Floquet scalar dynamics in global AdS

NASA Astrophysics Data System (ADS)

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

2018-04-01

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

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

PubMed

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

2017-06-01

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

Performance trade-off in an adaptive IEEE 802.11ad waveform design for a joint automotive radar and communication system.

DOT National Transportation Integrated Search

2017-05-01

The IEEE 802.11ad waveform can be used for automotive radar by exploiting the Golay complementary sequences in the preamble of a frame. The performance of radar, however, is limited by the preamble structure. In this paper, we propose an adaptive pre...

Comparison of dual-biomarker PIB-PET and dual-tracer PET in AD diagnosis.

PubMed

Fu, Liping; Liu, Linwen; Zhang, Jinming; Xu, Baixuan; Fan, Yong; Tian, Jiahe

2014-11-01

To identify the optimal time window for capturing perfusion information from early (11)C-PIB imaging frames (perfusion PIB, (11)C-pPIB) and to compare the performance of (18)F-FDG PET and "dual biomarker" (11)C-PIB PET [(11)C-pPIB and amyloid PIB ((11)C-aPIB)] for classification of AD, MCI and CN subjects. Forty subjects (14 CN, 12 MCI and 14 AD patients) underwent (18)F-FDG and (11)C-PIB PET studies. Pearson correlation between the (18)F-FDG image and sum of early (11)C-PIB frames was maximised to identify the optimal time window for (11)C-pPIB. The classification power of imaging parameters was evaluated with a leave-one-out validation. A 7-min time window yielded the highest correlation between (18)F-FDG and (11)C-pPIB. (11)C-pPIB and (18)F-FDG images shared a similar radioactive distribution pattern. (18)F-FDG performed better than (11)C-pPIB for the classification of both AD vs. CN and MCI vs. CN. (11)C-pPIB + (11)C-aPIB and (18)F-FDG + (11)C-aPIB yielded the highest classification accuracy for the classification of AD vs. CN, and (18)F-FDG + (11)C-aPIB had the best classification performance for the classification of MCI vs. C-pPIB could serve as a useful biomarker of rCBF for measuring neural activity and improve the diagnostic power of PET for AD in conjunction with (11)C-aPIB. (18)F-FDG and (11)C-PIB dual-tracer PET examination could better detect MCI. • Dual-tracer PET examination provides neurofunctional and neuropathological information for AD diagnosis. • The identified optimal 11C-pPIB time frames had highest correlation with 18F-FDG. • 11C-pPIB images shared a similar radioactive distribution pattern with 18F-FDG images. • 11C-pPIB can provide neurofunctional information. • Dual-tracer PET examination could better detect MCI.

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

PubMed Central

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

2013-01-01

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

Creative group performances to assess core competencies in a first-year patient-centered medicine course

PubMed Central

Terregino, Carol A.; Saks, Norma S.

2010-01-01

Introduction A novel assessment of systems-based practice and practice-based learning and improvement learning objectives, implemented in a first-year patient-centered medicine course, is qualitatively described. Methods Student learning communities were asked to creatively demonstrate a problem and solution for health care delivery. Skits, filmed performances, plays, and documentaries were chosen by the students. Video recordings were reviewed for themes and the presence of course competencies. Results All performances demonstrated not only the index competencies of team work and facilitation of the learning of others, but many other core objectives of the course. The assignment was rated positively both by the faculty and the students, and has been added to the assessment modalities of the course. PMID:20174597

The effectiveness of neurofeedback on cognitive functioning in patients with Alzheimer's disease: Preliminary results.

PubMed

Luijmes, Robin E; Pouwels, Sjaak; Boonman, Jacko

2016-06-01

Alzheimer's disease (AD) is the most common form of dementia. In quantified EEG (qEEG), the AD patients have a greater amount of theta activity compared with normal elderly individuals. Little is known about the effect of neurofeedback in patients with dementia. The objective of this study was to examine whether neurofeedback has a positive effect on cognitive performance in patients with AD. Ten patients with qEEG meeting criteria for AD received neurofeedback training. Participants were aged between 61 and 90 years. All patients underwent the CAMCOG test designed to assess cognitive functioning pre- and post-treatment. The individual results, analyzed with a reliable change index (RCI), showed that patients who received neurofeedback treatment had stable cognitive functions. These patients showed improvement in memory after neurofeedback and other cognitive functions were stable. In addition, an improvement was observed in recall of information and recognition. Patients with AD who received neurofeedback treatment had stable or improved cognitive performance. Future research should focus on the design of high quality randomized controlled trials to assess whether neurofeedback has a place in the treatment of AD. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Comparison of behaviour, performance and mortality in restricted and ad libitum-fed growing rabbits.

PubMed

Dalmau, A; Abdel-Khalek, A M; Ramon, J; Piles, M; Sanchez, J P; Velarde, A; Rafel, O

2015-07-01

The objective of this study was to determine whether rabbits fed in a restricted regimen (75%) showed increased competition for feeding, drinking and use of specific areas of the cages as compared with those provided feed ad libitum. This evaluation was carried out by measuring their space utilisation in the cage, the incidence of agonistic behaviour and rates of mortality. In total, 504 rabbits between 31 and 66 days of age were used in this study. A total of 200 heavy-weight rabbits and 56 light-weight rabbits were randomly housed in 32 cages, each cage containing eight rabbits: 25 cages housing heavy rabbits and seven cages housing the light-weight ones. They were all fed ad libitum (AD). In addition, a total of 208 heavy-weight rabbits and 40 light-weight rabbits were randomly housed in 31 cages, each of them containing eight rabbits: 26 cages housing heavy weight rabbits and five cages housing light-weight ones. They were all fed a restricted diet (R) regimen. The restriction was calculated to be 75% of the feed consumed by the AD group. The total space available in the cage was 3252 cm(2), with a stocking density of 24.6 animals/m(2). Animals between 32 and 60 days of age from 20 different cages were observed nine times per week (morning or afternoon) by means of scan and focal sampling by one observer. During each period, cages were assessed for 5 min, registering every minute the position of all the animals in relation to Area A (feeder), Area B (central part) or Area C (back and drinker area). The incidence of agonistic behaviour such as displacement, biting and jumping on each other was also assessed. Performance variables such as daily gain and feed conversion ratio, in addition to general health status and mortality rates, were recorded for all rabbits. When the rabbits were under restricted feeding, the competition for feed and drink increased with clear signs of agonistic behaviour such as biting, displacement and animals jumping on top of each other

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

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

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

2010-10-01

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

Loops in AdS from conformal field theory

DOE PAGES

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

2017-07-10

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

Loops in AdS from conformal field theory

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

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

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

Loops in AdS from conformal field theory

NASA Astrophysics Data System (ADS)

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

2017-07-01

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

Differential Contributions of Selective Attention and Sensory Integration to Driving Performance in Healthy Aging and Alzheimer's Disease.

PubMed

Venkatesan, Umesh M; Festa, Elena K; Ott, Brian R; Heindel, William C

2018-05-01

Patients with Alzheimer's disease (AD) demonstrate deficits in cross-cortical feature binding distinct from age-related changes in selective attention. This may have consequences for driving performance given its demands on multisensory integration. We examined the relationship of visuospatial search and binding to driving in patients with early AD and elderly controls (EC). Participants (42 AD; 37 EC) completed search tasks requiring either luminance-motion (L-M) or color-motion (C-M) binding, analogs of within and across visual processing stream binding, respectively. Standardized road test (RIRT) and naturalistic driving data (CDAS) were collected alongside clinical screening measures. Patients performed worse than controls on most cognitive and driving indices. Visual search and clinical measures were differentially related to driving behavior across groups. L-M search and Trail Making Test (TMT-B) were associated with RIRT performance in controls, while C-M binding, TMT-B errors, and Clock Drawing correlated with CDAS performance in patients. After controlling for demographic and clinical predictors, L-M reaction time significantly predicted RIRT performance in controls. In patients, C-M binding made significant contributions to CDAS above and beyond demographic and clinical predictors. RIRT and C-M binding measures accounted for 51% of variance in CDAS performance in patients. Whereas selective attention is associated with driving behavior in EC, cross-cortical binding appears most sensitive to driving in AD. This latter relationship may emerge only in naturalistic settings, which better reflect patients' driving behavior. Visual integration may offer distinct insights into driving behavior, and thus has important implications for assessing driving competency in early AD. (JINS, 2018, 24, 486-497).

Association between fully automated MRI-based volumetry of different brain regions and neuropsychological test performance in patients with amnestic mild cognitive impairment and Alzheimer's disease.

PubMed

Arlt, Sönke; Buchert, Ralph; Spies, Lothar; Eichenlaub, Martin; Lehmbeck, Jan T; Jahn, Holger

2013-06-01

Fully automated magnetic resonance imaging (MRI)-based volumetry may serve as biomarker for the diagnosis in patients with mild cognitive impairment (MCI) or dementia. We aimed at investigating the relation between fully automated MRI-based volumetric measures and neuropsychological test performance in amnestic MCI and patients with mild dementia due to Alzheimer's disease (AD) in a cross-sectional and longitudinal study. In order to assess a possible prognostic value of fully automated MRI-based volumetry for future cognitive performance, the rate of change of neuropsychological test performance over time was also tested for its correlation with fully automated MRI-based volumetry at baseline. In 50 subjects, 18 with amnestic MCI, 21 with mild AD, and 11 controls, neuropsychological testing and T1-weighted MRI were performed at baseline and at a mean follow-up interval of 2.1 ± 0.5 years (n = 19). Fully automated MRI volumetry of the grey matter volume (GMV) was performed using a combined stereotactic normalisation and segmentation approach as provided by SPM8 and a set of pre-defined binary lobe masks. Left and right hippocampus masks were derived from probabilistic cytoarchitectonic maps. Volumes of the inner and outer liquor space were also determined automatically from the MRI. Pearson's test was used for the correlation analyses. Left hippocampal GMV was significantly correlated with performance in memory tasks, and left temporal GMV was related to performance in language tasks. Bilateral frontal, parietal and occipital GMVs were correlated to performance in neuropsychological tests comprising multiple domains. Rate of GMV change in the left hippocampus was correlated with decline of performance in the Boston Naming Test (BNT), Mini-Mental Status Examination, and trail making test B (TMT-B). The decrease of BNT and TMT-A performance over time correlated with the loss of grey matter in multiple brain regions. We conclude that fully automated MRI

Worldsheet scattering in AdS3/CFT2

NASA Astrophysics Data System (ADS)

Sundin, Per; Wulff, Linus

2013-07-01

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

Fear recognition impairment in early-stage Alzheimer's disease: when focusing on the eyes region improves performance.

PubMed

Hot, Pascal; Klein-Koerkamp, Yanica; Borg, Céline; Richard-Mornas, Aurélie; Zsoldos, Isabella; Paignon Adeline, Adeline; Thomas Antérion, Catherine; Baciu, Monica

2013-06-01

A decline in the ability to identify fearful expression has been frequently reported in patients with Alzheimer's disease (AD). In patients with severe destruction of the bilateral amygdala, similar difficulties have been reduced by using an explicit visual exploration strategy focusing on gaze. The current study assessed the possibility of applying a similar strategy in AD patients to improve fear recognition. It also assessed the possibility of improving fear recognition when a visual exploration strategy induced AD patients to process the eyes region. Seventeen patients with mild AD and 34 healthy subjects (17 young adults and 17 older adults) performed a classical task of emotional identification of faces expressing happiness, anger, and fear in two conditions: The face appeared progressively from the eyes region to the periphery (eyes region condition) or it appeared as a whole (global condition). Specific impairment in identifying a fearful expression was shown in AD patients compared with older adult controls during the global condition. Fear expression recognition was significantly improved in AD patients during the eyes region condition, in which they performed similarly to older adult controls. Our results suggest that using a different strategy of face exploration, starting first with processing of the eyes region, may compensate for a fear recognition deficit in AD patients. Findings suggest that a part of this deficit could be related to visuo-perceptual impairments. Additionally, these findings suggest that the decline of fearful face recognition reported in both normal aging and in AD may result from impairment of non-amygdalar processing in both groups and impairment of amygdalar-dependent processing in AD. Copyright © 2013 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-06-01

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

Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data.

PubMed

Smith, Mark W; Owens, Pamela L; Andrews, Roxanne M; Steiner, Claudia A; Coffey, Rosanna M; Skinner, Halcyon G; Miyamura, Jill; Popescu, Ioana

2016-04-18

Rural/urban variations in admissions for heart failure may be influenced by severity at hospital presentation and local practice patterns. Laboratory data reflect clinical severity and guide hospital admission decisions and treatment for heart failure, a costly chronic illness and a leading cause of hospitalization among the elderly. Our main objective was to examine the role of laboratory test results in measuring disease severity at the time of admission for inpatients who reside in rural and urban areas. We retrospectively analyzed discharge data on 13,998 hospital discharges for heart failure from three states, Hawai'i, Minnesota, and Virginia. Hospital discharge records from 2008 to 2012 were derived from the State Inpatient Databases of the Healthcare Cost and Utilization Project, and were merged with results of laboratory tests performed on the admission day or up to two days before admission. Regression models evaluated the relationship between clinical severity at admission and patient urban/rural residence. Models were estimated with and without use of laboratory data. Patients residing in rural areas were more likely to have missing laboratory data on admission and less likely to have abnormal or severely abnormal tests. Rural patients were also less likely to be admitted with high levels of severity as measured by the All Patient Refined Diagnosis Related Groups (APR-DRG) severity subclass, derivable from discharge data. Adding laboratory data to discharge data improved model fit. Also, in models without laboratory data, the association between urban compared to rural residence and APR-DRG severity subclass was significant for major and extreme levels of severity (OR 1.22, 95% CI 1.03-1.43 and 1.55, 95% CI 1.26-1.92, respectively). After adding laboratory data, this association became non-significant for major severity and was attenuated for extreme severity (OR 1.12, 95% CI 0.94-1.32 and 1.43, 95% CI 1.15-1.78, respectively). Heart failure patients

Cognitive outcomes after sertaline treatment in patients with depression of Alzheimer disease.

PubMed

Munro, Cynthia A; Longmire, Crystal Flynn; Drye, Lea T; Martin, Barbara K; Frangakis, Constantine E; Meinert, Curtis L; Mintzer, Jacobo E; Porsteinsson, Anton P; Rabins, Peter V; Rosenberg, Paul B; Schneider, Lon S; Weintraub, Daniel; Lyketsos, Constantine G

2012-12-01

Although many depressed patients with Alzheimer disease (AD) are treated with antidepressants, the effect of such treatment on cognitive performance in these patients is not known. The authors report cognitive outcomes in patients with depression of AD (dAD) after a 24-week trial of sertraline or placebo. Placebo-controlled, randomized, double-blind trial. Outpatient memory clinics at five academic medical centers in the United States. A total of 131 patients with dAD (60 men) and Mini-Mental State Examination scores of 10-26. Sertraline (n = 67), target dose of 100 mg daily or matching placebo (n = 64). Caregivers received standardized psychosocial intervention throughout the trial. Mini-Mental State Examination, cognitive subscale of the Alzheimer's Disease Assessment Scale, letter fluency, backward digit span, Symbol Digit Modalities Test, and Finger Tapping Test, administered at baseline, and 8, 16, and 24 weeks following baseline. A series of linear models indicated no effect of treatment or of depression remission on cognitive test performance at 24 weeks. Regardless of treatment condition, very little change in cognitive test performance was noted in general. Treatment with sertraline in patients with dAD is not associated with greater improvement in cognition at week 24 than treatment with placebo.

Verbal fluency in bilingual Spanish/English Alzheimer's disease patients.

PubMed

Salvatierra, Judy; Rosselli, Monica; Acevedo, Amarilis; Duara, Ranjan

2007-01-01

Studies have demonstrated that in verbal fluency tests, monolinguals with Alzheimer's disease (AD) show greater difficulties retrieving words based on semantic rather than phonemic rules. The present study aimed to determine whether this difficulty was reproduced in both languages of Spanish/English bilinguals with mild to moderate AD whose primary language was Spanish. Performance on semantic and phonemic verbal fluency of 11 bilingual AD patients was compared to the performance of 11 cognitively normal, elderly bilingual individuals matched for gender, age, level of education, and degree of bilingualism. Cognitively normal subjects retrieved significantly more items under the semantic condition compared to the phonemic, whereas the performance of AD patients was similar under both conditions, suggesting greater decline in semantic verbal fluency tests. This pattern was produced in both languages, implying a related semantic decline in both languages. Results from this study should be considered preliminary because of the small sample size.

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…

Spinning AdS loop diagrams: two point functions

NASA Astrophysics Data System (ADS)

Giombi, Simone; Sleight, Charlotte; Taronna, Massimo

2018-06-01

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

Holography in Lovelock Chern-Simons AdS gravity

NASA Astrophysics Data System (ADS)

Cvetković, Branislav; Miskovic, Olivera; Simić, Dejan

2017-08-01

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

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

PubMed

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

2018-03-21

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

Gauge boson exchange in AdS d+1

NASA Astrophysics Data System (ADS)

D'Hoker, Eric; Freedman, Daniel Z.

1999-04-01

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

Ipilimumab in metastatic melanoma patients with pre-existing autoimmune disorders.

PubMed

Kähler, Katharina C; Eigentler, Thomas K; Gesierich, Anja; Heinzerling, Lucie; Loquai, Carmen; Meier, Friedegund; Meiss, Frank; Pföhler, Claudia; Schlaak, Max; Terheyden, Patrick; Thoms, Kai M; Ziemer, Mirjana; Zimmer, Lisa; Gutzmer, Ralf

2018-05-01

Ipilimumab and programmed death (PD) 1-antibodies are effective treatment options in metastatic melanoma. The safety and efficacy of ipilimumab in patients with pre-existing autoimmune disorders (AD) has only been evaluated in a selected number of patients. We performed a retrospective analysis in 14 German skin cancer centers for patients with metastatic melanoma and pre-existing AD treated with ipilimumab. 41 patients with 44 pre-existing AD were treated with ipilimumab (thyroiditis n = 15, rheumatoid n = 11, dermatologic n = 10, Crohn's disease/ulcerative colitis n = 3, neurological n = 2, sarcoidosis n = 2, pancreatitis n = 1). 3 out of 41 patients had two AD, 11 patients required immunosuppressants at the time of induction of ipilimumab. 12 patients (29.2%) experienced a flare of their pre-existing AD, mainly patients with rheumatoid or dermatologic diseases. Additional immune-related adverse events (irAEs) occurred in 12 patients (29.2%). In 23 patients (56%) neither a change of their AD nor additional irAEs were observed. Objective responses were seen in five patients (one complete remission, four partial remissions, 12.1%). This is the largest series of patients with pre-existing AD and treatment with ipilimumab reported. Flares of pre-existing AD were observed but manageable. Response rates and occurrence of new irAEs were comparable to previous trials. Thus, in this patient subgroup, ipilimumab can be a treatment option after a thorough discussion of pros and cons and taking severity and activity of the preexisting AD into account.

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

PubMed

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

2018-04-04

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

Suspected non-AD pathology in Mild Cognitive Impairment

PubMed Central

Wisse, Laura E.M.; Butala, Nirali; Das, Sandhitsu R.; Davatzikos, Christos; Dickerson, Bradford C.; Vaishnavi, Sanjeev N.; Yushkevich, Paul A.; Wolk, David A.

2015-01-01

We aim to better characterize Mild Cognitive Impairment (MCI) patients with suspected non-Alzheimer’s Disease (AD) pathology (SNAP) based on their longitudinal outcome, cognition, biofluid and neuroimaging profile. MCI participants (n=361) from ADNI-GO/2 were designated ‘amyloid positive’ with abnormal Aβ42 levels (AMY+) and ‘neurodegeneration positive’ (NEU+) with abnormal hippocampal volume or hypometabolism using FDG-PET. SNAP was compared with the other MCI groups and with AMY− controls. AMY−NEU+/SNAP, 16.6%, were older than the NEU− groups, but not AMY− controls. They had a lower conversion rate to AD after 24 months than AMY+NEU+ MCI participants. SNAP MCI participants had similar Aβ42 levels, florbetapir and tau levels, but larger white matter hyperintensity volumes than AMY− controls and AMY−NEU− MCI participants. SNAP participants performed worse on all memory domains and on other cognitive domains, than AMY−NEU− participants, but less so than AMY+NEU+ participants. Subthreshold levels of cerebral amyloidosis are unlikely to play a role in SNAP MCI, but pathologies involving the hippocampus and cerebrovascular disease may underlie the neurodegeneration and cognitive impairment in this group. PMID:26422359

Suspected non-AD pathology in mild cognitive impairment.

PubMed

Wisse, Laura E M; Butala, Nirali; Das, Sandhitsu R; Davatzikos, Christos; Dickerson, Bradford C; Vaishnavi, Sanjeev N; Yushkevich, Paul A; Wolk, David A

2015-12-01

We aim to better characterize mild cognitive impairment (MCI) patients with suspected non-Alzheimer's disease (AD) pathology (SNAP) based on their longitudinal outcome, cognition, biofluid, and neuroimaging profile. MCI participants (n = 361) from ADNI-GO/2 were designated "amyloid positive" with abnormal amyloid-beta 42 levels (AMY+) and "neurodegeneration positive" (NEU+) with abnormal hippocampal volume or hypometabolism using fluorodeoxyglucose-positron emission tomography. SNAP was compared with the other MCI groups and with AMY- controls. AMY-NEU+/SNAP, 16.6%, were older than the NEU- groups but not AMY- controls. They had a lower conversion rate to AD after 24 months than AMY+NEU+ MCI participants. SNAP-MCI participants had similar amyloid-beta 42 levels, florbetapir and tau levels, but larger white matter hyperintensity volumes than AMY- controls and AMY-NEU- MCI participants. SNAP participants performed worse on all memory domains and on other cognitive domains, than AMY-NEU- participants but less so than AMY+NEU+ participants. Subthreshold levels of cerebral amyloidosis are unlikely to play a role in SNAP-MCI, but pathologies involving the hippocampus and cerebrovascular disease may underlie the neurodegeneration and cognitive impairment in this group. Copyright © 2015 Elsevier Inc. All rights reserved.

