Bundling of ecosystem services to increase forestland value and enhance sustainable forest management

Treesearch

Robert L. Deal; Bobby Cochran; Gina LaRocco

2012-01-01

There has been increasing interest in the use of market-based approaches to add value for forestland and to assist with the conservation of natural resources. While markets for ecosystem services show potential for increasing forestland value, there is concern that the lack of an integrated program will simply add to the complexity of these services without generating...

Structure of a Novel O-Linked N-Acetyl-d-glucosamine (O-GlcNAc) Transferase, GtfA, Reveals Insights into the Glycosylation of Pneumococcal Serine-rich Repeat Adhesins*

PubMed Central

Shi, Wei-Wei; Jiang, Yong-Liang; Zhu, Fan; Yang, Yi-Hu; Shao, Qiu-Yan; Yang, Hong-Bo; Ren, Yan-Min; Wu, Hui; Chen, Yuxing; Zhou, Cong-Zhao

2014-01-01

Protein glycosylation catalyzed by the O-GlcNAc transferase (OGT) plays a critical role in various biological processes. In Streptococcus pneumoniae, the core enzyme GtfA and co-activator GtfB form an OGT complex to glycosylate the serine-rich repeat (SRR) of adhesin PsrP (pneumococcal serine-rich repeat protein), which is involved in the infection and pathogenesis. Here we report the 2.0 Å crystal structure of GtfA, revealing a β-meander add-on domain beyond the catalytic domain. It represents a novel add-on domain, which is distinct from the all-α-tetratricopeptide repeats in the only two structure-known OGTs. Structural analyses combined with binding assays indicate that this add-on domain contributes to forming an active GtfA-GtfB complex and recognizing the acceptor protein. In addition, the in vitro glycosylation system enables us to map the O-linkages to the serine residues within the first SRR of PsrP. These findings suggest that fusion with an add-on domain might be a universal mechanism for diverse OGTs that recognize varying acceptor proteins/peptides. PMID:24936067

Typological diversity of tall buildings and complexes in relation to their functional structure

NASA Astrophysics Data System (ADS)

Generalov, Viktor P.; Generalova, Elena M.; Kalinkina, Nadezhda A.; Zhdanova, Irina V.

2018-03-01

The paper focuses on peculiarities of tall buildings and complexes, their typology and its formation in relation to their functional structure. The research is based on the analysis of tall buildings and complexes and identifies the following main functional elements of their formation: residential, administrative (office), hotel elements. The paper also considers the following services as «disseminated» in the space-planning structure: shops, medicine, entertainment, kids and sports facilities, etc., their location in the structure of the total bulk of the building and their impact on typological diversity. Research results include suggestions to add such concepts as «single-function tall buildings» and «mixed-use tall buildings and complexes» into the classification of tall buildings. In addition, if a single-function building or complex performs serving functions, it is proposed to add such concepts as «a residential tall building (complex) with provision of services», «an administrative (public) tall building (complex) with provision of services» into the classification of tall buildings. For mixed-use buildings and complexes the following terms are suggested: «a mixed-use tall building with provision of services», «a mixed-use tall complex with provision of services».

Cyclodextrins improving the physicochemical and pharmacological properties of antidepressant drugs: a patent review.

PubMed

Diniz, Tâmara Coimbra; Pinto, Tiago Coimbra Costa; Menezes, Paula Dos Passos; Silva, Juliane Cabral; Teles, Roxana Braga de Andrade; Ximenes, Rosana Christine Cavalcanti; Guimarães, Adriana Gibara; Serafini, Mairim Russo; Araújo, Adriano Antunes de Souza; Quintans Júnior, Lucindo José; Almeida, Jackson Roberto Guedes da Silva

2018-01-01

Depression is a serious mood disorder and is one of the most common mental illnesses. Despite the availability of several classes of antidepressants, a substantial percentage of patients are unresponsive to these drugs, which have a slow onset of action in addition to producing undesirable side effects. Some scientific evidence suggests that cyclodextrins (CDs) can improve the physicochemical and pharmacological profile of antidepressant drugs (ADDs). The purpose of this paper is to disclose current data technology prospects involving antidepressant drugs and cyclodextrins. Areas covered: We conducted a patent review to evaluate the antidepressive activity of the compounds complexed in CDs, and we analyzed whether these complexes improved their physicochemical properties and pharmacological action. The present review used 8 specialized patent databases for patent research, using the term 'cyclodextrin' combined with 'antidepressive agents' and its related terms. We found 608 patents. In the end, considering the inclusion criteria, 27 patents reporting the benefits of complexation of ADDs with CDs were included. Expert opinion: The use of CDs can be considered an important tool for the optimization of physicochemical and pharmacological properties of ADDs, such as stability, solubility and bioavailability.

77 FR 10579 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-22

... participants that add or remove liquidity in the Complex Order Book (``maker/taker fees'') in symbols that are... liquidity on the Complex Order Book and $0.30 per contract ($0.32 per contract in the Select Symbols) for taking liquidity from the Complex Order Book. ISE market makers who take liquidity from the Complex Order...

76 FR 79236 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... Rule Change Relating to Fees for Certain Complex Orders Executed on the Exchange December 15, 2011... proposing to amend fees for certain complex orders executed on the Exchange. The text of the proposed rule... participants that add or remove liquidity in the Complex Order Book (``maker/taker fees'') in symbols that are...

The De Novo Design of Protein-Protein Interfaces

DTIC Science & Technology

it was our intention to add to this body by engineering de novo (from scratch) protein/protein complexes. Using this inverse approach we have furthered...key physical features needed to drive specific protein/protein interactions. It is considered inverse because, instead of studying natural complexes

Engineering and fabrication cost considerations for cryogenic wind tunnel models

NASA Technical Reports Server (NTRS)

Boykin, R. M., Jr.; Davenport, J. B., Jr.

1983-01-01

Design and fabrication cost drivers for cryogenic transonic wind tunnel models are defined. The major cost factors for wind tunnel models are model complexity, tolerances, surface finishes, materials, material validation, and model inspection. The cryogenic temperatures require the use of materials with relatively high fracture toughness but at the same time high strength. Some of these materials are very difficult to machine, requiring extensive machine hours which can add significantly to the manufacturing costs. Some additional engineering costs are incurred to certify the materials through mechanical tests and nondestructive evaluation techniques, which are not normally required with conventional models. When instrumentation such as accelerometers and electronically scanned pressure modules is required, temperature control of these devices needs to be incorporated into the design, which requires added effort. Additional thermal analyses and subsystem tests may be necessary, which also adds to the design costs. The largest driver to the design costs is potentially the additional static and dynamic analyses required to insure structural integrity of the model and support system.

The Effect of Co-occurring Substance Use on Gamma-hydroxybutyric Acid Withdrawal Syndrome.

PubMed

Kamal, Rama M; Dijkstra, Boukje A G; Loonen, Anton J; De Jong, Cornelis A J

2016-01-01

Gamma-hydroxybutyric acid (GHB) withdrawal is a complex syndrome which can be potentially life-threatening. Additionally, GHB-dependent patients frequently report co-occurring substance use of other psychoactive drugs. We assessed the add-on effect of co-use on GHB withdrawal symptoms. We conducted an open-label, pretest-posttest design study with 95 patients selected from 229 inpatients admitted for detoxification, who were divided into GHB only (GO, n = 40), GHB plus sedatives (GSE, n = 38), and GHB plus stimulants (GST, n = 17) groups. GHB withdrawal was evaluated by means of the Subjective Withdrawal Scale. Co-use add-on effects on the severity of withdrawal symptoms were evaluated 2.5 hours after the last illicit GHB self-administration (T1) when withdrawal was expected and 2.5 hours later, after administration of a very low dose of pharmaceutical GHB (T2). The GO group reported high scores of psychomotor retardation symptoms at both T1 and T2, and also high cravings, agitation, and restlessness at T1, and anxiety at T2. The GSE group reported the highest score in psycho-autonomic distress symptoms at both T1 and T2, whereas the GST group reported the highest score in psycho-motor stress factor at T2. There was no significant difference in withdrawal intensity in all symptom clusters between T1 and T2 for both GSE and GO groups. However, after 5 hours, the GST group reported significant decreases in intensity for all symptoms except for psycho-motor stress. At T1, GST and GSE groups reported more muscle twitches than the GO group as a significant add-on effect to the GHB withdrawal. At T2, the GST group experienced more agitation (P = 0.009), restlessness (P = 0.001), and rapid pulse (P = 0.034) than the GO group. Co-use, especially of stimulants, caused an add-on effect on the GHB withdrawal symptoms within the first 5 hours.

Variable complexity online sequential extreme learning machine, with applications to streamflow prediction

NASA Astrophysics Data System (ADS)

Lima, Aranildo R.; Hsieh, William W.; Cannon, Alex J.

2017-12-01

In situations where new data arrive continually, online learning algorithms are computationally much less costly than batch learning ones in maintaining the model up-to-date. The extreme learning machine (ELM), a single hidden layer artificial neural network with random weights in the hidden layer, is solved by linear least squares, and has an online learning version, the online sequential ELM (OSELM). As more data become available during online learning, information on the longer time scale becomes available, so ideally the model complexity should be allowed to change, but the number of hidden nodes (HN) remains fixed in OSELM. A variable complexity VC-OSELM algorithm is proposed to dynamically add or remove HN in the OSELM, allowing the model complexity to vary automatically as online learning proceeds. The performance of VC-OSELM was compared with OSELM in daily streamflow predictions at two hydrological stations in British Columbia, Canada, with VC-OSELM significantly outperforming OSELM in mean absolute error, root mean squared error and Nash-Sutcliffe efficiency at both stations.

Quality of life, mood and seizure control in patients with brain tumor related epilepsy treated with lacosamide as add-on therapy: A prospective explorative study with a historical control group.

PubMed

Maschio, Marta; Zarabla, Alessia; Maialetti, Andrea; Fabi, Alessandra; Vidiri, Antonello; Villani, Veronica; Giannarelli, Diana

2017-08-01

Brain tumor-related epilepsy (BTRE) is often drug resistant and patients can be forced to take polytherapy that can adversely affect their quality of life (QoL). Lacosamide (LCM) is a new antiepileptic drug (AED) used as adjunctive therapy in patients with partial seizures with or without secondary generalization, with a favorable pharmacokinetic profile that seems to be effective and well tolerated. Therefore it represents a possible therapeutic choice for patients with BTRE. We propose a prospective study with a historical control group to evaluate the effect of LCM as add-on therapy on seizure control and quality of life in patients with BTRE. This study has been designed to test the superiority of Lacosamide over Levetiracetam as an add-on. We compared a prospective cohort of 25 patients treated with Lacosamide with a historical control group (n=19) treated with Levetiracetam as an add-on. We recruited 25 adult patients (M 18, F 7; mean age 41.9) affected by BTRE with uncontrolled partial-onset seizures treated with AED polytherapy. We added LCM as an add-on. Patients were evaluated at baseline, after 3months and at 6months. This population has been compared with a historical control group of 19 BTRE adult patients (M 13, F 6; median age 48.0, range: 28-70) with uncontrolled partial-onset seizures treated with LEV as add-on. The patients underwent QoL, mood and adverse events tests (Adverse Event Profile-AEP) and evaluation of seizure frequency. Twelve patients had high grade gliomas, and thirteen had low grade gliomas. During follow-up, thirteen patients underwent chemotherapy, three radiotherapy and five patients had disease progression. Nine patients had simple partial seizures, eight had complex partial seizures, and eight had secondary generalized seizures. Fifteen patients were in monotherapy and ten in polytherapy with AEDs. LCM was added up to reach the maximum dosage of 400mg/die (mean final dose 300mg/die). Four patients dropped out due to poor compliance and 1 for inefficacy. In the historical control group treated with LEV (mean final dose 2000mg/die) 12 patients had high-grade gliomas, and 7 had low grade gliomas. Thirteen patients were in monotherapy and 6 in polytherapy with AEDs. In the 22 patients evaluable of 25 patients treated with LCM, we observed at final follow-up 7 patients seizure free, 12 with a significant reduction of seizures≥50%, 2 stable and 1 patient with number of seizures increased. Mean seizure frequency at baseline compared with baseline period: the mean number of seizures significantly decreased from baseline (9.4) to final follow-up (1.2) (P=0.005). The Responder Rate was 86.4%. Comparing responder rate of 22 evaluable patients with LCM with responder rate of 19 patients with LEV we didn't observe significant differences (p=0.31). In our patients treated with LCM we didn't observe significant difference at 3 and 6months in QoL tests results; we observe a significant reduction in the mean score of Karnofsky Performance Status (KPS) and Barthel Index (BI) between baseline and 6months of follow-up (KPS p=0.003; BI p=0.007). No clinical side effects were observed. Comparing the LCM with the historical group treated with LEV in add-on, we observed that LCM seems to have a higher clinical efficacy than LEV. In our patients, we did not observe any significant changes in QoL tests, indicating stability in all quality of life domains explored, despite the objective worsening in their functional status. Although this is a small series with a relatively short follow-up, our data indicates that LCM in add-on in patients with BTRE appears to be as effective as LEV in add-on, without impact on mood and quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

Mononuclear nickel (II) and copper (II) coordination complexes supported by bispicen ligand derivatives: Experimental and computational studies

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

Singh, Nirupama; Niklas, Jens; Poluektov, Oleg

2017-01-01

The synthesis, characterization and density functional theory calculations of mononuclear Ni and Cu complexes supported by the N,N’-Dimethyl-N,N’-bis-(pyridine-2-ylmethyl)-1,2-diaminoethane ligand and its derivatives are reported. The complexes were characterized by X-ray crystallography as well as by UV-visible absorption spectroscopy and EPR spectroscopy. The solid state structure of these coordination complexes revealed that the geometry of the complex depended on the identity of the metal center. Solution phase characterization data are in accord with the solid phase structure, indicating minimal structural changes in solution. Optical spectroscopy revealed that all of the complexes exhibit color owing to d-d transition bands in the visiblemore » region. Magnetic parameters obtained from EPR spectroscopy with other structural data suggest that the Ni(II) complexes are in pseudo-octahedral geometry and Cu(II) complexes are in a distorted square pyramidal geometry. In order to understand in detail how ligand sterics and electronics affect complex topology detailed computational studies were performed. The series of complexes reported in this article will add significant value in the field of coordination chemistry as Ni(II) and Cu(II) complexes supported by tetradentate pyridyl based ligands are rather scarce.« less

Efficacy and safety of repaglinide added to sitagliptin in Japanese patients with type 2 diabetes: A randomized 24-week open-label clinical trial.

PubMed

Nishimura, Akihiro; Usui, Shuki; Kumashiro, Naoki; Uchino, Hiroshi; Yamato, Azusa; Yasuda, Daijiro; Nagasawa, Kaoru; Okubo, Minoru; Mori, Yasumichi; Hirose, Takahisa

2016-12-30

Although sitagliptin and repaglinide monotherapies improve postprandial hyperglycemia, the long-term effects and safety of their combination has not been examined. In this randomized 24-week trial of Japanese patients with poor control (HbA1c 7.0-8.5%) by sitagliptin, we divided 40 patients randomly into two equal groups of the repaglinide add-on to sitagliptin (ADD-ON, n=20), or sitagliptin switched to repaglinide (SWITCH, n=20). The meal tolerance test was carried out at weeks 0 and 24. The primary outcomes were changes in HbA1c and area under the curves (AUC) of glucose from the baseline to week 24. The mean change in HbA1c from baseline to week 24 was larger in the ADD-ON (-0.87±0.63%, mean±SD), compared with the SWITCH (0.03±0.65%, p=0.000). Significant improvements were noted in the mean changes in fasting glucose and AUCs of glucose in the ADD-ON vs. SWITCH (p=0.007 and p=0.000). Insulin secretion relative to glucose elevation (ISG; defined as AUC insulin/AUC glucose) increased significantly in the ADD-ON, although the mean change in fasting insulin level was significantly decreased in the ADD-ON (p=0.015 and p=0.026). The AUC of glucagon was significantly lower at 24-week relative to baseline in the ADD-ON, but was not significant in the two groups (p=0.047 and p=0.056, respectively). The combination therapy produced significant reductions in HbA1c, AUC of glucose and fasting glucose compared with switching to repaglinide without weight gain or severe hypoglycemia. The improved glycemic control with this combination therapy may be at least in part due to augmentation of repaglinide-induced insulin secretion by sitagliptin.

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

PubMed

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

2008-01-01

To combine the rational use of marine benthic resources and economic development of small-scale fishers, Chile passed legislation in 1991 establishing a comanagement policy that grants exclusive territorial user rights for fisheries (TURFs) to artisanal fisher organizations in well-defined inshore coastal areas, known as Management and Exploitation Areas for Benthic Resources (MEABRs). In general the policy has been proclaimed a management and economic success because benthic resource abundances have increased inside MEABRs in comparison with open-access areas. However, there is a lack of studies assessing the impact of this management policy on nontargeted subtidal species and community assemblages and the policy's implications for biodiversity and conservation. This study starts to fill this gap and links the allocation of TURFs for benthic resources with add-on conservation benefits for species that are not directly linked with the fishery policy. Comparative subtidal surveys inside vs. outside MEABRs were used to assess the effects of three MEABRs on managed targeted benthic species, biodiversity (species richness), and community assemblages in central Chile. Surveys focused exclusively on subtidal kelp forest habitats dominated by Lessonia trabeculata, spanning 4-12 m in depth and with similar levels of habitat complexity. The study comprised: (1) quantification of kelp forest complexity, (2) understory survey of sessile species, (3) quantification of conspicuous benthic macroinvertebrates, including those under management, and (4) quantification of reef-fish species inside the kelp habitat. Results showed population enhancement of target-managed invertebrates inside MEABRs. Moreover, reef-fish species were significantly more diverse and abundant inside MEABRs, and community assemblages of nontarget benthic invertebrates and reef fish were significantly different inside vs. outside MEABRs. The comanagement of inshore benthic resources in Chile, through MEABRs aims for the sustainability of invertebrate and algae stocks. However, our study shows that this management tool, which in practice restricts access to the entire management area, provides important conservation add-on effects for species that are not the focus of the management policies. Therefore, in Chile, the hundreds of already established MEABRs could represent an important ancillary network, which complements the biodiversity objectives of fully protected areas such as no-take marine protected areas or others.

Quantum-limited Terahertz detection without liquid cryogens

NASA Technical Reports Server (NTRS)

2005-01-01

Under this contract, we have successfully designed, fabricated and tested a revolutionary new type of detector for Terahertz (THz) radiation, the tunable antenna-coupled intersubband Terahertz (TACIT) detector. The lowest-noise THz detectors used in the astrophysics community require cooling to temperatures below 4K. This deep cryogenic requirement forces satellites launched for THz- observing missions to include either large volumes of liquid Helium, complex cryocoolers, or both. Cryogenic requirements thus add significantly to the cost, complexity and mass of satellites and limit the duration of their missions. It hence desirable to develop new detector technologies with less stringent cryogenic requirements. Such detectors will not only be important in space-based astrophysics, but also respond to a growing demand for THz technology for earth-based scientific and commercial applications.

Simulation Training for the Office-Based Anesthesia Team.

PubMed

Ritt, Richard M; Bennett, Jeffrey D; Todd, David W

2017-05-01

An OMS office is a complex environment. Within such an environment, a diverse scope of complex surgical procedures is performed with different levels of anesthesia, ranging from local anesthesia to general anesthesia, on patients with varying comorbidities. Optimal patient outcomes require a functional surgical and anesthetic team, who are familiar with both standard operational principles and emergency recognition and management. Offices with high volume and time pressure add further stress and potential risk to the office environment. Creating and maintaining a functional surgical and anesthetic team that is competent with a culture of patient safety and risk reduction is a significant challenge that requires time, commitment, planning, and dedication. This article focuses on the role of simulation training in office training and preparation. Copyright © 2017 Elsevier Inc. All rights reserved.

Biomarker Signatures of Mitochondrial NDUFS3 in Invasive Breast Carcinoma

PubMed Central

Suhane, Sonal; Berel, Dror; Ramanujan, V Krishnan

2011-01-01

We present evidence for potential biomarker utility of a mitochondrial complex I subunit, (NDUFS3) in discriminating normal and highly invasive breast carcinoma specimens obtained from clinical patients. Besides being a robust indicator of breast cancer aggressiveness, NDUFS3 also shows clear signatures of a hypoxia/necrosis marker in invasive ductal carcinoma specimens. Statistically significant positive correlation was observed between nuclear grade and NDUFS3 expression level in the tumor specimens analyzed. We support these findings with a plausible mechanism involving mitochondrial complex I assembly defects and/or redox buffering induced mitochondrial dysfunction during the process of cancer cell transformation. From a clinical standpoint, this novel observation adds value in augmenting the current receptor-based biomarkers for better accuracy in diagnosis and predicting survival rate in patients with breast carcinoma. PMID:21867691

Technical support for digital systems technology development. Task order 1: ISP contention analysis and control

NASA Technical Reports Server (NTRS)

Stehle, Roy H.; Ogier, Richard G.

1993-01-01

Alternatives for realizing a packet-based network switch for use on a frequency division multiple access/time division multiplexed (FDMA/TDM) geostationary communication satellite were investigated. Each of the eight downlink beams supports eight directed dwells. The design needed to accommodate multicast packets with very low probability of loss due to contention. Three switch architectures were designed and analyzed. An output-queued, shared bus system yielded a functionally simple system, utilizing a first-in, first-out (FIFO) memory per downlink dwell, but at the expense of a large total memory requirement. A shared memory architecture offered the most efficiency in memory requirements, requiring about half the memory of the shared bus design. The processing requirement for the shared-memory system adds system complexity that may offset the benefits of the smaller memory. An alternative design using a shared memory buffer per downlink beam decreases circuit complexity through a distributed design, and requires at most 1000 packets of memory more than the completely shared memory design. Modifications to the basic packet switch designs were proposed to accommodate circuit-switched traffic, which must be served on a periodic basis with minimal delay. Methods for dynamically controlling the downlink dwell lengths were developed and analyzed. These methods adapt quickly to changing traffic demands, and do not add significant complexity or cost to the satellite and ground station designs. Methods for reducing the memory requirement by not requiring the satellite to store full packets were also proposed and analyzed. In addition, optimal packet and dwell lengths were computed as functions of memory size for the three switch architectures.

Comparison of the effects of tolvaptan and furosemide on renal water and sodium excretion in patients with heart failure and advanced chronic kidney disease: a subanalysis of the K-STAR study.

PubMed

Tominaga, Naoto; Kida, Keisuke; Inomata, Takayuki; Sato, Naoki; Izumi, Tohru; Akashi, Yoshihiro J; Shibagaki, Yugo

2018-06-22

Tolvaptan (TLV) is known to increase electrolyte-free water clearance. However, TLV actions on renal electrolytes including urine sodium (uNa) excretion and its consequences are less well understood. This subanalysis investigated the effect of add-on TLV compared to increased furosemide (FUR) on both electrolyte-free water and electrolyte clearance in patients with congestive heart failure (CHF) complicated by advanced chronic kidney disease (CKD). The Kanagawa Aquaresis Investigators Trial of TLV on HF Patients with Renal Impairment (K-STAR) was a multicenter, open-labeled, randomized, and controlled prospective clinical study. Eighty-one Japanese patients with CHF and residual signs of congestion despite oral FUR treatment (≥ 40 mg/day) were recruited and randomly assigned to a 7-day add-on treatment with either ≤ 40 mg/day FUR or ≤ 15 mg/day TLV. Electrolyte-free water clearance, electrolyte osmolar clearance and electrolyte excretion were compared between the two groups before and after therapy. The change (Δ) in electrolyte-free water clearance was significantly higher in the add-on TLV group than in the add-on FUR group. However, Δelectrolyte osmolar clearance was also higher in the add-on TLV group than in the increased FUR group. This was primarily because ΔuNa excretion was significantly higher in the add-on TLV group than in the increased FUR group, since Δurine potassium excretion was significantly lower in the add-on TLV group than in the increased FUR group. Add-on TLV may increase both renal water and Na excretion in CHF patients with advanced CKD to a greater degree than increased FUR.

Formal verification of a set of memory management units

NASA Technical Reports Server (NTRS)

Schubert, E. Thomas; Levitt, K.; Cohen, Gerald C.

1992-01-01

This document describes the verification of a set of memory management units (MMU). The verification effort demonstrates the use of hierarchical decomposition and abstract theories. The MMUs can be organized into a complexity hierarchy. Each new level in the hierarchy adds a few significant features or modifications to the lower level MMU. The units described include: (1) a page check translation look-aside module (TLM); (2) a page check TLM with supervisor line; (3) a base bounds MMU; (4) a virtual address translation MMU; and (5) a virtual address translation MMU with memory resident segment table.

Precision manufacturing for clinical-quality regenerative medicines.

PubMed

Williams, David J; Thomas, Robert J; Hourd, Paul C; Chandra, Amit; Ratcliffe, Elizabeth; Liu, Yang; Rayment, Erin A; Archer, J Richard

2012-08-28

Innovations in engineering applied to healthcare make a significant difference to people's lives. Market growth is guaranteed by demographics. Regulation and requirements for good manufacturing practice-extreme levels of repeatability and reliability-demand high-precision process and measurement solutions. Emerging technologies using living biological materials add complexity. This paper presents some results of work demonstrating the precision automated manufacture of living materials, particularly the expansion of populations of human stem cells for therapeutic use as regenerative medicines. The paper also describes quality engineering techniques for precision process design and improvement, and identifies the requirements for manufacturing technology and measurement systems evolution for such therapies.

Longhorn Business Jets

NASA Technical Reports Server (NTRS)

1980-01-01

Developed in NASA's Aircraft Energy Efficiency program and manufactured by Gates Learjet Corporation, the winglet is an aerodynamic innovation designed to reduce fuel consumption and improve airplane performance. Winglets are lifting surfaces designed to operate in the "vortex" or air whirlpool which occurs at an airplane's wingtip. Complex flow of air around wingtip creates drag which retards the plane's progress. Winglet reduces strength of vortex and thereby reduces strength of drag. Additionally, winglet generates its own lift, producing forward thrust in the manner of a boat's sail. Combination of reduced drag and additional thrust adds up to significant improvement in fuel efficiency.

50 CFR 86.60 - What are the criteria used to select projects for grants?

Code of Federal Regulations, 2014 CFR

2014-10-01

... features add a high value compared with the funds from the proposal, for example, where you construct a small feature such as a transient mooring dock within an existing harbor that adds high value and... above features would add less value for the cost 0-10 points. (6) Provide a significant link to...

50 CFR 86.60 - What are the criteria used to select projects for grants?

Code of Federal Regulations, 2013 CFR

2013-10-01

... features add a high value compared with the funds from the proposal, for example, where you construct a small feature such as a transient mooring dock within an existing harbor that adds high value and... above features would add less value for the cost 0-10 points. (6) Provide a significant link to...

50 CFR 86.60 - What are the criteria used to select projects for grants?

Code of Federal Regulations, 2012 CFR

2012-10-01

... features add a high value compared with the funds from the proposal, for example, where you construct a small feature such as a transient mooring dock within an existing harbor that adds high value and... above features would add less value for the cost 0-10 points. (6) Provide a significant link to...

50 CFR 86.60 - What are the criteria used to select projects for grants?

Code of Federal Regulations, 2011 CFR

2011-10-01

... features add a high value compared with the funds from the proposal, for example, where you construct a small feature such as a transient mooring dock within an existing harbor that adds high value and... above features would add less value for the cost 0-10 points. (6) Provide a significant link to...

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

PubMed

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

2017-10-01

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

Soil vapor extraction with dewatering

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

Thomson, N.R.

1996-08-01

The physical treatment technology of soil vapor extraction (SVE) is reliable, safe, robust, and able to remove significant amounts of mass at a relatively low cost. SVE combined with a pump-and-treat system to create a dewatered zone has the opportunity to remove more mass with the added cost of treating the extracted groundwater. Various limiting processes result in a significant reduction in the overall mass removal rates from a SVE system in porous media. Only pilot scale, limited duration SVE tests conducted in low permeability media have been reported in the literature. It is expected that the presence of amore » fracture network in low permeability media will add another complexity to the limiting conditions surrounding the SVE technology. 20 refs., 4 figs.« less

Impaired postural balance correlates with complex walking performance in mildly disabled persons with multiple sclerosis.