Receiver-Based Ad Hoc On Demand Multipath Routing Protocol for Mobile Ad Hoc Networks.

PubMed

Al-Nahari, Abdulaziz; Mohamad, Mohd Murtadha

2016-01-01

Decreasing the route rediscovery time process in reactive routing protocols is challenging in mobile ad hoc networks. Links between nodes are continuously established and broken because of the characteristics of the network. Finding multiple routes to increase the reliability is also important but requires a fast update, especially in high traffic load and high mobility where paths can be broken as well. The sender node keeps re-establishing path discovery to find new paths, which makes for long time delay. In this paper we propose an improved multipath routing protocol, called Receiver-based ad hoc on demand multipath routing protocol (RB-AOMDV), which takes advantage of the reliability of the state of the art ad hoc on demand multipath distance vector (AOMDV) protocol with less re-established discovery time. The receiver node assumes the role of discovering paths when finding data packets that have not been received after a period of time. Simulation results show the delay and delivery ratio performances are improved compared with AOMDV.

Typicality Mediates Performance during Category Verification in Both Ad-Hoc and Well-Defined Categories

ERIC Educational Resources Information Center

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…

Arousal-state modulation in children with AD/HD.

PubMed

Benikos, Nicholas; Johnstone, Stuart J

2009-01-01

To investigate the effect of arousal-state modulation, via manipulation of stimulus event-rate, on response inhibition in children with Attention-Deficit/Hyperactivity disorder (AD/HD) using behavioural and ERP measures. Eighteen children with AD/HD, aged 7-14years, and 18 age-and sex-matched controls performed a cued visual Go/Nogo task (70% Go) with stimuli presented at fast, medium and slow event-rates. Task performance and ERPs to Warning, Go and Nogo stimuli, as well as preparation between the S1-S2 interval, were examined for group differences. AD/HD subjects displayed poorer response inhibition during the fast condition, accompanied by a reduced Nogo P3. Group differences during the fast rate extended to Warning cues, with the AD/HD group showing ERP evidence of atypical orienting/preparation, as indexed by the early and late CNV, and early sensory/attentive processing prior to S2. Although deficient response inhibition has been proposed as the core deficit in AD/HD, the results of the present study highlight the key role of energetic factors. Furthermore, group differences found to cues suggest that this effect extends to the processing of task-irrelevant stimuli. This was the first ERP Go/Nogo task investigation using three event-rates, and the results support the theory that state factors may contribute to response inhibition deficits in AD/HD.

A meta-analysis of inhibitory-control deficits in patients diagnosed with Alzheimer's dementia.

PubMed

Kaiser, Anna; Kuhlmann, Beatrice G; Bosnjak, Michael

2018-05-10

The authors conducted meta-analyses to determine the magnitude of performance impairments in patients diagnosed with Alzheimer's dementia (AD) compared with healthy aging (HA) controls on eight tasks commonly used to measure inhibitory control. Response time (RT) and error rates from a total of 64 studies were analyzed with random-effects models (overall effects) and mixed-effects models (moderator analyses). Large differences between AD patients and HA controls emerged in the basic inhibition conditions of many of the tasks with AD patients often performing slower, overall d = 1.17, 95% CI [0.88-1.45], and making more errors, d = 0.83 [0.63-1.03]. However, comparably large differences were also present in performance on many of the baseline control-conditions, d = 1.01 [0.83-1.19] for RTs and d = 0.44 [0.19-0.69] for error rates. A standardized derived inhibition score (i.e., control-condition score - inhibition-condition score) suggested no significant mean group difference for RTs, d = -0.07 [-0.22-0.08], and only a small difference for errors, d = 0.24 [-0.12-0.60]. Effects systematically varied across tasks and with AD severity. Although the error rate results suggest a specific deterioration of inhibitory-control abilities in AD, further processes beyond inhibitory control (e.g., a general reduction in processing speed and other, task-specific attentional processes) appear to contribute to AD patients' performance deficits observed on a variety of inhibitory-control tasks. Nonetheless, the inhibition conditions of many of these tasks well discriminate between AD patients and HA controls. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Adding video recording increases the diagnostic yield of routine electroencephalograms in children with frequent paroxysmal events.

PubMed

Watemberg, Nathan; Tziperman, Barak; Dabby, Ron; Hasan, Mariana; Zehavi, Liora; Lerman-Sagie, Tally

2005-05-01

To report on the usefulness of adding video recording to routine EEG studies of infants and children with frequent paroxysmal events. We analyzed the efficacy of this diagnostic means during a 4-year period. The decision whether to add video recording was made by the pediatric EEG interpreter at the time of the study. Studies were planned to last between 20 and 30 min, and, if needed, were extended by the EEG interpreter. For most studies, video recording was added from the beginning of EEG recording. In a minority of cases, the addition of video was implemented during the first part of the EEG test, as clinical events became obvious. In these cases, a new study (file) was begun. The success rate was analyzed according to the indications for the EEG study: paroxysmal eye movements, tremor, suspected seizures, myoclonus, staring episodes, suspected stereotypias and tics, absence epilepsy follow-up, cyanotic episodes, and suspected psychogenic nonepileptic events. Video recording was added to 137 of 666 routine studies. Mean patient age was 4.8 years. The nature of the event was determined in 61 (45%) of the EEG studies. Twenty-eight percent were hospitalized patients. The average study duration was 26 min. This diagnostic means was particularly useful for paroxysmal eye movements, staring spells, myoclonic jerks, stereotypias, and psychogenic nonepileptic events. About 46% of 116 patients for whom cognitive data were available were mentally retarded. EEG with added video recording was successfully performed in all 116 cases and provided useful information in 29 (55%) of these 53 patients. Adding video recording to routine EEG was helpful in 45% of cases referred for frequent paroxysmal events. This technique proved useful for hospitalized children as well as for outpatients. Moreover, it was successfully applied in cognitively impaired patients. Infants and children with paroxysmal eye movements, staring spells, myoclonic jerks, stereotypias, and pseudoseizures

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-01-01

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

Flotation performances and surface properties of chalcopyrite with xanthate collector added before and after grinding

NASA Astrophysics Data System (ADS)

Peng, Huiqing; Wu, Di; Abdelmonem, Mohamed

In this study, effects of the collector added before grinding and after grinding on the subsequent flotation and mineral surface properties were investigated. The pH was controlled at 10 during the grinding and flotation processes opened to the atmosphere. With enough amounts of sodium butyl xanthate addition, adding the collector before grinding recovered more chalcopyrite than adding it after grinding in single mineral flotation. The Eh of each ground pulp before and after conditioning were measured and it was found that adding collector before grinding obtained higher and relatively suitable pulp potential for chalcopyrite flotation. Particle size analyses of the flotation products indicate that the different flotation recoveries occurred due to the different flotation losses in fine particles (<20 μm). XPS analyses focused on the fine particles of flotation feedings and found that more carbon and oxygen, and less iron were remained on mineral surfaces when the collector was added before grinding, due to the higher collector adsorption capacity, larger free oxygen adsorbance and less iron oxide/hydroxide species.

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

NASA Astrophysics Data System (ADS)

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

2017-07-01

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

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

PubMed

Toumi, Mondher; Rémuzat, Cécile

2017-01-01

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

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

PubMed Central

Toumi, Mondher; Rémuzat, Cécile

2017-01-01

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

Effect of a multimodal exercise program on sleep disturbances and instrumental activities of daily living performance on Parkinson's and Alzheimer's disease patients.

PubMed

Nascimento, Carla Manuela Crispim; Ayan, Carlos; Cancela, Jose Maria; Gobbi, Lilian Teresa Bucken; Gobbi, Sebastião; Stella, Florindo

2014-04-01

To assess the contribution of a multimodal exercise program on the sleep disturbances (SD) and on the performance of instrumental activities daily living (IADL) in patients with clinical diagnosis of Alzheimer's disease (AD) and Parkinson's disease patients (PD). A total of 42 consecutive patients (23 training group, 19 control group) with PD and 35 demented patients with AD (19 trained group, 16 control group) were recruited. Participants in both training groups carried out three 1-h sessions per week of a multimodal exercise program for 6 months. The Pfeffer Questionnaire for Instrumental Activities and the Mini-Sleep Questionnaire were used to assess the effects of the program on IADL and SD respectively. Two-way ancova showed interactions in IADL and SD. Significant improvements were observed for these variables in both intervention groups, and maintenance or worsening was observed in control groups. The analysis of effect size showed these improvements. The present study results show that a mild to moderate intensity of multimodal physical exercises carried out on a regular basis over 6 months can contribute to reducing IADL deficits and attenuating SD. © 2013 Japan Geriatrics Society.

Vacuum degeneracy and Conformal Mass in Lovelock AdS gravity

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

Writing Impairments in Japanese Patients with Mild Cognitive Impairment and with Mild Alzheimer's Disease.

PubMed

Hayashi, Atsuko; Nomura, Hiroshi; Mochizuki, Ruriko; Ohnuma, Ayumu; Kimpara, Teiko; Suzuki, Kyoko; Mori, Etsuro

2015-01-01

We investigated writing abilities in patients with the amnestic type of mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD). To examine the earliest changes in writing function, we used writing tests for both words and sentences with different types of Japanese characters (Hiragana, Katakana, and Kanji). A total of 25 aMCI patients, 38 AD patients, and 22 healthy controls performed writing to dictation for Kana and Kanji words, copied Kanji words, and wrote in response to a picture story task. Analysis of variance was used to test the subject group effects on the scores in the above writing tasks. For the written Kanji words, the mild AD group performed worse than the aMCI group and the controls, but there was no difference between the aMCI group and the controls. For the picture story writing task, the mild AD and aMCI groups performed worse than the controls, but the difference between the AD and the aMCI groups was not significant. The mild AD group showed defects in writing Kanji characters, and the aMCI group showed impairments in narrative writing. Our study suggests that narrative writing, which demands complex integration of multiple cognitive functions, can be used to detect the subtle writing deficits in aMCI patients.

Effects of adding liquid DL-methionine hydroxy analogue-free acid to drinking water on growth performance and small intestinal morphology of nursery pigs.

PubMed

Kaewtapee, C; Krutthai, N; Poosuwan, K; Poeikhampha, T; Koonawootrittriron, S; Bunchasak, C

2010-06-01

This study was conducted to evaluate the effect of adding liquid DL-methionine hydroxy analogue free acid (LMA) to drinking water on growth performance, small intestinal morphology and volatile fatty acids in the caecum of nursery pigs. Twenty-four crossbred pigs (Large White x Landrace, BW approximately 18 kg) were divided into three groups with four replications of two piglets each. The piglets received drinking water without (control), with 0.05 or 0.10% LMA. The results indicated that adding LMA at 0.10% to drinking water significantly increased their weight gain, average daily feed intake (p < 0.05) and tended to improve the feed conversion ratio. Adding LMA to drinking water significantly increased their water intake and significantly reduced the pH of drinking water (p < 0.01), thus total plate count (p < 0.01) and Escherichia coli in drinking water was reduced (p < 0.05), while the total number of bacteria in the caecum was not significantly affected. Liquid DL-methionine hydroxy analogue free acid supplementation in drinking water tended to decrease pH in the stomach, duodenum, jejunum, colon and rectum. Furthermore, adding LMA at 0.10% significantly increased villous height in the duodenum, jejunum and ileum (p < 0.05), and the villous height:crypt depth ratio in the jejunum and ileum (p < 0.01) was higher, whereas acetic acid concentration in the caecum was significantly lower than in the control group. It could be concluded that adding LMA to drinking water improved growth performance of the nursery pigs because of high water quality and high nutrient utilization caused by an improvement of small intestinal morphology (not from nutritional effect of methionine source).

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

PubMed Central

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

2012-01-01

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

Patient warming excess heat: the effects on orthopedic operating room ventilation performance.

PubMed

Belani, Kumar G; Albrecht, Mark; McGovern, Paul D; Reed, Mike; Nachtsheim, Christopher

2013-08-01

Patient warming has become a standard of care for the prevention of unintentional hypothermia based on benefits established in general surgery. However, these benefits may not fully translate to contamination-sensitive surgery (i.e., implants), because patient warming devices release excess heat that may disrupt the intended ceiling-to-floor ventilation airflows and expose the surgical site to added contamination. Therefore, we studied the effects of 2 popular patient warming technologies, forced air and conductive fabric, versus control conditions on ventilation performance in an orthopedic operating room with a mannequin draped for total knee replacement. Ventilation performance was assessed by releasing neutrally buoyant detergent bubbles ("bubbles") into the nonsterile region under the head-side of the anesthesia drape. We then tracked whether the excess heat from upper body patient warming mobilized the "bubbles" into the surgical site. Formally, a randomized replicated design assessed the effect of device (forced air, conductive fabric, control) and anesthesia drape height (low-drape, high-drape) on the number of bubbles photographed over the surgical site. The direct mass-flow exhaust from forced air warming generated hot air convection currents that mobilized bubbles over the anesthesia drape and into the surgical site, resulting in a significant increase in bubble counts for the factor of patient warming device (P < 0.001). Forced air had an average count of 132.5 versus 0.48 for conductive fabric (P = 0.003) and 0.01 for control conditions (P = 0.008) across both drape heights. Differences in average bubble counts across both drape heights were insignificant between conductive fabric and control conditions (P = 0.87). The factor of drape height had no significant effect (P = 0.94) on bubble counts. Excess heat from forced air warming resulted in the disruption of ventilation airflows over the surgical site, whereas conductive patient warming devices had

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

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

2009-09-01

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. A total of 768 patients (18-77 years; HbA(1c) screening >or= 7.5 to performed using ANCOVA and last-observation-carried-forward methodology. 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 HbA(1c) (-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 HbA(1c) < 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%). 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.

Tailored donor-acceptor polymers with an A-D1-A-D2 structure: controlling intermolecular interactions to enable enhanced polymer photovoltaic devices.

PubMed

Qin, Tianshi; Zajaczkowski, Wojciech; Pisula, Wojciech; Baumgarten, Martin; Chen, Ming; Gao, Mei; Wilson, Gerry; Easton, Christopher D; Müllen, Klaus; Watkins, Scott E

2014-04-23

Extensive efforts have been made to develop novel conjugated polymers that give improved performance in organic photovoltaic devices. The use of polymers based on alternating electron-donating and electron-accepting units not only allows the frontier molecular orbitals to be tuned to maximize the open-circuit voltage of the devices but also controls the optical band gap to increase the number of photons absorbed and thus modifies the other critical device parameter-the short circuit current. In fact, varying the nonchromophoric components of a polymer is often secondary to the efforts to adjust the intermolecular aggregates and improve the charge-carrier mobility. Here, we introduce an approach to polymer synthesis that facilitates simultaneous control over both the structural and electronic properties of the polymers. Through the use of a tailored multicomponent acceptor-donor-acceptor (A-D-A) intermediate, polymers with the unique structure A-D1-A-D2 can be prepared. This approach enables variations in the donor fragment substituents such that control over both the polymer regiochemistry and solubility is possible. This control results in improved intermolecular π-stacking interactions and therefore enhanced charge-carrier mobility. Solar cells using the A-D1-A-D2 structural polymer show short-circuit current densities that are twice that of the simple, random analogue while still maintaining an identical open-circuit voltage. The key finding of this work is that polymers with an A-D1-A-D2 structure offer significant performance benefits over both regioregular and random A-D polymers. The chemical synthesis approach that enables the preparation of A-D1-A-D2 polymers therefore represents a promising new route to materials for high-efficiency organic photovoltaic devices.

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

PubMed Central

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

2014-01-01

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

Art as an Evolutionary Adaptation: Inspiration from the Visible Supernovae of AD 1054 and AD 3054

NASA Astrophysics Data System (ADS)

Corbally, C. J.; Rappaport, M. B.

2016-01-01

The authors, an astronomer/priest and an anthropologist/biologist, describe their use of the dramatic arts at the INSAP VIII meeting in their performance of two short skits on the sighting of a supernova in AD 1054 (creating the beautiful Crab Nebula) and a future “Rho Cas” stellar explosion in the constellation Cassiopeia, in AD 3054. They speculate on the emergence of science, religion, and art as bona fide adaptations, responding to natural selection, which served early hominins well in their struggle for existence. They draw parallels to the continued functions of science, religion, and art in modern society.

Neutronics performance and activation calculation of dense tungsten granular target for China-ADS

NASA Astrophysics Data System (ADS)

Zhang, Yaling; Li, Jianyang; Zhang, Xunchao; Cai, Hanjie; Yan, Xuesong; Yu, Lin; Fu, Fen; Lin, Ping; Gao, Xiaofei; Zhang, Zhilei; Zhang, Yanshi; Yang, Lei

2017-11-01

Spallation target, which constitutes the physical and functional interface between the high power accelerator and the subcritical core, is one of the most important components in Accelerator Driven Subcritical System (ADS). In this paper, we investigated the neutronics performance, the radiation damage and the activation of dense tungsten granular flow spallation target by using the Monte Carlo programs GMT and FLUKA at the proton energy of 250 MeV with a beam current of 10 mA . First, the leaking neutron yield, leaking neutron energy spectrum and laterally leaking neutron distribution at several time nodes and with different target parameters are explored. After that, the displacement per atom (DPA) and the helium/hydrogen production for tungsten grains and structural materials with stainless steel 316L are estimated. Finally, the radioactivity, residual dose rate and afterheat of granular target are presented. Results indicate that granule diameter below 1 cm and the beam profile diameter have negligible impact on neutronics performance, while the target diameter and volume fraction of grain have notable influence. The maximum DPA for target vessel (beam tube) is about 1.0 (1.6) DPA/year in bare target, and increased to 2.6 (2.8) DPA/year in fission environment. Average DPA for tungsten grains is relatively low. The decline rate of radioactivity and afterheat with cooling time grows with the decrease of the irradiation time.

Diffusion and chaos from near AdS 2 horizons

DOE PAGES

Blake, Mike; Donos, Aristomenis

2017-02-03

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

AdS6 solutions of type II supergravity

NASA Astrophysics Data System (ADS)

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

2014-11-01

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

Receiver-Based Ad Hoc On Demand Multipath Routing Protocol for Mobile Ad Hoc Networks

PubMed Central

Al-Nahari, Abdulaziz; Mohamad, Mohd Murtadha

2016-01-01

Decreasing the route rediscovery time process in reactive routing protocols is challenging in mobile ad hoc networks. Links between nodes are continuously established and broken because of the characteristics of the network. Finding multiple routes to increase the reliability is also important but requires a fast update, especially in high traffic load and high mobility where paths can be broken as well. The sender node keeps re-establishing path discovery to find new paths, which makes for long time delay. In this paper we propose an improved multipath routing protocol, called Receiver-based ad hoc on demand multipath routing protocol (RB-AOMDV), which takes advantage of the reliability of the state of the art ad hoc on demand multipath distance vector (AOMDV) protocol with less re-established discovery time. The receiver node assumes the role of discovering paths when finding data packets that have not been received after a period of time. Simulation results show the delay and delivery ratio performances are improved compared with AOMDV. PMID:27258013

Geometry and supersymmetry of heterotic warped flux AdS backgrounds

NASA Astrophysics Data System (ADS)

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

2015-07-01

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

Brimonidine 0.2% vs unoprostone 0.15% both added to timolol maleate 0.5% given twice daily to patients with primary open-angle glaucoma or ocular hypertension.

PubMed

Sharpe, E D; Henry, C J; Mundorf, T K; Day, D G; Stewart, J A; Jenkins, J N; Stewart, W C

2005-01-01

To compare the efficacy and safety of brimonidine 0.2% vs unoprostone 0.15%, both added to timolol maleate 0.5% each given twice daily. In this prospective, multi-centred, double-masked, crossover comparison, patients were randomized to one treatment group for a 6-week treatment period, and then crossed over to the opposite treatment. Measurements were performed at 0800, 1000, 1600, 1800, and 2000 h at baseline and at the end of each treatment period. In all, 33 patients entered this trial and 29 completed. The baseline trough intraocular pressure (IOP) was 23.3+/-2.4 and the diurnal curve IOP was 22.0+/-1.3 mmHg. For the brimonidine and timolol maleate treatment group, the trough IOP was 21.6+/-3.3 and the diurnal curve IOP was 19.8+/-2.1 mmHg, while the timolol and unoprostone treatment showed a trough IOP of 20.9+/-3.8 and a diurnal curve IOP of 19.3+/-2.4 mmHg. There was no significant difference between treatment groups at any time point for the diurnal curve, or in the reduction from baseline (P>0.05). Both treatments failed to statistically reduce the IOP from baseline at 1800 h. There was no difference between treatment groups regarding ocular and systemic unsolicited adverse events, but patients admitted to more dryness (P=0.02) and burning upon instillation (P<0.0001) with unoprostone by survey. Brimonidine 0.2% or unoprostone 0.15% added to timolol maleate 0.5% provide similar efficacy and safety throughout the daytime diurnal curve.

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

PubMed

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

2015-01-01

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

Humor and Comparatives in Ads for High- and Low-Involvement Products.

ERIC Educational Resources Information Center

Wu, Bob T. W.; And Others

1989-01-01

Investigates the effectiveness of humor in advertising, comparative advertising, and consumer involvement with the product. Finds that humorous ads are more eye catching but less impressive and less sufficient in information than nonhumorous ads. Finds the performance of comparative ads is generally negative and especially so in the high…

[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,…

Performance Evaluation of an Automated ELISA System for Alzheimer's Disease Detection in Clinical Routine.