PubMed

Brincks, John; Andersen, Elisabeth Due; Sørensen, Henrik; Dalgas, Ulrik

2017-01-01

It is relevant to understand the possible influence of impaired postural balance on walking performance in multiple sclerosis (MS) gait rehabilitation. We expected associations between impaired postural balance and complex walking performance in mildly disabled persons with MS, but not in healthy controls. Thirteen persons with MS (Expanded Disability Status Scale = 2.5) and 13 healthy controls' walking performance were measured at fast walking speed, Timed Up & Go and Timed 25 Feet Walking. Postural balance was measured by stabilometry, 95% confidence ellipse sway area and sway velocity. Except from sway velocity (p = 0.07), significant differences were found between persons with MS and healthy controls in postural balance and walking. Significant correlations were observed between sway area and Timed Up & Go (r = 0.67) and fastest safe walking speed (r = -0.63) in persons with MS but not in healthy controls (r = 0.52 and r = 0.24, respectively). No other significant correlations were observed between postural balance and walking performance in neither persons with MS nor healthy controls. Findings add to the understanding of postural balance and walking in persons with MS, as impaired postural balance was related to complex walking performance. Exercises addressing impaired postural balance are encouraged in early MS gait rehabilitation.

A complex case of congenital cystic renal disease

PubMed Central

Cordiner, David S; Evans, Clair A; Brundler, Marie-Anne; McPhillips, Maeve; Murio, Enric; Darling, Mark; Taheri, Sepideh

2012-01-01

This case outlines the potential complexity of autosomal recessive polycystic kidney disease (ARPKD). It highlights the challenges involved in managing this condition, some of the complications faced and areas of uncertainty in the decision making process. With a paucity of published paediatric cases on this subject, this should add to the pool of information currently available. PMID:22605879

MolPrint3D: Enhanced 3D Printing of Ball-and-Stick Molecular Models

ERIC Educational Resources Information Center

Paukstelis, Paul J.

2018-01-01

The increased availability of noncommercial 3D printers has provided instructors and students improved access to printing technology. However, printing complex ball-and-stick molecular structures faces distinct challenges, including the need for support structures that increase with molecular complexity. MolPrint3D is a software add-on for the…

Harnessing the Power of Play: Opportunities for Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Mastrangelo, Sonia

2009-01-01

Play is a complex phenomenon that occurs naturally for most children; they move through the various stages of play development and are able to add complexity, imagination, and creativity to their thought processes and actions. However, for many children with autism spectrum disorders (ASD), the various stages of play never truly develop, or occur…

--No Title--

Science.gov Websites

using mesonet visbility observations and CLARUS QC'd obs; Add ceiling height and sky cover analysis to precipitation coverage gaps near CONUS coastlines; Add significant wave height analysis to OCONUS domains

A Binuclear 1,1'-Bis(boratabenzene) Complex: Unprecedented Intramolecular Metal-Metal Communication through a B-B Bond.

PubMed

Braunschweig, Holger; Demeshko, Serhiy; Ewing, William C; Krummenacher, Ivo; Macha, Bret B; Mattock, James D; Meyer, Franc; Mies, Jan; Schäfer, Marius; Vargas, Alfredo

2016-06-27

We report the synthesis of the first 1,1'-bis(boratabenzene) species by tetrabromodiborane(4)-induced ring-expansion reactions of cobaltocene. Six equivalents of cobaltocene are required as the species plays the dual role of reagent and reductant to yield [{(η(5) -C5 H5 )Co}2 {μ:η(6) ,η(6) -(BC5 H5 )2 }]. The formally dianionic bis(boratabenzene) moiety with a boron-boron single bond can be viewed as a symmetric dimer of the parent boratabenzene anion as well as the first example of a diboron analogue of biphenyl. The solution electrochemistry of the bimetallic complex shows four stepwise redox events, indicating significant intramolecular interaction between the cobalt ions across the 1,1'-bis(boratabenzene) unit. The magnetic properties, as investigated by variable-temperature SQUID magnetometry, reveal weak intramolecular antiferromagnetic interactions. Density functional theory calculations support the experimental results and add insight into the various electronic states of the complex. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Using complex networks towards information retrieval and diagnostics in multidimensional imaging

NASA Astrophysics Data System (ADS)

Banerjee, Soumya Jyoti; Azharuddin, Mohammad; Sen, Debanjan; Savale, Smruti; Datta, Himadri; Dasgupta, Anjan Kr; Roy, Soumen

2015-12-01

We present a fresh and broad yet simple approach towards information retrieval in general and diagnostics in particular by applying the theory of complex networks on multidimensional, dynamic images. We demonstrate a successful use of our method with the time series generated from high content thermal imaging videos of patients suffering from the aqueous deficient dry eye (ADDE) disease. Remarkably, network analyses of thermal imaging time series of contact lens users and patients upon whom Laser-Assisted in situ Keratomileusis (Lasik) surgery has been conducted, exhibit pronounced similarity with results obtained from ADDE patients. We also propose a general framework for the transformation of multidimensional images to networks for futuristic biometry. Our approach is general and scalable to other fluctuation-based devices where network parameters derived from fluctuations, act as effective discriminators and diagnostic markers.

Using complex networks towards information retrieval and diagnostics in multidimensional imaging.

PubMed

Banerjee, Soumya Jyoti; Azharuddin, Mohammad; Sen, Debanjan; Savale, Smruti; Datta, Himadri; Dasgupta, Anjan Kr; Roy, Soumen

2015-12-02

We present a fresh and broad yet simple approach towards information retrieval in general and diagnostics in particular by applying the theory of complex networks on multidimensional, dynamic images. We demonstrate a successful use of our method with the time series generated from high content thermal imaging videos of patients suffering from the aqueous deficient dry eye (ADDE) disease. Remarkably, network analyses of thermal imaging time series of contact lens users and patients upon whom Laser-Assisted in situ Keratomileusis (Lasik) surgery has been conducted, exhibit pronounced similarity with results obtained from ADDE patients. We also propose a general framework for the transformation of multidimensional images to networks for futuristic biometry. Our approach is general and scalable to other fluctuation-based devices where network parameters derived from fluctuations, act as effective discriminators and diagnostic markers.

Using complex networks towards information retrieval and diagnostics in multidimensional imaging

PubMed Central

Banerjee, Soumya Jyoti; Azharuddin, Mohammad; Sen, Debanjan; Savale, Smruti; Datta, Himadri; Dasgupta, Anjan Kr; Roy, Soumen

2015-01-01

We present a fresh and broad yet simple approach towards information retrieval in general and diagnostics in particular by applying the theory of complex networks on multidimensional, dynamic images. We demonstrate a successful use of our method with the time series generated from high content thermal imaging videos of patients suffering from the aqueous deficient dry eye (ADDE) disease. Remarkably, network analyses of thermal imaging time series of contact lens users and patients upon whom Laser-Assisted in situ Keratomileusis (Lasik) surgery has been conducted, exhibit pronounced similarity with results obtained from ADDE patients. We also propose a general framework for the transformation of multidimensional images to networks for futuristic biometry. Our approach is general and scalable to other fluctuation-based devices where network parameters derived from fluctuations, act as effective discriminators and diagnostic markers. PMID:26626047

Response of walleye and yellow perch to water-level fluctuations in glacial lakes

USGS Publications Warehouse

Dembkowski, D.J.; Chipps, Steven R.; Blackwell, B. G.

2014-01-01

The influence of water levels on population characteristics of yellow perch, Perca flavescens (Mitchill), and walleye, Sander vitreus (Mitchill), was evaluated across a range of glacial lakes in north-eastern South Dakota, USA. Results showed that natural variation in water levels had an important influence on frequently measured fish population characteristics. Yellow perch abundance was significantly (P<0.10) greater during elevated water levels. Yellow perch size structure, as indexed by the proportional size distribution of quality- and preferred-length fish (PSD and PSD-P), was significantly greater during low-water years, as was walleye PSD. Mean relative weight of walleye increased significantly during high-water periods. The dynamic and unpredictable nature of water-level fluctuations in glacial lakes ultimately adds complexity to management of these systems.

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

PubMed

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

2015-01-01

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

Processing of Positive-Causal and Negative-Causal Coherence Relations in Primary School Children and Adults: A Test of the Cumulative Cognitive Complexity Approach in German

ERIC Educational Resources Information Center

Knoepke, Julia; Richter, Tobias; Isberner, Maj-Britt; Naumann, Johannes; Neeb, Yvonne; Weinert, Sabine

2017-01-01

Establishing local coherence relations is central to text comprehension. Positive-causal coherence relations link a cause and its consequence, whereas negative-causal coherence relations add a contrastive meaning (negation) to the causal link. According to the cumulative cognitive complexity approach, negative-causal coherence relations are…

77 FR 40136 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-06

... add or remove liquidity in the Complex Order Book (``maker/taker fees and rebates'') in a number of... Book and receive a base rebate of $0.32 per contract (and may receive a rebate of up to $0.345 per... the Complex Order Book. \\4\\ The term ``Market Makers'' refers to ``Competitive Market Makers'' and...

[Isolation of children with attention deficit disorder in their classrooms].

PubMed

Mino, Y; Yasuda, N; Ohara, H; Nagamatsu, K; Yoshida, T

1990-10-01

The isolation of children with attention deficit disorder (ADD) among peers was examined by conducting sociometric tests in 28 classrooms to which ADD children belonged. The conclusions are as follows: 1. Among ADD children, 39.3% were classified as isolated children who received no Social Choice votes, a proportion that was significantly higher than normal controls. 2. Results suggests that isolation was correlated with such characteristics of ADD children as higher grade in school, later first consultation and lower IQ levels. 3. Classroom characteristics which correlated with isolation of ADD children were larger number of children per class and stronger class cohesion. It is thought that reducing the number of children in each class will be effective in preventing isolation of ADD children. 4. The possibility of an association between assessment of parents for social relationships of ADD children and their isolation exists and needs to be assessed. The authors emphasize the need for ADD children to have support in their interpersonal relationships, and discuss ways of intervention to prevent their being isolated in their classrooms.

Adding control to arbitrary unknown quantum operations

PubMed Central

Zhou, Xiao-Qi; Ralph, Timothy C.; Kalasuwan, Pruet; Zhang, Mian; Peruzzo, Alberto; Lanyon, Benjamin P.; O'Brien, Jeremy L.

2011-01-01

Although quantum computers promise significant advantages, the complexity of quantum algorithms remains a major technological obstacle. We have developed and demonstrated an architecture-independent technique that simplifies adding control qubits to arbitrary quantum operations—a requirement in many quantum algorithms, simulations and metrology. The technique, which is independent of how the operation is done, does not require knowledge of what the operation is, and largely separates the problems of how to implement a quantum operation in the laboratory and how to add a control. Here, we demonstrate an entanglement-based version in a photonic system, realizing a range of different two-qubit gates with high fidelity. PMID:21811242

A developmental approach to understanding drawings and narratives from children displaced by Hurricane Katrina.

PubMed

Looman, Wendy Sue

2006-01-01

Using art as a process to help children externalize complex feelings can add another layer of assessment in the primary care setting. In the face of trauma, drawing may help children gain symbolic control over events that are confusing and frightening. Through examples of children who were affected by Hurricane Katrina, this article describes the use of drawings and narratives to understand children's experiences related to traumatic displacement. Recommendations include using a developmental lens to understanding children's art, asking children to talk about their drawings, and considering the significance of place for children who have been traumatically displaced.

Parent Expectations Mediate Outcomes for Young Adults with Autism Spectrum Disorder.

PubMed

Kirby, Anne V

2016-05-01

Understanding the complex relationships among factors that may predict the outcomes of young adults with autism spectrum disorder (ASD) is of utmost importance given the increasing population undergoing and anticipating the transition to adulthood. With a sample of youth with ASD (n = 1170) from the National Longitudinal Transition Study-2, structural equation modeling techniques were used to test parent expectations as a mediator of young adult outcomes (i.e., employment, residential independence, social participation) in a longitudinal analysis. The mediation hypothesis was confirmed; family background and functional performance variables significantly predicted parent expectations which significantly predicted outcomes. These findings add context to previous studies examining the role of parent expectations on young adult outcomes and inform directions for family-centered interventions and future research.

Equilibrium expert: an add-in to Microsoft Excel for multiple binding equilibrium simulations and parameter estimations.

PubMed

Raguin, Olivier; Gruaz-Guyon, Anne; Barbet, Jacques

2002-11-01

An add-in to Microsoft Excel was developed to simulate multiple binding equilibriums. A partition function, readily written even when the equilibrium is complex, describes the experimental system. It involves the concentrations of the different free molecular species and of the different complexes present in the experiment. As a result, the software is not restricted to a series of predefined experimental setups but can handle a large variety of problems involving up to nine independent molecular species. Binding parameters are estimated by nonlinear least-square fitting of experimental measurements as supplied by the user. The fitting process allows user-defined weighting of the experimental data. The flexibility of the software and the way it may be used to describe common experimental situations and to deal with usual problems such as tracer reactivity or nonspecific binding is demonstrated by a few examples. The software is available free of charge upon request.

Incorporating Geriatric Medicine Providers into the Care of the Older Adult with Cancer.

PubMed

Magnuson, Allison; Canin, Beverly; van Londen, G J; Edwards, Beatrice; Bakalarski, Pamela; Parker, Ira

2016-11-01

A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum. In this article, we review the role of geriatric assessment in the care of older cancer patients, highlight specific case scenarios in which GMPs may offer additional understanding and insight in the care of older adults with cancer, and discuss specific mechanisms for incorporating GMPs into oncology care.

Using gas chromatography with ion mobility spectrometry to resolve explosive compounds in the presence of interferents.

PubMed

Cook, Greg W; LaPuma, Peter T; Hook, Gary L; Eckenrode, Brian A

2010-11-01

Ion mobility spectrometry (IMS) is a valued field detection technology because of its speed and high sensitivity, but IMS cannot easily resolve analytes of interest within mixtures. Coupling gas chromatography (GC) to IMS adds a separation capability to resolve complex matrices. A GC-IONSCAN® operated in IMS and GC⁄ IMS modes was evaluated with combinations of five explosives and four interferents. In 100 explosive/interferent combinations, IMS yielded 21 false positives while GC⁄ IMS substantially reduced the occurrence of false positives to one. In addition, the results indicate that through redesign or modification of the preconcentrator there would be significant advantages to using GC⁄ IMS, such as enhancement of the linear dynamic range (LDR) in some situations. By balancing sensitivity with LDR, GC⁄ IMS could prove to be a very advantageous tool when addressing real world complex mixture situations.

Capturing the Role of Explicit Solvent in the Dimerization of RuV (bda) Water Oxidation Catalysts.

PubMed

Zhan, Shaoqi; Mårtensson, Daniel; Purg, Miha; Kamerlin, Shina C L; Ahlquist, Mårten S G

2017-06-06

A ground-breaking empirical valence bond study for a soluble transition-metal complex is presented. The full reaction of catalyst monomers approaching and reacting in the Ru V oxidation state were studied. Analysis of the solvation shell in the reactant and along the reaction coordinate revealed that the oxo itself is hydrophobic, which adds a significant driving force to form the dimer. The effect of the solvent on the reaction between the prereactive dimer and the product was small. The solvent seems to lower the barrier for the isoquinoline (isoq) complex while it is increased for pyridines. By comparing the reaction in the gas phase and solution, the proposed π-stacking interaction of the isoq ligands is found to be entirely driven by the water medium. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

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

PubMed

Leisman, Gerry; Mualem, Raed; Machado, Calixto

2013-01-01

ADD/ADHD is the most common and most studied neurodevelopmental problem. Recent statistics from the U.S. Center for Disease Control state that 11% or approximately one out of every nine children in the US and one in five high school boys are diagnosed with ADD/ADHD. This number is thought to be increasing at around 15-20% per year. The US National Institute of Mental Health's Multi-modal Treatment Study has shown that medication has no long-term benefit for those with ADHD. To effectively address ADD/ADHD from within the framework of child public health, an interdisciplinary strategy is necessary that is based on a neuroeducational model that can be readily implemented on a large-scale within the educational system. This study is based on previous findings that ADD/ADHD children possess underactivity between sub-cortical and cortical regions. An imbalance of activity or arousal in one area can result in functional disconnections similar to that seen in split-brain patients. Since ADD/ADHD children exhibit deficient performance on tests developed to measure perceptual laterality, evidence of weak laterality or failure to develop laterality has been found across various modalities (auditory, visual, tactile). This has reportedly resulted in abnormal cerebral organization and ineffective cortical specialization necessary for the development of language and non-language function. This pilot study examines groups of ADD/ADHD and control elementary school children all of whom were administered all of the subtests of the Wechsler Individual Achievement Tests, the Brown Parent Questionnaire, and given objective performance measures on tests of motor and sensory coordinative abilities. Results measured after a 12-week remediation program aimed at increasing the activity of the hypothesized underactive right hemisphere function, yielded significant improvement of greater than 2 years in grade level in all domains except in mathematical reasoning. The treated group also displayed a significant improvement in behavior with a reduction in Brown scale behavioral scores. Non-treated control participants did not exhibit significant differences during the same 12 week period in academic measurements. Controls were significantly different from treatment participants in all domains after a 12-week period. The non-treatment group also demonstrated an increase in behavioral scores and increased symptoms of ADD/ADHD over the same time period when compared to the treated group. Results are discussed in the context of the concept of functional disconnectivity in ADD/ADHD children.

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

NASA Astrophysics Data System (ADS)

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

2008-04-01

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

Is mandibular asymmetry more frequent and severe with unilateral disc displacement?

PubMed

Xie, Qianyang; Yang, Chi; He, Dongmei; Cai, Xieyi; Ma, Zhigui

2015-01-01

To investigate the prevalence of mandibular asymmetry (MA) within the symptomatic unilateral anterior disc displacement (ADD) patients, and analyze the influence TMJ factors of the MA severity. Patients aged under 20 years old with symptomatic unilateral ADD and asymptomatic volunteers with normal disc-condyle relationship diagnosed by magnetic resonance imaging (MRI) were included in this study. Posteroanterior cephalometric radiographs were taken to measure MA. Condylar height, disc length and disc displacement were measured by MRI. The prevalence and severity of MA were compared between the ADD and the control groups. The correlation between the severity of MA with the amount of condylar height shortage, disc deformity and distance of disc displacement were also evaluated within the ADD group. There were 165 cases in the unilateral ADD group, and 156 cases in the control group. One hundred and nineteen cases had MA which accounted 72.12% (119/165) in the ADD group; while in the control group, only 25.64% (40/156) exhibited MA. The mean horizontal menton deviation and condylar height shortage in the unilateral ADD group were significantly larger than that in the control group (5.62 mm vs. 4.19 mm; 3.14 mm vs. 1.32 mm, p < 0.01). The severity of MA was significantly correlated with the amount of disc displacement, disc deformity and condylar height shortage (correlation coefficient: 0.80, 0.70, and 0.82). MA is much more common and severe in young unilateral ADD patients. The severity of MA is correlated with the height of condyle and the status of the disc. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

PubMed Central

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

2016-01-01

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

Race, ethnicity, and the relevance of obesity for social integration.

PubMed

Cunningham, Solveig Argeseanu; Vaquera, Elizabeth; Long, Jeanne L

2012-01-01

To examine race and ethnic differences in the importance of obesity for social integration using the National Longitudinal Study of Adolescent Health (Add Health). A cross-sectional study utilizing survey-adjusted statistics and multivariate logistic and linear regression models. Models were stratified by sex and included interaction terms capturing race, ethnicity and obesity. United States of America. A nationally representative sample of 15,355 respondents grades 7 through 12 who participated in both the In-School and In-Home Wave I surveys of Add Health. Four self-reported and schoolmate-reported indicators of social integration. The consequences of obesity for social integration are greatest for White adolescents, who were selected by almost 2 fewer schoolmates as friends and had half the odds of having their friendships reciprocated compared with non-obese White adolescents. The social disadvantage of obesity was lower for non-White adolescents; though they are selected by significantly fewer schoolmates as friends and were less likely to have their friendships reciprocated, they did not face additional discrimination from being both obese and minority. There are significant differences between obese and non-obese adolescents by race and ethnicity in friendships. As friendships are among the most valued assets in adolescence, understanding the impact of obesity on access to friendships for diverse adolescents is a necessary component to understanding the complex motivations that guide health-related behavior at these formative ages.

Impact of Frequent Interruption on Nurses' Patient-Controlled Analgesia Programming Performance.

PubMed

Campoe, Kristi R; Giuliano, Karen K

2017-12-01

The purpose was to add to the body of knowledge regarding the impact of interruption on acute care nurses' cognitive workload, total task completion times, nurse frustration, and medication administration error while programming a patient-controlled analgesia (PCA) pump. Data support that the severity of medication administration error increases with the number of interruptions, which is especially critical during the administration of high-risk medications. Bar code technology, interruption-free zones, and medication safety vests have been shown to decrease administration-related errors. However, there are few published data regarding the impact of number of interruptions on nurses' clinical performance during PCA programming. Nine acute care nurses completed three PCA pump programming tasks in a simulation laboratory. Programming tasks were completed under three conditions where the number of interruptions varied between two, four, and six. Outcome measures included cognitive workload (six NASA Task Load Index [NASA-TLX] subscales), total task completion time (seconds), nurse frustration (NASA-TLX Subscale 6), and PCA medication administration error (incorrect final programming). Increases in the number of interruptions were associated with significant increases in total task completion time ( p = .003). We also found increases in nurses' cognitive workload, nurse frustration, and PCA pump programming errors, but these increases were not statistically significant. Complex technology use permeates the acute care nursing practice environment. These results add new knowledge on nurses' clinical performance during PCA pump programming and high-risk medication administration.

[Passive tactile stimulation and its clinical and neurophysiological repercussions (P300) in blind children with symptoms of attention deficit disorder].

PubMed

Serrano-Marugán, Isabel; Herrera, Begoña; Romero, Sara; Nogales, Ramón; Poch-Broto, Joaquín; Quintero, Javier; Ortiz, Tomás

2014-02-24

Tactile stimulation is key for the posterior brain re-organization activity and attention processes, however the impact of tactile stimulation on attention deficit disorder (ADD) in blind children remains unexplored. We carried out a study with children having or not ADD (four per group). The subjects have been exposed during six months to tactile stimulation protocol consisting in two daily sessions (morning and afternoon sessions) of 30 minutes each. We have measured the ability to detect an infrequent tactile stimulus, reaction time, latency of P300, sources of brain activity, and ADD clinical symptoms, before and after tactile training. Passive tactile stimulation significantly improves ADD clinical symptoms, particularly attention, behavior and self-control of involuntary movements and tics. In addition, tactile stimulation changes the pattern of brain activity in ADD blind children inducing activity in frontal and occipital areas, which could be associated to a compensation of the attention deficit. Passive tactile stimulation training may improve ADD clinical symptoms and can reorganize the pattern of brain activity in blind ADD children.

Evaluation of the adhesive properties of the cornea by means of optical coherence tomography in patients with meibomian gland dysfunction and lacrimal tear deficiency.

PubMed

Napoli, Pietro Emanuele; Coronella, Franco; Satta, Giovanni Maria; Galantuomo, Maria Silvana; Fossarello, Maurizio

2014-01-01

The aim was to determine the influence of meibomian gland dysfunction (MGD) and aqueous tear deficiency dry eye (ADDE) on the adhesive properties of the central cornea by means of optical coherence tomography (OCT), and to investigate the relationship between corneal adhesiveness and classical tear tests, as well as the reliability of results, in these lacrimal functional unit disorders. Prospective, case-control study. Twenty-eight patients with MGD and 27 patients with ADDE were studied. A group of 32 healthy subjects of similar age and gender distribution served as a control group. The adhesive properties of the anterior corneal surface were measured by OCT, based on the retention time of adhesion marker above it, in all participants. An excellent (≥5 minutes), borderline (within 3-5 minutes), fair (within 1-3 minutes) and poor (<1 minute) values of corneal adhesiveness were found, respectively, in 0%, 7.1%, 64.3% and 28.6% of MGD, in 0%, 7.4%, 63% and 29.6% of ADDE, and in 31.3%, 65.6%, 3.1% and 0% of healthy patients. The differences in time of corneal adhesiveness between MGD and healthy patients, as well as between ADDE and healthy patients, were found to be statistically significant (p<0.001; p<0.001; respectively). Conversely, no statistical significant differences between MGD and ADDE were found (p = 0.952). Data analysis revealed a statistically significant correlation between corneal adhesiveness and clinical tests of dry eye, as well as an excellent degree of inter-rater reliability and reproducibility for OCT measurements (p<0.001). ADDE and MGD share similar abnormalities on OCT imaging. Decreased adhesive properties of the anterior cornea were identified as a common feature of MGD and ADDE. This simple OCT approach may provide new clues into the mechanism and evaluation of dry eye syndrome.

Bridging the Gap Between Science and Clinical Efficacy: Physiology, Imaging, and Modeling of Aerosols in the Lung.

PubMed

Darquenne, Chantal; Fleming, John S; Katz, Ira; Martin, Andrew R; Schroeter, Jeffry; Usmani, Omar S; Venegas, Jose; Schmid, Otmar

2016-04-01

Development of a new drug for the treatment of lung disease is a complex and time consuming process involving numerous disciplines of basic and applied sciences. During the 2015 Congress of the International Society for Aerosols in Medicine, a group of experts including aerosol scientists, physiologists, modelers, imagers, and clinicians participated in a workshop aiming at bridging the gap between basic research and clinical efficacy of inhaled drugs. This publication summarizes the current consensus on the topic. It begins with a short description of basic concepts of aerosol transport and a discussion on targeting strategies of inhaled aerosols to the lungs. It is followed by a description of both computational and biological lung models, and the use of imaging techniques to determine aerosol deposition distribution (ADD) in the lung. Finally, the importance of ADD to clinical efficacy is discussed. Several gaps were identified between basic science and clinical efficacy. One gap between scientific research aimed at predicting, controlling, and measuring ADD and the clinical use of inhaled aerosols is the considerable challenge of obtaining, in a single study, accurate information describing the optimal lung regions to be targeted, the effectiveness of targeting determined from ADD, and some measure of the drug's effectiveness. Other identified gaps were the language and methodology barriers that exist among disciplines, along with the significant regulatory hurdles that need to be overcome for novel drugs and/or therapies to reach the marketplace and benefit the patient. Despite these gaps, much progress has been made in recent years to improve clinical efficacy of inhaled drugs. Also, the recent efforts by many funding agencies and industry to support multidisciplinary networks including basic science researchers, R&D scientists, and clinicians will go a long way to further reduce the gap between science and clinical efficacy.

Bridging the Gap Between Science and Clinical Efficacy: Physiology, Imaging, and Modeling of Aerosols in the Lung

PubMed Central

Fleming, John S.; Katz, Ira; Martin, Andrew R.; Schroeter, Jeffry; Usmani, Omar S.; Venegas, Jose

2016-01-01

Abstract Development of a new drug for the treatment of lung disease is a complex and time consuming process involving numerous disciplines of basic and applied sciences. During the 2015 Congress of the International Society for Aerosols in Medicine, a group of experts including aerosol scientists, physiologists, modelers, imagers, and clinicians participated in a workshop aiming at bridging the gap between basic research and clinical efficacy of inhaled drugs. This publication summarizes the current consensus on the topic. It begins with a short description of basic concepts of aerosol transport and a discussion on targeting strategies of inhaled aerosols to the lungs. It is followed by a description of both computational and biological lung models, and the use of imaging techniques to determine aerosol deposition distribution (ADD) in the lung. Finally, the importance of ADD to clinical efficacy is discussed. Several gaps were identified between basic science and clinical efficacy. One gap between scientific research aimed at predicting, controlling, and measuring ADD and the clinical use of inhaled aerosols is the considerable challenge of obtaining, in a single study, accurate information describing the optimal lung regions to be targeted, the effectiveness of targeting determined from ADD, and some measure of the drug's effectiveness. Other identified gaps were the language and methodology barriers that exist among disciplines, along with the significant regulatory hurdles that need to be overcome for novel drugs and/or therapies to reach the marketplace and benefit the patient. Despite these gaps, much progress has been made in recent years to improve clinical efficacy of inhaled drugs. Also, the recent efforts by many funding agencies and industry to support multidisciplinary networks including basic science researchers, R&D scientists, and clinicians will go a long way to further reduce the gap between science and clinical efficacy. PMID:26829187

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

PubMed

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

2018-04-16

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

SeaFrame: Sustaining Today’s Fleet Efficiently and Effectively. Volume 5, Issue 1, 2009

DTIC Science & Technology

2009-01-01

Maneuvering 11 Shipboard Launch and Recovery Systems 13 Integrated Logistics System 15 Special Hull Treatment Tile Manufacturing 17 Navy Shipboard Oil ...Developing advanced blade section design technology for propulsors that reduces cavitation damage and required repair cost and time. - Conducting...complex we have ever written.” Ammeen adds that steering and diving algorithms are also very complex, because hydrodynamic effects of a submarine

Cyberinfrastructure: The Second Revolution

ERIC Educational Resources Information Center

Bement, Arden L.