PubMed

Chiasserini, Davide; Biscetti, Leonardo; Farotti, Lucia; Eusebi, Paolo; Salvadori, Nicola; Lisetti, Viviana; Baschieri, Francesca; Chipi, Elena; Frattini, Giulia; Stoops, Erik; Vanderstichele, Hugo; Calabresi, Paolo; Parnetti, Lucilla

2016-07-22

The variability of Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers undermines their full-fledged introduction into routine diagnostics and clinical trials. Automation may help to increase precision and decrease operator errors, eventually improving the diagnostic performance. Here we evaluated three new CSF immunoassays, EUROIMMUNtrademark amyloid-β 1-40 (Aβ1-40), amyloid-β 1-42 (Aβ1-42), and total tau (t-tau), in combination with automated analysis of the samples. The CSF biomarkers were measured in a cohort consisting of AD patients (n = 28), mild cognitive impairment (MCI, n = 77), and neurological controls (OND, n = 35). MCI patients were evaluated yearly and cognitive functions were assessed by Mini-Mental State Examination. The patients clinically diagnosed with AD and MCI were classified according to the CSF biomarkers profile following NIA-AA criteria and the Erlangen score. Technical evaluation of the immunoassays was performed together with the calculation of their diagnostic performance. Furthermore, the results for EUROIMMUN Aβ1-42 and t-tau were compared to standard immunoassay methods (INNOTESTtrademark). EUROIMMUN assays for Aβ1-42 and t-tau correlated with INNOTEST (r = 0.83, p < 0.001 for both) and allowed a similar interpretation of the CSF profiles. The Aβ1-42/Aβ1-40 ratio measured with EUROIMMUN was the best parameter for AD detection and improved the diagnostic accuracy of Aβ1-42 (area under the curve = 0.93). In MCI patients, the Aβ1-42/Aβ1-40 ratio was associated with cognitive decline and clinical progression to AD.The diagnostic performance of the EUROIMMUN assays with automation is comparable to other currently used methods. The variability of the method and the value of the Aβ1-42/Aβ1-40 ratio in AD diagnosis need to be validated in large multi-center studies.

75 FR 37712 - Automatic Dependent Surveillance-Broadcast (ADS-B) Out Performance Requirements To Support Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

...-29305; Amdt. No. 91-316] RIN 2120-AI92 Automatic Dependent Surveillance--Broadcast (ADS-B) Out... Dependent Surveillance--Broadcast (ADS-B) Out avionics on aircraft operating in Classes A, B, and C airspace... technical questions concerning this final rule, contact Vincent Capezzuto, Surveillance and Broadcast...

Adding glucose to food and solutions to enhance fructose absorption is not effective in preventing fructose-induced functional gastrointestinal symptoms: randomised controlled trials in patients with fructose malabsorption.

PubMed

Tuck, C J; Ross, L A; Gibson, P R; Barrett, J S; Muir, J G

2017-02-01

In healthy individuals, the absorption of fructose in excess of glucose in solution is enhanced by the addition of glucose. The present study aimed to assess the effects of glucose addition to fructose or fructans on absorption patterns and genesis of gastrointestinal symptoms in patients with functional bowel disorders. Randomised, blinded, cross-over studies were performed in healthy subjects and functional bowel disorder patients with fructose malabsorption. The area-under-the-curve (AUC) was determined for breath hydrogen and symptom responses to: (i) six sugar solutions (fructose in solution) (glucose; sucrose; fructose; fructose + glucose; fructan; fructan + glucose) and (ii) whole foods (fructose in foods) containing fructose in excess of glucose given with and without additional glucose. Intake of fermentable short chain carbohydrates (FODMAPs; fermentable, oligo-, di-, monosaccharides and polyols) was controlled. For the fructose in solution study, in 26 patients with functional bowel disorders, breath hydrogen was reduced after glucose was added to fructose compared to fructose alone [mean (SD) AUC 92 (107) versus 859 (980) ppm 4 h -1 , respectively; P = 0.034). Glucose had no effect on breath hydrogen response to fructans (P = 1.000). The six healthy controls showed breath hydrogen patterns similar to those with functional bowel disorders. No differences in symptoms were experienced with the addition of glucose, except more nausea when glucose was added to fructose (P = 0.049). In the fructose in foods study, glucose addition to whole foods containing fructose in excess of glucose in nine patients with functional bowel disorders and nine healthy controls had no significant effect on breath hydrogen production or symptom response. The absence of a favourable response on symptoms does not support the concomitant intake of glucose with foods high in either fructose or fructans in patients with functional bowel disorders. © 2016 The British Dietetic

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

NASA Astrophysics Data System (ADS)

Myung, Yun Soo; Moon, Taeyoon

2014-04-01

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

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

PubMed Central

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

2013-01-01

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

Using Google AdWords for international multilingual recruitment to health research websites.

PubMed

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

2014-01-20

Google AdWords, the placement of sponsored links in Google search results, is a potent method of recruitment to Internet-based health studies and interventions. However, the performance of Google AdWords varies considerably depending on the language and the location of the target audience. Our goal was to describe differences in AdWords performance when recruiting participants to the same study conducted in four languages and to determine whether AdWords campaigns can be optimized in order to increase recruitment while decreasing costs. Google AdWords were used to recruit participants to the Mood Screener, a multilingual online depression screening tool available in English, Russian, Spanish, and Chinese. Two distinct recruitment periods are described: (1) "Unmanaged", a 6-month period in which ads were allowed to run using only the AdWords tool itself, with no human intervention, and (2) "Managed", a separate 7-week period during which we systematically sought to optimize our recruitment campaigns. During 6 months of unmanaged recruitment, our ads were shown over 1.3 million times, resulting in over 60,000 site visits. The average click-through rate (ratio of ads clicked to ads displayed) varied from 1.86% for Chinese ads to 8.48% for Russian ads, as did the average cost-per-click (from US $0.20 for Chinese ads to US $0.50 for English ads). Although Chinese speakers' click-through rate was lowest, their rate of consenting to participate was the highest, at 3.62%, with English speakers exhibiting the lowest consent rate (0.97%). The conversion cost (cost to recruit a consenting participant) varied from US $10.80 for Russian speakers to US $51.88 for English speakers. During the 7 weeks of "managed" recruitment, we attempted to improve AdWords' performance in regards to the consent rate and cost by systematically deleting underperforming ads and adjusting keywords. We were able to increase the number of people who consent after coming to the site by 91.8% while also

Using Google AdWords for International Multilingual Recruitment to Health Research Websites

PubMed Central

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

2014-01-01

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

Alzheimer's disease and memory-monitoring impairment: Alzheimer's patients show a monitoring deficit that is greater than their accuracy deficit.

PubMed

Dodson, Chad S; Spaniol, Maggie; O'Connor, Maureen K; Deason, Rebecca G; Ally, Brandon A; Budson, Andrew E

2011-07-01

We assessed the ability of two groups of patients with mild Alzheimer's disease (AD) and two groups of older adults to monitor the likely accuracy of recognition judgments and source identification judgments about who spoke something earlier. Alzheimer's patients showed worse performance on both memory judgments and were less able to monitor with confidence ratings the likely accuracy of both kinds of memory judgments, as compared to a group of older adults who experienced the identical study and test conditions. Critically, however, when memory performance was made comparable between the AD patients and the older adults (e.g., by giving AD patients extra exposures to the study materials), AD patients were still greatly impaired at monitoring the likely accuracy of their recognition and source judgments. This result indicates that the monitoring impairment in AD patients is actually worse than their memory impairment, as otherwise there would have been no differences between the two groups in monitoring performance when there were no differences in accuracy. We discuss the brain correlates of this memory-monitoring deficit and also propose a Remembrance-Evaluation model of memory-monitoring. Copyright © 2011 Elsevier Ltd. All rights reserved.

Collapse and Nonlinear Instability of AdS Space with Angular Momentum

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

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

Rule induction performance in amnestic mild cognitive impairment and Alzheimer's dementia: examining the role of simple and biconditional rule learning processes.

PubMed

Oosterman, Joukje M; Heringa, Sophie M; Kessels, Roy P C; Biessels, Geert Jan; Koek, Huiberdina L; Maes, Joseph H R; van den Berg, Esther

2017-04-01

Rule induction tests such as the Wisconsin Card Sorting Test require executive control processes, but also the learning and memorization of simple stimulus-response rules. In this study, we examined the contribution of diminished learning and memorization of simple rules to complex rule induction test performance in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's dementia (AD). Twenty-six aMCI patients, 39 AD patients, and 32 control participants were included. A task was used in which the memory load and the complexity of the rules were independently manipulated. This task consisted of three conditions: a simple two-rule learning condition (Condition 1), a simple four-rule learning condition (inducing an increase in memory load, Condition 2), and a complex biconditional four-rule learning condition-inducing an increase in complexity and, hence, executive control load (Condition 3). Performance of AD patients declined disproportionately when the number of simple rules that had to be memorized increased (from Condition 1 to 2). An additional increment in complexity (from Condition 2 to 3) did not, however, disproportionately affect performance of the patients. Performance of the aMCI patients did not differ from that of the control participants. In the patient group, correlation analysis showed that memory performance correlated with Condition 1 performance, whereas executive task performance correlated with Condition 2 performance. These results indicate that the reduced learning and memorization of underlying task rules explains a significant part of the diminished complex rule induction performance commonly reported in AD, although results from the correlation analysis suggest involvement of executive control functions as well. Taken together, these findings suggest that care is needed when interpreting rule induction task performance in terms of executive function deficits in these patients.

The effect of adding a background infusion to patient-controlled epidural labor analgesia on labor, maternal, and neonatal outcomes: a systematic review and meta-analysis.

PubMed

Heesen, Michael; Böhmer, Johannes; Klöhr, Sven; Hofmann, Thomas; Rossaint, Rolf; Straube, Sebastian

2015-07-01

Patient-controlled epidural analgesia (PCEA) has gained popularity, but it is still unclear whether adding a background infusion confers any benefit. A systematic literature search in PubMed, Embase, CINAHL, LILACS, CENTRAL, Clinicaltrials.gov, and ISI WOS was performed to identify randomized controlled double-blind trials that compare PCEA-only with PCEA combined with a continuous infusion (PCEA + CI) in parturients. The data were subjected to meta-analyses using the random-effects model. Our primary outcome was the incidence of instrumental vaginal delivery. Secondary outcomes were incidences of spontaneous vaginal and cesarean deliveries, duration of labor, analgesic outcomes, maternal outcomes (visual analog scale scores for pain, maternal satisfaction, nausea, pruritus, hypotension), and neonatal outcomes (Apgar score, umbilical artery pH). We identified 7 trials with a low risk of bias, reporting on 891 parturients, for inclusion in our systematic review. The risk of instrumental vaginal delivery was increased in the PCEA + CI group, risk ratio (RR) 1.66 (95% confidence interval 1.08-2.56, P = 0.02; I = 0%); the RR for cesarean delivery was 0.83 (95% confidence interval 0.61-1.13, I = 0%). The second stage of labor was prolonged (weighted mean difference 12.3 minutes, 95% confidence interval 5.1-19.5 minutes, P = 0.0008; I = 0%) in the PCEA + CI group. Fewer patients in the PCEA + CI group required physician-administered boluses (RR 0.35 [95% confidence interval 0.25-0.47, P < 0.00001; I = 0%]). No differences regarding maternal adverse events (nausea, pruritus, hypotension) or neonatal outcomes (Apgar scores <7, umbilical artery pH) were observed. On the basis of current evidence, no conclusion can be drawn regarding the risks or benefits of adding a continuous background infusion to PCEA compared with PCEA-only epidural labor analgesia. Further high-quality studies involving a sufficient number of patients are required.

Writing Impairments in Japanese Patients with Mild Cognitive Impairment and with Mild Alzheimer's Disease

PubMed Central

Hayashi, Atsuko; Nomura, Hiroshi; Mochizuki, Ruriko; Ohnuma, Ayumu; Kimpara, Teiko; Suzuki, Kyoko; Mori, Etsuro

2015-01-01

Background/Aims We investigated writing abilities in patients with the amnestic type of mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD). To examine the earliest changes in writing function, we used writing tests for both words and sentences with different types of Japanese characters (Hiragana, Katakana, and Kanji). Methods A total of 25 aMCI patients, 38 AD patients, and 22 healthy controls performed writing to dictation for Kana and Kanji words, copied Kanji words, and wrote in response to a picture story task. Analysis of variance was used to test the subject group effects on the scores in the above writing tasks. Results For the written Kanji words, the mild AD group performed worse than the aMCI group and the controls, but there was no difference between the aMCI group and the controls. For the picture story writing task, the mild AD and aMCI groups performed worse than the controls, but the difference between the AD and the aMCI groups was not significant. Conclusions The mild AD group showed defects in writing Kanji characters, and the aMCI group showed impairments in narrative writing. Our study suggests that narrative writing, which demands complex integration of multiple cognitive functions, can be used to detect the subtle writing deficits in aMCI patients. PMID:26483830

On information loss in AdS 3/CFT 2

DOE PAGES

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

2016-05-18

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

Depth of word processing in Alzheimer patients and normal controls: a magnetoencephalographic (MEG) study.

PubMed

Walla, P; Püregger, E; Lehrner, J; Mayer, D; Deecke, L; Dal Bianco, P

2005-05-01

Effects related to depth of verbal information processing were investigated in probable Alzheimer's disease patients (AD) and age matched controls. During word encoding sessions 10 patients and 10 controls had either to decide whether the letter "s" appeared in visually presented words (alphabetical decision, shallow encoding), or whether the meaning of each presented word was animate or inanimate (lexical decision, deep encoding). These encoding sessions were followed by test sessions during which all previously encoded words were presented again together with the same number of new words. The task was then to discriminate between repeated and new words. Magnetic field changes related to brain activity were recorded with a whole cortex MEG.5 probable AD patients showed recognition performances above chance level related to both depths of information processing. Those patients and 5 age matched controls were then further analysed. Recognition performance was poorer in probable AD patients compared to controls for both levels of processing. However, in both groups deep encoding led to a higher recognition performance than shallow encoding. We therefore conclude that the performance reduction in the patient group was independent of depth of processing. Reaction times related to false alarms differed between patients and controls after deep encoding which perhaps could already be used for supporting an early diagnosis. The analysis of the physiological data revealed significant differences between correctly recognised repetitions and correctly classified new words (old/new-effect) in the control group which were missing in the patient group after deep encoding. The lack of such an effect in the patient group is interpreted as being due to the respective neuropathology related to probable AD. The present results demonstrate that magnetic field recordings represent a useful tool to physiologically distinguish between probable AD and age matched controls.

Semiclassical Virasoro blocks from AdS 3 gravity

DOE PAGES

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

2015-12-14

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

EXACT S-MATRICES FOR AdS3/CFT2

NASA Astrophysics Data System (ADS)

Ahn, Changrim; Bombardelli, Diego

2013-12-01

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

Minimal surfaces in AdS space and integrable systems

NASA Astrophysics Data System (ADS)

Burrington, Benjamin A.; Gao, Peng

2010-04-01

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

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

PubMed

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

2012-01-01

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

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

PubMed

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

2011-03-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

The diagnostic performance and added value of (18)F-FDG PET/CT in the detection of liver metastases in recurrent colorectal carcinoma patients.

PubMed

Odalovic, Strahinja; Artiko, Vera; Sobic-Saranovic, Dragana; Stojiljkovic, Milica; Petrovic, Milorad; Petrovic, Nebojsa; Kozarevic, Nebojsa; Grozdic-Milojevic, Isidora; Obradovic, Vladimir

2015-01-01

The aim of this study was to assess the value of (18)F-fluorodeoxyglucose ((18)F-FDG) PET/CT in detection of liver metastases in patients with suspected recurrent colorectal carcinoma, as well as to compare diagnostic performance of (18)F-FDG PET/CT with conventional imaging methods (MDCT). This study included 73 patients with resected primary colorectal adenocarcinoma referred for (18)F-FDG PET/CT to the National PET Center, at the Clinical Center of Serbia, Belgrade, from January 2010 to May 2013, with suspicion of recurrence. The patients underwent (18)F-FDG PET/CT examination on a 64-slice hybrid PET/CT scanner (Biograph, TruePoint64, Siemens Medical Solutions, Inc. USA). Prior to (18)F-FDG PET/CT all patients underwent contrast-enhanced MDCT. Findings of (18)F-FDG PET/CT and MDCT were compared to findings of subsequent histopathological examinations or with results of clinical and imaging follow-up over at least six months. Final diagnosis of liver metastases of colorectal cancer was made either by histopathological examination of specimen after biopsy or surgery, or based on clinical, laboratory and imaging evaluation during first six months after PET/CT scan. In detection of liver metastases (18)F-FDG PET/CT showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 83.3%, 95.3%, 92.6%, 89.1% and 90.4%, respectively. In addition, MDCT showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy in detection of liver metastases of 60%, 88.4%, 78.3%, 76% and 76.7%, respectively. There was significant difference in sensitivity (83.3% vs 60%; P=0.045) between these two methods. In addition, significant difference was observed in accuracy between PET/CT and MDCT (90.4% vs 76.7%; P=0.016). The higher specificity in visualization of liver metastases was also achieved by (18)F-FDG PET/CT compared to MDCT (95.3% vs 88.4%), but this difference was not significant (P=0.37). (18)F-FDG PET

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…

String in AdS black hole: A thermo field dynamic approach

NASA Astrophysics Data System (ADS)

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

2012-10-01

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

Tweaking one-loop determinants in AdS3

NASA Astrophysics Data System (ADS)

Castro, Alejandra; Keeler, Cynthia; Szepietowski, Phillip

2017-10-01

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

Distinct neuroanatomical bases of episodic and semantic memory performance in Alzheimer's disease.

PubMed

Hirni, Daniela I; Kivisaari, Sasa L; Monsch, Andreas U; Taylor, Kirsten I

2013-04-01

Alzheimer's disease (AD) neurofibrillary pathology begins in the medial perirhinal cortex (mPRC) before spreading to the entorhinal cortex (ERC) and hippocampus (HP) in anterior medial temporal lobe (aMTL). While the role of the ERC/HP complex in episodic memory formation is well-established, recent research suggests that the PRC is required to form semantic memories of individual objects. We aimed to test whether commonly used clinical measures of episodic and semantic memory are distinctly associated with ERC/HP and mPRC integrity, respectively, in healthy mature individuals and very early AD patients. One hundred thirty normal controls, 32 amnestic mild cognitive impairment patients, some of whom are in the earliest (i.e., preclinical) stages of AD, and ten early-stage AD patients received neuropsychological testing and high-resolution anatomic and diffusion MRI. Voxel-based regression analyses tested for regions where episodic memory (delayed recall scores on the California Verbal Learning and Rey Osterrieth Complex Figure Tests) and semantic memory (Boston Naming Test, category fluency) performance correlated with gray matter (GM) regions of interest and whole-brain fractional anisotropy (FA) voxel values. When controlling for the opposing memory performance, poorer episodic memory performance was associated with reduced bilateral ERC/HP GM volume and related white matter integrity, but not with mPRC GM volume. Poor semantic memory performance was associated with both reduced left mPRC and ERC/HP GM volume, as well as reduced FA values in white matter tracts leading to the PRC. These results indicate a partial division of labor within the aMTL and suggest that mPRC damage in very early AD may be detectable with common clinical tests of semantic memory if episodic memory performance is controlled. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

NASA Astrophysics Data System (ADS)

Metsaev, R. R.

2018-05-01

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

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

PubMed

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

2013-01-01

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

[Performance and personality of patients with hypersomnia].

PubMed

Mayer, G; Leonhardt, E

1996-01-01

5 groups of patients with hypersomnia (narcolepsy, posttraumatic, psychophysiologic, idiopathic hypersomnia and circadian sleep-wake disorders) were tested with a battery of psychometric tests (FPI, MMPI, BVND, BIV, Benton, d2, WIP), visual vigilance test, polysomnography and MSLT in order to investigate the context between personality and performance. MSLT showed a range from clear pathologic to borderline sleep latencies among all groups, only patients with posttraumatic hypersomnia and narcolepsy displayed sleep onset REM. Correct results of vigilance tests correlated negatively with performance-motivation and orientation in patients with narcolepsy and posttraumatic hypersomnia, whereas there was positive correlation for patients with idiopathic hypersomnia. In patients with psychophysiologic hypersomnia performance orientation and false reactions correlate negatively. Patients with posttraumatic hypersomnia have better results on d2. Benton and vigilance tests than all other groups. Results of personality diagnosis are similar to those of healthy subjects, while patients with psychophysiologic hypersomnia are more sensible than all other groups with high social fears and the highest disposition among all groups toward somatic complaints. Patients with idiopathic hypersomnia show strong introversion and inhibition. Patients with circadian sleep-wake disorders display the most striking personality disorders, which are most probably sequelae of their strong disease-dependent impairment. The degree of personality disorder seems to be strongly dependent on the duration of the hypersomnias. The assessment of the whole set of tests can only be recommended for patients with psychophysiologic hypersomnia and circadian sleep-wake disorders, a few tests suffice to describe the other groups.

Managing patient deterioration: assessing teamwork and individual performance.

PubMed

Cooper, Simon; Cant, Robyn; Porter, Jo; Missen, Karen; Sparkes, Louise; McConnell-Henry, Tracy; Endacott, Ruth

2013-05-01

To assess the ability of rural Australian nurse teams to manage deteriorating patients. This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Knowledge in relation to patient deterioration management varied (mean 63%, range 27-100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17-83%, SD 14.03) with significantly higher levels in younger participants (r=-0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.

Comparison of effectiveness of Transcutaneous Electrical Nerve Stimulation and Kinesio Taping added to exercises in patients with myofascial pain syndrome.