2007-01-01

The engine of change for the next revolution is cyberinfrastructure, a comprehensive phenomenon that involves the creation, dissemination, preservation, and application of knowledge. It adds new dimensions that greatly increase transformational potential. Cyberinfrastructure combines complex elements to create a dynamic system. It eclipses its…

Interdisciplinarity and the Question of Being

ERIC Educational Resources Information Center

Welch, James, IV

2012-01-01

The question of being adds another dimension to interdisciplinary theory and practice. The interdisciplinary approach to complex problems requires engaging with multiple perspectives from various disciplines, schools of thought, ideologies, and belief systems. All of these perspectives possess underlying and often unacknowledged ontological…

Angiotensin-Converting Enzyme (ACE) I/D and Alpha-Adducin (ADD1) G460W Gene Polymorphisms in Turkish Patients with Severe Chronic Tinnitus.

PubMed

Yuce, Salim; Sancakdar, Enver; Bağcı, Gokhan; Koc, Sema; Kurtulgan, Hande Kucuk; Bağcı, Binnur; Doğan, Mansur; Uysal, İsmail Onder

2016-04-01

Tinnitus is described as a disturbing sound sensation in the absence of external stimulation. We aimed to investigate whether there is any relationship between severe chronic tinnitus and angiotensin-converting enzyme (ACE) I/D and α-adducin (ADD1) G460W gene polymorphisms. The patient group and control group consisted of 89 and 104 individuals, respectively. The evaluation of tinnitus was performed using the Strukturiertes Tinnitus-Interview (STI). The Tinnitus Handicap Inventory (THI) was used to evaluate the tinnitus severity. Polymerase chain reaction (PCR) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques were used for genotyping. With regard to the ACE I/D polymorphism, there was no significant difference in genotype and allele frequencies between the patient group and control group. However, a statistically significant difference was found in genotype (p<0.01) and allele frequencies (p=0.021) of the ADD1 G460W gene polymorphism. Combined genotype analysis showed that the ACE II /ADD1 GW genotype was statistically significantly higher in the patient group than in the control group (X2: 7.15, p=0.007). The odds ratio value of the GW genotype was 2.5 (95% CI=1.4-4.7) (p<0.01). Our results demonstrate an association between ADD1 G460W gene polymorphism and susceptibility to severe chronic tinnitus. It was found that the GW genotype increased the disease risk by 2.5-fold compared with other genotypes. This indicates that ADD1 G460W polymorphism could be an important factor in the pathophysiology of tinnitus.

Trafficking and function of the cystic fibrosis transmembrane conductance regulator: a complex network of posttranslational modifications

PubMed Central

McClure, Michelle L.; Barnes, Stephen; Brodsky, Jeffrey L.

2016-01-01

Posttranslational modifications add diversity to protein function. Throughout its life cycle, the cystic fibrosis transmembrane conductance regulator (CFTR) undergoes numerous covalent posttranslational modifications (PTMs), including glycosylation, ubiquitination, sumoylation, phosphorylation, and palmitoylation. These modifications regulate key steps during protein biogenesis, such as protein folding, trafficking, stability, function, and association with protein partners and therefore may serve as targets for therapeutic manipulation. More generally, an improved understanding of molecular mechanisms that underlie CFTR PTMs may suggest novel treatment strategies for CF and perhaps other protein conformational diseases. This review provides a comprehensive summary of co- and posttranslational CFTR modifications and their significance with regard to protein biogenesis. PMID:27474090

Structural and Functional Impacts of ER Coactivator Sequential Recruitment.

PubMed

Yi, Ping; Wang, Zhao; Feng, Qin; Chou, Chao-Kai; Pintilie, Grigore D; Shen, Hong; Foulds, Charles E; Fan, Guizhen; Serysheva, Irina; Ludtke, Steven J; Schmid, Michael F; Hung, Mien-Chie; Chiu, Wah; O'Malley, Bert W

2017-09-07

Nuclear receptors recruit multiple coactivators sequentially to activate transcription. This "ordered" recruitment allows different coactivator activities to engage the nuclear receptor complex at different steps of transcription. Estrogen receptor (ER) recruits steroid receptor coactivator-3 (SRC-3) primary coactivator and secondary coactivators, p300/CBP and CARM1. CARM1 recruitment lags behind the binding of SRC-3 and p300 to ER. Combining cryo-electron microscopy (cryo-EM) structure analysis and biochemical approaches, we demonstrate that there is a close crosstalk between early- and late-recruited coactivators. The sequential recruitment of CARM1 not only adds a protein arginine methyltransferase activity to the ER-coactivator complex, it also alters the structural organization of the pre-existing ERE/ERα/SRC-3/p300 complex. It induces a p300 conformational change and significantly increases p300 HAT activity on histone H3K18 residues, which, in turn, promotes CARM1 methylation activity on H3R17 residues to enhance transcriptional activity. This study reveals a structural role for a coactivator sequential recruitment and biochemical process in ER-mediated transcription. Copyright © 2017 Elsevier Inc. All rights reserved.

A Longitudinal Study on Human Outdoor Decomposition in Central Texas.

PubMed

Suckling, Joanna K; Spradley, M Katherine; Godde, Kanya

2016-01-01

The development of a methodology that estimates the postmortem interval (PMI) from stages of decomposition is a goal for which forensic practitioners strive. A proposed equation (Megyesi et al. 2005) that utilizes total body score (TBS) and accumulated degree days (ADD) was tested using longitudinal data collected from human remains donated to the Forensic Anthropology Research Facility (FARF) at Texas State University-San Marcos. Exact binomial tests examined the rate of the equation to successfully predict ADD. Statistically significant differences were found between ADD estimated by the equation and the observed value for decomposition stage. Differences remained significant after carnivore scavenged donations were removed from analysis. Low success rates for the equation to predict ADD from TBS and the wide standard errors demonstrate the need to re-evaluate the use of this equation and methodology for PMI estimation in different environments; rather, multivariate methods and equations should be derived that are environmentally specific. © 2015 American Academy of Forensic Sciences.

Modelling robot's behaviour using finite automata

NASA Astrophysics Data System (ADS)

Janošek, Michal; Žáček, Jaroslav

2017-07-01

This paper proposes a model of a robot's behaviour described by finite automata. We split robot's knowledge into several knowledge bases which are used by the inference mechanism of the robot's expert system to make a logic deduction. Each knowledgebase is dedicated to the particular behaviour domain and the finite automaton helps us switching among these knowledge bases with the respect of actual situation. Our goal is to simplify and reduce complexity of one big knowledgebase splitting it into several pieces. The advantage of this model is that we can easily add new behaviour by adding new knowledgebase and add this behaviour into the finite automaton and define necessary states and transitions.

Homelessness as culture: How transcultural nursing theory can assist caring for the homeless.

PubMed

Law, Kate; John, William

2012-11-01

The concepts of culture and homelessness are both complex and contested. This paper examines homelessness through the lens of transcultural nursing theory, increasing understanding of both homelessness and transcultural theory. We argue that homelessness can be usefully conceptualised as a culture and that the application of transcultural theory to caring for homeless people will add further to the utility of these theories. The application of transcultural theory can add to the repertoire of skills the nurse needs to care for not only homeless clients, but, for a diverse range of client groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

ISSUES AND CHALLENGES IN MODELING CHILDREN'S LONGITUDINAL EXPOSURES: AN OZONE STUDY

EPA Science Inventory

Modeling children's exposures is a complicated, data-intensive process. Modeling longitudinal exposures, which are important for regulatory decision making, especially for most air toxics, adds another level of complexity and data requirements. Because it is difficult to model in...

Water Resources and Supply Adaptation: A paradigm Shifting for Future Climate?

EPA Science Inventory

Climate change adds another layer of complexity in planning, engineering and management of water resources and urban water infrastructures. Yet our current practice is confined to the traditional approach that evaluates developmental scenarios and their sustainability mostly by a...

Impact of Anxiety and/or Depressive Disorders and Chronic Somatic Diseases on disability and work impairment.

PubMed

Bokma, Wicher A; Batelaan, Neeltje M; van Balkom, Anton J L M; Penninx, Brenda W J H

2017-03-01

Anxiety and/or Depressive Disorders (ADDs) and Chronic Somatic Diseases (CSDs) are associated with substantial levels of health-related disability and work impairment. However, it is unclear whether comorbid ADDs and CSDs additively affect functional outcomes. This paper examines the impact of ADDs, CSDs, and their comorbidity on disability, work absenteeism and presenteeism. Baseline data from the Netherlands Study of Depression and Anxiety (n=2371) were used. We assessed presence of current ADDs (using psychiatric interviews, CIDI) and presence of self-reported CSDs. Outcome measures were disability scores (WHO-DAS II questionnaire, overall and domain-specific), work absenteeism (≤2weeks and >2weeks; TiC-P) and presenteeism (reduced and impaired work performance; TiC-P). We conducted multivariate regression analyses adjusted for socio-demographics. Both ADDs and CSDs significantly and independently impact total disability, but the impact was substantially larger for ADDs (main effect unstandardized β=20.1, p<.001) than for CSDs (main effect unstandardized β=3.88, p<.001). There was a positive interaction between ADDs and CSDs on disability (unstandardized β interaction=4.06, p=.004). Although CSDs also induce absenteeism (OR for extended absenteeism=1.42, p=.015) and presenteeism (OR for impaired work performance=1.42, p=.013), associations with ADDs were stronger (OR for extended absenteeism=6.64, p<.001; OR for impaired work performance=7.51, p<.001). Both CSDs and ADDs cause substantial disability, work absenteeism and presenteeism, but the impact of ADDs far exceeds that of CSDs. CSDs and ADDs interact synergistically on disability, thereby bolstering the current view that patients with physical mental comorbidity (PM-comorbidity) form a severe subgroup with an unfavourable prognosis. Copyright © 2017 Elsevier Inc. All rights reserved.

Novel Image Quality Control Systems(Add-On). Innovative Computational Methods for Inverse Problems in Optical and SAR Imaging

DTIC Science & Technology

2007-02-28

Iterative Ultrasonic Signal and Image Deconvolution for Estimation of the Complex Medium Response, International Journal of Imaging Systems and...1767-1782, 2006. 31. Z. Mu, R. Plemmons, and P. Santago. Iterative Ultrasonic Signal and Image Deconvolution for Estimation of the Complex...rigorous mathematical and computational research on inverse problems in optical imaging of direct interest to the Army and also the intelligence agencies

Trellises and Trellis-Based Decoding Algorithms for Linear Block Codes. Part 3

NASA Technical Reports Server (NTRS)

Lin, Shu

1998-01-01

Decoding algorithms based on the trellis representation of a code (block or convolutional) drastically reduce decoding complexity. The best known and most commonly used trellis-based decoding algorithm is the Viterbi algorithm. It is a maximum likelihood decoding algorithm. Convolutional codes with the Viterbi decoding have been widely used for error control in digital communications over the last two decades. This chapter is concerned with the application of the Viterbi decoding algorithm to linear block codes. First, the Viterbi algorithm is presented. Then, optimum sectionalization of a trellis to minimize the computational complexity of a Viterbi decoder is discussed and an algorithm is presented. Some design issues for IC (integrated circuit) implementation of a Viterbi decoder are considered and discussed. Finally, a new decoding algorithm based on the principle of compare-select-add is presented. This new algorithm can be applied to both block and convolutional codes and is more efficient than the conventional Viterbi algorithm based on the add-compare-select principle. This algorithm is particularly efficient for rate 1/n antipodal convolutional codes and their high-rate punctured codes. It reduces computational complexity by one-third compared with the Viterbi algorithm.

Building Community-Based Consensus: The Oconto Experience.

ERIC Educational Resources Information Center

Behr, Chris; Shaffer, Ron; Lamb, Greg; Miller, Al; Sadowske, Sue

1998-01-01

Coastal communities face difficult choices regarding the use if their waterfront resources. The complexity of issues, contradictory scientific evidence, different visions of the future, and uncertainty regarding community interests add to the difficulty of reaching consensus. The community of Oconto, Wisconsin, attempted to integrate technical and…

Recent developments in computer modeling add ecological realism to landscape genetics

EPA Science Inventory

Background / Question / Methods A factor limiting the rate of progress in landscape genetics has been the shortage of spatial models capable of linking life history attributes such as dispersal behavior to complex dynamic landscape features. The recent development of new models...

Generative Processes: Thick Drawing

ERIC Educational Resources Information Center

Wallick, Karl

2012-01-01

This article presents techniques and theories of generative drawing as a means for developing complex content in architecture design studios. Appending the word "generative" to drawing adds specificity to the most common representation tool and clarifies that such drawings are not singularly about communication or documentation but are…

Innovation versus complexity: what is too much of a good thing?

PubMed

Gottfredson, Mark; Aspinall, Keith

2005-11-01

What's the number of product or service offerings that would optimize both your revenues and your profits? For most firms, it's considerably lower than the number they offer today. The fact is, companies have strong incentives to be overly innovative in new product development. But continual launches of new products and line extensions add complexity throughout a company's operations, and as the costs of managing that complexity multiply, margins shrink. To maximize profit potential, a company needs to identify its innovation fulcrum, the point at which an additional offering destroys more value than it creates. The usual antidotes to complexity miss their mark because they treat the problem on the factory floor rather than at its source: in the product line. Mark Gottfredson and Keith Aspinall of Bain & Company present an approach that goes beyond the typical Six Sigma or lean-operations program to root out complexity hidden in the value chain. The first step is to ask, What would our company look like if it made and sold only a single product or service? In other words, you identify your company's equivalent of Henry Ford's one-size-fits-all Model T-for Starbucks, it might be a medium-size cup of coffee; for a bank, a simple checking account-and then determine the cost of producing that baseline offering. Next, you add variety back into the business system, product by product, and carefully forecast the resulting impact on sales as well as the cost implications across the value chain. When the analysis shows the costs beginning to overwhelm the added revenues, you've found your innovation fulcrum. By deconstructing their companies to a zero-complexity baseline, managers can break through organizational resistance and deeply entrenched ways of thinking to find the right balance between innovation and complexity.

28 CFR 91.55 - Categorical exclusions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... disposal, or water facilities. (c) Expansion of support facilities. Projects for the expansion of bed space... Historic Places, or is eligible for listing on the register. (b) Limited expansion. Projects for the expansion of an existing facility or within an existing correctional complex, which does not add more than...

28 CFR 91.55 - Categorical exclusions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... disposal, or water facilities. (c) Expansion of support facilities. Projects for the expansion of bed space... Historic Places, or is eligible for listing on the register. (b) Limited expansion. Projects for the expansion of an existing facility or within an existing correctional complex, which does not add more than...

28 CFR 91.55 - Categorical exclusions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... disposal, or water facilities. (c) Expansion of support facilities. Projects for the expansion of bed space... Historic Places, or is eligible for listing on the register. (b) Limited expansion. Projects for the expansion of an existing facility or within an existing correctional complex, which does not add more than...

Knowledge Theories Can Inform Evaluation Practice: What Can a Complexity Lens Add?

ERIC Educational Resources Information Center

Hawe, Penelope; Bond, Lyndal; Butler, Helen

2009-01-01

Programs and policies invariably contain new knowledge. Theories about knowledge utilization, diffusion, implementation, transfer, and knowledge translation theories illuminate some mechanisms of change processes. But more often than not, when it comes to understanding patterns about change processes, "the foreground" is privileged more…

A controlled study of Tourette syndrome. IV. Obsessions, compulsions, and schizoid behaviors.

PubMed Central

Comings, D E; Comings, B G

1987-01-01

To determine the frequency of obsessive, compulsive, and schizoid behaviors in Tourette syndrome (TS), we prospectively questioned 246 patients with TS, 17 with attention-deficit disorder (ADD), 15 with ADD due to a TS gene, and 47 random controls. The comparative frequency of obsessive, compulsive, and repetitive behaviors--such as obsessive unpleasant thoughts, obsessive silly thoughts, echolalia, palilalia, touching things excessively, touching things a specific number of times, touching others excessively, sexual touching, biting or hurting oneself, head banging, rocking, mimicking others, counting things, and occasional or frequent public exhibitionism--were significantly more common in TS patients than in controls. The frequency of each of these was much higher for grade 3 (severe) TS. Most of these behaviors also occurred significantly more often in individuals with ADD or in individuals with ADD secondary to TS (ADD 2(0) TS). When these features were combined into an obsessive-compulsive score, 45.4% of TS patients had a score of 4-15, whereas 8.5% of controls had a score of 4 or 5. These results indicate that obsessive-compulsive behaviors are an integral part of the expression of the TS gene and can be inherited as an autosomal dominant trait. Schizoid symptoms, such as thinking that people were watching them or plotting against them, were significantly more common in TS patients than in controls. Auditory hallucinations of hearing voices were present in 14.6% of TS patients, compared with 2.1% of controls (P = .02). These symptoms were absent in ADD patients but present in ADD 2(0) TS patients. These voices were often blamed for telling them to do bad things and were frequently identified with the devil. None of the controls had a total schizoid behavior score greater than 3, whereas 10.9% of the TS patients had scores of 4-10 (P = .02). This frequency increased to 20.6% in the grade 3 TS patients. These quantitative results confirm our clinical impression that some TS patients have paranoid ideations, often feel that people are out to get them, and hear voices. PMID:3479015

How to change environmental conditions for health.

PubMed

Commers, Matthew J; Gottlieb, Nell; Kok, Gerjo

2007-03-01

Since the Lalonde report, contemporary public-health theory has given steadily more attention to the role of environments in influencing health status. Environments, both social and physical, influence health directly or through complex interactions with behavior, genetics and health-care systems. They are also important for public-health because environments are the complex systems through which people are both empowered and exercise their empowerment. If public-health professionals are to play a significant role in influencing environments for health, they need analytical instruments that enable them to link specific environmental conditions with the actions necessary to improve them. These instruments must also enable public-health professionals to identify points of leverage for stimulating key actors to take the actions necessary to make environments more promoting of health. This article first presents one such analytical instrument. Then, building on examples relating to socio-economic health inequities, the analytical instrument is applied to reveal how it can add value to health professionals' effectiveness in planning interventions for more health-promoting environments.

Clinical decision support for personalized medicine: an opportunity for pharmacist-physician collaboration.

PubMed

Barlow, Jane F

2012-06-01

Pharmacogenomics has significant potential to improve the efficacy and safety of medication therapy, but it requires new expertise and adds a new layer of complexity for all healthcare professionals. Pharmacists and pharmacy management systems can play a leading role in providing clinical decision support for the use and interpretation of pharmacogenomic tests. To serve this role effectively, pharmacists will need to expand their expertise in the emerging field of clinical pharmacogenomics. Pharmacy-based clinical programs can expedite the use of pharmacogenomic testing, help physicians interpret the test results and identify future medication risks associated with the patient's phenotype. Over time, some of these functions can be embedded in clinical decision support systems as part of the broader automation of the healthcare system.

Data Transformations for Inference with Linear Regression: Clarifications and Recommendations

ERIC Educational Resources Information Center

Pek, Jolynn; Wong, Octavia; Wong, C. M.

2017-01-01

Data transformations have been promoted as a popular and easy-to-implement remedy to address the assumption of normally distributed errors (in the population) in linear regression. However, the application of data transformations introduces non-ignorable complexities which should be fully appreciated before their implementation. This paper adds to…

A New Approach to Teaching Business Oriented Students.

ERIC Educational Resources Information Center

Merchant, Ronald

1980-01-01

Describes a competency based business mathematics course offered at Spokane Falls Community College (Washington) in which students, through the use of calculators, master mathematical concepts without having to mentally add columns of figures or perform complex arithmetic problems on paper. Examines both the mathematical and 10-key skills…

Do bus accidents cause nonepileptic seizures?: complex issues of medicolegal causation.

PubMed

LaFrance, W Curt; Self, Janet A

2008-01-01

The question of causation is approached through a case description and analysis. An alternative perspective is discussed for addressing neuropsychiatric cases in the medicolegal context. Viewing medical litigation from the perspective of risk factors, timeline, and baseline may add clarity to the difficulty of understanding causation.

EFFECT OF ARSENICALS ON ULTRAVIOLET-RADIATION-INDUCED GROWTH ARREST AND RELATED SIGNALING EVENTS IN HUMAN KERATINOCYTES

EPA Science Inventory

The molecular mechanisms mediating arsenic-induced carcinogenesis are not well understood. The role of confounding factors such as ultraviolet radiation (UV), add another level of complexity to the study of arsenic carcinogenesis and the cancer risk assessment to humans. We hypot...

Teaching Consolidations Accounting: An Approach to Easing the Challenge

ERIC Educational Resources Information Center

Murphy, Elizabeth A.; McCarthy, Mark A.

2010-01-01

Teaching and learning accounting for consolidations is a challenging endeavor. Students not only need to understand the conceptual underpinnings of the accounting requirements for consolidations, but also must master the complex accounting needed to prepare consolidated financial statements. To add to the challenge, the consolidation process is…

A Rationale for Criterion-Referenced Proficiency Testing

ERIC Educational Resources Information Center

Clifford, Ray

2016-01-01

This article summarizes some of the technical issues that add to the complexity of language testing. It focuses in particular on the criterion-referenced nature of the ACTFL Proficiency Guidelines-Speaking; and it proposes a criterion-referenced interpretation of the ACTFL guidelines for reading and listening. It then demonstrates how using…

Improving wait times to care for individuals with multimorbidities and complex conditions using value stream mapping.

PubMed

Sampalli, Tara; Desy, Michel; Dhir, Minakshi; Edwards, Lynn; Dickson, Robert; Blackmore, Gail

2015-04-05

Recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely - an adaptation of Value Stream Mapping (VSM) to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding. Over an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC) and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times. The care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS) intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province. Wait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions. © 2015 by Kerman University of Medical Sciences.

3D Laser Imprint Using a Smoother Ray-Traced Power Deposition Method

NASA Astrophysics Data System (ADS)

Schmitt, Andrew J.

2017-10-01

Imprinting of laser nonuniformities in directly-driven icf targets is a challenging problem to accurately simulate with large radiation-hydro codes. One of the most challenging aspects is the proper construction of the complex and rapidly changing laser interference structure driving the imprint using the reduced laser propagation models (usually ray-tracing) found in these codes. We have upgraded the modelling capability in our massively-parallel fastrad3d code by adding a more realistic EM-wave interference structure. This interference model adds an axial laser speckle to the previous transverse-only laser structure, and can be impressed on our improved smoothed 3D raytrace package. This latter package, which connects rays to form bundles and performs power deposition calculations on the bundles, is intended to decrease ray-trace noise (which can mask or add to imprint) while using fewer rays. We apply this improved model to 3D simulations of recent imprint experiments performed on the Omega-EP laser and the Nike laser that examined the reduction of imprinting due to very thin high-Z target coatings. We report on the conditions in which this new model makes a significant impact on the development of laser imprint. Supported by US DoE/NNSA.

Morphological alterations in the elastic fibers of the rabbit craniomandibular joint following experimentally induced anterior disk displacement.

PubMed

Ali, A M; Sharawy, M; O'Dell, N L; al-Behery, G

1993-01-01

Elastic fibers are important components of the connective tissue that attaches the articular disk of the craniomandibular joint (CMJ) to the skull and mandible. Biopsies of the articular disk proper and bilaminar zone (BZ) tissues from patients with anterior disk displacement (ADD) have shown previously that there is a marked loss of elastic fibers. In the present study, the effects of inducing ADD on the elastic fibers in the rabbit CMJ disk proper, BZ and condylar cartilage were investigated. The right CMJ was exposed surgically and the discal attachments were severed except for the BZ attachments. Then, the disk was displaced anteriorly and sutured to the zygomatic arch. The CMJs were removed after 1, 2 or 6 weeks and processed for histochemical demonstration of elastic fibers. The results showed osteoarthritic changes following ADD, and a significant decrease in the number of the elastic fibers in the disk proper and BZ. The remaining elastic fibers were abnormal in their appearance and orientation. In addition, ADD led to the appearance of fine elastic fibers among the chondrocytes in the hyaline cartilage of the condyle that were not present in the cartilage of the control condyle. We conclude that induced ADD can lead to a significant loss of elastic fibers in the articular disk, and result in the appearance of elastic fibers within the cartilage of the mandibular condyle.

Complex matrix multiplication operations with data pre-conditioning in a high performance computing architecture

DOEpatents

Eichenberger, Alexandre E; Gschwind, Michael K; Gunnels, John A

2014-02-11

Mechanisms for performing a complex matrix multiplication operation are provided. A vector load operation is performed to load a first vector operand of the complex matrix multiplication operation to a first target vector register. The first vector operand comprises a real and imaginary part of a first complex vector value. A complex load and splat operation is performed to load a second complex vector value of a second vector operand and replicate the second complex vector value within a second target vector register. The second complex vector value has a real and imaginary part. A cross multiply add operation is performed on elements of the first target vector register and elements of the second target vector register to generate a partial product of the complex matrix multiplication operation. The partial product is accumulated with other partial products and a resulting accumulated partial product is stored in a result vector register.

Predicting survival in AIDS: refining the model.

PubMed

Hutchinson, S J; Brettle, R P; Gore, S M

1997-11-01

We tested the validity of a previously-published AIDS staging system by examining AIDS-defining diseases (ADDs) and CD4 counts as prognostic factors for survival of the 248 AIDS patients in the Edinburgh City Hospital Cohort, of whom 56% were injecting drug-users (IDUs). Cox regression was used to model the proportionality of risk of death as the CD4 count declined and more ADDs were experienced, and dependence upon post-AIDS treatment. Using the system of Mocroft et al. (Lancet 1995; 346:12-17) to grade severity, our data were well enough modelled, but we suggest: (i) regrading of HIV dementia (RR 3.9, 95% CI 2.5-6.0), mainly attributed to the drug users, to a very severe ADD; (ii) reduction in risk from zidovudine (RR 0.7, 95% CI 0.5-1.0) during AIDS follow-up for patients starting treatment at or after AIDS diagnosis; (iii) improved management of first mild ADDs (from 1987-89 to 1994-95: 40% reduction in IDUs appearing with mild index diseases, and an approximate three-fold reduction in risk associated with a mild ADD). This study supports previous findings on the significance of ADDs and lowest CD4 count in predicting the lifetime of AIDS patients.

Adding pegylated interferon to entecavir for hepatitis B e antigen-positive chronic hepatitis B: A multicenter randomized trial (ARES study).

PubMed

Brouwer, Willem Pieter; Xie, Qing; Sonneveld, Milan J; Zhang, Ningping; Zhang, Qin; Tabak, Fehmi; Streinu-Cercel, Adrian; Wang, Ji-Yao; Idilman, Ramazan; Reesink, Hendrik W; Diculescu, Mircea; Simon, Krzysztof; Voiculescu, Mihai; Akdogan, Meral; Mazur, Wlodzimierz; Reijnders, Jurrien G P; Verhey, Elke; Hansen, Bettina E; Janssen, Harry L A

2015-05-01

Entecavir (ETV) is a potent inhibitor of hepatitis B viral replication, but long-term therapy may be required. We investigated whether adding on pegylated interferon (Peg-IFN) to ETV therapy enhances serological response rates. In this global investigator-initiated, open-label, multicenter, randomized trial, hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) patients with compensated liver disease started on ETV monotherapy (0.5 mg/day) and were randomized in a 1:1 ratio to either Peg-IFN add-on therapy (180 µg/week) from week 24 to 48 (n = 85) or to continue ETV monotherapy (n = 90). Response was defined as HBeAg loss with HBV DNA <200 IU/mL at week 48. Responders discontinued ETV at week 72. All patients were followed until week 96. Response was achieved in 16 of 85 (19%) patients allocated to the add-on arm versus 9 of 90 (10%) in the monotherapy arm (P = 0.095). Adjusted for HBV DNA levels before randomized therapy, Peg-IFN add-on was significantly associated with response (odds ratio: 4.8; 95% confidence interval: 1.6-14.0; P = 0.004). Eleven (13%) of the add-on-treated patients achieved disease remission after ETV cessation versus 2 of 90 (2%) of those treated with monotherapy (P = 0.007), which was 79% (11 of 14) versus 25% (2 of 8) of those who discontinued ETV (P = 0.014). At week 96, 22 (26%) patients assigned add-on versus 12 (13%) assigned monotherapy achieved HBeAg seroconversion (P = 0.036). Peg-IFN add-on led to significantly more decline in hepatitis B surface antigen, HBeAg, and HBV DNA (all P < 0.001). Combination therapy was well tolerated. Although the primary endpoint was not reached, 24 weeks of Peg-IFN add-on therapy led to a higher proportion of HBeAg response, compared to ETV monotherapy. Add-on therapy resulted in more viral decline and appeared to prevent relapse after stopping ETV. Hence, Peg-IFN add-on therapy may facilitate the discontinuation of nucleos(t)ide analogs. © 2014 by the American Association for the Study of Liver Diseases.

Anticancer efficacy of a supramolecular complex of a 2-diethylaminoethyl-dextran-MMA graft copolymer and paclitaxel used as an artificial enzyme.

PubMed

Onishi, Yasuhiko; Eshita, Yuki; Ji, Rui-Cheng; Onishi, Masayasu; Kobayashi, Takashi; Mizuno, Masaaki; Yoshida, Jun; Kubota, Naoji

2014-01-01

The anticancer efficacy of a supramolecular complex that was used as an artificial enzyme against multi-drug-resistant cancer cells was confirmed. A complex of diethylaminoethyl-dextran-methacrylic acid methylester copolymer (DDMC)/paclitaxel (PTX), obtained with PTX as the guest and DDMC as the host, formed a nanoparticle 50-300 nm in size. This complex is considered to be useful as a drug delivery system (DDS) for anticancer compounds since it formed a stable polymeric micelle in water. The resistance of B16F10 melanoma cells to PTX was shown clearly through a maximum survival curve. Conversely, the DDMC/PTX complex showed a superior anticancer efficacy and cell killing rate, as determined through a Michaelis-Menten-type equation, which may promote an allosteric supramolecular reaction to tubulin, in the same manner as an enzymatic reaction. The DDMC/PTX complex showed significantly higher anticancer activity compared to PTX alone in mouse skin in vivo. The median survival times of the saline, PTX, DDMC/PTX4 (particle size 50 nm), and DDMC/PTX5 (particle size 290 nm) groups were 120 h (treatment (T)/control (C), 1.0), 176 h (T/C, 1.46), 328 h (T/C, 2.73), and 280 h (T/C, 2.33), respectively. The supramolecular DDMC/PTX complex showed twice the effectiveness of PTX alone (p < 0.036). Above all, the DDMC/PTX complex is not degraded in cells and acts as an intact supramolecular assembly, which adds a new species to the range of DDS.

Association between genetic variants of the ADD1 and GNB3 genes and blood pressure response to the cold pressor test in a Chinese Han population: the GenSalt Study.

PubMed

Wang, Laiyuan; Chen, Shufeng; Zhao, Qi; Hixson, James E; Rao, Dabeeru C; Jaquish, Cashell E; Huang, Jianfeng; Lu, Xiangfeng; Chen, Jichun; Cao, Jie; Li, Jianxin; Li, Hongfan; He, Jiang; Liu, De-Pei; Gu, Dongfeng

2012-08-01

Genetic factors influence blood pressure (BP) response to the cold pressor test (CPT), which is a phenotype related to hypertension risk. We examined the association between variants of the α-adducin (ADD1) and guanine nucleotide binding protein (G protein) β-polypeptide 3 (GNB3) genes and BP response to the CPT. A total of 1998 Han Chinese participants from the Genetic Epidemiology Network of Salt Sensitivity completed the CPT. The area under the curve (AUC) above the baseline BP during the CPT was used to measure the BP response. Twelve single-nucleotide polymorphisms (SNPs) of the ADD1 and GNB3 genes were selected and genotyped. Both single-marker and haplotype association analyses were conducted using linear mixed models. The rs17833172 and rs3775067 SNPs of the ADD1 gene and the rs4963516 SNP of the GNB3 gene were significantly associated with the BP response to CPT, even after adjusting for multiple testing. For the ADD1 gene, the AA genotype of SNP rs17833172 was associated with lower systolic BP (SBP) reactivity (P<0.0001) and faster BP recovery (P=0.0003). The TT genotype of rs3775067 was associated with slower SBP recovery (P=0.004). For the GNB3 gene, the C allele of SNP rs4963516 was associated with faster diastolic BP recovery (P=0.002) and smaller overall AUC (P=0.003). Haplotype analysis indicated that the CCGC haplotype of ADD1 constructed by rs1263359, rs3775067, rs4961 and rs4963 was significantly associated with the BP response to CPT. These data suggest that genetic variants of the ADD1 and GNB3 genes may have important roles in BP response to the CPT. Future studies aimed at replicating these novel findings are warranted.

Elagolix for the management of heavy menstrual bleeding associated with uterine fibroids: results from a phase 2a proof-of-concept study.

PubMed

Archer, David F; Stewart, Elizabeth A; Jain, Rita I; Feldman, Robert A; Lukes, Andrea S; North, Janine D; Soliman, Ahmed M; Gao, Jingjing; Ng, Juki W; Chwalisz, Kristof

2017-07-01

To evaluate the safety and efficacy of elagolix vs. placebo and elagolix with low-dose E 2 /progestogen add-back therapy. Proof-of-concept, dose-ranging, multiple-cohort study. Clinics. Premenopausal women with fibroids and heavy menstrual bleeding (menstrual blood loss [MBL] >80 mL per cycle). Three months' treatment with elagolix alone: 100 mg twice daily (BID), 200 mg BID, 300 mg BID, 400 mg once daily (QD), or 600 mg QD (all but the 600 mg QD arm were placebo controlled); or elagolix plus add-back therapy: 200 mg BID plus continuous low-dose E 2 0.5 mg/norethindrone acetate 0.1 mg or elagolix 300 mg BID plus E 2 1 mg continuously and cyclical P 200 mg. Least-squares mean percentage change in MBL; adverse events (AEs). Mean age was 41.8 years; 73.8% were black; mean baseline MBL was 267 mL. Of randomized women (elagolix alone, n = 160; placebo, n = 50; elagolix with add-back therapy, n = 61), 228 of 271 completed the 3-month treatment period. The MBL percentage change from baseline to last 28 days was significantly greater with elagolix alone (range, -72% to -98%; dose-dependent reduction was highest with 300 mg BID) vs. placebo (range, -8% to -41%); mean percentage changes with add-back regimens were -80% to -85%. Overall AEs were dose independent (elagolix alone, 70.0%-81.3%) but lower with placebo (56.0%) and add-back regimens (55.6%-70.6%). Hot flush was the most common AE (elagolix alone, 45.5%-62.5%; placebo, 12.0%; add-back regimens, 18.5%-26.5%). Elagolix significantly reduced heavy menstrual bleeding in women with fibroids. Low-dose add-back regimens substantially reduced flushing. NCT01441635. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Initiatives to improve prescribing efficiency for drugs to treat Parkinson's disease in Croatia: influence and future directions.

PubMed

Brkicic, Ljiljana Sovic; Godman, Brian; Voncina, Luka; Sovic, Slavica; Relja, Maja

2012-06-01

Parkinson's disease (PD) is the second most common neurological disease affecting older adults. Consequently, this disease should be a focus among payers, with increasing utilization of newer premium-priced patent-protected add-on therapies to stabilize or even improve motor function over time. However, expenditure can be moderated by reforms. Consequently, there is a need to assess the influence of these reforms on the prescribing efficiency for drugs to treat PD in Croatia before proposing additional measures. Prescribing efficiency is defined as increasing the use of add-on therapies for similar expenditure. An observational retrospective study of the Croatian Institute for Health Insurance database of drugs to treat patients with PD in Croatia from 2000 to 2010 was carried out, with utilization measured in defined daily doses (defined as the average maintenance dose of a drug when used in its major indication in adults). The study years were chosen to reflect recent reforms. Only reimbursed expenditure is measured from a health insurance perspective. Utilization of drugs to treat PD increased by 218% between 2000 and 2010. Reimbursed expenditure increased by 360%, principally driven by increasing utilization of premium-priced patent-protected add-on therapies, including ropinirole and pramipexole. However, following recent reforms, reducing expenditure/defined daily dose for the different drugs, as well as overall expenditure, stabilized reimbursed expenditure between 2005 and 2010. Treatment of PD is complex, and add-on therapies are needed to improve care. Reimbursed expenditure should now fall following stabilization, despite increasing volumes, as successive add-on therapies lose their patents, further increasing prescribing efficiency.

Stepping into the omics era: Opportunities and challenges for biomaterials science and engineering☆

PubMed Central

Rabitz, Herschel; Welsh, William J.; Kohn, Joachim; de Boer, Jan

2016-01-01

The research paradigm in biomaterials science and engineering is evolving from using low-throughput and iterative experimental designs towards high-throughput experimental designs for materials optimization and the evaluation of materials properties. Computational science plays an important role in this transition. With the emergence of the omics approach in the biomaterials field, referred to as materiomics, high-throughput approaches hold the promise of tackling the complexity of materials and understanding correlations between material properties and their effects on complex biological systems. The intrinsic complexity of biological systems is an important factor that is often oversimplified when characterizing biological responses to materials and establishing property-activity relationships. Indeed, in vitro tests designed to predict in vivo performance of a given biomaterial are largely lacking as we are not able to capture the biological complexity of whole tissues in an in vitro model. In this opinion paper, we explain how we reached our opinion that converging genomics and materiomics into a new field would enable a significant acceleration of the development of new and improved medical devices. The use of computational modeling to correlate high-throughput gene expression profiling with high throughput combinatorial material design strategies would add power to the analysis of biological effects induced by material properties. We believe that this extra layer of complexity on top of high-throughput material experimentation is necessary to tackle the biological complexity and further advance the biomaterials field. PMID:26876875

Efficacy and Safety of Carbomer-Based Lipid-Containing Artificial Tear Formulations in Patients With Dry Eye Syndrome.

PubMed

Chung, So-Hyang; Lim, Sung A; Tchach, Hungwon

2016-02-01

To evaluate the efficacy and safety profile of carbomer-based lipid-containing artificial tear formulations (CBLAT) in patients with dry eye syndrome. A multicenter parallel-group study was conducted in 412 patients with dry eye syndrome. Of these patients, 221 switched from using artificial tears to CBLAT (switching group) and 191 added CBLAT to their current treatment (add-on group). Ocular symptom scores, ocular staining grades, tear film breakup time (tBUT), Schirmer I test value, and Korean dry eye level (as defined by the Korean Corneal Disease Study Group guidelines) were evaluated at baseline and after 4 weeks of treatment. After 4 weeks of treatment, ocular surface staining grade, tBUT, Schirmer I value, ocular irritation symptom scores, and the positive rate of visual symptom improved significantly in both groups. Mean reductions in ocular surface staining grades (-0.8 ± 0.9) and ocular irritation symptom scores (-0.8 ± 0.8) in the add-on group were significantly higher than those (-0.5 ± 0.8 and -0.6 ± 0.8) in the switching group (P < 0.01 and P < 0.05). The positive rate of visual symptoms (44.2%) in the add-on group was significantly higher than that (26.4%) in the switching group (P < 0.01). The decrease of Korean dry eye level was 30.1% in the switching group and 51.6% in the add-on group. More patients in the add-on group had decreased dry eye levels than those in the switching group (P < 0.0001). CBLAT improves ocular surface staining grades, tBUT, Schirmer I values, and ocular symptoms in patients with dry eye syndrome.

Say Cheese! A Snapshot of Elementary Teachers' Engagement and Motivation for Classroom Assessment

ERIC Educational Resources Information Center

Black, Glenda L.

2014-01-01

Assessment is a complex function requiring an understanding of student learning, assessment principles, practices, and purposes of data to implement effective classroom assessment. The purpose of this study was to add to the growing base of knowledge about teachers' engagement with assessment data and their motivation for classroom assessment.…

Philanthropies Add Weight to "i3" Effort

ERIC Educational Resources Information Center

Robelen, Erik W.; McNeil, Michele

2010-01-01

The author reports on a new effort by 12 major education philanthropies that aims to dovetail with the Education Department's "i3" agenda, raising complex issues. The decision by a dozen major education grantmakers to team up on an initiative designed to dovetail with the federal "Investing in Innovation" grant competition is being seen by…

Deconstructing Statistical Analysis

ERIC Educational Resources Information Center

Snell, Joel

2014-01-01

Using a very complex statistical analysis and research method for the sake of enhancing the prestige of an article or making a new product or service legitimate needs to be monitored and questioned for accuracy. 1) The more complicated the statistical analysis, and research the fewer the number of learned readers can understand it. This adds a…

Higher Degree Research Supervision: From Practice toward Theory

ERIC Educational Resources Information Center

Maxwell, T. W.; Smyth, Robyn

2011-01-01

This paper presents our theorizing about the complex nature of higher degree research supervision. The intent is to make a contribution to the current debates about higher education generally, and supervision of higher degree research students in particular. We add to the pedagogy of supervision by extending its scope to and beyond the supervisory…

Climate Cases: Learning about Student Conceptualizations of Global Climate Change

ERIC Educational Resources Information Center

Tierney, Benjamin P.

2013-01-01

The complex topic of global climate change continues to be a challenging yet important topic among science educators and researchers. This mixed methods study adds to the growing research by investigating student conceptions of climate change from a system theory perspective (Von Bertalanffy, 1968) by asking the question, "How do differences…

Experiences of Bereaved Secondary Students in the High School Environment

ERIC Educational Resources Information Center

Myers-Autrey, Roberta Lee

2010-01-01

Bereaved high school adolescents are often affected in a myriad of ways by the death of a loved one. The traumatic experience and bereavement process add complexity to high school adolescents' development and this phenomenon is not fully understood, in particular in regards to communication and relationships in the school environment. The…

Calibrating your grain drill or seeder can save both seed and money

USDA-ARS?s Scientific Manuscript database

The agronomic impact of over-seeding or under-seeding a field is complex. Most farmers have worked out a seeding rate with their agronomist. Exceeding that rate may not be productive, especially at $265+ per bag of alfalfa ($500 for switchgrass). Over-seeding costs add up, even across a small number...

Tuberous Sclerosis Complex National Database

DTIC Science & Technology

2006-10-01

about conditions in the following areas (as applicable to the participant): academic, cardiac, cognitive, dental , dermatological, liver, neurological...Search Criteria Add To These Results With an Affected Area Academic Cardiac Dental Dermatological Liver Neurological...The Research Integrity Officer, with the assistance of counsel (if needed), will convene the first meeting of the investigation committee to review

Life Journey through Autism: A Guide for Military Families

ERIC Educational Resources Information Center

Alexander, Katie C.; Clemens, Erin M.; Gilbert, Marilyn; McBreen, Joseph

2010-01-01

Autism presents parents and families with many challenges under normal circumstances. Autism in a military family magnifies many of those challenges and adds a few more that are unique to the demands of military life and service, further complicating an already complex neurobiological disorder. Military sources indicate that more than 13,000…

Multigenerational Challenges: Team-Building for Positive Clinical Workforce Outcomes

PubMed

Moore, Jill M; Everly, Marcee; Bauer, Renee

2016-05-31

Patient acuity in hospital settings continues to increase, and there is greater emphasis on patient outcomes. The current nursing workforce is comprised of four distinct generational cohorts that include veterans, baby boomers, millennials, and generation Xers. Each group has unique characteristics that add complexity to the workforce and this can add challenges to providing optimal patient care. Team building is one strategy to increase mutual understanding, communication, and respect, and thus potentially improve patient outcomes. In this article, we first briefly define generational cohorts by characteristics, and discuss differing expectations for work/life balance and potential negative outcomes. Our discussion offers team building strategies for positive outcomes, a case scenario, and concludes with resources for team building and organizational opportunities.

Thermal fluctuation based study of aqueous deficient dry eyes by non-invasive thermal imaging.

PubMed

Azharuddin, Mohammad; Bera, Sumanta Kr; Datta, Himadri; Dasgupta, Anjan Kr

2014-03-01

In this paper we have studied the thermal fluctuation patterns occurring at the ocular surface of the left and right eyes for aqueous deficient dry eye (ADDE) patients and control subjects by thermal imaging. We conducted our experiment on 42 patients (84 eyes) with aqueous deficient dry eyes and compared with 36 healthy volunteers (72 eyes) without any history of ocular surface disorder. Schirmer's test, Tear Break-up Time, tear Meniscus height and fluorescein staining tests were conducted. Ocular surface temperature measurement was done, using an FL-IR thermal camera and thermal fluctuation in left and right eyes was calculated and analyzed using MATLAB. The time series containing the sum of squares of the temperature fluctuation on the ocular surface were compared for aqueous deficient dry eye and control subjects. Significant statistical difference between the fluctuation patterns for control and ADDE was observed (p < 0.001 at 95% confidence interval). Thermal fluctuations in left and right eyes are significantly correlated in controls but not in ADDE subjects. The possible origin of such correlation in control and lack of correlation in the ADDE subjects is discussed in the text. Copyright © 2014 Elsevier Ltd. All rights reserved.

Deployment of 464XLAT (RFC6877) alongside IPv6-only CPU resources at WLCG sites

NASA Astrophysics Data System (ADS)

Froy, T. S.; Traynor, D. P.; Walker, C. J.

2017-10-01

IPv4 is now officially deprecated by the IETF. A significant amount of effort has already been expended by the HEPiX IPv6 Working Group on testing dual-stacked hosts and IPv6-only CPU resources. Dual-stack adds complexity and administrative overhead to sites that may already be starved of resource. This has resulted in a very slow uptake of IPv6 from WLCG sites. 464XLAT (RFC6877) is intended for IPv6 single-stack environments that require the ability to communicate with IPv4-only endpoints. This paper will present a deployment strategy for 464XLAT, operational experiences of using 464XLAT in production at a WLCG site and important information to consider prior to deploying 464XLAT.

Childhood maltreatment, intervening variables, and adult psychological difficulties in women: an overview.

PubMed

Briere, John; Jordan, Carol E

2009-10-01

This article reviews the complex relationship between child maltreatment and later psychosocial difficulties among adult women. Specifically addressed are (a) the various forms of childhood maltreatment, (b) the range of potential long-term psychological outcomes, and (c) important contextual variables that mediate or add to these maltreatment-symptom relationships. Among the latter are characteristics of the abuse and/or neglect; effects of impaired parental functioning; premaltreatment and postmaltreatment psychobiology; qualities of the parent-child attachment; abuse and/or neglect-related affect dysregulation that may lead to further symptomatology; the extent to which the child responds with significant emotional or behavioral avoidance; and whether later traumas are also present. Also relevant are sociocultural contributors to both child maltreatment and maltreatment effects, especially poverty and marginalization. Clinical and research implications are considered.

Community detection in complex networks using link prediction

NASA Astrophysics Data System (ADS)

Cheng, Hui-Min; Ning, Yi-Zi; Yin, Zhao; Yan, Chao; Liu, Xin; Zhang, Zhong-Yuan

2018-01-01

Community detection and link prediction are both of great significance in network analysis, which provide very valuable insights into topological structures of the network from different perspectives. In this paper, we propose a novel community detection algorithm with inclusion of link prediction, motivated by the question whether link prediction can be devoted to improving the accuracy of community partition. For link prediction, we propose two novel indices to compute the similarity between each pair of nodes, one of which aims to add missing links, and the other tries to remove spurious edges. Extensive experiments are conducted on benchmark data sets, and the results of our proposed algorithm are compared with two classes of baselines. In conclusion, our proposed algorithm is competitive, revealing that link prediction does improve the precision of community detection.

The Power of SS 433's Jets

NASA Technical Reports Server (NTRS)

Band, David F.

1999-01-01

We observed SS 433 for the third time with RXTE, this time simultaneously with a Nobeyama millimeter band monitoring campaign. These observations extended the RXTE coverage of SS 433's precession phases. and once again monitored the source during a binary eclipse. Our AO-2 campaign of a joint RXTE-VLBA-VLA-MERLIN observation was delayed to little more than a month before the AO-3 observations. We also had an AO-1 observation of SS 433. In each case we observed an eclipse of the compact ob'ect by the companion star, and had contemporaneous optical observations. We are analyzing all three sets of observations together. A publication is in preparation; Its completion will be supported by the remaining AO-2 funds. Here I will summarize the general results and point out the relevant features of the AO-3 observations. The spectrum is detected to approx. 50 keV, which is entirely within the PCA energy band. We find that the HEXTE data do not add significantly to the spectrum, and most of our fits are without HEXTE. We find that the continuum can be fit with a power law with an exponential cutoff; the photon index is usually approx. 1.4. A line at approx. 6.4 keV is definitely required, and the fits improve significant, if we add a second line, also with an energy in the iron K(alpha) complex, and an absorption edge. The edge usually has an energy of approx. 5.8 keV, which does not correspond to any known physical feature. and may be an instrumental artifact. This is under further investigation.

Accommodative Behavior of Young Eyes Wearing Multifocal Contact Lenses.

PubMed

Altoaimi, Basal H; Almutairi, Meznah S; Kollbaum, Pete S; Bradley, Arthur

2018-05-01

The effectiveness of multifocal contact lenses (MFCLs) at slowing myopia progression may hinge on the accommodative behavior of young eyes fit with these presbyopic style lenses. Can they remove hyperopic defocus? Convergence accommodation as well as pupil size and the zonal geometry are likely to contribute to the final accommodative responses. The aim of this study was to examine the accommodation behavior of young adult eyes wearing MFCLs and the effectiveness of these MFCLs at removing foveal hyperopic defocus when viewing near targets binocularly. Using a high-resolution Shack-Hartmann aberrometer, accommodation and pupil behavior of eight young adults (27.25 ± 2.05 years) were measured while subjects fixated a 20/40 character positioned between 2 m and 20 cm (0.50 to 5.00 diopters [D]) in 0.25-D steps. Refractive states were measured while viewing binocularly and monocularly with single-vision and both center-distance and center-near +2.00 D add MFCLs. Refractive state was defined using three criteria: the dioptric power that would (1) minimize the root mean square wavefront error, (2) focus the pupil center, and (3) provide the peak image quality. Refractive state pupil maps reveal the complex optics that exist in eyes wearing MFCLs. Reduced accommodative gain beyond the far point of the near add revealed that young subjects used the added plus power to help focus near targets. During accommodation to stimuli closer than the far point generated by the add power, a midperipheral region of the pupil was approximately focused, resulting in the smallest accommodative errors for the minimum root mean square-defined measures of refractive state. Paraxial images were always hyperopically or myopically defocused in eyes viewing binocularly with center-distance or center-near MFCLs, respectively. Because of zone geometry in the concentric MFCLs tested, the highly aberrated transition zone between the distance and near optics contributed a significant proportion and sometimes the majority of light to the resulting images. Young eyes fit with MFCLs containing significant transition zones accommodated to focus pupil regions between the near and distance optics, which resulted in less than optimal retinal image quality and myopic or hyperopic defocus in either the pupil center or pupil margins.

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

PubMed

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

2011-03-01

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

The antiepileptic activity of Vitex agnus castus extract on amygdala kindled seizures in male rats.

PubMed

Saberi, Mehdi; Rezvanizadeh, Alireza; Bakhtiarian, Azam

2008-08-22

The antiepileptic activity of hydrophilic extract of Vitex agnus castus fruit (Vitex) was evaluated by the kindling model of epilepsy. Intact male rats (250-300 g) were stereotaxically implanted with a tripolar and two monopolar electrodes in amygdala and dura, respectively. The afterdischarge (AD) threshold was determined in each animal and stimulated daily until fully kindled. The animals were administered different doses (60, 120 or 180 mg/kg) of Vitex or 0.1 ml of hydro alcoholic solvent intra-peritoneally (i.p.) and kindling parameters including AD threshold, seizure stages (SS), afterdischarge duration (ADD), stage 4 latency (S4L) and stage 5 duration (S5D) were recorded 30 min post-injection. The obtained data showed that even low dose (60 mg/kg) of Vitex could significantly increase the AD threshold and decrease the ADD and S5D (P<0.05). These changes were more significant with higher doses (120 or 180 mg/kg) for ADD (P<0.01) and S5D (P<0.001). Vitex at the dose of 120 mg/kg, induced significant increment in S4L (P<0.05). This effect was more prominent at the dose of 180 mg/kg (P<0.001). The latter dose could significantly reduce seizure stage (P<0.01) and most of the animals did not show S5. These results indicate that Vitex can reduce or prevent epileptic activity as demonstrated by reduction of ADD and S5D (length of convulsion) in a dose dependent manner. In conclusion, Vitex at appropriate dose can probably reduce or control epileptic activities.

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

PubMed

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

2018-06-01

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

On- and off-response ERGs elicited by sawtooth stimuli in normal subjects and glaucoma patients.

PubMed

Pangeni, Gobinda; Lämmer, Robert; Tornow, Ralf P; Horn, Folkert K; Kremers, Jan

2012-06-01

The aim of this study is to measure the on- and off-responses and their response asymmetries elicited by sawtooth stimuli in normal subjects and glaucoma patients. Furthermore, the correlation between the ERGs and other functional and structural parameters are investigated. Full-field stimuli were produced using a Ganzfeld bowl with Light Emitting Diodes (LEDs) as light sources. On- and off-response ERGs were recorded from 17 healthy subjects, 12 pre-perimetric and 15 perimetric glaucoma patients using 4-Hz luminance rapid-on and rapid-off sawtooth stimuli (white light; mean luminance 55 cd/m(2)) at 100% contrast. The on- and off-responses were added to study response asymmetries. In addition, flash ERGs were elicited by red stimuli (200 cd/m(2)) on a blue background (10 cd/m(2)). The mean deviations (MD) of the visual field defects were obtained by standard automated perimetry. The retinal nerve fibre layer thickness (RNFLT) was measured with Spectral Domain Optical Coherence Tomography (SOCT). We studied the correlation between ERG response amplitudes, visual field mean deviation (MDs) and RNFLT values. The on-responses showed an initial negative (N-on) followed by a positive (P-on), a late positive (LP-on) and a late negative responses (LN-on). The off-responses showed an initial positive (P-off) a late positive (LP-off) and a late negative response (LN-off). The addition of on- and off-responses revealed an initial positive (P-add) and a late negative response (LN-add). The on-response components (N-on, P-on and LN-on) in the glaucoma patients were relatively similar to those of the control subjects. However, the LP-on was significantly elevated (p = 0.03) in perimetric patients. The LP-off was significantly elevated (p < 0.001), and the amplitude of LN-off was significantly reduced in perimetric patients (p = 0.02). The LN-add amplitude was significantly reduced (p < 0.001) and delayed (p = 0.03) in perimetric patients. The amplitudes of the LN-off and LN-add ERG components were significantly correlated with the PhNR in the flash ERG (LN-off: p = 0.01; LN-add: p < 0.001) and with RNFLT (LN-off: p = 0.006; LN-add: p = 0.001). On- and off-response ERGs and their response asymmetries, elicited by sawtooth stimuli, are altered in the glaucoma patients. The late components are affected. Changes in the late negative components are correlated with structural and other functional changes.

The Hidden Complexity of Biological "Dirty Bombs": Implications for Special Operations Medical Personnel.

PubMed

Washington, Michael A; Blythe, Jauchia

The recent capture of a terrorist in Belgium carrying explosives, fecal matter, and animal tissue may indicate a shift from conventional weapons to crude bacteriological preparations as instruments of terror. It is important to note that although such weapons lack technological sophistication, bacteria are inherently complex, unpredictable, and undetectable in the field. Therefore, it is important that Special Operations medical personnel understand the complications that such seemingly simple devices can add to the treatment of casualties in the field and subsequent evaluation in the clinic. 2016.

Rainbows, graticules, and logos…oh my!