PubMed

Azatcam, Gokmen; Atalay, Nilgun Simsir; Akkaya, Nuray; Sahin, Fusun; Aksoy, Sibel; Zincir, Ozge; Topuz, Oya

2017-01-01

Although there are several studies of Transcutaneous Electrical Nerve Stimulation (TENS) and exercise in myofascial pain syndrome, there are no studies comparing the effectiveness of Kinesio Taping (KT) and TENS in myofascial pain syndrome patients. To compare the early and late effects of TENS and KT on pain, disability and range of motion in myofascial pain syndrome patients. Sixty-nine patients were divided into three groups randomly as TENS+Exercise, KT+Exercise and exercise groups. Visual Analogue Scale (VAS), pain threshold, Neck Disability Index and cervical contralateral lateral flexion were employed in the evaluation of the patients performed before treatment, after treatment and 3rd month after treatment. The VAS, pain threshold, Neck Disability Index and contralateral lateral flexion values were improved in all groups both in after treatment and 3rd month after treatment (p< 0.01). In the comparison of after treatment vs. before treatment evaluations, VAS score was decreased in KT group compared to the TENS and control group (p= 0.001), in the TENS group compared to control group (p= 0.011). In the comparison of 3rd month and before treatment evaluations, VAS score was decreased in the TENS group compared to control group (p= 0.001) and in the KT group compared to the control group (p= 0.001). There was no significant difference between TENS and KT groups. All other parameters did not differ between the groups. TENS and KT added exercises can decrease pain severity and increase pain threshold, function and cervical range of motion in myofascial pain syndrome patients. Addition of TENS or KT to the exercise therapy resulted in more significant improvement compared to exercise therapy alone with a more pronounced improvement in KT group compared to the TENS group in the early period. Because KT was found to be more effective in decreasing the pain and had the advantage of being used in every 3 days, it seems to be beneficial in acute painful periods in

The effects of cognitive rehabilitation on Alzheimer's dementia patients' cognitive assessment reference diagnosis system performance based on level of cognitive functioning.

PubMed

Hwang, Jung-Ha; Cha, Hyun-Gyu; Cho, Hyuk-Shin

2015-09-01

[Purpose] The purpose of this study is to apply cognitive rehabilitation according to Alzheimer's disease (AD) patients' level of cognitive functioning to compare changes in Cognitive Assessment Reference Diagnosis System performance and present standards for effective intervention. [Subjects] Subjects were 30 inpatients diagnosed with AD. Subjects were grouped by Clinical Dementia Rating (CDR) class (CDR-0.5, CDR-1, or CDR-2, n = 10 per group), which is based on level of cognitive functioning, and cognitive rehabilitation was applied for 50 minutes per day, five days per week, for four weeks. [Methods] After cognitive rehabilitation intervention, CARDS tests were conducted to evaluate memory. [Results] Bonferroni tests comparing the three groups revealed that the CDR-0.5 and CDR-1 groups showed significant increases in Delayed 10 word-list, Delayed 10 object-list, Recognition 10 object, and Recent memory performance compared to the CDR-2 group. In addition, the CDR-0.5 group showed significant decreases in Recognition 10 word performance compared to the CDR-1 group. [Conclusion] Cognitive rehabilitation, CDR-0.5 or CDR-1 subjects showed significantly greater memory improvements than CDR-2 subjects. Moreover, was not effective for CDR-2 subjects.

Exogenous Variables and Value-Added Assessments: A Fatal Flaw

ERIC Educational Resources Information Center

Berliner, David C.

2014-01-01

Background: There has been rapid growth in value-added assessment of teachers to meet the widely supported policy goal of identifying the most effective and the most ineffective teachers in a school system. The former group is to be rewarded while the latter group is to be helped or fired for their poor performance. But, value-added approaches to…

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

PubMed

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

2015-03-01

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

Abnormal degree centrality in Alzheimer's disease patients with depression: A resting-state functional magnetic resonance imaging study.

PubMed

Guo, Zhongwei; Liu, Xiaozheng; Hou, Hongtao; Wei, Fuquan; Liu, Jian; Chen, Xingli

2016-06-15

Depression is common in Alzheimer's disease (AD) and occurs in AD patients with a prevalence of up to 40%. It reduces cognitive function and increases the burden on caregivers. Currently, there are very few medications that are useful for treating depression in AD patients. Therefore, understanding the brain abnormalities in AD patients with depression (D-AD) is crucial for developing effective interventions. The aim of this study was to investigate the intrinsic dysconnectivity pattern of whole-brain functional networks at the voxel level in D-AD patients based on degree centrality (DC) as measured by resting-state functional magnetic resonance imaging (R-fMRI). Our study included 32 AD patients. All patients were evaluated using the Neuropsychiatric Inventory and Hamilton Depression Rating Scale and further divided into two groups: 15 D-AD patients and 17 non-depressed AD (nD-AD) patients. R-fMRI datasets were acquired from these D-AD and nD-AD patients. First, we performed a DC analysis to identify voxels that showed altered whole brain functional connectivity (FC) with other voxels. We then further investigated FC using the abnormal DC regions to examine in more detail the connectivity patterns of the identified DC changes. D-AD patients had lower DC values in the right middle frontal, precentral, and postcentral gyrus than nD-AD patients. Seed-based analysis revealed decreased connectivity between the precentral and postcentral gyrus to the supplementary motor area and middle cingulum. FC also decreased in the right middle frontal, precentral, and postcentral gyrus. Thus, AD patients with depression fit a 'network dysfunction model' distinct from major depressive disorder and AD. Copyright © 2016. Published by Elsevier Inc.

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

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

The CERAD Neuropsychological Battery in Patients with Frontotemporal Lobar Degeneration

PubMed Central

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

2015-01-01

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

Humidification performance of humidifying devices for tracheostomized patients with spontaneous breathing: a bench study.

PubMed

Chikata, Yusuke; Oto, Jun; Onodera, Mutsuo; Nishimura, Masaji

2013-09-01

Heat and moisture exchangers (HMEs) are commonly used for humidifying respiratory gases administered to mechanically ventilated patients. While they are also applied to tracheostomized patients with spontaneous breathing, their performance in this role has not yet been clarified. We carried out a bench study to investigate the effects of spontaneous breathing parameters and oxygen flow on the humidification performance of 11 HMEs. We evaluated the humidification provided by 11 HMEs for tracheostomized patients, and also by a system delivering high-flow CPAP, and an oxygen mask with nebulizer heater. Spontaneous breathing was simulated with a mechanical ventilator, lung model, and servo-controlled heated humidifier at tidal volumes of 300, 500, and 700 mL, and breathing frequencies of 10 and 20 breaths/min. Expired gas was warmed to 37°C. The high-flow CPAP system was set to deliver 15, 30, and 45 L/min. With the 8 HMEs that were equipped with ports to deliver oxygen, and with the high-flow CPAP system, measurements were taken when delivering 0 and 3 L/min of dry oxygen. After stabilization we measured the absolute humidity (AH) of inspired gas with a hygrometer. AH differed among HMEs applied to tracheostomized patients with spontaneous breathing. For all the HMEs, as tidal volume increased, AH decreased. At 20 breaths/min, AH was higher than at 10 breaths/min. For all the HMEs, when oxygen was delivered, AH decreased to below 30 mg/L. With an oxygen mask and high-flow CPAP, at all settings, AH exceeded 30 mg/L. None of the HMEs provided adequate humidification when supplemental oxygen was added. In the ICU, caution is required when applying HME to tracheostomized patients with spontaneous breathing, especially when supplemental oxygen is required.

Stability of warped AdS3 vacua of topologically massive gravity

NASA Astrophysics Data System (ADS)

Anninos, Dionysios; Esole, Mboyo; Guica, Monica

2009-10-01

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

Managing hospital quality performance in two related areas: patient care and customer service.

PubMed

Dwore, R B

1993-01-01

The Joint Commission on Accreditation of Healthcare Organization's new emphasis on continuous quality improvement provides hospitals with an opportunity to enhance both customer service as well as patient care. Both are expected by patients and delivered by providers. Patient care is the core product; customer service augments it by adding value and providing the opportunity for a competitive advantage. This article discusses issues for administrators to consider before including customer service as a component of continuous quality improvement and then presents methods for bringing about change.

Can Value-Added Measures of Teacher Performance Be Trusted? Working Paper #18

ERIC Educational Resources Information Center

Guarino, Cassandra M.; Reckase, Mark D.; Woolridge, Jeffrey M.

2012-01-01

We investigate whether commonly used value-added estimation strategies can produce accurate estimates of teacher effects. We estimate teacher effects in simulated student achievement data sets that mimic plausible types of student grouping and teacher assignment scenarios. No one method accurately captures true teacher effects in all scenarios,…

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

Improving lithium-ion battery performances by adding fly ash from coal combustion on cathode film

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

Dyartanti, Endah Retno; Jumari, Arif, E-mail: arifjumari@yahoo.com; Nur, Adrian

A lithium battery is composed of anode, cathode and a separator. The performance of lithium battery is also influenced by the conductive material of cathode film. In this research, the use of fly ash from coal combustion as conductive enhancer for increasing the performances of lithium battery was investigated. Lithium iron phosphate (LiFePO{sub 4}) was used as the active material of cathode. The dry fly ash passed through 200 mesh screen, LiFePO{sub 4} and acethylene black (AB), polyvinylidene fluoride (PVDF) as a binder and N-methyl-2-pyrrolidone (NMP) as a solvent were mixed to form slurry. The slurry was then coated, driedmore » and hot pressed to obtain the cathode film. The ratio of fly ash and AB were varied at the values of 1%, 2%, 3%, 4% and 5% while the other components were at constant. The anode film was casted with certain thickness and composition. The performance of battery lithium was examined by Eight Channel Battery Analyzer, the composition of the cathode film was examined by XRD (X-Ray Diffraction), and the structure and morphology of the anode film was analyzed by SEM (Scanning Electron Microscope). The composition, structure and morphology of cathode film was only different when fly ash added was 4% of AB or more. The addition of 2% of AB on cathode film gave the best performance of 81.712 mAh/g on charging and 79.412 mAh/g on discharging.« less

Recognition of familiar people with a mobile cloud architecture for Alzheimer patients.

PubMed

Fardoun, Habib M; Mashat, Abdullah A; Ramirez Castillo, Jaime

2017-02-01

This article aims to the evaluation of a prototypal assistive technology for Alzheimer's disease (AD) patients that helps them to remember personal details of familiar people they meet in their daily lives. An architecture is proposed for a personal information system powered by face recognition, where the main AD patient's interaction is performed in a smart watch device and the face recognition is carried out on the Cloud. A prototype was developed to perform some tests in a real-life scenario. The prototype showed correct results as a personal information system based on face recognition. However, usability flaws were identified in the interaction with the smart watch. Our architecture showed correct performance and we realized that it could be introduced in other fields, apart from assistive technology. However, when being targeted to patients with dementia some usability problems appeared, such as difficulties to read information in a small screen or take a proper photo. These problems should be addressed in further research. Implications for Rehabilitation This article presents a prototypal assistive technology for Alzheimer's disease (AD) patients. It targets AD patients to recognize their familiars, especially in medium-advanced stages of the disease. Analysing pictures taken by a smart watch, which the patient carries, the person in front is recognized and information about him is sent to the watch. This technology enables patients to have all the information of any close person, as a remainder, easing their daily lives, improving their self-esteem and stimulating the patient with novel technology.

Prediction of new-onset atrial fibrillation after first-ever ischemic stroke: A comparison of CHADS2, CHA2DS2-VASc and HATCH scores and the added value of stroke severity.

PubMed

Hsieh, Cheng-Yang; Lee, Cheng-Han; Wu, Darren Philbert; Sung, Sheng-Feng

2018-05-01

Early detection of atrial fibrillation after stroke is important for secondary prevention in stroke patients without known atrial fibrillation (AF). We aimed to compare the performance of CHADS 2 , CHA 2 DS 2 -VASc and HATCH scores in predicting AF detected after stroke (AFDAS) and to test whether adding stroke severity to the risk scores improves predictive performance. Adult patients with first ischemic stroke event but without a prior history of AF were retrieved from a nationwide population-based database. We compared C-statistics of CHADS 2 , CHA 2 DS 2 -VASc and HATCH scores for predicting the occurrence of AFDAS during stroke admission (cohort I) and during follow-up after hospital discharge (cohort II). The added value of stroke severity to prediction models was evaluated using C-statistics, net reclassification improvement, and integrated discrimination improvement. Cohort I comprised 13,878 patients and cohort II comprised 12,567 patients. Among them, 806 (5.8%) and 657 (5.2%) were diagnosed with AF, respectively. The CHADS 2 score had the lowest C-statistics (0.558 in cohort I and 0.597 in cohort II), whereas the CHA 2 DS 2 -VASc score had comparable C-statistics (0.603 and 0.644) to the HATCH score (0.612 and 0.653) in predicting AFDAS. Adding stroke severity to each of the three risk scores significantly increased the model performance. In stroke patients without known AF, all three risk scores predicted AFDAS during admission and follow-up, but with suboptimal discrimination. Adding stroke severity improved their predictive abilities. These risk scores, when combined with stroke severity, may help prioritize patients for continuous cardiac monitoring in daily practice. Copyright © 2018 Elsevier B.V. All rights reserved.

Should we systematically test patients with clinically isolated syndrome for auto-antibodies?

PubMed

Negrotto, Laura; Tur, Carmen; Tintoré, Mar; Arrambide, Georgina; Sastre-Garriga, Jaume; Río, Jordi; Comabella, Manuel; Nos, Carlos; Galán, Ingrid; Vidal-Jordana, Angela; Simon, Eva; Castilló, Joaquín; Palavra, Filipe; Mitjana, Raquel; Auger, Cristina; Rovira, Àlex; Montalban, Xavier

2015-12-01

Several autoimmune diseases (ADs) can mimic multiple sclerosis (MS). For this reason, testing for auto-antibodies (auto-Abs) is often included in the diagnostic work-up of patients with a clinically isolated syndrome (CIS). The purpose was to study how useful it was to systematically determine antinuclear-antibodies, anti-SSA and anti-SSB in a non-selected cohort of CIS patients, regarding the identification of other ADs that could represent an alternative diagnosis. From a prospective CIS cohort, we selected 772 patients in which auto-Ab levels were tested within the first year from CIS. Baseline characteristics of auto-Ab positive and negative patients were compared. A retrospective revision of clinical records was then performed in the auto-Ab positive patients to identify those who developed ADs during follow-up. One or more auto-Ab were present in 29.4% of patients. Only 1.8% of patients developed other ADs during a mean follow-up of 6.6 years. In none of these cases the concurrent AD was considered the cause of the CIS. In all cases the diagnosis of the AD resulted from the development of signs and/or symptoms suggestive of each disease. Antinuclear-antibodies, anti-SSA and anti-SSB should not be routinely determined in CIS patients but only in those presenting symptoms suggestive of other ADs. © The Author(s), 2015.

The impact of reinforcement contingencies on AD/HD: a review and theoretical appraisal.

PubMed

Luman, Marjolein; Oosterlaan, Jaap; Sergeant, Joseph A

2005-02-01

One of the core deficits in attention deficit/hyperactivity disorder (AD/HD) is thought to be an aberrant sensitivity to reinforcement, such as reward and response cost. Twenty-two studies (N=1181 children) employing AD/HD and reinforcement contingencies are reviewed from vantage points: task performance, motivation, and psychophysiology. Results indicate that reinforcement contingencies have a positive impact on task performance and levels of motivation for both children with AD/HD and normal controls. There is evidence that the effect related to task performance is somewhat more prominent in AD/HD. There is some evidence that a high intensity of reinforcement is highly effective in AD/HD. Children with AD/HD prefer immediate over delayed reward. From a psychophysiological point of view, children with AD/HD seem less sensitive to reinforcement compared to controls. While comorbid disorders are suggested to be confounders of the dependent variables, many studies do not examine the effect of oppositional defiant disorder (ODD) and conduct disorder (CD). We discuss the implications of the findings for five theoretical frameworks, including the model by, the cognitive-energetic model (CEM), the dual-pathway model and the BIS/BAS model. Results show a discrepancy between the theoretical models and the behavioural findings.

Rewarding healthy behaviors--pay patients for performance.

PubMed

Wu, Joanne

2012-01-01

Despite a considerable investment of resources into pay for performance, preliminary studies have found that it may not be significantly more effective in improving health outcome measures when compared with voluntary quality improvement programs. Because patient behaviors ultimately affect health outcomes, I would propose a novel pay-for-performance program that rewards patients directly for achieving evidence-based health goals. These rewards would be in the form of discounts towards co-payments for doctor's visits, procedures, and medications, thereby potentially reducing cost and compliance issues. A pilot study recruiting patients with diabetes or hypertension, diseases with clear and objective outcome measures, would be useful to examine true costs, savings, and health outcomes of such a reward program. Offering incentives to patients for reaching health goals has the potential to foster a stronger partnership between doctors and patients and improve health outcomes.

[Working memory for music in patients with mild cognitive impairment and early stage Alzheimer's disease].

PubMed

Kerer, Manuela; Marksteiner, Josef; Hinterhuber, Hartmann; Mazzola, Guerino; Kemmler, Georg; Bliem, Harald R; Weiss, Elisabeth M

2013-01-01

A variety of studies demonstrated that some forms of memory for music are spared in dementia, but only few studies have investigated patients with early stages of dementia. In this pilot-study we tested working memory for music in patients with mild cognitive impairment (MCI) and early stage Alzheimer's disease (AD) with a newly created test. The test probed working memory using 7 gradually elongated tone-lines and 6 chords which were each followed by 3 similar items and 1 identical item. The participants of the study, namely 10 patients with MCI, 10 patients with early stage AD and 23 healthy subjects were instructed to select the identical tone-line or chord. Subjects with MCI and early AD showed significantly reduced performance than controls in most of the presented tasks. In recognizing chords MCI- participants surprisingly showed an unimpaired performance. The gradual increase of the impairment during the preclinical phase of AD seems to spare this special ability in MCI.

Cognitive and affective theory of mind abilities in alcohol-dependent patients: the role of autobiographical memory.

PubMed

Nandrino, Jean-Louis; Gandolphe, Marie-Charlotte; Alexandre, Charlotte; Kmiecik, Elodie; Yguel, Jacques; Urso, Laurent

2014-10-01

Many studies of patients with alcohol dependence (AD) have highlighted their difficulty in identifying both their own emotional state and those of a social partner. We examined (1) the cognitive and affective theory of mind (ToM) abilities of AD patients and (2) how the efficiency of their autobiographical memory (AM) can affect the effectiveness of ToM ability. In a cross-sectional design, AD patients (N=50) and healthy controls (N=30) completed a ToM movie paradigm (Versailles-Situational Intention Reading, V-SIR) in which they inferred the intentions of characters in movies depicting social interactions, and the "Reading the Mind in the Eyes" Test (RMET), which assessed the emotional dimension of the ToM. AM was investigated using the "Autobiographical Memory Interview" (AMI) to assess both episodic and semantic components of AM. Concerning ToM, patients with AD showed lower performance in the RMET than control participants, whereas no difference was observed on the V-SIR test. AD patients had lower scores than controls on the AMI, for both episodic and semantic components and for different periods of life. A multiple linear regression analysis also showed that AM deficits might predict lower ToM performance, especially for the RMET task. Patients with AD have a specific affective ToM deficit. They used episodic memories to perceive the emotions of others, whereas controls used preferentially semantic memories to perform the task. Both these deficits could constitute a risk of relapse and should be a target for psychotherapeutic interventions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Amyloid negativity in patients with clinically diagnosed Alzheimer disease and MCI.

PubMed

Landau, Susan M; Horng, Andy; Fero, Allison; Jagust, William J

2016-04-12

To examine the clinical and biomarker characteristics of patients with amyloid-negative Alzheimer disease (AD) and mild cognitive impairment (MCI) from the Alzheimer's Disease Neuroimaging Initiative (ADNI), a prospective cohort study. We first investigated the reliability of florbetapir- PET in patients with AD and patients with MCI using CSF-Aβ1-42 as a comparison amyloid measurement. We then compared florbetapir- vs florbetapir+ patients with respect to several AD-specific biomarkers, baseline and longitudinal cognitive measurements, and demographic and clinician report data. Florbetapir and CSF-Aβ1-42 +/- status agreed for 98% of ADs (89% of MCIs), indicating that most florbetapir- scans were a reliable representation of amyloid status. Florbetapir- AD (n = 27/177; 15%) and MCI (n = 74/217, 34%) were more likely to be APOE4-negative (MCI 83%, AD 96%) than their florbetapir+ counterparts (MCI 30%, AD 24%). Florbetapir- patients also had less AD-specific hypometabolism, lower CSF p-tau and t-tau, and better longitudinal cognitive performance, and were more likely to be taking medication for depression. In MCI only, florbetapir- participants had less hippocampal atrophy and hypometabolism and lower functional activity questionnaire scores compared to florbetapir+ participants. Overall, image analysis problems do not appear to be a primary explanation of amyloid negativity. Florbetapir- ADNI patients have a variety of clinical and biomarker features that differ from their florbetapir+ counterparts, suggesting that one or more non-AD etiologies (which may include vascular disease and depression) account for their AD-like phenotype. © 2016 American Academy of Neurology.

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

PubMed

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

2013-01-01

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

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

PubMed Central

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

2013-01-01

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

Added Value of Physical Performance Measures in Predicting Adverse Health-Related Events: Results from the Health, Aging, and Body Composition Study

PubMed Central

Cesari, Matteo; Kritchevsky, Stephen B; Newman, Anne B; Simonsick, Eleanor M; Harris, Tamara B; Penninx, Brenda W; Brach, Jennifer S; Tylavsky, Frances A; Satterfield, Suzanne; Bauer, Doug C; Rubin, Susan M; Visser, Marjolein; Pahor, Marco

2009-01-01

Objectives To determine how three different physical performance measures (PPM) combine for added utility in predicting adverse health events in elders. Design Prospective cohort study. Setting Health, Aging, and Body Composition Study. Participants 3,024 well-functioning older persons (mean age 73.6 years). Measurements Timed gait, repeated chair stands and balance (semi- and full-tandem, and single leg stands each held for 30 seconds) tests were administered at baseline. Usual gait speed was categorized to distinguish high and low risk participants using the previously established 1 m/sec cut-point. The same population-percentile (21.3%) was used to identify cut-points for repeated chair stands (17.05 sec) and balance (53 sec) tests. Cox proportional hazard analyses were performed to evaluate the added value of PPM in predicting mortality, hospitalization, and (severe) mobility limitation events over 6.9 years of follow-up. Results Risk estimates for developing adverse health-related events were similarly large for each of the three high risk groups considered separately. A greater number of PPM scores at the high risk level was associated with a greater risk of developing adverse health-related events. When all three PPMs were considered, having only one poor performance was sufficient to indicate a highly significant higher risk of (severe) lower extremity and mortality events. Conclusion Although gait speed is considered the most important predictor of adverse health events, these findings demonstrate that poor performance on other tests of lower extremity function are equally prognostic. This suggests that chair stand and standing balance performance may be adequate substitutes when gait speed is unavailable. PMID:19207142

Infrared realization of dS2 in AdS2

NASA Astrophysics Data System (ADS)

Anninos, Dionysios; Hofman, Diego M.