NASA Astrophysics Data System (ADS)

Pisut, D.; MacIntosh, E.; McDougall, C.

2016-12-01

Data visualizations are meant to simplify the complex. However, visualizations in geosciences are often made more complex than need be. Color palettes that hide Earth system dynamics or even cannot be seen; annotations that clutter the display more than provide context; logos that only add meaningless acronyms and other visual distraction. We will share lessons learned on how tweaking these and other components of visualizations improve the usability and comprehension for multiple audiences - especially since the best practices for one audience (e.g., television) do not necessarily translate to other audiences (e.g., print, education, web, etc).

[Social-professional status, identity, social participation and media utilization. Analysis of a complex dynamics].

PubMed

Laflamme, Simon; Roggero, Pascal; Southcott, Chris

2010-08-01

This article examines the link between the domain and level of occupation, on the one hand, and use of media, including internet, on the other. It adds to this investigation an analysis of identity in its relation to media use and accessibility. It challenges the hypothesis of a strong correlation between level of occupation and use and accessibility to media. It reveals complex phenomena of social homogenization and differentiation. Data is extracted from a sample of workers who completed a questionnaire which focused on use of media.

Participation Structures as a Mediational Means: Learning Balinese Gamelan in the United States through Intent Participation, Mediated Discourse, and Distributed Cognition

ERIC Educational Resources Information Center

Jocuns, Andrew

2009-01-01

Participation has presented a complex unit of analysis for interactional sociolinguistics. In this study I add another dimension to participation by considering recent theories related to sociocultural activity theory--mediated discourse analysis and distributed cognition. Drawing on examples from "maguru panggul", the traditional…

An Examination of Mediators and Moderators in Applied Research

ERIC Educational Resources Information Center

Miller, Janice; Hellman, Chan M.

2007-01-01

Researchers are being asked to conduct more complex analyses to add clarity and confidence in decision-making. This is especially true for researchers in the community college systems as they serve a more non-traditional student and are more likely to also serve at-risk populations. In this article we distinguish between moderators and mediators…

Valuing the Student Loan Consolidation Option. Congressional Budget Office Background Paper

ERIC Educational Resources Information Center

Weinberg, Steven

2006-01-01

Federal student loans include a complex consolidation option that gives borrowers the opportunity to combine several loans into a single loan with a longer term to maturity and, for loans originated before July 2006, to convert from a variable- to a fixed-rate loan. The consolidation option adds substantial costs to the federal student loan…

Automatic Domain Adaptation of Word Sense Disambiguation Based on Sublanguage Semantic Schemata Applied to Clinical Narrative

ERIC Educational Resources Information Center

Patterson, Olga

2012-01-01

Domain adaptation of natural language processing systems is challenging because it requires human expertise. While manual effort is effective in creating a high quality knowledge base, it is expensive and time consuming. Clinical text adds another layer of complexity to the task due to privacy and confidentiality restrictions that hinder the…

Principal Perspectives on Social Networking and the Disruptive Effects of Cyberbullying

ERIC Educational Resources Information Center

Welker, Heidi Stevenson

2010-01-01

Cyberbullying on social networking sites such as MySpace and Facebook has had negative effects on children at school. Cyberbullying disruption during the school day adds to the complexity of maintaining school operations, safety, and academic achievement. With the advancement of technology, there is a gap in the literature on the disruption in…

Learning and Teaching in Uncertain Times: A Nietzschean Approach in Professional Higher Education

ERIC Educational Resources Information Center

Joosten, Henriëtta

2013-01-01

Today professionals have to deal with more uncertainties in their field than before. We live in complex and rapidly changing environments. The British philosopher Ronald Barnett adds the term "supercomplexity" to highlight the fact that "we can no longer be sure how even to describe the world that faces us" (Barnett, 2004).…

Optimizing smoke and plume rise modeling approaches at local scales

Treesearch

Derek V. Mallia; Adam K. Kochanski; Shawn P. Urbanski; John C. Lin

2018-01-01

Heating from wildfires adds buoyancy to the overlying air, often producing plumes that vertically distribute fire emissions throughout the atmospheric column over the fire. The height of the rising wildfire plume is a complex function of the size of the wildfire, fire heat flux, plume geometry, and atmospheric conditions, which can make simulating plume rises difficult...

The role of the Forest Service in aquatic invasive species research

Treesearch

Susan B. Adams; Kelly M. Burnett; Peter Bisson; Bret Harvey; Keith H. Nislow; Bruce E. Rieman; John Rinne

2010-01-01

Aquatic ecosystems include the most imperiled taxa in the United States, and invasive species are the second leading contributor to this imperilment. The U.S. Department of Agriculture (USDA), Forest Service is legally mandated to sustainably manage aquatic habitats and native species on National Forest System (NFS) lands. Invasive species add complexity and...

Recreation Use of the Ocala National Forest in Florida

Treesearch

George A. James; Robert A. Harper

1965-01-01

Forest land managers charged with operating and developing an outdoor recreation complex--whether large or small, public or private - constantly face a host of management decisions. What are my cleanup and maintenance needs? What uses and facilities should be provided? Should I expand? Should I add new units? These questions are not easy to answer. And before sound...

On the Margins or at the Center? Distance Education in Higher Education

ERIC Educational Resources Information Center

Xiao, Junhong

2018-01-01

This reflection focuses on the position of distance education in today's global higher education. Firstly, it identifies three types of convergence of distance and campus-based education--dual mode, add-on/blended, and full convergence--arguing that the last type has yet to be fully realized due to the complexities involved. It then critiques the…

76 FR 71089 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-16

... Receipts/SPDRs (``SPY''); (ii) the PowerShares QQQ Trust (``QQQ'') [reg]; (iii) Apple, Inc. (``AAPL''); (iv... initially filed a proposed rule change \\6\\ to pay a different Customer Complex Order Rebate to Add Liquidity... the Exchange from continuing to increase its order flow. Currently, the Exchange pays a Customer...

Global Skills and Mobility Challenges and Possibilities for VET: A Crossborder Cross-Sectoral Case Study

ERIC Educational Resources Information Center

Cameron, Roslyn; O'Hanlon-Rose, Terry

2011-01-01

The complex interplay of technological advances, global demographic trends and macroeconomic forces has seen the emergence of global markets, economies, supply chains and labour markets. The use of skilled migration policy and initiatives for many countries feeling the effects of aging populations and skill shortages adds another dimension to this…

Discussion: With Choices Come Consequences

ERIC Educational Resources Information Center

Braun, Henry

2009-01-01

The Growth Model Pilot Program (GMPP) was introduced as a response to criticism of the reliance of No Child Left Behind on status-based indicators. Although incorporating a growth component appears to be a step in the right direction, it adds a level of complexity that brings to the fore new concerns. Three of the four papers in this special issue…

78 FR 26096 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Order Approving Proposed Rule Change To...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... to add three new definitions--Spread Type Order; Complex Order (to help distinguish between the multi... legs. The Commission believes that such automation may benefit the Exchange, its members and users, and... through a better price on the book or on another market.\\35\\ Automating formerly manual trades should help...

Basic School Law. "What Every School Board Member Should Know" Series.

ERIC Educational Resources Information Center

Martinez, Robert P.; And Others

Designed to tell the school board member what New Jersey school law requires and permits, this second edition of "Basic School Law" avoids exploring the complex legal issues that gave rise to the regulations discussed. Dropping the first edition's chapter on labor law, this edition adds material on the sunshine laws regarding the conduct…

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

PubMed

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

2009-10-01

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

Multifractality in individual honeybee behavior hints at colony-specific social cascades: Reanalysis of radio-frequency identification data from five different colonies

NASA Astrophysics Data System (ADS)

Carver, Nicole S.; Kelty-Stephen, Damian G.

2017-02-01

Honeybees (Apis mellifera) exhibit complex coordination and interaction across multiple behaviors such as swarming. This coordination among honeybees in the same colony is remarkably similar to the concept of informational cascades. The multifractal geometry of cascades suggests that multifractal measures of individual honeybee activity might carry signatures of these colony-wide coordinations. The present work reanalyzes time stamps of entrances to and exits from the hive captured by radio-frequency identification (RFID) sensors reading RFID tags on individual bees. Indeed, both multifractal spectrum width for individual bees' inter-reading interval series and differences of those widths from surrogates significantly predicted not just whether the individual bee's hive had a mesh enclosure but also predicted the specific membership of individual bees in one of five colonies. The significant effects of multifractality in matching honeybee activity to type of colony and, further, matching individual honeybees to their exact home colony suggests that multifractality quantifies key features of the colony-wide interactions across many scales. This relevance of multifractality to predicting colony type or colony membership adds additional credence to the cascade metaphor for colony organization. Perhaps, multifractality provides a new tool for exploring the relationship between individual organisms and larger, more complex social behaviors.

The Coagulation Profile of End-Stage Liver Disease and Considerations for Intraoperative Management.

PubMed

Forkin, Katherine T; Colquhoun, Douglas A; Nemergut, Edward C; Huffmyer, Julie L

2018-01-01

The coagulopathy of end-stage liver disease results from a complex derangement in both anticoagulant and procoagulant processes. With even minor insults, cirrhotic patients experience either inappropriate bleeding or clotting, or even both simultaneously. The various phases of liver transplantation along with fluid and blood product administration may contribute to additional disturbances in coagulation. Thus, anesthetic management of patients undergoing liver transplantation to improve hemostasis and avoid inappropriate thrombosis in the perioperative environment can be challenging. To add to this challenge, traditional laboratory tests of coagulation are difficult to interpret in patients with end-stage liver disease. Viscoelastic coagulation tests such as thromboelastography (Haemonetics Corporation, Braintree, MA) and rotational thromboelastometry (TEM International, Munich, Germany) have helped to reduce transfusion of allogeneic blood products, especially fresh frozen plasma, but have also lead to the increased use of fibrinogen-containing products. In general, advancements in surgical techniques and anesthetic management have led to significant reduction in blood transfusion requirements during liver transplantation. Targeted transfusion protocols and pharmacologic prevention of fibrinolysis may further aid in the management of the complex coagulopathy of end-stage liver disease.

Development of allergic sensitization and its relevance to paediatric asthma.

PubMed

Oksel, Ceyda; Custovic, Adnan

2018-04-01

The purpose of this review is to summarize the recent evidence on the distinct atopic phenotypes and their relationship with childhood asthma. We start by considering definitions and phenotypic classification of atopy and then review evidence on its association with asthma in children. It is now well recognized that both asthma and atopy are complex entities encompassing various different sub-groups that also differ in the way they interconnect. The lack of gold standards for diagnostic markers of atopy and asthma further adds to the existing complexity over diagnostic accuracy and definitions. Although recent statistical phenotyping studies contributed significantly to our understanding of these heterogeneous disorders, translating these findings into meaningful information and effective therapies requires further work on understanding underpinning biological mechanisms. The disaggregation of allergic sensitization may help predict how the allergic disease is likely to progress. One of the important questions is how best to incorporate tests for the assessment of allergic sensitization into diagnostic algorithms for asthma, both in terms of confirming asthma diagnosis, and the assessment of future risk.

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

PubMed

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

2015-11-01

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

Out of the frying pan? Streamlining the ethics review process of multisite qualitative research projects.

PubMed

Iedema, Rick A M; Allen, Suellen; Britton, Kate; Hor, Suyin

2013-05-01

This paper describes the ethics approval processes for two multicentre, nationwide, qualitative health service research projects. The paper explains that the advent of the National Ethics Application Form has brought many improvements, but that attendant processes put in place at local health network and Human Research Ethics Committee levels may have become significantly more complicated, particularly for innovative qualitative research projects. The paper raises several questions based on its analysis of ethics application processes currently in place. WHAT IS KNOWN ABOUT THE TOPIC? The complexity of multicentre research ethics applications for research in health services has been addressed by the introduction of the National Ethics Application Form. Uptake of the form across the country's human research ethics committees has been uneven. WHAT DOES THIS PAPER ADD? This paper adds detailed insight into the ethics application process as it is currently enacted across the country. The paper details this process with reference to difficulties faced by multisite and qualitative studies in negotiating access to research sites, ethics committees' relative unfamiliarity with qualitative research , and apparent tensions between harmonisation and local sites' autonomy in approving research. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Practitioners aiming to engage in research need to be aware that ethics approval takes place in an uneven procedural landscape, made up of variable levels of ethics approval harmonization and intricate governance or site-specific assessment processes.

Don't overlook disease management programs for low-incidence, high-cost diseases to improve your bottom line.

PubMed

Bruce, D; Dickmeyer, J

2001-01-01

Comprehensive coordinated care management for low-incident, high-cost diseases, like chronic renal failure, can provide a great opportunity for health plans to add immediate and significant profit to their bottom line. The resultant benefits of improved operations, improved clinical outcomes and increased patient satisfaction add further incentive for health plans to take action to implement outsourced disease management for this condition.

Going beyond the hero in leadership development: the place of healthcare context, complexity and relationships: Comment on "Leadership and leadership development in healthcare settings - a simplistic solution to complex problems?".

PubMed

Ford, Jackie

2015-04-01

There remains a conviction that the torrent of publications and the financial outlay on leadership development will create managers with the skills and characters of perfect leaders, capable of guiding healthcare organisations through the challenges and crises of the 21st century. The focus of much attention continues to be the search for the (illusory) core set of heroic qualities, abilities or competencies that will enable the development of leaders to achieve levels of supreme leadership and organisational performance. This brief commentary adds support to McDonald's (1) call for recognition of the complexity of the undertaking.

Robotic partial nephrectomy for complex renal tumors: surgical technique.

PubMed

Rogers, Craig G; Singh, Amar; Blatt, Adam M; Linehan, W Marston; Pinto, Peter A

2008-03-01

Laparoscopic partial nephrectomy requires advanced training to accomplish tumor resection and renal reconstruction while minimizing warm ischemia times. Complex renal tumors add an additional challenge to a minimally invasive approach to nephron-sparing surgery. We describe our technique, illustrated with video, of robotic partial nephrectomy for complex renal tumors, including hilar, endophytic, and multiple tumors. Robotic assistance was used to resect 14 tumors in eight patients (mean age: 50.3 yr; range: 30-68 yr). Three patients had hereditary kidney cancer. All patients had complex tumor features, including hilar tumors (n=5), endophytic tumors (n=4), and/or multiple tumors (n=3). Robotic partial nephrectomy procedures were performed successfully without complications. Hilar clamping was used with a mean warm ischemia time of 31 min (range: 24-45 min). Mean blood loss was 230 ml (range: 100-450 ml). Histopathology confirmed clear-cell renal cell carcinoma (n=3), hybrid oncocytic tumor (n=2), chromophobe renal cell carcinoma (n=2), and oncocytoma (n=1). All patients had negative surgical margins. Mean index tumor size was 3.6 cm (range: 2.6-6.4 cm). Mean hospital stay was 2.6 d. At 3-mo follow-up, no patients experienced a statistically significant change in serum creatinine or estimated glomerular filtration rate and there was no evidence of tumor recurrence. Robotic partial nephrectomy is safe and feasible for select patients with complex renal tumors, including hilar, endophytic, and multiple tumors. Robotic assistance may facilitate a minimally invasive, nephron-sparing approach for select patients with complex renal tumors who might otherwise require open surgery or total nephrectomy.

Concepts and Updates in the Evaluation and Diagnosis of Common Disorders of Sexual Development.

PubMed

Rawal, Amar Y; Austin, Paul F

2015-12-01

Our understanding of disorders of sexual differentiation (DSD) has evolved from aberrations of human genital development to a broad group of complex disorders of etiological and functional significance. The unique challenge of DSD conditions is that they create a cause for significant angst and concern for both parents and physician, as they frequently lead to questions with regards to gender assignment, surgically corrective options, long-term outlook regarding gender identity, and reproductive potential. To further add to the burden, many patients who present with genital abnormalities do not have a clear explanation as to the underlying basis of their disorder. This review looks at DSD from a pediatric urology point of view with emphasis on evaluation, diagnosis, and algorithm for work-up. We also discuss novel genetic analysis techniques and their value in diagnosis. Overall, this is an all-encompassing review on a diagnostic approach to DSD, with inclusion of recent developments and controversies, which will benefit urologists and other physicians alike.

Long-term efficacy and safety of sodium-glucose cotransporter-2 inhibitors as add-on to metformin treatment in the management of type 2 diabetes mellitus

PubMed Central

Li, Jian; Gong, Yanping; Li, Chunlin; Lu, Yanhui; Liu, Yu; Shao, Yinghong

2017-01-01

Abstract Background: Drug intensification is often required for patients with type 2 diabetes mellitus on stable metformin therapy. Among the potential candidates for a combination therapy, sodium-glucose transporter-2 (SGLT2) inhibitors have shown promising outcomes. This meta-analysis was performed to compare the efficacy and safety of SGLT2 inhibitors with non-SGLT2 combinations as add-on treatment to metformin. Methods: Literature search was carried out in multiple electronic databases for the acquisition of relevant randomized controlled trials (RCTs) by following a priori eligibility criteria. After the assessment of quality of the included RCTs, meta-analyses of mean differences or odds ratios (OR) were performed to achieve overall effect sizes of the changes from baseline in selected efficacy and safety endpoints reported in the individual studies. Between-studies heterogeneity was estimated with between-studies statistical heterogeneity (I2) index. Results: Six RCTs fulfilled the eligibility criteria. SGLT2 inhibitors as add-on to metformin treatment reduced % HbA1c significantly more than non-SGLT2 combinations after 52 weeks (P = .002) as well as after 104 weeks (P < .00001). Among other endpoints, SGLT2 inhibitors also reduced fasting plasma glucose levels, body weight, systolic, and diastolic blood pressures after 52 weeks and 104 weeks significantly (P < .00001) more than non-SGLT2 combinations. Incidence of hypoglycemia was significantly lower (P = .02) but incidence of suspected or confirmed genital tract infections was significantly higher (P < .00001) in SGLT2 inhibitors treated in comparison with non-SGLT2 combinations. Conclusion: As add-on to metformin treatment, SGLT2 inhibitors are found significantly more efficacious than non-SGLT2 inhibitor combinations in the management of type 2 diabetes mellitus, although, SGLT2 inhibitor therapy is associated with significantly higher incidence of suspected or confirmed genital tract infections. PMID:28682870

Positive upshots of cortisol in everyday life

PubMed Central

Hoyt, Lindsay T.; Zeiders, Katharine H.; Ehrlich, Katherine B.; Adam, Emma K.

2016-01-01

Cortisol, the major physiological end-product of the hypothalamic-pituitary-adrenal (HPA) axis, is usually associated with stress and negative affect. However, a new body of research highlights the complex, adaptive significance of elevated cortisol within individuals in everyday life. Whereas most studies do not have the power to test the dynamic transactions between cortisol and affect within a person throughout the entire waking day, we employed an intensive study protocol analyzing hourly diary reports of affect in relation to hourly salivary cortisol samples among 24 healthy adults from morning to bedtime, across two consecutive weekdays (n = 862 total samples). Utilizing multi-leveling modeling and focusing on within-person effects, we examined whether momentary increases in cortisol could be mood protective, or energy enhancing, in everyday life, supporting the cortisol boost hypothesis. Results revealed no significant associations between cortisol and current affective state; however, within-person increases in cortisol were significantly associated with subsequent rises in activeness, alertness, and relaxation, and trend-level reductions in stress and nervousness. This study adds to growing evidence that cortisol plays a positive role in regulating affect in everyday life. PMID:26950364

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

PubMed

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

2016-06-03

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

The Impact of Specific and Complex Trauma on the Mental Health of Homeless Youth.

PubMed

Wong, Carolyn F; Clark, Leslie F; Marlotte, Lauren

2016-03-01

This study investigates the relative impact of trauma experiences that occurred prior to and since becoming homeless on depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and self-injurious behaviors among a sample of homeless youth (N = 389). Youth (aged 13 to 25) who had been homeless or precariously housed in the past year completed a survey about housing history, experiences of violence and victimization, mental health, and service utilization. In addition to examining the impact associated with specific trauma types, we also considered the effect of "early-on" poly-victimization (i.e., cumulative number of reported traumas prior to homelessness) and the influence of a compound sexual trauma variable created to represent earlier complex trauma. This created-variable has values ranging from no reported trauma, single trauma, multiple non-sexual traumas, and multiple traumas that co-occurred with sexual abuse. Multivariate analyses revealed that specific traumatic experiences prior to homelessness, including sexual abuse, emotional abuse/neglect, and adverse home environment, predicted greater mental health symptoms. Poly-victimization did not add to the prediction of mental health symptoms after the inclusion of specific traumas. Results with early compound sexual trauma revealed significant differences between lower-order trauma exposures and multiple-trauma exposures. Specifically, experience of multiple traumas that co-occurred with sexual trauma was significantly more detrimental in predicting PTSD symptoms than multiple traumas of non-sexual nature. Findings support the utility of an alternate/novel conceptualization of complex trauma, and support the need to carefully evaluate complex traumatic experiences that occurred prior to homelessness, which can impact the design and implementation of mental health care and services for homeless youth. © The Author(s) 2014.

GWAS4D: multidimensional analysis of context-specific regulatory variant for human complex diseases and traits.

PubMed

Huang, Dandan; Yi, Xianfu; Zhang, Shijie; Zheng, Zhanye; Wang, Panwen; Xuan, Chenghao; Sham, Pak Chung; Wang, Junwen; Li, Mulin Jun

2018-05-16

Genome-wide association studies have generated over thousands of susceptibility loci for many human complex traits, and yet for most of these associations the true causal variants remain unknown. Tissue/cell type-specific prediction and prioritization of non-coding regulatory variants will facilitate the identification of causal variants and underlying pathogenic mechanisms for particular complex diseases and traits. By leveraging recent large-scale functional genomics/epigenomics data, we develop an intuitive web server, GWAS4D (http://mulinlab.tmu.edu.cn/gwas4d or http://mulinlab.org/gwas4d), that systematically evaluates GWAS signals and identifies context-specific regulatory variants. The updated web server includes six major features: (i) updates the regulatory variant prioritization method with our new algorithm; (ii) incorporates 127 tissue/cell type-specific epigenomes data; (iii) integrates motifs of 1480 transcriptional regulators from 13 public resources; (iv) uniformly processes Hi-C data and generates significant interactions at 5 kb resolution across 60 tissues/cell types; (v) adds comprehensive non-coding variant functional annotations; (vi) equips a highly interactive visualization function for SNP-target interaction. Using a GWAS fine-mapped set for 161 coronary artery disease risk loci, we demonstrate that GWAS4D is able to efficiently prioritize disease-causal regulatory variants.

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

PubMed

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

2013-03-01

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

The relationship of document and quantitative literacy with learning styles and selected personal variables for aerospace technology students at Indiana State University

NASA Astrophysics Data System (ADS)

Martin, Royce Ann

The purpose of this study was to determine the extent that student scores on a researcher-constructed quantitative and document literacy test, the Aviation Documents Delineator (ADD), were associated with (a) learning styles (imaginative, analytic, common sense, dynamic, and undetermined), as identified by the Learning Type Measure, (b) program curriculum (aerospace administration, professional pilot, both aerospace administration and professional pilot, other, or undeclared), (c) overall cumulative grade point average at Indiana State University, and (d) year in school (freshman, sophomore, junior, or senior). The Aviation Documents Delineator (ADD) was a three-part, 35 question survey that required students to interpret graphs, tables, and maps. Tasks assessed in the ADD included (a) locating, interpreting, and describing specific data displayed in the document, (b) determining data for a specified point on the table through interpolation, (c) comparing data for a string of variables representing one aspect of aircraft performance to another string of variables representing a different aspect of aircraft performance, (d) interpreting the documents to make decisions regarding emergency situations, and (e) performing single and/or sequential mathematical operations on a specified set of data. The Learning Type Measure (LTM) was a 15 item self-report survey developed by Bernice McCarthy (1995) to profile an individual's processing and perception tendencies in order to reveal different individual approaches to learning. The sample used in this study included 143 students enrolled in Aerospace Technology Department courses at Indiana State University in the fall of 1996. The ADD and the LTM were administered to each subject. Data collected in this investigation were analyzed using a stepwise multiple regression analysis technique. Results of the study revealed that the variables, year in school and GPA, were significant predictors of the criterion variables, document, quantitative, and total literacy, when utilizing the ADD. The variables learning style and program of study were found not to be significant predictors of literacy scores on the ADD instrument.

Describing dengue epidemics: Insights from simple mechanistic models

NASA Astrophysics Data System (ADS)

Aguiar, Maíra; Stollenwerk, Nico; Kooi, Bob W.

2012-09-01

We present a set of nested models to be applied to dengue fever epidemiology. We perform a qualitative study in order to show how much complexity we really need to add into epidemiological models to be able to describe the fluctuations observed in empirical dengue hemorrhagic fever incidence data offering a promising perspective on inference of parameter values from dengue case notifications.

School Funding in Michigan: Common Myths. A Mackinac Center Report

ERIC Educational Resources Information Center

Van Beek, Michael

2010-01-01

Michigan's state-run school system is the largest and most expensive government service taxpayers support. It employs more than 350,000 people who work in one of the more than 4,100 different entities. The total amount this system expends each year adds up to more than $20 billion. Given the enormity and complexity of the system, it's no surprise…

Pre-Service Physics Teachers' Content Knowledge of Electric and Magnetic Field Concepts: Conceptual Facets and Their Balance

ERIC Educational Resources Information Center

Nousiainen, Maija; Koponen, Ismo T.

2017-01-01

The concepts of electricity and magnetism in physics are complex and demanding to learn because their meaning builds through several different phenomenological areas. Each of the phenomenological areas adds a certain facet of the meaning of the concept. All standard physics textbooks discuss at least 1) force, 2) energy and work, and 3) electric…

Come Out, Come Out, Wherever You Are: A Synthesis of Queer Research in Education.

ERIC Educational Resources Information Center

Jackson, Janna

This paper examines the research in the area of teachers' attitudes, practices, and beliefs about gay and lesbian issues in education, focusing on homosexuality because although there is some overlap in regards to both the population and the issues, the differences between gay and transgendered issues add another layer of complexity to an already…

76 FR 9067 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

... pay a rebate solely for Customer complex orders that add liquidity in order to continue to attract... because this Customer rebate would attract Customer order flow to the Exchange for the benefit of all..., priced at a net debit or credit based on the relative prices of the individual components, for the same...

Enhancing Multicultural Perspectives in the Formation of Preservice Teachers through Immersion in a Culturally Different Context

ERIC Educational Resources Information Center

Walkington, Jackie

2015-01-01

The composition of today's school classrooms is now more diverse in a world of greater global mobility and communication. For teachers, this adds further complexity to the task of ensuring each child has the most appropriate opportunity to learn. This paper posits that future teachers are more able to cater for cultural diversity by developing…

Recipes for Success: Independent Schools Break the Mold When It Comes to Social Media

ERIC Educational Resources Information Center

Stoner, Michael

2010-01-01

Most communicators are not giving up print or other traditional media. But they recognize that social media has quickly become an important channel for the audiences they want to reach. Social media adds texture and complexity to the marketing mix. To take advantage of social media, it pays to be nimble. Independent schools' communicators…

Climate-induced changes in vulnerability to biological threats in the southern United States

Treesearch

Rabiu Olatinwo; Qinfeng Guo; Songlin Fei; William Otrosina; Kier Klepzig; Douglas Streett

2014-01-01

Forest land managers face the challenges of preparing their forests for the impacts of climate change. However, climate change adds a new dimension to the task of developing and testing science-based management options to deal with the effects of stressors on forest ecosystems in the southern United States. The large spatial scale and complex interactions make...

76 FR 71322 - Taking and Importing Marine Mammals; U.S. Navy Training in the Hawaii Range Complex

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

..., most operationally sound method of initiating a demolition charge on a floating mine or mine at depth...; require building/ deploying an improvised, bulky, floating system for the receiver; and add another 180 ft... charge initiating device are taken to the detonation point. Military forms of C-4 are used as the...

Exploring Taiwanese Preservice Teachers' Identity Construction in the Context of Service-Learning: Conflict and Development

ERIC Educational Resources Information Center

Tseng, Ming-i Lydia

2017-01-01

Language teacher identity (LTI) has gained prominence in second language education in the recent two decades, particularly the complexity of identity construction in the changing context shaped by local and global forces. This study adds to recent work on LTI by exploring how Asian teachers of English as a foreign language (EFL) constructed their…

Searching for "A Third Space": A Creative Pathway towards International PhD Students' Academic Acculturation

ERIC Educational Resources Information Center

Elliot, Dely Lazarte; Baumfield, Vivienne; Reid, Kate

2016-01-01

Undertaking a PhD is a challenging endeavour. Pursuing a doctoral education in a "foreign" context tends to increase the demands of this intellectual venture. The nature of research-based PhD programmes, often characterised by a lack of formal curricula where academic supervision lasts several years, may add another layer of complexity.…

Network anomaly detection system with optimized DS evidence theory.

PubMed

Liu, Yuan; Wang, Xiaofeng; Liu, Kaiyu

2014-01-01

Network anomaly detection has been focused on by more people with the fast development of computer network. Some researchers utilized fusion method and DS evidence theory to do network anomaly detection but with low performance, and they did not consider features of network-complicated and varied. To achieve high detection rate, we present a novel network anomaly detection system with optimized Dempster-Shafer evidence theory (ODS) and regression basic probability assignment (RBPA) function. In this model, we add weights for each sensor to optimize DS evidence theory according to its previous predict accuracy. And RBPA employs sensor's regression ability to address complex network. By four kinds of experiments, we find that our novel network anomaly detection model has a better detection rate, and RBPA as well as ODS optimization methods can improve system performance significantly.

Impact of centrifugal drifts on ion turbulent transport

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

Belli, Emily A.; Candy, J.

Here, the influence of sonic toroidal rotation on gyrokinetic stability and transport is studied, with important implications for heavy impurity dynamics. When centrifugal drifts and electrostatic trapping corrections are included, significant modifications to the calculated transport of heavy impurities are observed. These high-rotation corrections add to the standard Coriolis drift and toroidal rotation shear drive which are normally included in gyrokinetics. Yet, because of their complexity, centrifugal and electrostatic trapping terms (quadratic in the main ion Mach number) are not generally included in gyrokinetic codes. In this work, we explore the implications of using reduced descriptions of the rotational physics.more » For heavy impurities such as tungsten, cross terms due to the centrifugal force can dominate the rotation dynamics, and neglecting them is shown to lead to large errors in the impurity particle flux.« less

Impact of centrifugal drifts on ion turbulent transport

DOE PAGES

Belli, Emily A.; Candy, J.

2018-03-01

Here, the influence of sonic toroidal rotation on gyrokinetic stability and transport is studied, with important implications for heavy impurity dynamics. When centrifugal drifts and electrostatic trapping corrections are included, significant modifications to the calculated transport of heavy impurities are observed. These high-rotation corrections add to the standard Coriolis drift and toroidal rotation shear drive which are normally included in gyrokinetics. Yet, because of their complexity, centrifugal and electrostatic trapping terms (quadratic in the main ion Mach number) are not generally included in gyrokinetic codes. In this work, we explore the implications of using reduced descriptions of the rotational physics.more » For heavy impurities such as tungsten, cross terms due to the centrifugal force can dominate the rotation dynamics, and neglecting them is shown to lead to large errors in the impurity particle flux.« less

Contrasts Between Young Males Dying by Suicide, Those Dying From Other Causes and Those Still Living: Observations From the National Longitudinal Survey of Adolescent to Adult Health.

PubMed

Feigelman, William; Joiner, Thomas; Rosen, Zohn; Silva, Caroline; Mueller, Anna S

2016-07-02

Utilizing Add Health longitudinal data, we compared 21 male suicide casualties to 10,101 living respondents identifying suicide correlates. 21 suicide decedents completed surveys in 1994/1995 (Wave 1) and 11 completed at Wave 3; responses were compared with Chi-square and oneway ANOVA tests. Suicide decedents were prone to higher delinquency and fighting at Wave 1, but not at Wave 3. At Wave 1 suicide decedents remained undistinguished from living respondents in depression, self-esteem, and drug uses. Yet, after Wave 3, the 11 respondents dying by suicide showed significantly higher depression, drug use and lower self-esteem. Delinquency trends can readily understood, but more complex causes are needed to account for unexpected changes in self-esteem, depression and drug uses.

Network Anomaly Detection System with Optimized DS Evidence Theory

PubMed Central

Liu, Yuan; Wang, Xiaofeng; Liu, Kaiyu

2014-01-01

Network anomaly detection has been focused on by more people with the fast development of computer network. Some researchers utilized fusion method and DS evidence theory to do network anomaly detection but with low performance, and they did not consider features of network—complicated and varied. To achieve high detection rate, we present a novel network anomaly detection system with optimized Dempster-Shafer evidence theory (ODS) and regression basic probability assignment (RBPA) function. In this model, we add weights for each senor to optimize DS evidence theory according to its previous predict accuracy. And RBPA employs sensor's regression ability to address complex network. By four kinds of experiments, we find that our novel network anomaly detection model has a better detection rate, and RBPA as well as ODS optimization methods can improve system performance significantly. PMID:25254258

Security aspects of electronic data interchange between a state health department and a hospital emergency department.

PubMed

Magnuson, J A; Klockner, Rocke; Ladd-Wilson, Stephen; Zechnich, Andrew; Bangs, Christopher; Kohn, Melvin A

2004-01-01

Electronic emergency department reporting provides the potential for enhancing local and state surveillance capabilities for a wide variety of syndromes and reportable conditions. The task of protecting data confidentiality and integrity while developing electronic data interchange between a hospital emergency department and a state public health department proved more complex than expected. This case study reports on the significant challenges that had to be resolved to accomplish this goal; these included application restrictions and incompatibilities, technical malfunctions, changing standards, and insufficient dedicated resources. One of the key administrative challenges was that of coordinating project security with enterprise security. The original project has evolved into an ongoing pilot, with the health department currently receiving secure data from the emergency department at four-hour intervals. Currently, planning is underway to add more emergency departments to the project.

The Roles of Chronic Disease Complexity, Health System Integration, and Care Management in Post-Discharge Healthcare Utilization in a Low-Income Population.

PubMed

Hewner, Sharon; Casucci, Sabrina; Castner, Jessica

2016-08-01

Economically disadvantaged individuals with chronic disease have high rates of in-patient (IP) readmission and emergency department (ED) utilization following initial hospitalization. The purpose of this study was to explore the relationships between chronic disease complexity, health system integration (admission to accountable care organization [ACO] hospital), availability of care management interventions (membership in managed care organization [MCO]), and 90-day post-discharge healthcare utilization. We used de-identified Medicaid claims data from two counties in western New York. The study population was 114,295 individuals who met inclusion criteria, of whom 7,179 had index hospital admissions in the first 9 months of 2013. Individuals were assigned to three disease complexity segments based on presence of 12 prevalent conditions. The 30-day inpatient (IP) readmission rates ranged from 6% in the non-chronic segment to 12% in the chronic disease complexity segment and 21% in the organ system failure complexity segment. Rehospitalization rates (both inpatient and emergency department [ED]) were lower for patients in MCOs and ACOs than for those in fee-for-service care. Complexity of chronic disease, initial hospitalization in a facility that was part of an ACO, MCO membership, female gender, and longer length of stay were associated with a significantly longer time to readmission in the first 90 days, that is, fewer readmissions. Our results add to evidence that high-value post-discharge utilization (fewer IP or ED rehospitalizations and early outpatient follow-up) require population-based transitional care strategies that improve continuity between settings and take into account the illness complexity of the Medicaid population. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

radEq Add-On Module for CFD Solver Loci-CHEM

NASA Technical Reports Server (NTRS)

McCloud, Peter

2013-01-01

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

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

PubMed Central

Prasuna, P Lakshmi; Sudhakar, TP

2015-01-01

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

Dextromethorphan attenuated inflammation and combined opioid use in humans undergoing methadone maintenance treatment.

PubMed

Chen, Shiou-Lan; Lee, Sheng-Yu; Tao, Pao-Luh; Chang, Yun-Hsuan; Chen, Shih-Heng; Chu, Chun-Hsien; Chen, Po See; Lee, I Hui; Yeh, Tzung Lieh; Yang, Yen Kuang; Hong, Jau-Shyong; Lu, Ru-Band

2012-12-01

Recent studies show that proinflammatory cytokines might be related to the development of opioid dependence (physiological, psychological, or both). In a double-blind, randomly stratified clinical trial investigating whether add-on dextromethorphan (60-120 mg/day) attenuated inflammation and the combined use of opioids in heroin-dependent patients undergoing methadone maintenance treatment, we evaluated whether inflammation is related to the progression of opioid dependence. All participants (107 heroin-dependent patients and 84 nondependent healthy controls) were recruited from National Cheng Kung University Hospital. Their plasma cytokine levels were measured to evaluate the effect of add-on dextromethorphan. Plasma TNF-α and IL-8 levels were significantly higher in long-term heroin-dependent patients than in healthy controls (p < 0.001). Chronic heroin-use-induced TNF-α and IL-8 levels were significantly (p < 0.05) attenuated in patients treated for 12 weeks with add-on dextromethorphan. Moreover, both tolerance to methadone and the combined use of opioids were significantly (p < 0.05) attenuated in patients taking dextromethorphan. We conclude that dextromethorphan might be a feasible adjuvant therapeutic for attenuating inflammation and inhibiting methadone tolerance and combined opioid use in heroin-dependent patients.

Low complexity 1D IDCT for 16-bit parallel architectures

NASA Astrophysics Data System (ADS)

Bivolarski, Lazar

2007-09-01

This paper shows that using the Loeffler, Ligtenberg, and Moschytz factorization of 8-point IDCT [2] one-dimensional (1-D) algorithm as a fast approximation of the Discrete Cosine Transform (DCT) and using only 16 bit numbers, it is possible to create in an IEEE 1180-1990 compliant and multiplierless algorithm with low computational complexity. This algorithm as characterized by its structure is efficiently implemented on parallel high performance architectures as well as due to its low complexity is sufficient for wide range of other architectures. Additional constraint on this work was the requirement of compliance with the existing MPEG standards. The hardware implementation complexity and low resources where also part of the design criteria for this algorithm. This implementation is also compliant with the precision requirements described in MPEG IDCT precision specification ISO/IEC 23002-1. Complexity analysis is performed as an extension to the simple measure of shifts and adds for the multiplierless algorithm as additional operations are included in the complexity measure to better describe the actual transform implementation complexity.

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

PubMed

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

2014-08-01

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

Improving the management of acute diarrhoea and dehydration in under-5 children in a paediatric referral facility in Lagos, Nigeria.

PubMed

Senbanjo, Idowu O; Ch'ng, Chin Lye; Allen, Stephen J

2017-02-01

Mortality from acute diarrhoea and dehydration (AD/D) in children is high despite existing management guidelines. The aim of this study was to identify deficiencies in the management of AD/D by health staff and assess changes in management after a training intervention in a paediatric referral facility in Lagos, Nigeria. In a retrospective review of case notes, the management of AD/D was assessed using WHO guidelines as the standard. An e-learning module was developed that directly addressed deficiencies and was used to train health staff. Changes in the management of AD/D were assessed by re-auditing case notes. There were learning needs among health staff in the management of AD/D. Altogether, 34 (97.1%) of 35 residents were trained. Training resulted in modest improvements in the number of children in whom nutritional status was assessed, use of oral rather than intravenous fluids for rehydration and reducing unnecessary laboratory tests. Training resulted in marked improvements in the correct volume of (pre- vs. post-training 6.3% vs. 94.1%, P<0.001) and follow-up of fluid therapy (8.1% vs. 98.0%; P<0.001), prescription of zinc (41.6% vs. 85.1%, P<0.001) and providing advice on when to return after discharge (77.6% vs. 96.0%, P<0.001). Although statistically significant, the minimal improvements in antibiotic use (43.8% vs. 56.6%, P = 0.03), re-starting feeds (10.6% vs. 38.6%, P<0.001) and counselling about feeding (11.8% vs. 33.7%, P<0.001) highlighted areas for further training. In low-resource countries, clinical auditing and training can significantly improve the management of illnesses that contribute to child deaths and identify areas where further training is required.

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

PubMed

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

2016-11-01

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

Influence of Meibomian Gland Dysfunction and Friction-Related Disease on the Severity of Dry Eye.

PubMed

Vu, Chi Hoang Viet; Kawashima, Motoko; Yamada, Masakazu; Suwaki, Kazuhisa; Uchino, Miki; Shigeyasu, Chika; Hiratsuka, Yoshimune; Yokoi, Norihiko; Tsubota, Kazuo

2018-02-16

To evaluate the effect of meibomian gland dysfunction (MGD) and friction-related disease (FRD) on the severity of dry eye disease (DED). Cross-sectional observational study. This study enrolled 449 patients with DED (63 men and 386 women; mean age, 62.6±15.7 years [range, 21-90 years]) for analysis. Subjective symptoms, the ocular surface, tear function, and the presence of MGD and FRD (superior limbic keratoconjunctivitis, conjunctivochalasis, and lid wiper epitheliopathy) were investigated. Schirmer value, tear film breakup time (TBUT), and keratoconjunctival score. We classified the participants into aqueous-deficient dry eye (ADDE; n = 231 [51.4%]) and short TBUT dry eye subtype (TBUT-DE; n = 109 [24.3%]) subgroups. The TBUT was shorter in patients with MGD than in those without MGD, whereas other ocular signs showed no difference (TBUT: MGD present, 1.97±1.02 seconds; MGD absent, 2.94±1.63 seconds [P < 0.001]; ADDE/MGD present, 1.94±1.08 seconds; ADDE/MGD absent, 2.77±1.61 seconds [P < 0.001]; short TBUT-DE/MGD present, 2.07±0.97 seconds; short TBUT-DE/MGD absent, 2.94±1.23 seconds [P = 0.01]). The ADDE patients with FRD showed a worse TBUT than ADDE patients without FRD (TBUT: ADDE/FRD present, 2.08±1.39 seconds; ADDE/FRD absent, 2.92±1.54 seconds; P < 0.001). This study showed associations between MGD, FRD, or both and ocular signs in DED. In the presence of MGD, FRD, or both, TBUT was significantly shortened regardless of the dry eye status or subtype. Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-10-01

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

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

PubMed

Al Saif, Amer; Alsenany, Samira

2015-01-01

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

Influence of air temperature on the first flowering date of Prunus yedoensis Matsum

PubMed Central

Shi, Peijian; Chen, Zhenghong; Yang, Qingpei; Harris, Marvin K; Xiao, Mei

2014-01-01

Climate change is expected to have a significant effect on the first flowering date (FFD) in plants flowering in early spring. Prunus yedoensis Matsum is a good model plant for analyzing this effect. In this study, we used a degree day model to analyze the effect of air temperatures on the FFDs of P. yedoensis at Wuhan University from a long-time series from 1951 to 2012. First, the starting date (=7 February) is determined according to the lowest correlation coefficient between the FFD and the daily average accumulated degree days (ADD). Second, the base temperature (=−1.2°C) is determined according to the lowest root mean square error (RMSE) between the observed and predicted FFDs based on the mean of 62-year ADDs. Finally, based on this combination of starting date and base temperature, the daily average ADD of every year was calculated. Performing a linear fit of the daily average ADD to year, we find that there is an increasing trend that indicates climate warming from a biological climatic indicator. In addition, we find that the minimum annual temperature also has a significant effect on the FFD of P. yedoensis using the generalized additive model. This study provides a method for analyzing the climate change on the FFD in plants' flowering in early spring. PMID:24558585

19 Urban Questions: Teaching in the City. Second Edition. Counterpoints: Studies in Postmodern Theory of Education, Vol. 215

ERIC Educational Resources Information Center

Steinberg, Shirley R., Ed

2010-01-01

The second edition of "19 Urban Questions: Teaching in the City" adds new questions to those in the original volume. Continuing the developing conversation in urban education, the book is provocative in style and rich in detail. Emphasizing the complexity of urban education, Shirley R. Steinberg and the authors ask direct questions about what…

Advanced Technology for Portable Personal Visualization.

DTIC Science & Technology

1992-06-01

interactive radiosity . 6 Advanced Technology for Portable Personal Visualization Progress Report January-June 1992 9 2.5 Virtual-Environment Ultrasound...the system, with support for textures, model partitioning, more complex radiosity emitters, and the replacement of model parts with objects from our...model libraries. "* Add real-time, interactive radiosity to the display program on Pixel-Planes 5. "* Move the real-time model mesh-generation to the

Climate Change and Everyday Life: Repertoires Children Use to Negotiate a Socio-Scientific Issue

ERIC Educational Resources Information Center

Byrne, Jenny; Ideland, Malin; Malmberg, Claes; Grace, Marcus

2014-01-01

There are only a few studies about how primary school students engage in socio-scientific discussions. This study aims to add to this field of research by focusing on how 9-10-year-olds in Sweden and England handle climate change as a complex environmental socio-scientific issue (SSI), within the context of their own lives and in relation to…

Selecting a Benchmark Suite to Profile High-Performance Computing (HPC) Machines

DTIC Science & Technology

2014-11-01

architectures. Machines now contain central processing units (CPUs), graphics processing units (GPUs), and many integrated core ( MIC ) architecture all...evaluate the feasibility and applicability of a new architecture just released to the market . Researchers are often unsure how available resources will...architectures. Having a suite of programs running on different architectures, such as GPUs, MICs , and CPUs, adds complexity and technical challenges

Characterising Complex Enzyme Reaction Data

PubMed Central

Rahman, Syed Asad; Thornton, Janet M.

2016-01-01

The relationship between enzyme-catalysed reactions and the Enzyme Commission (EC) number, the widely accepted classification scheme used to characterise enzyme activity, is complex and with the rapid increase in our knowledge of the reactions catalysed by enzymes needs revisiting. We present a manual and computational analysis to investigate this complexity and found that almost one-third of all known EC numbers are linked to more than one reaction in the secondary reaction databases (e.g., KEGG). Although this complexity is often resolved by defining generic, alternative and partial reactions, we have also found individual EC numbers with more than one reaction catalysing different types of bond changes. This analysis adds a new dimension to our understanding of enzyme function and might be useful for the accurate annotation of the function of enzymes and to study the changes in enzyme function during evolution. PMID:26840640

Integrating Mass Spectrometry of Intact Protein Complexes into Structural Proteomics

PubMed Central

Hyung, Suk-Joon; Ruotolo, Brandon T.

2013-01-01

Summary Mass spectrometry analysis of intact protein complexes has emerged as an established technology for assessing the composition and connectivity within dynamic, heterogeneous multiprotein complexes at low concentrations and in the context of mixtures. As this technology continues to move forward, one of the main challenges is to integrate the information content of such intact protein complex measurements with other mass spectrometry approaches in structural biology. Methods such as H/D exchange, oxidative foot-printing, chemical cross-linking, affinity purification, and ion mobility separation add complementary information that allows access to every level of protein structure and organization. Here, we survey the structural information that can be retrieved by such experiments, demonstrate the applicability of integrative mass spectrometry approaches in structural proteomics, and look to the future to explore upcoming innovations in this rapidly-advancing area. PMID:22611037

The ESC/E(Z) complex, an effector of response to ovarian steroids, manifests an intrinsic difference in cells from women with Premenstrual Dysphoric Disorder

PubMed Central

Dubey, Neelima; Hoffman, Jessica F.; Schuebel, Kornel; Yuan, Qiaoping; Martinez, Pedro E.; Nieman, Lynnette K.; Rubinow, David R.; Schmidt, Peter J.; Goldman, David

2016-01-01

Clinical evidence suggests that mood and behavioral symptoms in Premenstrual Dysphoric Disorder (PMDD), a common, recently recognized, psychiatric condition among women, reflect abnormal responsivity to ovarian steroids. This differential sensitivity could be due to an unrecognized aspect of hormonal signaling or a difference in cellular response. In this study, lymphoblastoid cell line cultures (LCLs) from women with PMDD and asymptomatic Controls were compared via whole transcriptome sequencing (RNA-seq) during untreated (ovarian steroid-free) conditions and following hormone treatment. The women with PMDD manifested ovarian steroid-triggered behavioral sensitivity during a hormone suppression and add-back clinical trial, and Controls did not, leading us to hypothesize that women with PMDD might differ in their cellular response to ovarian steroids. In untreated LCLs, our results overall suggest a divergence between mRNA (e.g., gene transcription) and protein (e.g., RNA translation in proteins) for the same genes. Pathway analysis of the LCL transcriptome revealed, among others, over-expression of ESC/E(Z) complex genes (an ovarian steroid-regulated gene silencing complex) in untreated LCLs from women with PMDD, with more than half of these genes over-expressed as compared to Controls, and with significant effects for MTF2, PHF19, and SIRT1 (p<0.05). RNA and protein expression of the 13 ESC/E(Z) complex genes were individually quantitated. This pattern of increased ESC/E(Z) mRNA expression was confirmed in a larger cohort by qRT-PCR. In contrast, protein expression of ESC/E(Z) genes was decreased in untreated PMDD LCLs with MTF2, PHF19, and SIRT1 all significantly decreased (p<0.05). Finally, mRNA expression of several ESC/E(Z) complex genes were increased by progesterone in Controls only, and decreased by estradiol in PMDD LCLs. These findings demonstrate that LCLs from women with PMDD manifest a cellular difference in ESC/E(Z) complex function both in the untreated condition and in response to ovarian hormones. Dysregulation of ESC/E(Z) complex function could contribute to PMDD. PMID:28044059

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

PubMed

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

2012-03-01

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

Increasing operating room efficiency through electronic medical record analysis.

PubMed

Attaallah, A F; Elzamzamy, O M; Phelps, A L; Ranganthan, P; Vallejo, M C

2016-05-01

We used electronic medical record (EMR) analysis to determine errors in operating room (OR) time utilisation. Over a two year period EMR data of 44,503 surgical procedures was analysed for OR duration, on-time, first case, and add-on time performance, within 19 surgical specialties. Maximal OR time utilisation at our institution could have saved over 302,620 min or 5,044 hours of OR efficiency over a two year period. Most specialties (78.95%) had inaccurately scheduled procedure times and therefore used the OR more than their scheduled allotment time. Significant differences occurred between the mean scheduled surgical durations (101.38 ± 87.11 min) and actual durations (108.18 ± 102.27 min; P < 0.001). Significant differences also occurred between the mean scheduled add-on durations (111.4 ± 75.5 min) and the actual add-on scheduled durations (118.6 ± 90.1 minutes; P < 0.001). EMR quality improvement analysis can be used to determine scheduling error and bias, in order to improve efficiency and increase OR time utilisation.

AHRQ series on complex intervention systematic reviews-paper 7: PRISMA-CI elaboration and explanation.

PubMed

Guise, Jeanne-Marie; Butler, Mary; Chang, Christine; Viswanathan, Meera; Pigott, Terri; Tugwell, Peter

2017-10-01

Complex interventions are widely used in health care, public health, education, criminology, social work, business, and welfare. They have increasingly become the subject of systematic reviews and are challenging to effectively report. The Complex Interventions Methods Workgroup developed an extension to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Complex Interventions (PRISMA-CI). Following the EQUATOR Network guidance for Preferred Reporting Items for Systematic Reviews and Meta-Analysis extensions, this Explanation and Elaboration (EE) document accompanies the PRISMA-CI checklist to promote consistency in reporting of systematic reviews of complex interventions. The EE document explains the meaning and rationale for each unique PRISMA-CI checklist item and provides examples to assist systematic review authors in operationalizing PRISMA-CI guidance. The Complex Interventions Workgroup developed PRISMA-CI as an important start toward increased consistency in reporting of systematic reviews of complex interventions. Because the field is rapidly expanding, the Complex Interventions Methods Workgroup plans to re-evaluate periodically for the need to add increasing specificity and examples as the field matures. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Carbon solids in oxygen-deficient explosives (LA-UR-13-21151)

NASA Astrophysics Data System (ADS)

Peery, Travis

2013-06-01

The phase behavior of excess carbon in oxygen-deficient explosives has a significant effect on detonation properties and product equations of state. Mixtures of fuel oil in ammonium nitrate (ANFO) above a stoichiometric ratio demonstrate that even small amounts of graphite, on the order of 5% by mole fraction, can substantially alter the Chapman-Jouget (CJ) state properties, a central ingredient in modeling the products equation of state. Similar effects can be seen for Composition B, which borders the carbon phase boundary between graphite and diamond. Nano-diamond formation adds complexity to the product modeling because of surface adsorption effects. I will discuss these carbon phase issues in our equation of state modeling of detonation products, including our statistical mechanics description of carbon clustering and surface chemistry to properly treat solid carbon formation. This work is supported by the Advanced Simulation and Computing Program, under the NNSA.

The Role of Adolescent Friendship Group Integration and Cohesion in Weapon-Related Violent Crime as a Young Adult.

PubMed

Mundt, Marlon P; Antonaccio, Olena P; French, Michael T; Zakletskaia, Larissa I

2017-08-01

Weapon-related violent crime is a serious, complex, and multifaceted public health problem. The present study uses data from Waves I and III of Add Health (n = 10,482, 54% female) to examine how friendship group integration and cohesion in adolescence (ages 12-19) is associated with weapon-related criminal activity as a young adult (ages 18-26). Results indicate that greater cohesion in friendship groups is associated with significantly lower weapon-related criminal activity in young adulthood. In addition, for adolescent girls, a greater number of close friendship ties-an indicator of friendship group integration-is associated with less weapon-related criminal activity in young adulthood. These findings suggest that school-based initiatives to facilitate inclusive and cohesive adolescent peer communities may be an effective strategy to curb weapon-related criminal activity in young adulthood.

Chelation and stabilization of berkelium in oxidation state +IV

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

Deblonde, Gauthier J. -P.; Sturzbecher-Hoehne, Manuel; Rupert, Peter B.

Berkelium (Bk) has been predicted to be the only transplutonium element able to exhibit both +III and +IV oxidation states in solution, but evidence of a stable oxidized Bk chelate has so far remained elusive. Here, in this work, we describe the stabilization of the heaviest 4+ ion of the periodic table, under mild aqueous conditions, using a siderophore derivative. The resulting Bk(IV) complex exhibits luminescence via sensitization through an intramolecular antenna effect. This neutral Bk(IV) coordination compound is not sequestered by the protein siderocalin - a mammalian metal transporter - in contrast to the negatively charged species obtained withmore » neighbouring trivalent actinides americium, curium and californium (Cf). The corresponding Cf(III)-ligand-protein ternary adduct was characterized by X-ray diffraction analysis. Finally, combined with theoretical predictions, these data add significant insight to the field of transplutonium chemistry, and may lead to innovative Bk separation and purification processes.« less

Chelation and stabilization of berkelium in oxidation state +IV

DOE PAGES

Deblonde, Gauthier J. -P.; Sturzbecher-Hoehne, Manuel; Rupert, Peter B.; ...

2017-04-10

Berkelium (Bk) has been predicted to be the only transplutonium element able to exhibit both +III and +IV oxidation states in solution, but evidence of a stable oxidized Bk chelate has so far remained elusive. Here, in this work, we describe the stabilization of the heaviest 4+ ion of the periodic table, under mild aqueous conditions, using a siderophore derivative. The resulting Bk(IV) complex exhibits luminescence via sensitization through an intramolecular antenna effect. This neutral Bk(IV) coordination compound is not sequestered by the protein siderocalin - a mammalian metal transporter - in contrast to the negatively charged species obtained withmore » neighbouring trivalent actinides americium, curium and californium (Cf). The corresponding Cf(III)-ligand-protein ternary adduct was characterized by X-ray diffraction analysis. Finally, combined with theoretical predictions, these data add significant insight to the field of transplutonium chemistry, and may lead to innovative Bk separation and purification processes.« less

Association Between Young Australian's Drinking Behaviours and Their Interactions With Alcohol Brands on Facebook: Results of an Online Survey.