2018-04-01

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

QCD Condensates and Holographic Wilson Loops for Asymptotically AdS Spaces

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

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

2014-02-01

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

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

PubMed

Herdeiro, Carlos A R; Radu, Eugen

2016-11-25

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

SKread predicts handwriting performance in patients with low vision.

PubMed

Downes, Ken; Walker, Laura L; Fletcher, Donald C

2015-06-01

To assess whether performance on the Smith-Kettlewell Reading (SKread) test is a reliable predictor of handwriting performance in patients with low vision. Cross-sectional study. Sixty-six patients at their initial low-vision rehabilitation evaluation. The patients completed all components of a routine low-vision appointment including logMAR acuity, performed the SKread test, and performed a handwriting task. Patients were timed while performing each task and their accuracy was recorded. The handwriting task was performed by having patients write 5 5-letter words into sets of boxes where each letter is separated by a box. The boxes were 15 × 15 mm, and accuracy was scored with 50 points possible from 25 letters: 1 point for each letter within the confines of a box and 1 point if the letter was legible. Correlation analysis was then performed. Median age of participants was 84 (range 54-97) years. Fifty-seven patients (86%) had age-related macular degeneration or some other maculopathy, whereas 9 patients (14%) had visual impairment from media opacity or neurologic impairment. Median Early Treatment Diabetic Retinopathy Study acuity was 20/133 (range 20/22 to 20/1000), and median logMAR acuity was 0.82 (range 0.04-1.70). SKread errors per block correlated with logMAR acuity (r = 0.6), and SKread time per block correlated with logMAR acuity (r = 0.51). SKread errors per block correlated with handwriting task time/accuracy ratio (r = 0.61). SKread time per block correlated with handwriting task time/accuracy ratio (r = 0.7). LogMAR acuity score correlated with handwriting task time/accuracy ratio (r = 0.42). All p values were < 0.01. SKread scores predict handwriting performance in patients with low vision better than logMAR acuity. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

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

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

PubMed

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

2017-01-01

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

Packets Distributing Evolutionary Algorithm Based on PSO for Ad Hoc Network

NASA Astrophysics Data System (ADS)

Xu, Xiao-Feng

2018-03-01

Wireless communication network has such features as limited bandwidth, changeful channel and dynamic topology, etc. Ad hoc network has lots of difficulties in accessing control, bandwidth distribution, resource assign and congestion control. Therefore, a wireless packets distributing Evolutionary algorithm based on PSO (DPSO)for Ad Hoc Network is proposed. Firstly, parameters impact on performance of network are analyzed and researched to obtain network performance effective function. Secondly, the improved PSO Evolutionary Algorithm is used to solve the optimization problem from local to global in the process of network packets distributing. The simulation results show that the algorithm can ensure fairness and timeliness of network transmission, as well as improve ad hoc network resource integrated utilization efficiency.

Half-BPS Wilson loop and AdS 2/CFT 1

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

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

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

Half-BPS Wilson loop and AdS 2/CFT 1

DOE PAGES

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

2017-09-01

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

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

PubMed

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

2010-01-01

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

An Evaluation of Empirical Bayes's Estimation of Value-Added Teacher Performance Measures

ERIC Educational Resources Information Center

Guarino, Cassandra M.; Maxfield, Michelle; Reckase, Mark D.; Thompson, Paul N.; Wooldridge, Jeffrey M.

2015-01-01

Empirical Bayes's (EB) estimation has become a popular procedure used to calculate teacher value added, often as a way to make imprecise estimates more reliable. In this article, we review the theory of EB estimation and use simulated and real student achievement data to study the ability of EB estimators to properly rank teachers. We compare the…

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,…

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

PubMed

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

2016-01-01

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

The use of fiber tractography for identifying patients with Alzheimer's disease

NASA Astrophysics Data System (ADS)

Dong, Kyung-Rae; Goo, Eun-Hoe; Lee, Jae-Seung; Chung, Woon-Kwan

2013-01-01

This study examined the usefulness of fiber tractography (FT) for identifying patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) through diffusion tensor imaging (DTI). DTI was performed on twelve patients with AD (four males and eight females, mean age: 78.1 ± 7.5 years) and an eleven patients with MCI (five males and six females, mean age: 69.3 ± 8.0 years) from January to December 2011 by using a 3.0T scanner. Two regions of interest were drawn on the pyramidal tract of Pons and the posterior limb of the internal capsule, which passed through both cortico spinal tracts on the color-cored fractional anisotropy (FA) map. The numbers of white matter fibers on the DTIs in the patients with AD and MCI were determined. The numbers of white matter fibers in the AD patients were 1055.67 ± 333.12 and 860.75 ± 355.50 on the left and the right, respectively. In the patients with MCI, the numbers of white matter fibers and were 1329.82 ± 238.99 and 1316.55 ± 215.25 on the left and the right, respectively. The difference between the right and the left sides in the AD patients was slightly higher than that in the MCI patients.

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

NASA Astrophysics Data System (ADS)

Rocha, Jorge V.

2008-08-01

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

Dopaminergic Modulation of Cortical Plasticity in Alzheimer's Disease Patients

PubMed Central

Koch, Giacomo; Di Lorenzo, Francesco; Bonnì, Sonia; Giacobbe, Viola; Bozzali, Marco; Caltagirone, Carlo; Martorana, Alessandro

2014-01-01

In animal models of Alzheimer's disease (AD), mechanisms of cortical plasticity such as long-term potentiation (LTP) and long-term depression (LTD) are impaired. In AD patients, LTP-like cortical plasticity is abolished, whereas LTD seems to be preserved. Dopaminergic transmission has been hypothesized as a new player in ruling mechanisms of cortical plasticity in AD. We aimed at investigating whether administration of the dopamine agonist rotigotine (RTG) could modulate cortical plasticity in AD patients, as measured by theta burst stimulation (TBS) protocols of repetitive transcranial stimulation applied over the primary motor cortex. Thirty mild AD patients were tested in three different groups before and after 4 weeks of treatment with RTG, rivastigmine (RVT), or placebo (PLC). Each patient was evaluated for plasticity induction of LTP/LTD-like effects using respectively intermittent TBS (iTBS) or continuous TBS protocols. Short-latency afferent inhibition (SAI) protocol was performed to indirectly assess central cholinergic activity. A group of age-matched healthy controls was recruited for baseline comparisons. Results showed that at baseline, AD patients were characterized by impaired LTP-like cortical plasticity, as assessed by iTBS. These reduced levels of LTP-like cortical plasticity were increased and normalized after RTG administration. No effect was induced by RVT or PLC on LTP. LTD-like cortical plasticity was not modulated in any condition. Cholinergic activity was increased by both RTG and RVT. Our findings reveal that dopamine agonists may restore the altered mechanisms of LTP-like cortical plasticity in AD patients, thus providing novel implications for therapies based on dopaminergic stimulation. PMID:24859851

Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia.

PubMed

Peters, Sanne A E; Dunford, Elizabeth; Jones, Alexandra; Ni Mhurchu, Cliona; Crino, Michelle; Taylor, Fraser; Woodward, Mark; Neal, Bruce

2017-07-05

The Health Star Rating (HSR) is an interpretive front-of-pack labelling system that rates the overall nutritional profile of packaged foods. The algorithm underpinning the HSR includes total sugar content as one of the components. This has been criticised because intrinsic sugars naturally present in dairy, fruits, and vegetables are treated the same as sugars added during food processing. We assessed whether the HSR could better discriminate between core and discretionary foods by including added sugar in the underlying algorithm. Nutrition information was extracted for 34,135 packaged foods available in The George Institute's Australian FoodSwitch database. Added sugar levels were imputed from food composition databases. Products were classified as 'core' or 'discretionary' based on the Australian Dietary Guidelines. The ability of each of the nutrients included in the HSR algorithm, as well as added sugar, to discriminate between core and discretionary foods was estimated using the area under the curve (AUC). 15,965 core and 18,350 discretionary foods were included. Of these, 8230 (52%) core foods and 15,947 (87%) discretionary foods contained added sugar. Median (Q1, Q3) HSRs were 4.0 (3.0, 4.5) for core foods and 2.0 (1.0, 3.0) for discretionary foods. Median added sugar contents (g/100 g) were 3.3 (1.5, 5.5) for core foods and 14.6 (1.8, 37.2) for discretionary foods. Of all the nutrients used in the current HSR algorithm, total sugar had the greatest individual capacity to discriminate between core and discretionary foods; AUC 0.692 (0.686; 0.697). Added sugar alone achieved an AUC of 0.777 (0.772; 0.782). A model with all nutrients in the current HSR algorithm had an AUC of 0.817 (0.812; 0.821), which increased to 0.871 (0.867; 0.874) with inclusion of added sugar. The HSR nutrients discriminate well between core and discretionary packaged foods. However, discrimination was improved when added sugar was also included. These data argue for inclusion of added

Incorporating Added Sugar Improves the Performance of the Health Star Rating Front-of-Pack Labelling System in Australia

PubMed Central

Peters, Sanne A. E.; Jones, Alexandra; Crino, Michelle; Taylor, Fraser; Woodward, Mark; Neal, Bruce

2017-01-01

Background: The Health Star Rating (HSR) is an interpretive front-of-pack labelling system that rates the overall nutritional profile of packaged foods. The algorithm underpinning the HSR includes total sugar content as one of the components. This has been criticised because intrinsic sugars naturally present in dairy, fruits, and vegetables are treated the same as sugars added during food processing. We assessed whether the HSR could better discriminate between core and discretionary foods by including added sugar in the underlying algorithm. Methods: Nutrition information was extracted for 34,135 packaged foods available in The George Institute’s Australian FoodSwitch database. Added sugar levels were imputed from food composition databases. Products were classified as ‘core’ or ‘discretionary’ based on the Australian Dietary Guidelines. The ability of each of the nutrients included in the HSR algorithm, as well as added sugar, to discriminate between core and discretionary foods was estimated using the area under the curve (AUC). Results: 15,965 core and 18,350 discretionary foods were included. Of these, 8230 (52%) core foods and 15,947 (87%) discretionary foods contained added sugar. Median (Q1, Q3) HSRs were 4.0 (3.0, 4.5) for core foods and 2.0 (1.0, 3.0) for discretionary foods. Median added sugar contents (g/100 g) were 3.3 (1.5, 5.5) for core foods and 14.6 (1.8, 37.2) for discretionary foods. Of all the nutrients used in the current HSR algorithm, total sugar had the greatest individual capacity to discriminate between core and discretionary foods; AUC 0.692 (0.686; 0.697). Added sugar alone achieved an AUC of 0.777 (0.772; 0.782). A model with all nutrients in the current HSR algorithm had an AUC of 0.817 (0.812; 0.821), which increased to 0.871 (0.867; 0.874) with inclusion of added sugar. Conclusion: The HSR nutrients discriminate well between core and discretionary packaged foods. However, discrimination was improved when added sugar was

Hairy black holes and the endpoint of AdS4 charged superradiance

NASA Astrophysics Data System (ADS)

Dias, Óscar J. C.; Masachs, Ramon

2017-02-01

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

Deodorants, value, and performance.

PubMed

Newcomer, L N

1997-11-01

For the health-care market, like the deodorant market, the message is clear: Add value or your product will not be competitive. For physicians of all specialties, the best way to add value is to measure and improve performance. Performance measurement is critical to improvement in health care. Without measurement, there can be no improvement in quality. Without improvement in quality, there is no added value. Oncologists can take at least two actions to add value for their health plans: (1) measure practice performance and demonstrate a quality improvement; and (2) become the personal-care physician for cancer patients.

Smooth causal patches for AdS black holes

NASA Astrophysics Data System (ADS)

Raju, Suvrat

2017-06-01

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

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

Beyond AdS Space-times, New Holographic Correspondences and Applications

NASA Astrophysics Data System (ADS)

Ghodrati, Mahdis

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

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

NASA Astrophysics Data System (ADS)

Klabbers, Rob; van Tongeren, Stijn J.

2017-12-01

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

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

PubMed

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

2016-12-01

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

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

PubMed

Andersen, Stig Ejdrup; Christensen, Mikkel

2016-11-01

The risk of hypoglycaemia may differ among sulphonylureas (SUs), but evidence from head-to-head comparisons is sparse. Performing a network meta-analysis to use indirect evidence from randomized controlled trials (RCTs), we compared the relative risk of hypoglycaemia with newer generation SUs when added to metformin. A systematic review identified RCTs lasting 12-52 weeks and evaluating SUs added to inadequate metformin monotherapy (≥1000 mg/day) in type 2 diabetes. Adding RCTs investigating the active comparators from the identified SU trials, we established a coherent network. Hypoglycaemia of any severity was the primary end point. Thirteen trials of SUs and 14 of oral non-SU antihyperglycaemic agents (16 260 patients) were included. All reported hypoglycaemia only as adverse events. Producing comparable reductions in HbA 1C of -0.66 to -0.84% (-7 to -9 mmol/mol), the risk of hypoglycaemia was lowest with gliclazide compared to glipizide (OR 0.22, CrI: 0.05 to 0.96), glimepiride (OR 0.40, CrI: 0.13 to 1.27), and glibenclamide (OR 0.21, CrI: 0.03 to 1.48). A major limitation is varying definitions of hypoglycaemia across studies. When added to metformin, gliclazide was associated with the lowest risk of hypoglycaemia between the newer generation SUs. Clinicians should consider the risk of hypoglycaemia agent-specific when selecting an SU agent. © 2016 The British Pharmacological Society.

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

PubMed Central

Christensen, Mikkel

2016-01-01

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

Ad hoc Laser networks component technology for modular spacecraft

NASA Astrophysics Data System (ADS)

Huang, Xiujun; Shi, Dele; Ma, Zongfeng; Shen, Jingshi

2016-03-01

Distributed reconfigurable satellite is a new kind of spacecraft system, which is based on a flexible platform of modularization and standardization. Based on the module data flow analysis of the spacecraft, this paper proposes a network component of ad hoc Laser networks architecture. Low speed control network with high speed load network of Microwave-Laser communication mode, no mesh network mode, to improve the flexibility of the network. Ad hoc Laser networks component technology was developed, and carried out the related performance testing and experiment. The results showed that ad hoc Laser networks components can meet the demand of future networking between the module of spacecraft.

Ad hoc laser networks component technology for modular spacecraft

NASA Astrophysics Data System (ADS)

Huang, Xiujun; Shi, Dele; Shen, Jingshi

2017-10-01

Distributed reconfigurable satellite is a new kind of spacecraft system, which is based on a flexible platform of modularization and standardization. Based on the module data flow analysis of the spacecraft, this paper proposes a network component of ad hoc Laser networks architecture. Low speed control network with high speed load network of Microwave-Laser communication mode, no mesh network mode, to improve the flexibility of the network. Ad hoc Laser networks component technology was developed, and carried out the related performance testing and experiment. The results showed that ad hoc Laser networks components can meet the demand of future networking between the module of spacecraft.

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

PubMed

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

2006-08-01

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

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

PubMed

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

2016-06-18

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

Verification of ADS-B performance to provide 5 nautical mile separation services in the Gulf of Mexico

DOT National Transportation Integrated Search

2010-01-01

Prior to Automatic Dependent SurveillanceBroadcast (ADS-B), non-radar separation was necessary in the Gulf of Mexico due to limited surveillance and air-ground communication. Five nautical mile separation using ADS-B improves capacity and streamli...

Discrimination and Reliance on Conceptual Fluency Cues are Inversely Related in Patients with Mild Alzheimer’s Disease

PubMed Central

Wolk, David A.; Gold, Carl A.; Signoff, Eric D.; Budson, Andrew E.

2009-01-01

Prior work suggests that patients with mild Alzheimer’s disease (AD) often base their recognition memory decisions on familiarity. It has been argued that conceptual fluency may play an important role in the feeling of familiarity. In the present study we measured the effect of conceptual fluency manipulations on recognition judgments of patients with mild AD and older adult controls. “Easy” and “hard” test conditions were created by manipulating encoding depth and list length to yield high and low discrimination, respectively. When the two participant groups performed identical procedures, AD patients displayed lower discrimination and greater reliance on fluency cues than controls. However, when the discrimination of older adult controls was decreased to the level of AD patients by use of a shallow encoding task, we found that controls reliance on fluency did not statistically differ from AD patients. Furthermore, we found that increasing discrimination using shorter study lists resulted in AD patients decreasing their reliance on fluency cues to a similar extent as controls. These findings support the notion that patients with AD are able to attribute conceptual fluency to prior experience. In addition these findings suggest that discrimination and reliance on fluency cues may be inversely related in both AD patients and older adult controls. PMID:19428418

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

PubMed Central

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

2016-01-01

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

Effect of patient selection method on provider group performance estimates.

PubMed

Thorpe, Carolyn T; Flood, Grace E; Kraft, Sally A; Everett, Christine M; Smith, Maureen A

2011-08-01

Performance measurement at the provider group level is increasingly advocated, but different methods for selecting patients when calculating provider group performance have received little evaluation. We compared 2 currently used methods according to characteristics of the patients selected and impact on performance estimates. We analyzed Medicare claims data for fee-for-service beneficiaries with diabetes ever seen at an academic multispeciality physician group in 2003 to 2004. We examined sample size, sociodemographics, clinical characteristics, and receipt of recommended diabetes monitoring in 2004 for the groups of patients selected using 2 methods implemented in large-scale performance initiatives: the Plurality Provider Algorithm and the Diabetes Care Home method. We examined differences among discordantly assigned patients to determine evidence for differential selection regarding these measures. Fewer patients were selected under the Diabetes Care Home method (n=3558) than the Plurality Provider Algorithm (n=4859). Compared with the Plurality Provider Algorithm, the Diabetes Care Home method preferentially selected patients who were female, not entitled because of disability, older, more likely to have hypertension, and less likely to have kidney disease and peripheral vascular disease, and had lower levels of predicted utilization. Diabetes performance was higher under Diabetes Care Home method, with 67% versus 58% receiving >1 A1c tests, 70% versus 65% receiving ≥1 low-density lipoprotein (LDL) test, and 38% versus 37% receiving an eye examination. The method used to select patients when calculating provider group performance may affect patient case mix and estimated performance levels, and warrants careful consideration when comparing performance estimates.

Vacuum currents in braneworlds on AdS bulk with compact dimensions

NASA Astrophysics Data System (ADS)

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

2015-11-01

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

Transformations of asymptotically AdS hyperbolic initial data and associated geometric inequalities

NASA Astrophysics Data System (ADS)

Cha, Ye Sle; Khuri, Marcus

2018-01-01

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

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

PubMed

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

2018-01-01

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

Open string fluctuations in AdS space with and without torsion

NASA Astrophysics Data System (ADS)

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

2003-09-01

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

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

PubMed

Arutyunov, Gleb; van Tongeren, Stijn J

2014-12-31

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

The added value of hepatitis E diagnostics in determining causes of hepatitis in routine diagnostic settings in the Netherlands.

PubMed

Doting, M H E; Weel, J; Niesters, H G M; Riezebos-Brilman, A; Brandenburg, A

2017-09-01

Hepatitis E virus (HEV) genotype 3 is endemic in Europe and an underdiagnosed and emerging (public) health issue. In recent years commercial enzyme immunoassays (EIAs) that detect antibodies to HEV more adequately, became available. We investigated the added value of this HEV serology in the diagnostic work flow to detect viral causes of recent hepatitis. During a 2-year period (May 2013 to May 2015), HEV serology was added to the hepatitis work flow, consisting of serological detection of hepatitis viruses A, B and C (HAV, HBV, HCV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Samples positive for HEV IgM were also analysed using PCR to detect HEV RNA. If positive, HEV sequencing was performed for genotyping purposes. In 235 out of 2521 patients (9.3%), a viral cause for hepatitis was found. Recent HAV, HBV, HCV, EBV or CMV infections were serologically diagnosed in 3, 34, 10, 69 and 42 patients, respectively. Seventy-eight patients (3.1%) had a recent HEV infection. In 49 of them, sufficient HEV RNA was present for genotyping. All patients were infected with HEV genotype 3. In our region, an HEV infection is the most frequently diagnosed viral cause for recent hepatitis. These results indicate that, in a country where HEV is endemic, serological HEV diagnostics should be added to the standard work-up for viral hepatitis. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Fermionic currents in AdS spacetime with compact dimensions

NASA Astrophysics Data System (ADS)

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

2017-09-01

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

Symmetry operators of Killing spinors and superalgebras in AdS5

NASA Astrophysics Data System (ADS)

Ertem, Ümit

2016-04-01

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

Relationships between testosterone levels and cognition in patients with Alzheimer disease and nondemented elderly men.

PubMed

Seidl, Jennifer N Travis; Massman, Paul J

2015-03-01

Previous research suggests that low levels of testosterone may be associated with the development of Alzheimer disease (AD), as well as poorer performance on certain neuropsychological tests and increased risk of depression. This study utilized data from 61 nondemented older men and 68 men with probable AD. Testosterone levels did not differ between the groups. Regression analyses in men with AD revealed that testosterone levels did not significantly predict performance on neuropsychological tests or a measure of depression. Among controls, testosterone levels predicted estimated premorbid verbal IQ and performance on a verbal fluency test. Findings suggest that testosterone is not associated with most neuropsychological test performances in patients with AD. © The Author(s) 2014.

Finger agnosia and cognitive deficits in patients with Alzheimer's disease.