PubMed

Jones, Sandra C; Robinson, Laura; Barrie, Lance; Francis, Kate; Lee, Jeong Kyu

2016-07-01

To examine the association of alcohol-brand social networking pages and Facebook users' drinking attitudes and behaviours. Cross-sectional, self-report data were obtained from a convenience sample of 283 Australian Facebook users aged 16-24 years via an online survey. More than half of the respondents reported using Facebook for more than an hour daily. While only 20% had actively interacted with an alcohol brand on Facebook, we found a significant association between this active interaction and alcohol consumption, and a strong association between engagement with alcohol brands on Facebook and problematic drinking. The findings of this study demonstrate the need for further research into the complex interaction between social networking and alcohol consumption, and add support to calls for effective regulation of alcohol marketing on social network platforms. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Pros and Cons of the Acceleration Scheme (NF-IDS)

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

Bogacz, Alex; Bogacz, Slawomir

The overall goal of the acceleration systems: large acceptance acceleration to 25 GeV and beam shaping can be accomplished by various fixed field accelerators at different stages. They involve three superconducting linacs: a single pass linear Pre-accelerator followed by a pair of multi-pass Recirculating Linear Accelerators (RLA) and finally a nonâ scaling FFAG ring. The present baseline acceleration scenario has been optimized to take maximum advantage of appropriate acceleration scheme at a given stage. Pros and cons of various stages are discussed here in detail. The solenoid based Pre-accelerator offers very large acceptance and facilitates correction of energy gain acrossmore » the bunch and significant longitudinal compression trough induced synchrotron motion. However, far off-crest acceleration reduces the effective acceleration gradient and adds complexity through the requirement of individual RF phase control for each cavity. Close proximity of strong solenoids and superc« less

Applications of reversible covalent chemistry in analytical sample preparation.

PubMed

Siegel, David

2012-12-07

Reversible covalent chemistry (RCC) adds another dimension to commonly used sample preparation techniques like solid-phase extraction (SPE), solid-phase microextraction (SPME), molecular imprinted polymers (MIPs) or immuno-affinity cleanup (IAC): chemical selectivity. By selecting analytes according to their covalent reactivity, sample complexity can be reduced significantly, resulting in enhanced analytical performance for low-abundance target analytes. This review gives a comprehensive overview of the applications of RCC in analytical sample preparation. The major reactions covered include reversible boronic ester formation, thiol-disulfide exchange and reversible hydrazone formation, targeting analyte groups like diols (sugars, glycoproteins and glycopeptides, catechols), thiols (cysteinyl-proteins and cysteinyl-peptides) and carbonyls (carbonylated proteins, mycotoxins). Their applications range from low abundance proteomics to reversible protein/peptide labelling to antibody chromatography to quantitative and qualitative food analysis. In discussing the potential of RCC, a special focus is on the conditions and restrictions of the utilized reaction chemistry.

Time-Dependent Kinematics of Complex Human Structures

NASA Astrophysics Data System (ADS)

Shaibani, Saami J.

2013-03-01

The human body can be arranged in numerous geometrical configurations, including many interesting scenarios from the sport of gymnastics. One particularly challenging analytical example among these is the forward flip with maximum separation from the ground at the apex of the flight. The temporal aspects of this move involve the evaluation of multiple different positions during the trajectory, which adds significantly to the effort required. When a forward flip was executed during a football game, ready access to the recording of this allowed a detailed kinematic examination to be performed. Careful application of highly intricate protocols produces results which are consistent with similar athletic environments. The emphasis in this research is to transcend standard approaches elsewhere, which are severely limited to generic athletes and/or generic circumstances. Pedagogical benefits of the rigorous methodology adopted here are explored beyond what was introduced in a recent related study.

Promysalin Elicits Species-Selective Inhibition of Pseudomonas aeruginosa by Targeting Succinate Dehydrogenase.

PubMed

Keohane, Colleen E; Steele, Andrew D; Fetzer, Christian; Khowsathit, Jittasak; Van Tyne, Daria; Moynié, Lucile; Gilmore, Michael S; Karanicolas, John; Sieber, Stephan A; Wuest, William M

2018-02-07

Natural products have served as an inspiration to scientists both for their complex three-dimensional architecture and exquisite biological activity. Promysalin is one such Pseudomonad secondary metabolite that exhibits narrow-spectrum antibacterial activity, originally isolated from the rhizosphere. We herein utilize affinity-based protein profiling (AfBPP) to identify succinate dehydrogenase (Sdh) as the biological target of the natural product. The target was further validated in silico, in vitro, in vivo, and through the selection, and sequencing, of a resistant mutant. Succinate dehydrogenase plays an essential role in primary metabolism of Pseudomonas aeruginosa as the only enzyme that is involved both in the tricarboxylic acid cycle (TCA) and in respiration via the electron transport chain. These findings add credence to other studies that suggest that the TCA cycle is an understudied target in the development of novel therapeutics to combat P. aeruginosa, a significant pathogen in clinical settings.

Use of statistical and neural net approaches in predicting toxicity of chemicals.

PubMed

Basak, S C; Grunwald, G D; Gute, B D; Balasubramanian, K; Opitz, D

2000-01-01

Hierarchical quantitative structure-activity relationships (H-QSAR) have been developed as a new approach in constructing models for estimating physicochemical, biomedicinal, and toxicological properties of interest. This approach uses increasingly more complex molecular descriptors in a graduated approach to model building. In this study, statistical and neural network methods have been applied to the development of H-QSAR models for estimating the acute aquatic toxicity (LC50) of 69 benzene derivatives to Pimephales promelas (fathead minnow). Topostructural, topochemical, geometrical, and quantum chemical indices were used as the four levels of the hierarchical method. It is clear from both the statistical and neural network models that topostructural indices alone cannot adequately model this set of congeneric chemicals. Not surprisingly, topochemical indices greatly increase the predictive power of both statistical and neural network models. Quantum chemical indices also add significantly to the modeling of this set of acute aquatic toxicity data.

Prospects and applicability of wave energy for South Africa

NASA Astrophysics Data System (ADS)

Lavidas, George; Venugopal, Vengatesan

2018-03-01

Renewable energy offers significant opportunities for electricity diversification. South Africa belongs to the group of developing nations and encompasses a lot of potential for renewable energy developments. Currently, the majority of its electricity production originates from fossil fuels; however, incorporation of clean coal technologies will aid in reaching the assigned targets. This study offers a long-term wave power quantification analysis with a numerical wave model. The investigation includes long-term resource assessment in the region, variability, seasonal and monthly wave energy content. Locations with high-energy content but low variability pose an opportunity that can contribute in the alleviation of energy poverty. Application of wave converters depends on the combination of complex terms. The study presents resource levels and the joint distributions, which indicate suitability for converter selection. Depending on the region of interest, these characteristics change. Thus, this resource assessment adds knowledge on wave power and optimal consideration for wave energy applicability.

Fast Formal Analysis of Requirements via "Topoi Diagrams"

NASA Technical Reports Server (NTRS)

Menzies, Tim; Powell, John; Houle, Michael E.; Kelly, John C. (Technical Monitor)

2001-01-01

Early testing of requirements can decrease the cost of removing errors in software projects. However, unless done carefully, that testing process can significantly add to the cost of requirements analysis. We show here that requirements expressed as topoi diagrams can be built and tested cheaply using our SP2 algorithm, the formal temporal properties of a large class of topoi can be proven very quickly, in time nearly linear in the number of nodes and edges in the diagram. There are two limitations to our approach. Firstly, topoi diagrams cannot express certain complex concepts such as iteration and sub-routine calls. Hence, our approach is more useful for requirements engineering than for traditional model checking domains. Secondly, out approach is better for exploring the temporal occurrence of properties than the temporal ordering of properties. Within these restrictions, we can express a useful range of concepts currently seen in requirements engineering, and a wide range of interesting temporal properties.

The Benefits and Challenges of an Interfaced Electronic Health Record and Laboratory Information System: Effects on Laboratory Processes.

PubMed

Petrides, Athena K; Bixho, Ida; Goonan, Ellen M; Bates, David W; Shaykevich, Shimon; Lipsitz, Stuart R; Landman, Adam B; Tanasijevic, Milenko J; Melanson, Stacy E F

2017-03-01

- A recent government regulation incentivizes implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR with their laboratory information system (LIS). - To determine the impact of an interfaced EHR-LIS on laboratory processes. - We analyzed several different processes before and after implementation of an interfaced EHR-LIS: the turnaround time, the number of stat specimens received, venipunctures per patient per day, preanalytic errors in phlebotomy, the number of add-on tests using a new electronic process, and the number of wrong test codes ordered. Data were gathered through the LIS and/or EHR. - The turnaround time for potassium and hematocrit decreased significantly (P = .047 and P = .004, respectively). The number of stat orders also decreased significantly, from 40% to 7% for potassium and hematocrit, respectively (P < .001 for both). Even though the average number of inpatient venipunctures per day increased from 1.38 to 1.62 (P < .001), the average number of preanalytic errors per month decreased from 2.24 to 0.16 per 1000 specimens (P < .001). Overall there was a 16% increase in add-on tests. The number of wrong test codes ordered was high and it was challenging for providers to correctly order some common tests. - An interfaced EHR-LIS significantly improved within-laboratory turnaround time and decreased stat requests and preanalytic phlebotomy errors. Despite increasing the number of add-on requests, an electronic add-on process increased efficiency and improved provider satisfaction. Laboratories implementing an interfaced EHR-LIS should be cautious of its effects on test ordering and patient venipunctures per day.

Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin.

PubMed

Kim, Jong Ho; Kim, Sang Soo; Baek, Hong Sun; Lee, In Kyu; Chung, Dong Jin; Sohn, Ho Sang; Bae, Hak Yeon; Kim, Mi Kyung; Park, Jeong Hyun; Choi, Young Sik; Kim, Young Il; Hahm, Jong Ryeal; Lee, Chang Won; Jo, Sung Rae; Park, Mi Kyung; Lee, Kwang Jae; Kim, In Joo

2016-06-01

We compared the efficacies of vildagliptin (50 mg twice daily) relative to pioglitazone (15 mg once daily) as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c) levels in Korean patients with type 2 diabetes. The present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin. The mean changes in HbA1c levels from baseline were -0.94% in the vildagliptin group and -0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG) levels were -60.2 mg/dL in the vildagliptin group and -38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040). There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL), and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was -0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002). As an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.

Beneficial Effects of Vildagliptin on Metabolic Parameters in Patients with Type 2 Diabetes.

PubMed

Shimodaira, Masanori; Niwa, Tomohiro; Nakajima, Koji; Kobayashi, Mutsuhiro

2015-01-01

Blood pressure and lipid profile are important determinants of cardiovascular risk in patients with type 2 diabetes mellitus (T2DM). To identify the pleiotropic effects of vildagliptin other than blood glucose lowering effect, a retrospective study was conducted in 128 patients with T2DM treated with vildagliptin 50 mg twice daily. The patients were separated into two groups: patients who were initiated with vildagliptin as monotherapy or add-on therapy (add-on group, n = 66) and patients who were switched from sitagliptin 100 mg once daily to vildagliptin (switching group, n = 62). Hemoglobin A1c (HbA1c), body mass index (BMI), systolic/diastolic blood pressure, lipid profiles, and uric acid (UA) at 3, 6, and 12 months of vildagliptin therapy were compared with those at baseline in each group. At baseline, there were no significant differences in HbA1c, BMI, blood pressures, lipid profiles, and UA levels between the two groups. After vildagliptin initiation, HbA1c decreased significantly but BMI and blood pressure did not change in both groups. Only in the add-on group, total cholesterol and low density lipoprotein cholesterol decreased significantly from baseline to 3, 6, and 12 months. On the other hand, triglyceride and high-density lipoprotein cholesterol did not change in both groups. Serum UA levels decreased only in the switching group from baseline to 3, 6, and 12 months. These results indicate that vildagliptin add-on treatment may have beneficial effects on lipid profiles, and switching from sitagliptin to vildagliptin reduces UA in patients with T2DM; these are important findings linked to the beneficial effects of vildagliptin on lipid and UA metabolisms in the treatment of T2DM.

Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients.

PubMed

Sujan, M U; Rao, M Raghavendra; Kisan, Ravikiran; Abhishekh, Hulegar A; Nalini, Atchayaram; Raju, Trichur R; Sathyaprabha, T N

2016-01-01

Migraine is associated with autonomic symptoms. The growing body of literature suggests that the dysfunctional autonomic nervous system might play a pivotal role in the pathogenesis of migraine. Thermal therapies have been hypothesized to modulate these changes and alleviate pain. However, data regarding the efficacy of hydrotherapy in migraine remain scant. We evaluated the effect of add on hydrotherapy procedure (a hot arm and foot bath with ice massage to head) in migraine patients. Forty chronic migraine patients fulfilling the International Classification of Headache Disorders II criteria were recruited from the neurology outpatient clinic. Patients were randomized to receive either hydrotherapy plus conventional pharmacological care (n = 20) or conventional medication only (n = 20). Hydrotherapy group received treatment with hot arm and foot bath (103°F to 110°F) and ice massage to head daily for 20 min for 45 days. Patients were assessed using headache impact test (HIT), visual analog scale for pain and cardiac autonomic function by heart rate variability (HRV) before and after intervention period. There was a significant decrease in HIT score, frequency, and intensity of headaches following treatment in both the groups. However, it was more evident in add on hydrotherapy group compared to pharmacological treatment alone group. There was also significant improvement in the HRV parameters. In particular, there was a significant decrease in heart rate (P = 0.017), increase in high frequency (HF) (P = 0.014) and decrease in low frequency/HF ratio (P = 0.004) in add on hydrotherapy group. Our study shows that add on hydrotherapy enhanced the vagal tone in addition to reducing the frequency and intensity of headaches in migraine patients.

Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients

PubMed Central

Sujan, M. U.; Rao, M. Raghavendra; Kisan, Ravikiran; Abhishekh, Hulegar A.; Nalini, Atchayaram; Raju, Trichur R.; Sathyaprabha, T. N.

2016-01-01

Background: Migraine is associated with autonomic symptoms. The growing body of literature suggests that the dysfunctional autonomic nervous system might play a pivotal role in the pathogenesis of migraine. Thermal therapies have been hypothesized to modulate these changes and alleviate pain. However, data regarding the efficacy of hydrotherapy in migraine remain scant. We evaluated the effect of add on hydrotherapy procedure (a hot arm and foot bath with ice massage to head) in migraine patients. Methods: Forty chronic migraine patients fulfilling the International Classification of Headache Disorders II criteria were recruited from the neurology outpatient clinic. Patients were randomized to receive either hydrotherapy plus conventional pharmacological care (n = 20) or conventional medication only (n = 20). Hydrotherapy group received treatment with hot arm and foot bath (103°F to 110°F) and ice massage to head daily for 20 min for 45 days. Patients were assessed using headache impact test (HIT), visual analog scale for pain and cardiac autonomic function by heart rate variability (HRV) before and after intervention period. Results: There was a significant decrease in HIT score, frequency, and intensity of headaches following treatment in both the groups. However, it was more evident in add on hydrotherapy group compared to pharmacological treatment alone group. There was also significant improvement in the HRV parameters. In particular, there was a significant decrease in heart rate (P = 0.017), increase in high frequency (HF) (P = 0.014) and decrease in low frequency/HF ratio (P = 0.004) in add on hydrotherapy group. Conclusion: Our study shows that add on hydrotherapy enhanced the vagal tone in addition to reducing the frequency and intensity of headaches in migraine patients. PMID:26933356

Stimulation of dopamine D₁ receptor improves learning capacity in cooperating cleaner fish.

PubMed

Messias, João P M; Santos, Teresa P; Pinto, Maria; Soares, Marta C

2016-01-27

Accurate contextual decision-making strategies are important in social environments. Specific areas in the brain are tasked to process these complex interactions and generate correct follow-up responses. The dorsolateral and dorsomedial parts of the telencephalon in the teleost fish brain are neural substrates modulated by the neurotransmitter dopamine (DA), and are part of an important neural circuitry that drives animal behaviour from the most basic actions such as learning to search for food, to properly choosing partners and managing decisions based on context. The Indo-Pacific cleaner wrasse Labroides dimidiatus is a highly social teleost fish species with a complex network of interactions with its 'client' reef fish. We asked if changes in DA signalling would affect individual learning ability by presenting cleaner fish two ecologically different tasks that simulated a natural situation requiring accurate decision-making. We demonstrate that there is an involvement of the DA system and D1 receptor pathways on cleaners' natural abilities to learn both tasks. Our results add significantly to the growing literature on the physiological mechanisms that underlie and facilitate the expression of cooperative abilities. © 2016 The Author(s).

Solving the Big Data (BD) Problem in Advanced Manufacturing (Subcategory for work done at Georgia Tech. Study Process and Design Factors for Additive Manufacturing Improvement)

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

Clark, Brett W.; Diaz, Kimberly A.; Ochiobi, Chinaza Darlene

2015-09-01

3D printing originally known as additive manufacturing is a process of making 3 dimensional solid objects from a CAD file. This ground breaking technology is widely used for industrial and biomedical purposes such as building objects, tools, body parts and cosmetics. An important benefit of 3D printing is the cost reduction and manufacturing flexibility; complex parts are built at the fraction of the price. However, layer by layer printing of complex shapes adds error due to the surface roughness. Any such error results in poor quality products with inaccurate dimensions. The main purpose of this research is to measure themore » amount of printing errors for parts with different geometric shapes and to analyze them for finding optimal printing settings to minimize the error. We use a Design of Experiments framework, and focus on studying parts with cone and ellipsoid shapes. We found that the orientation and the shape of geometric shapes have significant effect on the printing error. From our analysis, we also determined the optimal orientation that gives the least printing error.« less

Whole genome sequencing and imputation in isolated populations identify genetic associations with medically-relevant complex traits

PubMed Central

Southam, Lorraine; Gilly, Arthur; Süveges, Dániel; Farmaki, Aliki-Eleni; Schwartzentruber, Jeremy; Tachmazidou, Ioanna; Matchan, Angela; Rayner, Nigel W.; Tsafantakis, Emmanouil; Karaleftheri, Maria; Xue, Yali; Dedoussis, George; Zeggini, Eleftheria

2017-01-01

Next-generation association studies can be empowered by sequence-based imputation and by studying founder populations. Here we report ∼9.5 million variants from whole-genome sequencing (WGS) of a Cretan-isolated population, and show enrichment of rare and low-frequency variants with predicted functional consequences. We use a WGS-based imputation approach utilizing 10,422 reference haplotypes to perform genome-wide association analyses and observe 17 genome-wide significant, independent signals, including replicating evidence for association at eight novel low-frequency variant signals. Two novel cardiometabolic associations are at lead variants unique to the founder population sequences: chr16:70790626 (high-density lipoprotein levels beta −1.71 (SE 0.25), P=1.57 × 10−11, effect allele frequency (EAF) 0.006); and rs145556679 (triglycerides levels beta −1.13 (SE 0.17), P=2.53 × 10−11, EAF 0.013). Our findings add empirical support to the contribution of low-frequency variants in complex traits, demonstrate the advantage of including population-specific sequences in imputation panels and exemplify the power gains afforded by population isolates. PMID:28548082

Inferring diffusion in single live cells at the single-molecule level

PubMed Central

Robson, Alex; Burrage, Kevin; Leake, Mark C.

2013-01-01

The movement of molecules inside living cells is a fundamental feature of biological processes. The ability to both observe and analyse the details of molecular diffusion in vivo at the single-molecule and single-cell level can add significant insight into understanding molecular architectures of diffusing molecules and the nanoscale environment in which the molecules diffuse. The tool of choice for monitoring dynamic molecular localization in live cells is fluorescence microscopy, especially so combining total internal reflection fluorescence with the use of fluorescent protein (FP) reporters in offering exceptional imaging contrast for dynamic processes in the cell membrane under relatively physiological conditions compared with competing single-molecule techniques. There exist several different complex modes of diffusion, and discriminating these from each other is challenging at the molecular level owing to underlying stochastic behaviour. Analysis is traditionally performed using mean square displacements of tracked particles; however, this generally requires more data points than is typical for single FP tracks owing to photophysical instability. Presented here is a novel approach allowing robust Bayesian ranking of diffusion processes to discriminate multiple complex modes probabilistically. It is a computational approach that biologists can use to understand single-molecule features in live cells. PMID:23267182

A retrospective study evaluating the tolerability and effectiveness of adjunctive antihypertensive drugs in patients with inadequate response to initial treatment.

PubMed

Ayyagari, Rajeev; Xie, Jipan; Cheng, David; Wu, Eric Q; Huang, Xing-Yue; Chen, Stephanie

2018-06-01

Real-world tolerability and effectiveness of nebivolol as first add-on therapy were compared with hydrochlorothiazide, metoprolol, and amlodipine. Medical records of hypertensive adults initiating nebivolol, hydrochlorothiazide, metoprolol, or amlodipine as first add-on therapy between December 16, 2010 and July 21, 2011 were retrospectively abstracted (N = 1600; 400/treatment). Outcomes included medication-related side-effect rates and blood pressure (BP) reduction and control. Compared with nebivolol, metoprolol and amlodipine had significantly higher side-effect rates (incidence rate ratio [95% CI]: 1.82 [1.14-2.92] and 2.67 [1.69-4.21]), respectively); the hydrochlorothiazide-nebivolol rate ratio was not significant (1.61 [0.95-2.71]). All treatments reduced BP at 2 months. Metoprolol, amlodipine, and hydrochlorothiazide were associated with significantly lower odds of achieving 2-month BP control than nebivolol (odds ratios [95% CI]: 0.34 [0.23-0.51], 0.51 [0.35-0.75] and 0.66 [0.44-0.99], respectively). In a real-world setting, nebivolol as first add-on therapy was associated with fewer side effects than metoprolol or amlodipine and with a higher BP control rate than hydrochlorothiazide, metoprolol, or amlodipine. © 2018 The Authors. The Journal of Clinical Hypertension Published by Wiley Periodicals, Inc.

Modifications of the endosomal compartment in peripheral blood mononuclear cells and fibroblasts from Alzheimer's disease patients

PubMed Central

Corlier, F; Rivals, I; Lagarde, J; Hamelin, L; Corne, H; Dauphinot, L; Ando, K; Cossec, J-C; Fontaine, G; Dorothée, G; Malaplate-Armand, C; Olivier, J-L; Dubois, B; Bottlaender, M; Duyckaerts, C; Sarazin, M; Potier, M-C; Alnajjar-Carpentier, Dr Amer; Logak, Dr Michel; Leder, Dr Sara; Marchal, Dr Dominique; Pitti-Ferandi, Dr Hélène; Brugeilles, Dr Hélene; Roualdes, Dr Brigitte; Michon, Dr Agnes

2015-01-01

Identification of blood-based biomarkers of Alzheimer's disease (AD) remains a challenge. Neuropathological studies have identified enlarged endosomes in post-mortem brains as the earliest cellular change associated to AD. Here the presence of enlarged endosomes was investigated in peripheral blood mononuclear cells from 48 biologically defined AD patients (25 with mild cognitive impairment and 23 with dementia (AD-D)), and 23 age-matched healthy controls using immunocytochemistry and confocal microscopy. The volume and number of endosomes were not significantly different between AD and controls. However, the percentage of cells containing enlarged endosomes was significantly higher in the AD-D group as compared with controls. Furthermore, endosomal volumes significantly correlated to [C11]PiB cortical index measured by positron emission tomography in the AD group, independently of the APOE genotype, but not to the levels of amyloid-beta, tau and phosphorylated tau measured in the cerebrospinal fluid. Importantly, we confirmed the presence of enlarged endosomes in fibroblasts from six unrelated AD-D patients as compared with five cognitively normal controls. This study is the first, to our knowledge, to report morphological alterations of the endosomal compartment in peripheral cells from AD patients correlated to amyloid load that will now be evaluated as a possible biomarker. PMID:26151923

[Adequacy of clinical interventions in patients with advanced and complex disease. Proposal of a decision making algorithm].

PubMed

Ameneiros-Lago, E; Carballada-Rico, C; Garrido-Sanjuán, J A; García Martínez, A

2015-01-01

Decision making in the patient with chronic advanced disease is especially complex. Health professionals are obliged to prevent avoidable suffering and not to add any more damage to that of the disease itself. The adequacy of the clinical interventions consists of only offering those diagnostic and therapeutic procedures appropriate to the clinical situation of the patient and to perform only those allowed by the patient or representative. In this article, the use of an algorithm is proposed that should serve to help health professionals in this decision making process. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Nature and Nurture of Human Pain

PubMed Central

2013-01-01

Humans are very different when it comes to pain. Some get painful piercings and tattoos; others can not stand even a flu shot. Interindividual variability is one of the main characteristics of human pain on every level including the processing of nociceptive impulses at the periphery, modification of pain signal in the central nervous system, perception of pain, and response to analgesic strategies. As for many other complex behaviors, the sources of this variability come from both nurture (environment) and nature (genes). Here, I will discuss how these factors contribute to human pain separately and via interplay and how epigenetic mechanisms add to the complexity of their effects. PMID:24278778

Going beyond the hero in leadership development: the place of healthcare context, complexity and relationships

PubMed Central

Ford, Jackie

2015-01-01

There remains a conviction that the torrent of publications and the financial outlay on leadership development will create managers with the skills and characters of perfect leaders, capable of guiding healthcare organisations through the challenges and crises of the 21st century. The focus of much attention continues to be the search for the (illusory) core set of heroic qualities, abilities or competencies that will enable the development of leaders to achieve levels of supreme leadership and organisational performance. This brief commentary adds support to McDonald’s (1) call for recognition of the complexity of the undertaking. PMID:25844391

Scaffold Diversity Synthesis Delivers Complex, Structurally, and Functionally Distinct Tetracyclic Benzopyrones

PubMed Central

Sankar, Muthukumar G.; Roy, Sayantani; Tran, Tuyen Thi Ngoc; Wittstein, Kathrin; Bauer, Jonathan O.; Strohmann, Carsten; Ziegler, Slava

2018-01-01

Abstract Complexity‐generating chemical transformations that afford novel molecular scaffolds enriched in sp 3 character are highly desired. Here, we present a highly stereoselective scaffold diversity synthesis approach that utilizes cascade double‐annulation reactions of diverse pairs of zwitterionic and non‐zwitterionic partners with 3‐formylchromones to generate highly complex tetracyclic benzopyrones. Each pair of annulation partners adds to the common chroman‐4‐one scaffold to build two new rings, supporting up to four contiguous chiral centers that include an all‐carbon quaternary center. Differently ring‐fused benzopyrones display different biological activities, thus demonstrating their immense potential in medicinal chemistry and chemical biology research. PMID:29721402

Radial Flow Effects On A Retreating Rotor Blade

DTIC Science & Technology

2014-05-01

blades which are subject to the coupled effects of reactive centrifugal and Coriolis forces unique to the rotating environment. These forces are...coupled effects of centrifugal and Coriolis forces in the rotating environment add more complexity to the flow characteristics [96]. McCroskey’s [74...disk will definitely cause some non-linear effects on the radial velocity profile. These effects are not investigated in this study. The next of

Acquisition Research: Creating Synergy for Informed Change. May 15-16 2013

DTIC Science & Technology

2013-05-01

It requires sensors to collect data on component conditions that will be used to generate condition assessments. Royal Dutch Navy Fleet...electronic counter measures (ECMs), communications, and sensors . A more complex example is the ability to load different software onto pre-defined hardware...2013; Sherborne Sensors , 2013). To add to the confusion, Thomke’s (1997) paper, which contains excellent case studies into what we would call

Security Policy Enforcement

DTIC Science & Technology

2005-09-21

most notable was the CAP sys- tem (Wilkes & Needham, 1980 ). Although they can be im- plemented, the systems are notoriously complex and their lack of...when a system is subverted (Anderson, Irvine, & Schell, 2004; Myers, 1980 ). In this case, a member of the system’s development team intentionally adds...Cooper, R. H., Hyslop , W. F., Nickerson, B. G., Stewart, W. M., & Ward, O. K. (1993). The cascade vulnerability problem. In Proceedings of the IEEE

A single competency-based education and training and competency-based career framework for the Australian health workforce: discussing the potential value add.

PubMed

Brownie, Sharon Mary; Thomas, Janelle

2014-09-01

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable - in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project's genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers' commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia's current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented.

The development of a post-mortem interval estimation for human remains found on land in the Netherlands.