PubMed

Davis, Andrew S; Trotter, Jeffrey S; Hertza, Jeremy; Bell, Christopher D; Dean, Raymond S

2012-01-01

The purpose of this study was to examine the presence of finger agnosia in patients with Alzheimer's disease (AD) and to determine if level of finger agnosia was related to cognitive impairment. Finger agnosia is a sensitive measure of cerebral impairment and is associated with neurofunctional areas implicated in AD. Using a standardized and norm-referenced approach, results indicated that patients with AD evidenced significantly decreased performance on tests of bilateral finger agnosia compared with healthy age-matched controls. Finger agnosia was predictive of cognitive dysfunction on four of seven domains, including: Crystallized Language, Fluid Processing, Associative Learning, and Processing Speed. Results suggest that measures of finger agnosia, a short and simple test, may be useful in the early detection of AD.

Feasibility and effectiveness of adding object-related bilateral symmetrical training to mirror therapy in chronic stroke: A randomized controlled pilot study.

PubMed

Rodrigues, Letícia Cardoso; Farias, Nayara Correa; Gomes, Raquel Pinheiro; Michaelsen, Stella Maris

2016-01-01

To evaluate the feasibility and effectiveness of adding object-related bilateral symmetrical training to mirror therapy (MT) to improve upper limb (UL) activity in chronic stroke patients. Sixteen patients with moderate UL impairment were randomly allocated to either the experimental (EG) or control (CG) group. Both groups performed 1 hour sessions, 3 days/week for 4 weeks, involving object-related bilateral symmetrical training. EG performed the tasks observing their nonparetic UL reflected in the mirror, while CG observed the paretic UL directly. The primary outcome measure was unilateral and bilateral UL activity according to the Test d'Évaluation des Membres Supérieurs de Personnes Âgées (TEMPA). All measurements were taken at baseline, post-training, and follow-up (2 weeks). TEMPA total score showed the main effect of time. Significant improvement was found for bilateral but not unilateral tasks. Both groups showed gains after training, with no differences between them. This study showed the feasibility of adding object-related bilateral training to MT. Both types of training improved UL bilateral activity; however, a larger sample is required for a definitive study. Other studies need to be carried out to evaluate the effectiveness of combining more distal-oriented movements and object-related unilateral training to improve these effects in chronic stroke patients.

Association of Plasma Neurofilament Light With Neurodegeneration in Patients With Alzheimer Disease.

PubMed

Mattsson, Niklas; Andreasson, Ulf; Zetterberg, Henrik; Blennow, Kaj

2017-05-01

Existing cerebrospinal fluid (CSF) or imaging (tau positron emission tomography) biomarkers for Alzheimer disease (AD) are invasive or expensive. Biomarkers based on standard blood test results would be useful in research, drug development, and clinical practice. Plasma neurofilament light (NFL) has recently been proposed as a blood-based biomarker for neurodegeneration in dementias. To test whether plasma NFL concentrations are increased in AD and associated with cognitive decline, other AD biomarkers, and imaging evidence of neurodegeneration. In this prospective case-control study, an ultrasensitive assay was used to measure plasma NFL concentration in 193 cognitively healthy controls, 197 patients with mild cognitive impairment (MCI), and 180 patients with AD dementia from the Alzheimer's Disease Neuroimaging Initiative. The study dates were September 7, 2005, to February 13, 2012. The plasma NFL analysis was performed in September 2016. Associations were tested between plasma NFL and diagnosis, Aβ pathologic features, CSF biomarkers of neuronal injury, cognition, brain structure, and metabolism. Among 193 cognitively healthy controls, 197 patients with mild cognitive impairment, and 180 patients with AD with dementia, plasma NFL correlated with CSF NFL (Spearman ρ = 0.59, P < .001). Plasma NFL was increased in patients with MCI (mean, 42.8 ng/L) and patients with AD dementia (mean, 51.0 ng/L) compared with controls (mean, 34.7 ng/L) (P < .001) and had high diagnostic accuracy for patients with AD with dementia vs controls (area under the receiver operating characteristic curve, 0.87, which is comparable to established CSF biomarkers). Plasma NFL was particularly high in patients with MCI and patients with AD dementia with Aβ pathologic features. High plasma NFL correlated with poor cognition and AD-related atrophy (at baseline and longitudinally) and with brain hypometabolism (longitudinally). Plasma NFL is associated with AD diagnosis and with

Functional determinants of radial operators in AdS2

DOE PAGES

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

2018-06-01

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

Functional determinants of radial operators in AdS 2

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

The AdS3 propagator and the fate of locality

NASA Astrophysics Data System (ADS)

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

2018-04-01

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

ADS-B and multilateration sensor fusion algorithm for air traffic control

NASA Astrophysics Data System (ADS)

Liang, Mengchen

Air traffic is expected to increase rapidly in the next decade. But, the current Air Traffic Control (ATC) system does not meet the demand of the future safety and efficiency. The Next Generation Air Transportation System (NextGen) is a transformation program for the ATC system in the United States. The latest estimates by Federal Aviation Administration (FAA) show that by 2018 NextGen will reduce total delays in flight by 35 percent and provide 23 billion dollars in cumulative benefits. A satellite-based technology called the Automatic Dependent Surveillance-Broadcast (ADS-B) system is one of the most important elements in NextGen. FAA expects that ADS-B systems will be available in the National Airspace System (NAS) by 2020. However, an alternative surveillance system is needed due to vulnerabilities that exist in ADS-B systems. Multilateration has a high accuracy performance and is believed to be an ideal back-up strategy for ADS-B systems. Thus, in this study, we develop the ADS-B and multilateration sensor fusion algorithm for aircraft tracking applications in ATC. The algorithm contains a fault detection function for ADS-B information monitoring by using Trajectory Change Points reports from ADS-B and numerical vectors from a hybrid estimation algorithm. We consider two types of faults in the ADS-B measurement model to show that the algorithm is able to deal with the bad data from ADS-B systems and automatically select good data from multilateration systems. We apply fuzzy logic concepts and generate time variant parameters during the fusion process. The parameters play a role of weights for combining data from different sensors. The algorithm performance is validated through two aircraft tracking examples.

Ad35 and Ad26 Vaccine Vectors Induce Potent and Cross-Reactive Antibody and T-Cell Responses to Multiple Filovirus Species

PubMed Central

Zahn, Roland; Gillisen, Gert; Roos, Anna; Koning, Marina; van der Helm, Esmeralda; Spek, Dirk; Weijtens, Mo; Grazia Pau, Maria; Radošević, Katarina; Weverling, Gerrit Jan; Custers, Jerome; Vellinga, Jort; Schuitemaker, Hanneke; Goudsmit, Jaap; Rodríguez, Ariane

2012-01-01

Filoviruses cause sporadic but highly lethal outbreaks of hemorrhagic fever in Africa in the human population. Currently, no drug or vaccine is available for treatment or prevention. A previous study with a vaccine candidate based on the low seroprevalent adenoviruses 26 and 35 (Ad26 and Ad35) was shown to provide protection against homologous Ebola Zaire challenge in non human primates (NHP) if applied in a prime-boost regimen. Here we have aimed to expand this principle to construct and evaluate Ad26 and Ad35 vectors for development of a vaccine to provide universal filovirus protection against all highly lethal strains that have caused major outbreaks in the past. We have therefore performed a phylogenetic analysis of filovirus glycoproteins to select the glycoproteins from two Ebola species (Ebola Zaire and Ebola Sudan/Gulu,), two Marburg strains (Marburg Angola and Marburg Ravn) and added the more distant non-lethal Ebola Ivory Coast species for broadest coverage. Ad26 and Ad35 vectors expressing these five filovirus glycoproteins were evaluated to induce a potent cellular and humoral immune response in mice. All adenoviral vectors induced a humoral immune response after single vaccination in a dose dependent manner that was cross-reactive within the Ebola and Marburg lineages. In addition, both strain-specific as well as cross-reactive T cell responses could be detected. A heterologous Ad26–Ad35 prime-boost regime enhanced mainly the humoral and to a lower extend the cellular immune response against the transgene. Combination of the five selected filovirus glycoproteins in one multivalent vaccine potentially elicits protective immunity in man against all major filovirus strains that have caused lethal outbreaks in the last 20 years. PMID:23236343

Euclidean Wilson loops and minimal area surfaces in lorentzian AdS 3

DOE PAGES

Irrgang, Andrew; Kruczenski, Martin

2015-12-14

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

Holographic Rényi entropy in AdS3/LCFT2 correspondence

NASA Astrophysics Data System (ADS)

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

2014-03-01

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

Serotoninergic antidepressants positively affect platelet ADAM10 expression in patients with Alzheimer's disease.

PubMed

Bianco, Otávio Augusto Fernandes Marques; Manzine, Patrícia Regina; Nascimento, Carla Manuela Crispim; Vale, Francisco Assis Carvalho; Pavarini, Sofia Cristina Iost; Cominetti, Márcia Regina

2016-06-01

Studies have demonstrated a decreased platelet ADAM10 expression in patients with Alzheimer's Disease (AD), classifying this protein as a blood-based AD biomarker. About 50% of the patients with AD are diagnosed with depression, which is commonly treated with tricyclic and tetracyclic antidepressants, monoaminoxidade (MAO) inhibitors and, more preferably, with selective serotonin reuptake inhibitors (SSRIs). Considering that a large proportion of patients with AD takes antidepressant medications during the course of the disease we investigated the influence of this medication on the expression of platelet ADAM10, which is considered the main α-secretase preventing beta-amyloid (βA) formation. Blood was collected for protein extraction from platelets. ADAM10 was analyzed by using western blotting and reactive bands were measured using β-actin as endogenous control. Platelet ADAM10 protein expression in patients with AD was positively influenced by serotoninergic medication. More studies on the positive effects of serotonergic antidepressants on ADAM10 platelet expression should be performed in order to understand its biological mechanisms and to verify whether these effects are reflected in the central nervous system. This work represents an important advance for the study of AD biomarkers, as well as for more effective pharmacological treatment of patients with AD and associated depression.

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

PubMed

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

2011-10-01

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

The impact of lexical-semantic impairment and of executive dysfunction on the word reading performance of patients with probable Alzheimer dementia.

PubMed

Colombo, Lucia; Fonti, Cristina; Cappa, Stefano

2004-01-01

The influence of lexical-semantic impairment and of executive dysfunction on word naming performance was investigated in a group of patients with probable Alzheimer dementia (AD). The patients, who varied in the severity of the illness, were tested in a word naming task where they had to read aloud Italian three-syllable words with a dominant or subordinate stress pattern. These types of words have been shown to interact with frequency in normal adults [J. Exp. Psychol.: Hum. Percept. Perform. 18 (4) (1992) 987], so that the effect of the subordinate stress pattern (slower reading times) is only apparent for low frequency words. The frequency and stress effects on accuracy increased across dementia severity levels. Regression analyses showed that the impairment in reading low frequency words with subordinate stress depended largely on the level of lexical-semantic impairment, measured by a test of semantic memory and comprehension. Implications for the current reading models are discussed.

Performance of activities of daily living among hospitalized cancer patients.

PubMed

Lindahl-Jacobsen, Line; Hansen, Dorte Gilså; Wæhrens, Eva Ejlersen; la Cour, Karen; Søndergaard, Jens

2015-03-01

Many cancer patients report unmet rehabilitation needs. Rehabilitation may include activities of daily living (ADL) tasks, but little is known about how cancer patients perform these tasks and how they prioritize their daily activities. Hence, this study aims to identify and characterize ADL task performance problems among a group of adult disabled hospitalized cancer patients using interview and questionnaire data. Cross-sectional study on prevalence of ADL task performance problems experienced by disabled hospitalized cancer patients using the Activities of Daily Living Questionnaire (ADL-Q) (n = 118) and the Canadian Occupational Performance Measure (COPM) (n = 55). All 118 patients reported problems with ADL task performance. Based on the ADL-Q patients reported more problems within instrumental (I-)ADL than personal (P-)ADL. In both I-ADL and P-ADL the results differed between women and men. There was significant overlap between problems identified using the COPM and the ADL-Q instruments. RESULTS from the COPM showed that 65% of problems were related to self-care, 25% to leisure, and 19% to productivity. Using both instruments identified more ADL problems than when using only one of the instruments. Adult hospitalized disabled cancer patients experience a high degree and variation in difficulties performing ADL, illustrating the need for a comprehensively planned assessment of problems and needs.

Age and diagnostic performance of Alzheimer disease CSF biomarkers.

PubMed

Mattsson, N; Rosén, E; Hansson, O; Andreasen, N; Parnetti, L; Jonsson, M; Herukka, S-K; van der Flier, W M; Blankenstein, M A; Ewers, M; Rich, K; Kaiser, E; Verbeek, M M; Olde Rikkert, M; Tsolaki, M; Mulugeta, E; Aarsland, D; Visser, P J; Schröder, J; Marcusson, J; de Leon, M; Hampel, H; Scheltens, P; Wallin, A; Eriksdotter-Jönhagen, M; Minthon, L; Winblad, B; Blennow, K; Zetterberg, H

2012-02-14

Core CSF changes in Alzheimer disease (AD) are decreased amyloid β(1-42), increased total tau, and increased phospho-tau, probably indicating amyloid plaque accumulation, axonal degeneration, and tangle pathology, respectively. These biomarkers identify AD already at the predementia stage, but their diagnostic performance might be affected by age-dependent increase of AD-type brain pathology in cognitively unaffected elderly. We investigated effects of age on the diagnostic performance of CSF biomarkers in a uniquely large multicenter study population, including a cross-sectional cohort of 529 patients with AD dementia (median age 71, range 43-89 years) and 304 controls (67, 44-91 years), and a longitudinal cohort of 750 subjects without dementia with mild cognitive impairment (69, 43-89 years) followed for at least 2 years, or until dementia diagnosis. The specificities for subjects without AD and the areas under the receiver operating characteristics curves decreased with age. However, the positive predictive value for a combination of biomarkers remained stable, while the negative predictive value decreased only slightly in old subjects, as an effect of the high AD prevalence in older ages. Although the diagnostic accuracies for AD decreased with age, the predictive values for a combination of biomarkers remained essentially stable. The findings highlight biomarker variability across ages, but support the use of CSF biomarkers for AD even in older populations.

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

PubMed

Geylis, Valeria; Steinitz, Michael

2006-01-01

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

snpAD: An ancient DNA genotype caller.

PubMed

Prüfer, Kay

2018-06-21

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

Delayed audiovisual integration of patients with mild cognitive impairment and Alzheimer's disease compared with normal aged controls.

PubMed

Wu, Jinglong; Yang, Jiajia; Yu, Yinghua; Li, Qi; Nakamura, Naoya; Shen, Yong; Ohta, Yasuyuki; Yu, Shengyuan; Abe, Koji

2012-01-01

The human brain can anatomically combine task-relevant information from different sensory pathways to form a unified perception; this process is called multisensory integration. The aim of the present study was to test whether the multisensory integration abilities of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) differed from those of normal aged controls (NC). A total of 64 subjects were divided into three groups: NC individuals (n = 24), MCI patients (n = 19), and probable AD patients (n = 21). All of the subjects were asked to perform three separate audiovisual integration tasks and were instructed to press the response key associated with the auditory, visual, or audiovisual stimuli in the three tasks. The accuracy and response time (RT) of each task were measured, and the RTs were analyzed using cumulative distribution functions to observe the audiovisual integration. Our results suggest that the mean RT of patients with AD was significantly longer than those of patients with MCI and NC individuals. Interestingly, we found that patients with both MCI and AD exhibited adequate audiovisual integration, and a greater peak (time bin with the highest percentage of benefit) and broader temporal window (time duration of benefit) of multisensory enhancement were observed. However, the onset time and peak benefit of audiovisual integration in MCI and AD patients occurred significantly later than did those of the NC. This finding indicates that the cognitive functional deficits of patients with MCI and AD contribute to the differences in performance enhancements of audiovisual integration compared with NC.

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

NASA Astrophysics Data System (ADS)

Giribet, Gaston; Goya, Andrés; Leston, Mauricio

2011-09-01

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

A universal counting of black hole microstates in AdS4

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

Patients with Mild Alzheimer's Disease Fail When Using Their Working Memory: Evidence from the Eye Tracking Technique.

PubMed

Fernández, Gerardo; Manes, Facundo; Politi, Luis E; Orozco, David; Schumacher, Marcela; Castro, Liliana; Agamennoni, Osvaldo; Rotstein, Nora P

2016-01-01

Patients with Alzheimer's disease (AD) develop progressive language, visuoperceptual, attentional, and oculomotor changes that can have an impact on their reading comprehension. However, few studies have examined reading behavior in AD, and none have examined the contribution of predictive cueing in reading performance. For this purpose we analyzed the eye movement behavior of 35 healthy readers (Controls) and 35 patients with probable AD during reading of regular and high-predictable sentences. The cloze predictability of words N - 1, and N + 1 exerted an influence on the reader's gaze duration. The predictabilities of preceding words in high-predictable sentences served as task-appropriate cues that were used by Control readers. In contrast, these effects were not present in AD patients. In Controls, changes in predictability significantly affected fixation duration along the sentence; noteworthy, these changes did not affect fixation durations in AD patients. Hence, only in healthy readers did predictability of upcoming words influence fixation durations via memory retrieval. Our results suggest that Controls used stored information of familiar texts for enhancing their reading performance and imply that contextual-word predictability, whose processing is proposed to require memory retrieval, only affected reading behavior in healthy subjects. In AD patients, this loss reveals impairments in brain areas such as those corresponding to working memory and memory retrieval. These findings might be relevant for expanding the options for the early detection and monitoring in the early stages of AD. Furthermore, evaluation of eye movements during reading could provide a new tool for measuring drug impact on patients' behavior.

Performance analysis of multi-radio routing protocol in cognitive radio ad hoc networks under different path failure rate

NASA Astrophysics Data System (ADS)

Che-Aron, Z.; Abdalla, A. H.; Abdullah, K.; Hassan, W. H.

2013-12-01

In recent years, Cognitive Radio (CR) technology has largely attracted significant studies and research. Cognitive Radio Ad Hoc Network (CRAHN) is an emerging self-organized, multi-hop, wireless network which allows unlicensed users to opportunistically access available licensed spectrum bands for data communication under an intelligent and cautious manner. However, in CRAHNs, a lot of failures can easily occur during data transmission caused by PU (Primary User) activity, topology change, node fault, or link degradation. In this paper, an attempt has been made to evaluate the performance of the Multi-Radio Link-Quality Source Routing (MR-LQSR) protocol in CRAHNs under different path failure rate. In the MR-LQSR protocol, the Weighted Cumulative Expected Transmission Time (WCETT) is used as the routing metric. The simulations are carried out using the NS-2 simulator. The protocol performance is evaluated with respect to performance metrics like average throughput, packet loss, average end-to-end delay and average jitter. From the simulation results, it is observed that the number of path failures depends on the PUs number and mobility rate of SUs (Secondary Users). Moreover, the protocol performance is greatly affected when the path failure rate is high, leading to major service outages.

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

ERIC Educational Resources Information Center

Johnston, Anne; Kaid, Lynda Lee

2002-01-01

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

High resolution A/D conversion based on piecewise conversion at lower resolution

DOEpatents

Terwilliger, Steve [Albuquerque, NM

2012-06-05

Piecewise conversion of an analog input signal is performed utilizing a plurality of relatively lower bit resolution A/D conversions. The results of this piecewise conversion are interpreted to achieve a relatively higher bit resolution A/D conversion without sampling frequency penalty.

Performance improvement with patient service partners.

PubMed

Burns, J P

1998-01-01

Once the decision is made to use a patient-focused care delivery system, a variety of methods can be used to successfully design the model. The author describes the process used by a multilevel, multidisciplinary team at a community hospital to design and implement a Service Partner role that would meet and exceed customer expectations. Demonstrated performance improvements included increased patient satisfaction, productive labor dollar savings, and improvements in the work environment for staff members.

Word list and story recall elicit different patterns of memory deficit in patients with Alzheimer's disease, frontotemporal dementia, subcortical ischemic vascular disease, and Lewy body dementia.

PubMed

Perri, Roberta; Fadda, Lucia; Caltagirone, Carlo; Carlesimo, Giovanni Augusto

2013-01-01

Different roles have been attributed to mesio-temporal areas and frontal lobes in declarative memory functioning, and qualitative differences have been observed in the amnesic symptoms due to pathological damage of these two portions of the central nervous system. The aim of the present study was to look for memory profiles related to pathological involvement in the temporal and frontal structures in patients with different dementia syndromes on word-list and prose memory tasks. 20 patients with Alzheimer's disease (AD), 20 with frontal variant of FTD (fvFTD), 20 with subcortical ischemic vascular dementia (SIVD), and 20 with Lewy body dementia (LBD) and 34 healthy subjects (NCs) were submitted to word-list and prose memory tasks. All groups performed similarly on both the immediate and delayed recall of the word-list. Conversely, AD patients performed worse than all the other dementia groups on the immediate prose recall. On delayed prose recall, AD patients performed worse than fvFTD and SIVD patients but similar to LBD patients. Differential scores between word-list and prose tests were minimal in the AD group and very pronounced in fvFTD and SIVD groups. The combined use of the prose and word-list tasks evidenced a "mesio-temporal" memory profile in AD patients as opposed to a "frontal" one in fvFTD and SIVD patients and a mixed profile in the LBD patients. In particular, a differential score between the two tests can be useful in differentiating AD patients from patients with other forms of dementia.

Massive quiver matrix models for massive charged particles in AdS

DOE PAGES

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

2016-01-11

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

Impact of fluid restriction and ad libitum water intake or an 8% carbohydrate-electrolyte beverage on skill performance of elite adolescent basketball players.

PubMed

Carvalho, Pedro; Oliveira, Bruno; Barros, Renata; Padrão, Patricia; Moreira, Pedro; Teixeira, Vitor Hugo

2011-06-01

Twelve adolescent athletes underwent, in a crossover-design study, 3 separate 90-min training sessions in the following conditions: no fluid ingestion allowed (NF), ad libitum ingestion of water (W), and ad libitum ingestion of a commercial 8% carbohydrate-electrolyte sports beverage (CSB). After each session athletes performed a set of basketball drills (2-point, 3-point, and free-throw shootout, suicide sprints, and defensive zigzags). Body weight (before and after sessions), rating of perceived exertion (RPE), urine color, and beverage acceptability were determined in each session. Athletes also completed a survey about their knowledge and behaviors regarding hydration and fluid replacement. The percentage of weight loss was significantly higher in NF (2.46% ± 0.87%) than in the other 2 conditions (W, 1.08% ± 0.67%, p = .006; CSB, 0.65% ± 0.62%, p = .001) but also higher in W than CSB (p = .012). RPE was higher in NF (16.8 ± 1.96) than in the W (14.2 ± 1.99, p = .004) and CSB (13.3 ± 2.06, p = .002) trials. Athletes' fluid intake was positively correlated with proper self-reported behaviors (r = .75, p = .005) and knowledge (r = .76, p = .004) about fluid and hydration. In conclusion, fluid restriction during exercise was associated with a greater level of dehydration and increased perceived exertion but had no impact on basketball performance compared with ad libitum drinking of water or a CSB. Athletes with more knowledge about hydration and better self-reported hydration behaviors ingested more fluids during training sessions.

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

NASA Technical Reports Server (NTRS)

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

1992-01-01

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

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

NASA Astrophysics Data System (ADS)

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

1992-12-01

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

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

PubMed

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

2017-02-01

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

Proper temperature of the Schwarzschild AdS black hole revisited

NASA Astrophysics Data System (ADS)

Eune, Myungseok; Kim, Wontae

2017-10-01

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

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

ERIC Educational Resources Information Center

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

2016-01-01

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

Basal Forebrain Atrophy Contributes to Allocentric Navigation Impairment in Alzheimer’s Disease Patients

PubMed Central

Kerbler, Georg M.; Nedelska, Zuzana; Fripp, Jurgen; Laczó, Jan; Vyhnalek, Martin; Lisý, Jiří; Hamlin, Adam S.; Rose, Stephen; Hort, Jakub; Coulson, Elizabeth J.

2015-01-01

The basal forebrain degenerates in Alzheimer’s disease (AD) and this process is believed to contribute to the cognitive decline observed in AD patients. Impairment in spatial navigation is an early feature of the disease but whether basal forebrain dysfunction in AD is responsible for the impaired navigation skills of AD patients is not known. Our objective was to investigate the relationship between basal forebrain volume and performance in real space as well as computer-based navigation paradigms in an elderly cohort comprising cognitively normal controls, subjects with amnestic mild cognitive impairment and those with AD. We also tested whether basal forebrain volume could predict the participants’ ability to perform allocentric- vs. egocentric-based navigation tasks. The basal forebrain volume was calculated from 1.5 T magnetic resonance imaging (MRI) scans, and navigation skills were assessed using the human analog of the Morris water maze employing allocentric, egocentric, and mixed allo/egocentric real space as well as computerized tests. When considering the entire sample, we found that basal forebrain volume correlated with spatial accuracy in allocentric (cued) and mixed allo/egocentric navigation tasks but not the egocentric (uncued) task, demonstrating an important role of the basal forebrain in mediating cue-based spatial navigation capacity. Regression analysis revealed that, although hippocampal volume reflected navigation performance across the entire sample, basal forebrain volume contributed to mixed allo/egocentric navigation performance in the AD group, whereas hippocampal volume did not. This suggests that atrophy of the basal forebrain contributes to aspects of navigation impairment in AD that are independent of hippocampal atrophy. PMID:26441643

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

PubMed

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

2015-12-01

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

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

PubMed

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

2013-07-01

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

Delayed Audiovisual Integration of Patients with Mild Cognitive Impairment and Alzheimer’s Disease Compared with Normal Aged Controls

PubMed Central

Wu, Jinglong; Yang, Jiajia; Yu, Yinghua; Li, Qi; Nakamura, Naoya; Shen, Yong; Ohta, Yasuyuki; Yu, Shengyuan; Abe, Koji

2013-01-01

The human brain can anatomically combine task-relevant information from different sensory pathways to form a unified perception; this process is called multisensory integration. The aim of the present study was to test whether the multisensory integration abilities of patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) differed from those of normal aged controls (NC). A total of 64 subjects were divided into three groups: NC individuals (n = 24), MCI patients (n = 19), and probable AD patients (n = 21). All of the subjects were asked to perform three separate audiovisual integration tasks and were instructed to press the response key associated with the auditory, visual, or audiovisual stimuli in the three tasks. The accuracy and response time (RT) of each task were measured, and the RTs were analyzed using cumulative distribution functions to observe the audiovisual integration. Our results suggest that the mean RT of patients with AD was significantly longer than those of patients with MCI and NC individuals. Interestingly, we found that patients with both MCI and AD exhibited adequate audiovisual integration, and a greater peak (time bin with the highest percentage of benefit) and broader temporal window (time duration of benefit) of multisensory enhancement were observed. However, the onset time and peak benefit of audiovisual integration in MCI and AD patients occurred significantly later than did those of the NC. This finding indicates that the cognitive functional deficits of patients with MCI and AD contribute to the differences in performance enhancements of audiovisual integration compared with NC. PMID:22810093

Adding sleep restriction to the equation: impact on wildland firefighters' work performance and physiology in hot conditions.

PubMed

Vincent, Grace E; Ferguson, Sally; Larsen, Brianna; Ridgers, Nicola D; Snow, Rod; Aisbett, Brad

2018-04-06

To examine the effects of sleep restriction on firefighters' physical task performance, physical activity, and physiological and perceived exertion during simulated hot wildfire conditions. 31 firefighters were randomly allocated to either the hot (n = 18, HOT; 33 °C, 8-h sleep opportunity) or hot and sleep restricted (n = 13, HOT + SR; 33 °C, 4-h sleep opportunity) condition. Intermittent, self-paced work circuits of six firefighting tasks were performed for 3 days. Firefighters self-reported ratings of perceived exertion. Heart rate, core temperature, and physical activity were measured continuously. Fluids were consumed ad libitum, and all food and fluids consumed were recorded. Urine volume and urine specific gravity (USG) were analysed and sleep was assessed using polysomnography (PSG). There were no differences between the HOT and HOT + SR groups in firefighters' physical task performance, heart rate, core temperature, USG, or fluid intake. Ratings of perceived exertion were higher (p < 0.05) in the HOT + SR group for two of the six firefighting tasks. The HOT group spent approximately 7 min more undertaking moderate physical activity throughout the 2-h work circuits compared to the HOT + SR group. Two nights of sleep restriction did not influence firefighters' physical task performance or physiological responses during 3 days of simulated wildfire suppression. Further research is needed to explore firefighters' pacing strategies during real wildfire suppression.

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

NASA Astrophysics Data System (ADS)

van Tongeren, Stijn J.

2014-10-01

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

Analysis on Multicast Routing Protocols for Mobile Ad Hoc Networks

NASA Astrophysics Data System (ADS)

Xiang, Ma

As the Mobile Ad Hoc Networks technologies face a series of challenges like dynamic changes of topological structure, existence of unidirectional channel, limited wireless transmission bandwidth, the capability limitations of mobile termination and etc, therefore, the research to mobile Ad Hoc network routings inevitablely undertake a more important task than those to other networks. Multicast is a mode of communication transmission oriented to group computing, which sends the data to a group of host computers by using single source address. In a typical mobile Ad Hoc Network environment, multicast has a significant meaning. On the one hand, the users of mobile Ad Hoc Network usually need to form collaborative working groups; on the other hand, this is also an important means of fully using the broadcast performances of wireless communication and effectively using the limited wireless channel resources. This paper summarizes and comparatively analyzes the routing mechanisms of various existing multicast routing protocols according to the characteristics of mobile Ad Hoc network.

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

PubMed

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

2017-07-01

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

Effects of distillers dried grains with solubles and added fat fed immediately before slaughter on growth performance and carcass characteristics of finishing pigs.

PubMed

Coble, K F; DeRouchey, J M; Tokach, M D; Dritz, S S; Goodband, R D; Woodworth, J C

2017-01-01

The addition of dietary fat has been shown to increase HCW and carcass yield in pigs fed low-fiber corn-soy diets; however, data on added fat in high-fiber, low-energy diets is less available. Therefore, the potential for dietary fat to ameliorate the negative effect high-fiber diets have on carcass yield during the last 3 wk before slaughter is of high importance. This experiment was conducted to determine the interactive effects of 30% distillers dried grains with solubles (DDGS) and 5% added fat fed before slaughter on growth performance and carcass characteristics. A total of 1,258 pigs in 2 groups (initially 105.8 ± 0.1 kg BW; group 1 PIC 337 × 1,050; group 2 PIC 327 × 1,050) were used in a 20-d experiment. All pigs were fed a common diet with 30% DDGS until 20 d before slaughter. Then, all pens were weighed and allotted to treatments with 20 replicate pens per treatment. Dietary treatments were arranged in a 2 × 2 factorial with 2 diet types (corn-soybean meal-based with or without 30% DDGS) and added fat (0 or 5%; group 1 = tallow; group 2 = choice white grease). Diets were formulated to a constant standardized ileal digestible Lys:NE ratio. There were no treatment × group interactions for any response criteria. Thus, data for the 2 groups were combined for analysis. Overall, there was a tendency for a diet type × added fat interaction for ADG ( = 0.054), whereas this was significant for G:F ( = 0.008). This was a result of 5% added fat increasing ADG and G:F to a greater magnitude for pigs fed the diet containing 30% DDGS (8.6 and 10.4%, respectively) than for pigs fed the corn-soy diet (2.0 and 2.9%, respectively). Although diet type did not affect final live BW, pigs fed the diet containing DDGS had decreased HCW and carcass yield ( < 0.05). Adding 5% fat did not affect carcass yield. In conclusion, adding 5% fat to finishing pig diets containing 30% DDGS approximately 20 d before slaughter improved ADG and G:F but did not overcome the reduction in

Analysis of word number and content in discourse of patients with mild to moderate Alzheimer's disease.

PubMed

de Lira, Juliana Onofre; Minett, Thaís Soares Cianciarullo; Bertolucci, Paulo Henrique Ferreira; Ortiz, Karin Zazo

2014-01-01

Alzheimer's disease (AD) is characterized by impairments in memory and other cognitive functions such as language, which can be affected in all aspects including discourse. A picture description task is considered an effective way of obtaining a discourse sample whose key feature is the ability to retrieve appropriate lexical items. There is no consensus on findings showing that performance in content processing of spoken discourse deteriorates from the mildest phase of AD. To compare the quantity and quality of discourse among patients with mild to moderate AD and controls. A cross-sectional study was designed. Subjects aged 50 years and older of both sexes, with one year or more of education, were divided into three groups: control (CG), mild AD (ADG1) and moderate AD (ADG2). Participants were asked to describe the "cookie theft" picture. The total number of complete words spoken and information units (IU) were included in the analysis. There was no significant difference among groups in terms of age, schooling and sex. For number of words spoken, the CG performed significantly better than both the ADG 1 and ADG2, but no difference between the two latter groups was found. CG produced almost twice as many information units as the ADG1 and more than double that of the ADG2. Moreover, ADG2 patients had worse performance on IUs compared to the ADG1. Decreased performance in quantity and content of discourse was evident in patients with AD from the mildest phase, but only content (IU) continued to worsen with disease progression.

Analysis of word number and content in discourse of patients with mild to moderate Alzheimer's disease

PubMed Central

de Lira, Juliana Onofre; Minett, Thaís Soares Cianciarullo; Bertolucci, Paulo Henrique Ferreira; Ortiz, Karin Zazo

2014-01-01

Alzheimer's disease (AD) is characterized by impairments in memory and other cognitive functions such as language, which can be affected in all aspects including discourse. A picture description task is considered an effective way of obtaining a discourse sample whose key feature is the ability to retrieve appropriate lexical items. There is no consensus on findings showing that performance in content processing of spoken discourse deteriorates from the mildest phase of AD. Objective To compare the quantity and quality of discourse among patients with mild to moderate AD and controls. Methods A cross-sectional study was designed. Subjects aged 50 years and older of both sexes, with one year or more of education, were divided into three groups: control (CG), mild AD (ADG1) and moderate AD (ADG2). Participants were asked to describe the "cookie theft" picture. The total number of complete words spoken and information units (IU) were included in the analysis. Results There was no significant difference among groups in terms of age, schooling and sex. For number of words spoken, the CG performed significantly better than both the ADG 1 and ADG2, but no difference between the two latter groups was found. CG produced almost twice as many information units as the ADG1 and more than double that of the ADG2. Moreover, ADG2 patients had worse performance on IUs compared to the ADG1. Conclusion Decreased performance in quantity and content of discourse was evident in patients with AD from the mildest phase, but only content (IU) continued to worsen with disease progression. PMID:29213912

On supersymmetric AdS6 solutions in 10 and 11 dimensions

NASA Astrophysics Data System (ADS)

Gutowski, J.; Papadopoulos, G.

2017-12-01

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

Patterns of verbal memory performance in mild cognitive impairment, Alzheimer disease, and normal aging.

PubMed

Greenaway, Melanie C; Lacritz, Laura H; Binegar, Dani; Weiner, Myron F; Lipton, Anne; Munro Cullum, C

2006-06-01

Individuals with mild cognitive impairment (MCI) typically demonstrate memory loss that falls between normal aging (NA) and Alzheimer disease (AD), but little is known about the pattern of memory dysfunction in MCI. To explore this issue, California Verbal Learning Test (CVLT) performance was examined across groups of MCI, AD, and NA. MCI subjects displayed a pattern of deficits closely resembling that of AD, characterized by reduced learning, rapid forgetting, increased recency recall, elevated intrusion errors, and poor recognition discriminability with increased false-positives. MCI performance was significantly worse than that of controls and better than that of AD patients across memory indices. Although qualitative analysis of CVLT profiles may be useful in individual cases, discriminant function analysis revealed that delayed recall and total learning were the best aspects of learning/memory on the CVLT in differentiating MCI, AD, and NA. These findings support the position that amnestic MCI represents an early point of decline on the continuum of AD that is different from normal aging.

Decline of human tactile angle discrimination in patients with mild cognitive impairment and Alzheimer's disease.

PubMed

Yang, Jiajia; Ogasa, Takashi; Ohta, Yasuyuki; Abe, Koji; Wu, Jinglong

2010-01-01

There is a need to differentiate between patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) from normal-aged controls (NC) in the field of clinical drug discovery. In this study, we developed a tactile angle discrimination system and examined whether the ability to discriminate tactile angle differed between patients with MCI and AD and the NC group. Thirty-seven subjects were divided into three groups: NC individuals (n=14); MCI patients (n=10); and probable AD patients (n=13). All subjects were asked to differentiate the relative sizes of the reference angle (60°) and one of eight comparison angles by passive touch. The accuracy of angle discrimination was measured and the discrimination threshold was calculated. We discovered that there were significant differences in the angle discrimination thresholds of AD patients compared to the NC group. Interestingly, we also found that ability to discriminate tactile angle of MCI patients were significantly lower than that of the NC group. This is the first study to report that patients with MCI and AD have substantial performance deficits in tactile angle discrimination compared to the NC individuals. This finding may provide a monitor and therapeutic approach in AD diagnosis and treatment.

Performance Analysis of the IEEE 802.11p Multichannel MAC Protocol in Vehicular Ad Hoc Networks

PubMed Central

2017-01-01

Vehicular Ad Hoc Networks (VANETs) employ multichannel to provide a variety of safety and non-safety applications, based on the IEEE 802.11p and IEEE 1609.4 protocols. The safety applications require timely and reliable transmissions, while the non-safety applications require efficient and high throughput. In the IEEE 1609.4 protocol, operating interval is divided into alternating Control Channel (CCH) interval and Service Channel (SCH) interval with an identical length. During the CCH interval, nodes transmit safety-related messages and control messages, and Enhanced Distributed Channel Access (EDCA) mechanism is employed to allow four Access Categories (ACs) within a station with different priorities according to their criticality for the vehicle’s safety. During the SCH interval, the non-safety massages are transmitted. An analytical model is proposed in this paper to evaluate performance, reliability and efficiency of the IEEE 802.11p and IEEE 1609.4 protocols. The proposed model improves the existing work by taking serval aspects and the character of multichannel switching into design consideration. Extensive performance evaluations based on analysis and simulation help to validate the accuracy of the proposed model and analyze the capabilities and limitations of the IEEE 802.11p and IEEE 1609.4 protocols, and enhancement suggestions are given. PMID:29231882

Performance Analysis of the IEEE 802.11p Multichannel MAC Protocol in Vehicular Ad Hoc Networks.

PubMed

Song, Caixia

2017-12-12

Vehicular Ad Hoc Networks (VANETs) employ multichannel to provide a variety of safety and non-safety applications, based on the IEEE 802.11p and IEEE 1609.4 protocols. The safety applications require timely and reliable transmissions, while the non-safety applications require efficient and high throughput. In the IEEE 1609.4 protocol, operating interval is divided into alternating Control Channel (CCH) interval and Service Channel (SCH) interval with an identical length. During the CCH interval, nodes transmit safety-related messages and control messages, and Enhanced Distributed Channel Access (EDCA) mechanism is employed to allow four Access Categories (ACs) within a station with different priorities according to their criticality for the vehicle's safety. During the SCH interval, the non-safety massages are transmitted. An analytical model is proposed in this paper to evaluate performance, reliability and efficiency of the IEEE 802.11p and IEEE 1609.4 protocols. The proposed model improves the existing work by taking serval aspects and the character of multichannel switching into design consideration. Extensive performance evaluations based on analysis and simulation help to validate the accuracy of the proposed model and analyze the capabilities and limitations of the IEEE 802.11p and IEEE 1609.4 protocols, and enhancement suggestions are given.

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

PubMed

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

2008-10-21

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

Digital Quantum Simulation of Minimal AdS /CFT

NASA Astrophysics Data System (ADS)

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

2017-07-01

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

Teacher Effects, Value-Added Models, and Accountability

ERIC Educational Resources Information Center

Konstantopoulos, Spyros

2014-01-01

Background: In the last decade, the effects of teachers on student performance (typically manifested as state-wide standardized tests) have been re-examined using statistical models that are known as value-added models. These statistical models aim to compute the unique contribution of the teachers in promoting student achievement gains from grade…

Game-based combined cognitive and neurofeedback training using Focus Pocus reduces symptom severity in children with diagnosed AD/HD and subclinical AD/HD.

PubMed

Johnstone, Stuart J; Roodenrys, Steven J; Johnson, Kirsten; Bonfield, Rebecca; Bennett, Susan J

2017-06-01

Previous studies report reductions in symptom severity after combined working memory (WM) and inhibitory control (IC) training in children with AD/HD. Based on theoretical accounts of the role of arousal/attention modulation problems in AD/HD, the current study examined the efficacy of combined WM, IC, and neurofeedback training in children with AD/HD and subclinical AD/HD. Using a randomized waitlist control design, 85 children were randomly allocated to a training or waitlist condition and completed pre- and post-training assessments of overt behavior, trained and untrained cognitive task performance, and resting and task-related EEG activity. The training group completed twenty-five sessions of training using Focus Pocus software at home over a 7 to 8-week period. Trainees improved at the trained tasks, while enjoyment and engagement declined across sessions. After training, AD/HD symptom severity was reduced in the AD/HD and subclinical groups according to parents, and in the former group only according to blinded teachers and significant-others. There were minor improvements in two of six near-transfer tasks, and evidence of far-transfer of training effects in four of five far-transfer tasks. Frontal region changes indicated normalization of atypical EEG features with reduced delta and increased alpha activity. It is concluded that technology developments provide an interesting a vehicle for delivering interventions and that, while further research is needed, combined WM, IC, and neurofeedback training can reduce AD/HD symptom severity in children with AD/HD and may also be beneficial to children with subclinical AD/HD. Copyright © 2017 Elsevier B.V. All rights reserved.

Ad Hoc Information Extraction for Clinical Data Warehouses.

PubMed

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

2018-05-01

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

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

NASA Astrophysics Data System (ADS)

Canfora, Fabrizio; Tallarita, Gianni

2017-08-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-05-01

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

Effect of adding postoperative noninvasive ventilation to usual care to prevent pulmonary complications in patients undergoing coronary artery bypass grafting: a randomized controlled trial.

PubMed

Al Jaaly, Emad; Fiorentino, Francesca; Reeves, Barnaby C; Ind, Philip W; Angelini, Gianni D; Kemp, Scott; Shiner, Robert J

2013-10-01

We compared the efficacy of noninvasive ventilation with bilevel positive airway pressure added to usual care versus usual care alone in patients undergoing coronary artery bypass grafting. We performed a 2-group, parallel, randomized controlled trial. The primary outcome was time until fit for discharge. Secondary outcomes were partial pressure of carbon dioxide, forced expiratory volume in 1 second, atelectasis, adverse events, duration of intensive care stay, and actual postoperative stay. A total of 129 patients were randomly allocated to bilevel positive airway pressure (66) or usual care (63). Three patients allocated to bilevel positive airway pressure withdrew. The median duration of bilevel positive airway pressure was 16 hours (interquartile range, 11-19). The median duration of hospital stay until fit for discharge was 5 days for the bilevel positive airway pressure group (interquartile range, 4-6) and 6 days for the usual care group (interquartile range, 5-7; hazard ratio, 1.68; 95% confidence interval, 1.08-2.31; P = .019). There was no significant difference in duration of intensive care, actual postoperative stay, and mean percentage of predicted forced expiratory volume in 1 second on day 3. Mean partial pressure of carbon dioxide was significantly reduced 1 hour after bilevel positive airway pressure application, but there was no overall difference between the groups up to 24 hours. Basal atelectasis occurred in 15 patients (24%) in the usual care group and 2 patients (3%) in the bilevel positive airway pressure group. Overall, 30% of patients in the bilevel positive airway pressure group experienced an adverse event compared with 59% in the usual care group. Among patients undergoing elective coronary artery bypass grafting, the use of bilevel positive airway pressure at extubation reduced the recovery time. Supported by trained staff, more than 75% of all patients allocated to bilevel positive airway pressure tolerated it for more

Diagnosis of gastro-oesophageal reflux disease is enhanced by adding oesophageal histology and excluding epigastric pain.

PubMed

Vakil, N; Vieth, M; Wernersson, B; Wissmar, J; Dent, J

2017-05-01

The diagnosis of gastro-oesophageal reflux disease (GERD) in clinical practice is limited by the sensitivity and specificity of symptoms and diagnostic testing. To determine if adding histology as a criterion and excluding patients with epigastric pain enhances the diagnosis for GERD. Patients with frequent upper gastrointestinal symptoms who had not taken a proton pump inhibitor in the previous 2 months and who had evaluable distal oesophageal biopsies were included (Diamond study: NCT00291746). Epithelial hyperplasia was identified when total epithelial thickness was at least 430 μm. Investigation-based GERD criteria were: presence of erosive oesophagitis, pathological oesophageal acid exposure and/or positive symptom-acid association probability. Symptoms were assessed using the Reflux Disease Questionnaire and a pre-specified checklist. Overall, 127 (55%) of the 231 included patients met investigation-based GERD criteria and 195 (84%) met symptom-based criteria. Epithelial hyperplasia was present in 89 individuals, of whom 61 (69%) met investigation-based criteria and 83 (93%) met symptom-based criteria. Adding epithelial hyperplasia as a criterion increased the number of patients diagnosed with GERD on investigation by 28 [12%; number needed to diagnose (NND): 8], to 155 (67%). The proportion of patients with a symptom-based GERD diagnosis who met investigation-based criteria including epithelial hyperplasia was significantly greater when concomitant epigastric pain was absent than when it was present (P < 0.05; NND: 8). Histology increases diagnosis of GERD and should be performed when clinical suspicion is high and endoscopy is negative. Excluding patients with epigastric pain enhances sensitivity for the diagnosis of GERD. © 2017 John Wiley & Sons Ltd.

A Pragmatic Approach to Patch Testing Atopic Dermatitis Patients: Clinical Recommendations Based on Expert Consensus Opinion.

PubMed

Chen, Jennifer K; Jacob, Sharon E; Nedorost, Susan T; Hanifin, Jon M; Simpson, Eric L; Boguniewicz, Mark; Watsky, Kalman L; Lugo-Somolinos, Aida; Hamann, Carsten R; Eberting, Cheryl Lee; Silverberg, Jonathan I; Thyssen, Jacob P

2016-01-01

Allergic contact dermatitis (ACD) may complicate the clinical course of atopic dermatitis (AD), and patch testing remains the criterion standard for diagnosing ACD. To date, there have been no guidelines or consensus recommendations on when and how to patch test individuals with AD. Failure to patch test when appropriate may result in overlooking an important and potentially curable complicating comorbidity. In this article, we present consensus recommendations regarding when to perform patch testing in the AD patient, best practices, and common pitfalls. Patch testing should be considered in AD patients with dermatitis that fails to improve with topical therapy; with atypical/changing distribution of dermatitis, or pattern suggestive of ACD; with therapy-resistant hand eczema in the working population; with adult- or adolescent-onset AD; and/or before initiating systemic immunosuppressants for the treatment of dermatitis. A suggested patch testing algorithm for AD patients is provided.

Age and diagnostic performance of Alzheimer disease CSF biomarkers

PubMed Central

Rosén, E.; Hansson, O.; Andreasen, N.; Parnetti, L.; Jonsson, M.; Herukka, S.-K.; van der Flier, W.M.; Blankenstein, M.A.; Ewers, M.; Rich, K.; Kaiser, E.; Verbeek, M.M.; Olde Rikkert, M.; Tsolaki, M.; Mulugeta, E.; Aarsland, D.; Visser, P.J.; Schröder, J.; Marcusson, J.; de Leon, M.; Hampel, H.; Scheltens, P.; Wallin, A.; Eriksdotter-Jönhagen, M.; Minthon, L.; Winblad, B.; Blennow, K.; Zetterberg, H.

2012-01-01

Objectives: Core CSF changes in Alzheimer disease (AD) are decreased amyloid β1–42, increased total tau, and increased phospho-tau, probably indicating amyloid plaque accumulation, axonal degeneration, and tangle pathology, respectively. These biomarkers identify AD already at the predementia stage, but their diagnostic performance might be affected by age-dependent increase of AD-type brain pathology in cognitively unaffected elderly. Methods: We investigated effects of age on the diagnostic performance of CSF biomarkers in a uniquely large multicenter study population, including a cross-sectional cohort of 529 patients with AD dementia (median age 71, range 43–89 years) and 304 controls (67, 44–91 years), and a longitudinal cohort of 750 subjects without dementia with mild cognitive impairment (69, 43–89 years) followed for at least 2 years, or until dementia diagnosis. Results: The specificities for subjects without AD and the areas under the receiver operating characteristics curves decreased with age. However, the positive predictive value for a combination of biomarkers remained stable, while the negative predictive value decreased only slightly in old subjects, as an effect of the high AD prevalence in older ages. Conclusion: Although the diagnostic accuracies for AD decreased with age, the predictive values for a combination of biomarkers remained essentially stable. The findings highlight biomarker variability across ages, but support the use of CSF biomarkers for AD even in older populations. PMID:22302554

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

NASA Astrophysics Data System (ADS)

Valtancoli, P.

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

Stochastic quantization of conformally coupled scalar in AdS

NASA Astrophysics Data System (ADS)

Jatkar, Dileep P.; Oh, Jae-Hyuk

2013-10-01

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

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

PubMed Central

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

2014-01-01

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

Three-dimensional analysis of synapses in the transentorhinal cortex of Alzheimer's disease patients.

PubMed

Domínguez-Álvaro, M; Montero-Crespo, M; Blazquez-Llorca, L; Insausti, R; DeFelipe, J; Alonso-Nanclares, L

2018-03-02

Synaptic dysfunction or loss in early stages of Alzheimer's disease (AD) is thought to be a major structural correlate of cognitive dysfunction. Early loss of episodic memory, which occurs at the early stage of AD, is closely associated with the progressive degeneration of medial temporal lobe (MTL) structures of which the transentorhinal cortex (TEC) is the first affected area. However, no ultrastructural studies have been performed in this region in human brain samples from AD patients. In the present study, we have performed a detailed three-dimensional (3D) ultrastructural analysis using focused ion beam/scanning electron microscopy (FIB/SEM) to investigate possible synaptic alterations in the TEC of patients with AD. Surprisingly, the analysis of the density, morphological features and spatial distribution of synapses in the neuropil showed no significant differences between AD and control samples. However, light microscopy studies showed that cortical thickness of the TEC was severely reduced in AD samples, but there were no changes in the volume occupied by neuronal and glial cell bodies, blood vessels, and neuropil. Thus, the present results indicate that there is a dramatic loss of absolute number of synapses, while the morphology of synaptic junctions and synaptic spatial distribution are maintained. How these changes affect cognitive impairment in AD remains to be elucidated.

Exploring the bulk in AdS /CFT : A covariant approach

NASA Astrophysics Data System (ADS)

Engelhardt, Netta

2017-03-01

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

Noise-Coupled Image Rejection Architecture of Complex Bandpass ΔΣAD Modulator

NASA Astrophysics Data System (ADS)

San, Hao; Kobayashi, Haruo

This paper proposes a new realization technique of image rejection function by noise-coupling architecture, which is used for a complex bandpass ΔΣAD modulator. The complex bandpass ΔΣAD modulator processes just input I and Q signals, not image signals, and the AD conversion can be realized with low power dissipation. It realizes an asymmetric noise-shaped spectra, which is desirable for such low-IF receiver applications. However, the performance of the complex bandpass ΔΣAD modulator suffers from the mismatch between internal analog I and Q paths. I/Q path mismatch causes an image signal, and the quantization noise of the mirror image band aliases into the desired signal band, which degrades the SQNDR (Signal to Quantization Noise and Distortion Ratio) of the modulator. In our proposed modulator architecture, an extra notch for image rejection is realized by noise-coupled topology. We just add some passive capacitors and switches to the modulator; the additional integrator circuit composed of an operational amplifier in the conventional image rejection realization is not necessary. Therefore, the performance of the complex modulator can be effectively raised without additional power dissipation. We have performed simulation with MATLAB to confirm the validity of the proposed architecture. The simulation results show that the proposed architecture can achieve the realization of image-rejection effectively, and improve the SQNDR of the complex bandpass ΔΣAD modulator.

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

PubMed

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

2017-01-01

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

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

PubMed

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

2013-06-01

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

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

PubMed Central

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

2010-01-01

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

Lysophosphatidylcholine and amide as metabolites for detecting alzheimer disease using ultrahigh-performance liquid chromatography-quadrupole time-of-flight mass spectrometry-based metabonomics.

PubMed

Cui, Yu; Liu, Xiuqin; Wang, Maoqing; Liu, Liyan; Sun, Xiaohong; Ma, Lan; Xie, Wei; Wang, Chao; Tang, Sisi; Wang, Decai; Wu, Qunhong

2014-10-01

Alzheimer disease (AD) can be diagnosed by clinical and neuropsychologic tests and at autopsy, but there are no simple effective diagnostic methods for detecting biomarkers in patients at early stages of cognitive impairment. Early metabolic alterations that may facilitate AD diagnosis have not been thoroughly explored. We applied a nontargeted metabonomic approach using ultrahigh-performance liquid chromatography-quadrupole time-of-flight mass spectrometry to analyze serum and urine samples from 46 patients with AD and 36 healthy controls. Metabolite profiles were processed using multivariate analysis to identify potential metabolites, which were further confirmed using tandem mass spectrometry. Ultrahigh-performance liquid chromatography mass spectrometry methods were additionally used to quantify potentially important biomarkers. Independent samples were then selected to validate the identified biomarkers. There was a clear separation between healthy controls and AD patients; AD patient samples had disordered amino acid and phospholipid metabolism and dysregulated palmitic amide. Receiver operator characteristic curve and quantification suggested that palmitic amide, lysophosphatidylcholine (LysoPC, 18:0), LysoPC(18:2), L-glutamine, and 5-L-glutamylglycine were the optimal metabolites. In addition, areas under the curve from the palmitic amide, LysoPC(18:2), and 5-L-glutamylglycine in the validation study were 0.714, 0.996, and 0.734, respectively. These data elucidate the metabolic alterations associated with AD and suggest new biomarkers for AD diagnosis, thereby permitting early intervention designed to prevent disease progression.

Getting Value out of Value-Added: Report of a Workshop

ERIC Educational Resources Information Center

Braun, Henry, Ed.; Chudowsky, Naomi, Ed.; Koenig, Judith, Ed.

2010-01-01

Value-added methods refer to efforts to estimate the relative contributions of specific teachers, schools, or programs to student test performance. In recent years, these methods have attracted considerable attention because of their potential applicability for educational accountability, teacher pay-for-performance systems, school and teacher…

Genetics of Aggression in Alzheimer’s Disease (AD)

PubMed Central

Lukiw, Walter J.; Rogaev, Evgeny I.

2017-01-01

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

Small black holes in global AdS spacetime

NASA Astrophysics Data System (ADS)

Jokela, Niko; Pönni, Arttu; Vuorinen, Aleksi

2016-04-01

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

"Tu Que Te Mereces Un Principe, Un Dentista": The Use of Metaphors of Love, Desire, and Gender in Personal Ads on the Internet to Perform Heterosexuality. Creating and Supporting Ideologies of Heteronormativity and Sexuality in Spanish

ERIC Educational Resources Information Center

Rojas-Sosa, Deyanira

2009-01-01

This study investigates how heterosexuality is performed and achieved in everyday language use, specifically in personal ads from the Internet. Within personal ads, it focuses on the metaphors used by ad posters to articulate concepts of love, desire, gender and sexuality. The aim was to determine how the use of certain metaphors reflects ad…

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

Assessment of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Atopic Dermatitis Patients

PubMed Central

Jiang, Ying; Ma, Wencong

2017-01-01

Background To develop new strategies for identifying atopic dermatitis patients, a better understanding of the signs for chronic inflammatory status is needed. This study was designed to investigate whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are related to the severity of atopic dermatitis (AD) assessed by the Scoring Atopic Dermatitis (SCORAD) index. Material/Methods A retrospective study involving 80 AD patients and 45 healthy control subjects was performed. NLR, PLR, and the number of peripheral blood eosinophils were compared between AD patients and healthy controls, and correlations between these indexes and clinical characteristics were analyzed. Results NLR, PLR, and eosinophils in AD patients were all significantly higher than in healthy individuals. Among AD patients, NLR (p<0.001) and PLR (p<0.001), as contrasted with eosinophils (p=0.146), were correlated positively with SCORAD index. Additionally, an NLR level of 1.75 was determined as the predictive cut-off value of severe AD (SCORAD ≥51) (sensitivity 94.7%, specificity 58.6%, the area under the receiver-operating characteristic curve (AUROC) 0.778, p=0.001). For eosinophils, the sensitivity and specificity were 78.9% and 62.1%, respectively, and the AUROC was only 0.685 (p=0.032) in predicting high SCORAD. Conclusions NLR and PLR reflect inflammatory response and disease severity in AD patients. PMID:28306706

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

NASA Astrophysics Data System (ADS)

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

2018-03-01

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

Quantum load balancing in ad hoc networks

NASA Astrophysics Data System (ADS)

Hasanpour, M.; Shariat, S.; Barnaghi, P.; Hoseinitabatabaei, S. A.; Vahid, S.; Tafazolli, R.

2017-06-01

This paper presents a novel approach in targeting load balancing in ad hoc networks utilizing the properties of quantum game theory. This approach benefits from the instantaneous and information-less capability of entangled particles to synchronize the load balancing strategies in ad hoc networks. The quantum load balancing (QLB) algorithm proposed by this work is implemented on top of OLSR as the baseline routing protocol; its performance is analyzed against the baseline OLSR, and considerable gain is reported regarding some of the main QoS metrics such as delay and jitter. Furthermore, it is shown that QLB algorithm supports a solid stability gain in terms of throughput which stands a proof of concept for the load balancing properties of the proposed theory.

Predictors of patient dependence in mild-to-moderate Alzheimer's disease.

PubMed

Benke, Thomas; Sanin, Günter; Lechner, Anita; Dal-Bianco, Peter; Ransmayr, Gerhard; Uranüs, Margarete; Marksteiner, Josef; Gaudig, Maren; Schmidt, Reinhold

2015-01-01

Patient dependence has rarely been studied in mild-to-moderate Alzheimer's disease (AD). To identify factors which predict patient dependence in mild-to-moderate AD. We studied 398 non-institutionalized AD patients (234 females) of the ongoing Prospective Registry on Dementia (PRODEM) in Austria. The Dependence Scale (DS) was used to assess patient dependence. Patient assessment comprised functional abilities, neuropsychiatric symptoms and cognitive functions. A multiple linear regression analysis was performed to identify predictors of patient dependence. AD patients were mildly-to-moderately impaired (mean scores and SDs were: CDR 0.84 ± 0.43; DAD 74.4 ± 23.3, MMSE = 22.5 ± 3.6). Psychopathology and caregiver burden were in the low range (mean NPI score 13.2, range 0 to 98; mean ZBI score 18, range 0-64). Seventy five percent of patients were classified as having a mild level of patient dependence (DS sum score 0 to 6). Patient dependence correlated significantly and positively with age, functional measures, psychopathology and depression, disease duration, and caregiver burden. Significant negative, but low correlations were found between patient dependence, cognitive variables, and global cognition. Activities of daily living, patient age, and disease severity accounted for 63% of variance in patient dependence, whereas cognitive variables accounted for only 11%. Dependence in this cohort was mainly related to age and functional impairment, and less so to cognitive and neuropsychiatric variables. This differs from studies investigating patients in more advanced disease stages which found abnormal behavior and impairments of cognition as main predictors of patient dependence.

The effect of souvenaid on functional brain network organisation in patients with mild Alzheimer's disease: a randomised controlled study.

PubMed

de Waal, Hanneke; Stam, Cornelis J; Lansbergen, Marieke M; Wieggers, Rico L; Kamphuis, Patrick J G H; Scheltens, Philip; Maestú, Fernando; van Straaten, Elisabeth C W

2014-01-01

Synaptic loss is a major hallmark of Alzheimer's disease (AD). Disturbed organisation of large-scale functional brain networks in AD might reflect synaptic loss and disrupted neuronal communication. The medical food Souvenaid, containing the specific nutrient combination Fortasyn Connect, is designed to enhance synapse formation and function and has been shown to improve memory performance in patients with mild AD in two randomised controlled trials. To explore the effect of Souvenaid compared to control product on brain activity-based networks, as a derivative of underlying synaptic function, in patients with mild AD. A 24-week randomised, controlled, double-blind, parallel-group, multi-country study. 179 drug-naïve mild AD patients who participated in the Souvenir II study. Patients were randomised 1∶1 to receive Souvenaid or an iso-caloric control product once daily for 24 weeks. In a secondary analysis of the Souvenir II study, electroencephalography (EEG) brain networks were constructed and graph theory was used to quantify complex brain structure. Local brain network connectivity (normalised clustering coefficient gamma) and global network integration (normalised characteristic path length lambda) were compared between study groups, and related to memory performance. THE NETWORK MEASURES IN THE BETA BAND WERE SIGNIFICANTLY DIFFERENT BETWEEN GROUPS: they decreased in the control group, but remained relatively unchanged in the active group. No consistent relationship was found between these network measures and memory performance. The current results suggest that Souvenaid preserves the organisation of brain networks in patients with mild AD within 24 weeks, hypothetically counteracting the progressive network disruption over time in AD. The results strengthen the hypothesis that Souvenaid affects synaptic integrity and function. Secondly, we conclude that advanced EEG analysis, using the mathematical framework of graph theory, is useful and feasible for

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

PubMed

Amichai, B; Grunwald, M H

2009-12-01

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

A New Performance Improvement Model: Adding Benchmarking to the Analysis of Performance Indicator Data.

PubMed

Al-Kuwaiti, Ahmed; Homa, Karen; Maruthamuthu, Thennarasu

2016-01-01

A performance improvement model was developed that focuses on the analysis and interpretation of performance indicator (PI) data using statistical process control and benchmarking. PIs are suitable for comparison with benchmarks only if the data fall within the statistically accepted limit-that is, show only random variation. Specifically, if there is no significant special-cause variation over a period of time, then the data are ready to be benchmarked. The proposed Define, Measure, Control, Internal Threshold, and Benchmark model is adapted from the Define, Measure, Analyze, Improve, Control (DMAIC) model. The model consists of the following five steps: Step 1. Define the process; Step 2. Monitor and measure the variation over the period of time; Step 3. Check the variation of the process; if stable (no significant variation), go to Step 4; otherwise, control variation with the help of an action plan; Step 4. Develop an internal threshold and compare the process with it; Step 5.1. Compare the process with an internal benchmark; and Step 5.2. Compare the process with an external benchmark. The steps are illustrated through the use of health care-associated infection (HAI) data collected for 2013 and 2014 from the Infection Control Unit, King Fahd Hospital, University of Dammam, Saudi Arabia. Monitoring variation is an important strategy in understanding and learning about a process. In the example, HAI was monitored for variation in 2013, and the need to have a more predictable process prompted the need to control variation by an action plan. The action plan was successful, as noted by the shift in the 2014 data, compared to the historical average, and, in addition, the variation was reduced. The model is subject to limitations: For example, it cannot be used without benchmarks, which need to be calculated the same way with similar patient populations, and it focuses only on the "Analyze" part of the DMAIC model.

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

PubMed Central

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

2014-01-01

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

Entanglement entropy of AdS5 × S5 with massive flavors

NASA Astrophysics Data System (ADS)

Hu, Sen; Wu, Guozhen

2018-01-01

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

AdS black disk model for small-x DIS

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

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

2011-05-23

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

Distinct Neuroanatomical Substrates and Cognitive Mechanisms of Figure Copy Performance in Alzheimer's Disease and Behavioral Variant Frontotemporal Dementia

ERIC Educational Resources Information Center

Possin, Katherine L.; Laluz, Victor R.; Alcantar, Oscar Z.; Miller, Bruce L.; Kramer, Joel H.

2011-01-01

Figure copy is the most common method of visual spatial assessment in dementia evaluations, but performance on this test may be multifactorial. We examined the neuroanatomical substrates of figure copy performance in 46 patients with Alzheimer's disease (AD) and 48 patients with the behavioral variant of Frontotemporal dementia (bvFTD). A group of…

Practical treatment strategies for patients with Alzheimer's disease.

PubMed

Christensen, Daniel D; Lin, Peter

2007-12-01

With the "baby boomers" entering retirement and beyond and the life expectancy of the entire population increasing, the burden of Alzheimer's Disease (AD) grows alarmingly greater. Over 5 million people in the United States currently have AD, and that number could triple by 2050. The financial impact of caring for these patients is substantial. Estimates of direct and indirect costs are as high as $148 billion per year. In addition to its substantial economic impact, AD has devastating effects on patients and their families. Alzheimer's disease begins with gradual memory loss and progresses to personality change, behavioral disturbance, loss of executive function, and loss of the ability to perform basic activities of daily living, including eating, walking, dressing, and grooming. These impairments strain families and caregivers and create challenges to the care and safety of the patient as well as threaten the health and well-being of the caregiver. As the number of patients diagnosed with AD increases, there is an ever-growing need for early diagnosis, which often is first observed in the primary care setting. While AD cannot be reversed or stopped, disease progression can be delayed and quality of life enhanced with early diagnosis and treatment. Early and accurate diagnosis has become increasingly important and will become even more so with the anticipated new generation of medications. Though several consensus statements on diagnosis and treatment of AD have been developed, few primary care physicians routinely follow evidence-based guidelines in their clinical practices. A 2006 survey conducted by the American Academy of Family Physicians identified a moderate to high level of need for education on AD in a majority of respondents. This article illustrates the primary care management of AD beginning with diagnosis and concluding with autopsy. Enhancing diagnostic and treatment skills in primary care will promote earlier diagnosis, improved patient management