PubMed

Gelderman, H T; Boer, L; Naujocks, T; IJzermans, A C M; Duijst, W L J M

2018-05-01

The decomposition process of human remains can be used to estimate the post-mortem interval (PMI), but decomposition varies due to many factors. Temperature is believed to be the most important and can be connected to decomposition by using the accumulated degree days (ADD). The aim of this research was to develop a decomposition scoring method and to develop a formula to estimate the PMI by using the developed decomposition scoring method and ADD.A decomposition scoring method and a Book of Reference (visual resource) were made. Ninety-one cases were used to develop a method to estimate the PMI. The photographs were scored using the decomposition scoring method. The temperature data was provided by the Royal Netherlands Meteorological Institute. The PMI was estimated using the total decomposition score (TDS) and using the TDS and ADD. The latter required an additional step, namely to calculate the ADD from the finding date back until the predicted day of death.The developed decomposition scoring method had a high interrater reliability. The TDS significantly estimates the PMI (R 2  = 0.67 and 0.80 for indoor and outdoor bodies, respectively). When using the ADD, the R 2 decreased to 0.66 and 0.56.The developed decomposition scoring method is a practical method to measure decomposition for human remains found on land. The PMI can be estimated using this method, but caution is advised in cases with a long PMI. The ADD does not account for all the heat present in a decomposing remain and is therefore a possible bias.

Chemical Methods for the Direct Detection and Labeling of S-Nitrosothiols

PubMed Central

Bechtold, Erika

2012-01-01

Abstract Significance: Posttranslational modification of proteins through phosphorylation, glycosylation, and oxidation adds complexity to the proteome by reversibly altering the structure and function of target proteins in a highly controlled fashion. Recent Advances: The study of reversible cysteine oxidation highlights a role for this oxidative modification in complex signal transduction pathways. Nitric oxide (NO), and its respective metabolites (including reactive nitrogen species), participates in a variety of these cellular redox processes, including the reversible oxidation of cysteine to S-nitrosothiols (RSNOs). RSNOs act as endogenous transporters of NO, but also possess beneficial effects independent of NO-related signaling, which suggests a complex and versatile biological role. In this review, we highlight the importance of RSNOs as a required posttranslational modification and summarize the current methods available for detecting S-nitrosation. Critical Issues: Given the limitations of these indirect detection methods, the review covers recent developments toward the direct detection of RSNOs by phosphine-based chemical probes. The intrinsic properties that dictate this phosphine/RSNO reactivity are summarized. In general, RSNOs (both small molecule and protein) react with phosphines to yield reactive S-substituted aza-ylides that undergo further reactions leading to stable RSNO-based adducts. Future Directions: This newly explored chemical reactivity forms the basis of a number of exciting potential chemical methods for protein RSNO detection in biological systems. Antioxid. Redox Signal. 17, 981–991. PMID:22356122

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

PubMed

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

2017-01-01

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

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

PubMed

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

2011-04-01

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

When is an imine not an imine? Unusual reactivity of a series of Cu(II) imine-pyridine complexes and their exploitation for the Henry reaction.

PubMed

Cooper, Christine J; Jones, Matthew D; Brayshaw, Simon K; Sonnex, Benjamin; Russell, Mark L; Mahon, Mary F; Allan, David R

2011-04-14

In this paper we report the synthesis and solid-state structures for a series of pyridine based Cu(II) complexes and preliminary data for the asymmetric Henry reaction. Interestingly, the solid-state structures indicate the incorporation of an alcohol into one of the imine groups of the ligand, forming a rare α-amino ether group. The complexes have been studied via single crystal X-ray diffraction, EPR spectroscopy and mass spectrometry. Intriguingly, it has been observed that the alcohol only adds to one of the imine moieties. Density functional theory (DFT) calculations have also been employed to rationalise the observed structures. The Cu(II) complexes have been tested in the asymmetric Henry reaction (benzaldehyde + nitromethane or nitroethane) with ee's up to 84% being achieved as well as high conversions and modest diastereoselectivities. © The Royal Society of Chemistry 2011

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

Scholbrock, A. K.; Fleming, P. A.; Fingersh, L. J.

Wind turbines are complex, nonlinear, dynamic systems driven by aerodynamic, gravitational, centrifugal, and gyroscopic forces. The aerodynamics of wind turbines are nonlinear, unsteady, and complex. Turbine rotors are subjected to a chaotic three-dimensional (3-D) turbulent wind inflow field with imbedded coherent vortices that drive fatigue loads and reduce lifetime. In order to reduce cost of energy, future large multimegawatt turbines must be designed with lighter weight structures, using active controls to mitigate fatigue loads, maximize energy capture, and add active damping to maintain stability for these dynamically active structures operating in a complex environment. Researchers at the National Renewable Energymore » Laboratory (NREL) and University of Stuttgart are designing, implementing, and testing advanced feed-back and feed-forward controls in order to reduce the cost of energy for wind turbines.« less

Spatial and temporal processing in healthy aging: implications for perceptions of driving skills.

PubMed

Conlon, Elizabeth; Herkes, Kathleen

2008-07-01

Sensitivity to the attributes of a stimulus (form or motion) and accuracy when detecting rapidly presented stimulus information were measured in older (N = 36) and younger (N = 37) groups. Before and after practice, the older group was significantly less sensitive to global motion (but not to form) and less accurate on a rapid sequencing task when detecting the individual elements presented in long but not short sequences. These effect sizes produced power for the different analyses that ranged between 0.5 and 1.00. The reduced sensitivity found among older individuals to temporal but not spatial stimuli, adds support to previous findings of a selective age-related deficit in temporal processing. Older women were significantly less sensitive than older men, younger men and younger women on the global motion task. Gender effects were evident when, in response to global motion stimuli, complex extraction and integration processes needed to be undertaken rapidly. Significant moderate correlations were found between age, global motion sensitivity and reports of perceptions of other vehicles and road signs when driving. These associations suggest that reduced motion sensitivity may produce functional difficulties for the older adults when judging speeds or estimating gaps in traffic while driving.

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

NASA Astrophysics Data System (ADS)

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

2017-03-01

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

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

PubMed

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

2014-08-01

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

Natural Convection Cooling of the Advanced Stirling Radioisotope Generator Engineering Unit

NASA Technical Reports Server (NTRS)

Lewandowski, Edward J.; Hill, Dennis

2011-01-01

After fueling and prior to launch, the Advanced Stirling Radioisotope Generator (ASRG) will be stored for a period of time then moved to the launch pad for integration with the space probe and mounting on the launch vehicle. During this time, which could be as long as 3 years, the ASRG will operate continuously with heat rejected from the housing and fins. Typically, the generator will be cooled by forced convection using fans. During some of the ground operations, maintaining forced convection may add significant complexity, so allowing natural convection may simplify operations. A test was conducted on the ASRG Engineering Unit (EU) to quantify temperatures and operating parameters with natural convection only and determine if the EU could be safely operated in such an environment. The results show that with natural convection cooling the ASRG EU Stirling convertor pressure vessel temperatures and other parameters had significant margins while the EU was operated for several days in this configuration. Additionally, an update is provided on ASRG EU testing at NASA Glenn Research Center, where the ASRG EU has operated for over 16,000 hr and underwent extensive testing.

Lessons and Perspectives from a 25-Year Bioelectromagnetics Research Program

PubMed Central

Wood, Andrew W.; Lajevardipour, Alireza; McIntosh, Robert L.

2016-01-01

The question of whether electromagnetic fields from electric power or telecommunications systems can be linked unequivocally to health detriments has occupied scientific research endeavors for nearly half a century. For 25 years, the bioelectromagnetic research group at Swinburne University in Melbourne, Australia, has pursued a series of investigations with relevant endpoints, such as neurophysiological and neuropsychological effects, cell calcium level changes, proliferation, and genotoxic effects. Most have shown no significant changes due to fields, however, in some pilot studies significant changes were revealed, but in most cases these were not replicated in follow-up studies. This highlights a feature of this research area, generally; the unambiguous identification of small changes in noisy data where the understanding of possible interaction mechanisms is lacking. On the other hand, mathematical modelling studies, particularly with respect to fields near metallic implants, in workers exposed to fields in harsh environmental conditions and at very high frequencies (THz), continue to add to the expanding knowledge database on the characteristics of the complex electromagnetic environment we live in today. PMID:27669282

Synthesis of High-Speed Digital Systems.

DTIC Science & Technology

1985-11-08

1 (sub2 sub 16 2 (sub3 sub 16) 3 (sub4 sub 16) 4 (eub5 sub 16) 5 (sub6 sub 16) 6 ( sub7 sub 16) 7 (addi add 16) 8 (add2 add 16) 9 (add3 add 16) 10...seB uub5 J2 16 se5) 15 (se6 sub6 JI 16 soO) 18 (se7 sub7 J5 16 se7) 17 (aol addi Dl 16 aol) 18 (a921 add2 add7 18 a02) 19 (&922 add2 add5 16 a02) 20...de4l D4 add4 16 de4) 33 Wd942 D4 sub4 16 de4) 34 (de~i D5 sub7 16 de5) 35 (deS2 D5 add8 16 deS) 36 (jell Ji add7 16 jel) 37 (je12 JI D5 16 jel) 38 (je2

Processing of positive-causal and negative-causal coherence relations in primary school children and adults: a test of the cumulative cognitive complexity approach in German.

PubMed

Knoepke, Julia; Richter, Tobias; Isberner, Maj-Britt; Naumann, Johannes; Neeb, Yvonne; Weinert, Sabine

2017-03-01

Establishing local coherence relations is central to text comprehension. Positive-causal coherence relations link a cause and its consequence, whereas negative-causal coherence relations add a contrastive meaning (negation) to the causal link. According to the cumulative cognitive complexity approach, negative-causal coherence relations are cognitively more complex than positive-causal ones. Therefore, they require greater cognitive effort during text comprehension and are acquired later in language development. The present cross-sectional study tested these predictions for German primary school children from Grades 1 to 4 and adults in reading and listening comprehension. Accuracy data in a semantic verification task support the predictions of the cumulative cognitive complexity approach. Negative-causal coherence relations are cognitively more demanding than positive-causal ones. Moreover, our findings indicate that children's comprehension of negative-causal coherence relations continues to develop throughout the course of primary school. Findings are discussed with respect to the generalizability of the cumulative cognitive complexity approach to German.

Wildfires in California, August 17, 2015

NASA Image and Video Library

2017-12-08

Very hot, dry and unstable conditions in California and across the Pacific Northwest add to the challenges facing firefighters as they battle blazes around the region. Cal Fire is urging Californians to be extremely cautious, especially for the next few days, as the current conditions increase the dangers authorities face. This image was taken by NASA-NOAA's Suomi NPP satellite's VIIRS instrument around 2145 UTC (5:45 p.m. EDT) on August 17, 2015. Northern California is seeing smoke from the River Complex, Route Complex, South Complex, Fork Complex and Mad River Complex fires combine over a large area of the Shasta-Trinity National Forest west of Redding, California, while the Rough Fire in Fresno County is spreading toward the Black Rock Reservoir, causing evacuations and road closures. Fires across the Pacific Northwest aren't limited to California. Please see the Suomi NPP VIIRS composites in NOAA View to see the growth and extent of fires over the past weeks. Credit: NASA/NOAA via NOAA Environmental Visualization Laboratory

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

PubMed

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

2015-07-01

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

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

PubMed

Kishi, Taro; Matsuda, Yuki; Iwata, Nakao

2017-07-01

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

Sirolimus for epilepsy in children with tuberous sclerosis complex: A randomized controlled trial.

PubMed

Overwater, Iris E; Rietman, André B; Bindels-de Heus, Karen; Looman, Caspar W N; Rizopoulos, Dimitris; Sibindi, Tafadzwa M; Cherian, Perumpillichira J; Jansen, Floor E; Moll, Henriëtte A; Elgersma, Ype; de Wit, Marie-Claire Y

2016-09-06

To investigate whether mammalian target of rapamycin complex 1 (mTORC1) inhibitors could reduce seizure frequency in children with tuberous sclerosis complex (TSC). Due to slow inclusion rate, target inclusion of 30 children was not reached. Twenty-three children with TSC and intractable epilepsy (age 1.8-10.9 years) were randomly assigned (1:1) to open-label, add-on sirolimus treatment immediately or after 6 months. Sirolimus was titrated to trough levels of 5-10 ng/mL. Primary endpoint was seizure frequency change during the sixth month of sirolimus treatment. Intention-to-treat analysis showed sirolimus treatment resulted in 41% seizure frequency decrease (95% confidence interval [CI] -69% to +14%; p = 0.11) compared to the standard-care period. Per protocol analysis of 14 children who reached sirolimus target trough levels in the sixth sirolimus month showed a seizure frequency decrease of 61% (95% CI -86% to +6%; p = 0.06). Cognitive development did not change. All children had adverse events. Five children discontinued sirolimus prematurely. We describe a randomized controlled trial for a non-antiepileptic drug that directly targets a presumed causal mechanism of epileptogenesis in a genetic disorder. Although seizure frequency decreased, especially in children reaching target trough levels, we could not show a significant benefit. Larger trials or meta-analyses are needed to investigate if patients with TSC with seizures benefit from mTORC1 inhibition. This trial was registered at trialregister.nl (NTR3178) and supported by the Dutch Epilepsy Foundation. This study provides Class III evidence that sirolimus does not significantly reduce seizure frequency in children with TSC and intractable epilepsy. The study lacked the precision to exclude a benefit from sirolimus. © 2016 American Academy of Neurology.

2016 Summer Series - Ophir Frieder - Searching Harsh Environments

NASA Image and Video Library

2016-07-12

Analysis of selective data that fits our investigative tool may lead to erroneous or limited conclusions. The universe consists of multi states and our recording of them adds complexity. By finding methods to increase the robustness of our digital data collection and applying likely relationship search methods that can handle all the data, we will increase the resolution of our conclusions. Frieder will present methods to increase our ability to capture and search digital data.

Columbia Crew added to Astronaut Memorial Mirror

NASA Image and Video Library

2003-07-15

Workers add to the Astronaut Memorial Mirror the names of the Columbia crew who died in the STS-107 accident. Dedicated May 9, 1991, the Astronaut Memorial honors U.S. astronauts who gave their lives for space exploration. The "Space Mirror," 42 1/2 feet high by 50 feet wide, illuminates the names of the fallen astronauts cut through the monument's black granite surface. The Memorial Mirror is accessible through the KSC Visitor Complex.

The Influence of Baker Bay and Sand Island on Circulations in the Mouth of the Columbia River

DTIC Science & Technology

2014-06-01

the presence of Baker Bay, a shallow sub -embayment, adds further complexity. Drifter velocities were greatest during maximum ebb flows and were...Drifters occasionally entered Baker Bay via Baker Inlet during flood flows , especially in conjunction with strong southwesterly winds. During ebb flows ...occurred in the vicinity of the pile dikes, including reversed (upriver) flow between the pile dikes during maximum ebb . Understanding unique flow

Particulate matter exposure of bicycle path users in a high-altitude city

NASA Astrophysics Data System (ADS)

Fajardo, Oscar A.; Rojas, Nestor Y.

2012-01-01

It is necessary to evaluate cyclists' exposure to particulate matter and if they are at a higher risk due to their increased breathing rate and their exposure to freshly emitted pollutants. The aim of this pilot study was to determine cyclists' exposure to PM 10 in a highly-polluted, high-altitude city such as Bogotá, and comment on the appropriateness of building bicycle paths alongside roads with heavy traffic in third world cities. A total of 29 particulate matter (PM 10) measurements, taken at two sampling sites using Harvard impactors, were used for estimating the exposure of users of the 80th street bicycle path to this pollutant. PM 10 dose could be considered as being high, especially due to high concentrations and cyclists' increased inhalation rates. A random survey was conducted over 73 bicycle path users to determine cyclists' time, distance and speed on the bicycle path on a daily and weekly basis, their level of effort when cycling and general characteristics, such as this population's gender and age. Based on this information, the PM 10 average daily dose (ADD c) for different bicycle path users and the ratio between ADD c and a reference ADD for people at rest exposed to an indoor concentration of 25 μg m -3 were estimated. The average increase in ADD was 6%-9% when riding with light effort and by 12%-18% when riding with moderate effort. The most enthusiastic bicycle path users showed ADD c/ADD r ratios as high as 1.30 when riding with light effort and 1.64 when riding with moderate effort, thereby significantly increasing their PM 10 exposure-associated health risks.

The effects of antecedent dry days on the nitrogen removal in layered soil infiltration systems for storm run-off control.

PubMed

Cho, Kang-Woo; Yoon, Min-Hyuk; Song, Kyung-Guen; Ahn, Kyu-Hong

2011-01-01

The effects of antecedent dry days (ADD) on nitrogen removal efficiency were investigated in soil infiltration systems, with three distinguishable layers: mulch layer (ML), coarse soil layer (CSL) and fine soil layer (FSL). Two sets of lab-scale columns with loamy CSL (C1) and sandy CSL (C2) were dosed with synthetic run-off, carrying chemical oxygen demand of 100 mg L(-1) and total nitrogen of 13 mg L(-1). The intermittent dosing cycle was stepwise adjusted for 5, 10 and 20 days. The influent ammonium and organic nitrogen were adsorbed to the entire depth in C1, while dominantly to the FSL in C2. In both columns, the effluent ammonium concentration increased while the organic nitrogen concentration decreased, as ADD increased from 5 to 20 days. The effluent of C1 always showed nitrate concentration exceeding influent, caused by nitrification, by increasing amounts as ADD increased. However, the wash-out of nitrate in C1 was not distinct in terms of mass since the effluent flow rate was only 25% of the influent. In contrast, efficient reduction (>95%) of nitrate loading was observed in C2 under ADD of 5 and 10 days, because of insignificant nitrification in the CSL and denitrification in the FSL. However, for the ADD of 20 days, a significant nitrate wash-out appeared in C2 as well, possibly because of the re-aeration by the decreasing water content in the FSL. Consequently, the total nitrogen load escaping with the effluent was always smaller in C2, supporting the effectiveness of sandy CSL over loamy FSL for nitrogen removal under various ADDs.

Substrate Specificities and Conformational Flexibility of 3-Ketosteroid 9α-Hydroxylases*

PubMed Central

Penfield, Jonathan S.; Worrall, Liam J.; Strynadka, Natalie C.; Eltis, Lindsay D.

2014-01-01

KshA is the oxygenase component of 3-ketosteroid 9α-hydroxylase, a Rieske oxygenase involved in the bacterial degradation of steroids. Consistent with its role in bile acid catabolism, KshA1 from Rhodococcus rhodochrous DSM43269 had the highest apparent specificity (kcat/Km) for steroids with an isopropyl side chain at C17, such as 3-oxo-23,24-bisnorcholesta-1,4-diene-22-oate (1,4-BNC). By contrast, the KshA5 homolog had the highest apparent specificity for substrates with no C17 side chain (kcat/Km >105 s−1 m−1 for 4-estrendione, 5α-androstandione, and testosterone). Unexpectedly, substrates such as 4-androstene-3,17-dione (ADD) and 4-BNC displayed strong substrate inhibition (KiS ∼100 μm). By comparison, the cholesterol-degrading KshAMtb from Mycobacterium tuberculosis had the highest specificity for CoA-thioesterified substrates. These specificities are consistent with differences in the catabolism of cholesterol and bile acids, respectively, in actinobacteria. X-ray crystallographic structures of the KshAMtb·ADD, KshA1·1,4-BNC-CoA, KshA5·ADD, and KshA5·1,4-BNC-CoA complexes revealed that the enzymes have very similar steroid-binding pockets with the substrate's C17 oriented toward the active site opening. Comparisons suggest Tyr-245 and Phe-297 are determinants of KshA1 specificity. All enzymes have a flexible 16-residue “mouth loop,” which in some structures completely occluded the substrate-binding pocket from the bulk solvent. Remarkably, the catalytic iron and α-helices harboring its ligands were displaced up to 4.4 Å in the KshA5·substrate complexes as compared with substrate-free KshA, suggesting that Rieske oxygenases may have a dynamic nature similar to cytochrome P450. PMID:25049233

Does fibrinogen add to prediction of cardiovascular disease? Results from the Scottish Heart Health Extended Cohort Study.

PubMed

Woodward, Mark; Tunstall-Pedoe, Hugh; Rumley, Ann; Lowe, Gordon D O

2009-08-01

Plasma fibrinogen is an established risk factor for cardiovascular disease (CVD), but it has not been established whether it adds predictive value to risk scores. In the Scottish Heart Health Extended Cohort Study, we measured plasma fibrinogen in 13 060 men and women, aged 30-74 years, initially free of CVD. After follow-up for a median of 19.2 years, 2626 subjects had at least one CVD event. After adjusting for classical CVD risk factors and socio-economic status, the hazard ratios (95% confidence interval) for a one unit (g/l) increase in plasma fibrinogen were 1.09 (1.02, 1.16) for men and 1.10 (1.02, 1.19) for women. Although fibrinogen added significantly to the discrimination of the Framingham risk score for women, it failed to do so for men. Fibrinogen did not add significantly to the ASSIGN risk score. Fibrinogen added between 1.3% and 3.2% to the classification of CVD status by the existing risk scores. We conclude that the added value of fibrinogen to two currently used risk scores is low; hence population screening with fibrinogen for this purpose is unlikely to be clinically useful or cost-effective.

Effects of Polar Bear and Killer Whale Derived Contaminant Cocktails on Marine Mammal Immunity.

PubMed

Desforges, Jean-Pierre; Levin, Milton; Jasperse, Lindsay; De Guise, Sylvain; Eulaers, Igor; Letcher, Robert J; Acquarone, Mario; Nordøy, Erling; Folkow, Lars P; Hammer Jensen, Trine; Grøndahl, Carsten; Bertelsen, Mads F; St Leger, Judy; Almunia, Javier; Sonne, Christian; Dietz, Rune

2017-10-03

Most controlled toxicity studies use single chemical exposures that do not represent the real world situation of complex mixtures of known and unknown natural and anthropogenic substances. In the present study, complex contaminant cocktails derived from the blubber of polar bears (PB; Ursus maritimus) and killer whales (KW; Orcinus orca) were used for in vitro concentration-response experiments with PB, cetacean and seal spp. immune cells to evaluate the effect of realistic contaminant mixtures on various immune functions. Cytotoxic effects of the PB cocktail occurred at lower concentrations than the KW cocktail (1 vs 16 μg/mL), likely due to differences in contaminant profiles in the mixtures derived from the adipose of each species. Similarly, significant reduction of lymphocyte proliferation occurred at much lower exposures in the PB cocktail (EC 50 : 0.94 vs 6.06 μg/mL; P < 0.01), whereas the KW cocktail caused a much faster decline in proliferation (slope: 2.9 vs 1.7; P = 0.04). Only the KW cocktail modulated natural killer (NK) cell activity and neutrophil and monocyte phagocytosis in a concentration- and species-dependent manner. No clear sensitivity differences emerged when comparing cetaceans, seals and PB. Our results showing lower effect levels for complex mixtures relative to single compounds suggest that previous risk assessments underestimate the effects of real world contaminant exposure on immunity. Our results using blubber-derived contaminant cocktails add realism to in vitro exposure experiments and confirm the immunotoxic risk marine mammals face from exposure to complex mixtures of environmental contaminants.

Risk analysis with a fuzzy-logic approach of a complex installation

NASA Astrophysics Data System (ADS)

Peikert, Tim; Garbe, Heyno; Potthast, Stefan

2016-09-01

This paper introduces a procedural method based on fuzzy logic to analyze systematic the risk of an electronic system in an intentional electromagnetic environment (IEME). The method analyzes the susceptibility of a complex electronic installation with respect to intentional electromagnetic interference (IEMI). It combines the advantages of well-known techniques as fault tree analysis (FTA), electromagnetic topology (EMT) and Bayesian networks (BN) and extends the techniques with an approach to handle uncertainty. This approach uses fuzzy sets, membership functions and fuzzy logic to handle the uncertainty with probability functions and linguistic terms. The linguistic terms add to the risk analysis the knowledge from experts of the investigated system or environment.

Simulation of complex pharmacokinetic models in Microsoft Excel.

PubMed

Meineke, Ingolf; Brockmöller, Jürgen

2007-12-01

With the arrival of powerful personal computers in the office numerical methods are accessible to everybody. Simulation of complex processes therefore has become an indispensible tool in research and education. In this paper Microsoft EXCEL is used as a platform for a universal differential equation solver. The software is designed as an add-in aiming at a minimum of required user input to perform a given task. Four examples are included to demonstrate both, the simplicity of use and the versatility of possible applications. While the layout of the program is admittedly geared to the needs of pharmacokineticists, it can be used in any field where sets of differential equations are involved. The software package is available upon request.

System on a Chip (SoC) Overview

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.

2010-01-01

System-on-a-chip or system on chip (SoC or SOC) refers to integrating all components of a computer or other electronic system into a single integrated circuit (chip). It may contain digital, analog, mixed-signal, and often radio-frequency functions all on a single chip substrate. Complexity drives it all: Radiation tolerance and testability are challenges for fault isolation, propagation, and validation. Bigger single silicon die than flown before and technology is scaling below 90nm (new qual methods). Packages have changed and are bigger and more difficult to inspect, test, and understand. Add in embedded passives. Material interfaces are more complex (underfills, processing). New rules for board layouts. Mechanical and thermal designs, etc.

PCLIPS: Parallel CLIPS

NASA Technical Reports Server (NTRS)

Gryphon, Coranth D.; Miller, Mark D.

1991-01-01

PCLIPS (Parallel CLIPS) is a set of extensions to the C Language Integrated Production System (CLIPS) expert system language. PCLIPS is intended to provide an environment for the development of more complex, extensive expert systems. Multiple CLIPS expert systems are now capable of running simultaneously on separate processors, or separate machines, thus dramatically increasing the scope of solvable tasks within the expert systems. As a tool for parallel processing, PCLIPS allows for an expert system to add to its fact-base information generated by other expert systems, thus allowing systems to assist each other in solving a complex problem. This allows individual expert systems to be more compact and efficient, and thus run faster or on smaller machines.

ARPA surveillance technology for detection of targets hidden in foliage

NASA Astrophysics Data System (ADS)

Hoff, Lawrence E.; Stotts, Larry B.

1994-02-01

The processing of large quantities of synthetic aperture radar data in real time is a complex problem. Even the image formation process taxes today's most advanced computers. The use of complex algorithms with multiple channels adds another dimension to the computational problem. Advanced Research Projects Agency (ARPA) is currently planning on using the Paragon parallel processor for this task. The Paragon is small enough to allow its use in a sensor aircraft. Candidate algorithms will be implemented on the Paragon for evaluation for real time processing. In this paper ARPA technology developments for detecting targets hidden in foliage are reviewed and examples of signal processing techniques on field collected data are presented.

Game theory and extremal optimization for community detection in complex dynamic networks.

PubMed

Lung, Rodica Ioana; Chira, Camelia; Andreica, Anca

2014-01-01

The detection of evolving communities in dynamic complex networks is a challenging problem that recently received attention from the research community. Dynamics clearly add another complexity dimension to the difficult task of community detection. Methods should be able to detect changes in the network structure and produce a set of community structures corresponding to different timestamps and reflecting the evolution in time of network data. We propose a novel approach based on game theory elements and extremal optimization to address dynamic communities detection. Thus, the problem is formulated as a mathematical game in which nodes take the role of players that seek to choose a community that maximizes their profit viewed as a fitness function. Numerical results obtained for both synthetic and real-world networks illustrate the competitive performance of this game theoretical approach.

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

PubMed

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

2017-02-23

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

Effects of fuselage forebody geometry on low-speed lateral-directional characteristics of twin-tail fighter model at high angles of attack

NASA Technical Reports Server (NTRS)

Carr, P. C.; Gilbert, W. P.

1979-01-01

Low-speed, static wind-tunnel tests were conducted to explore the effects of fighter fuselage forebody geometry on lateral-directional characteristics at high angles of attack and to provide data for general design procedures. Effects of eight different forebody configurations and several add-on devices (e.g., nose strakes, boundary-layer trip wires, and nose booms) were investigated. Tests showed that forebody design features such as fineness ratio, cross-sectional shape, and add-on devices can have a significant influence on both lateral-directional and longitudinal aerodynamic stability. Several of the forebodies produced both lateral-directional symmetry and strong favorable changes in lateral-directional stability. However, the same results also indicated that such forebody designs can produce significant reductions in longitudinal stability near maximum lift and can significantly change the influence of other configuration variables. The addition of devices to highly tailored forebody designs also can significantly degrade the stability improvements provided by the clean forebody.

The Jackson Career Explorer: Correlates With Self-Monitoring and Social Desirability.

PubMed

Schermer, Julie Aitken

2018-01-01

The Jackson Career Explorer (JCE) is a short form and continuous version of the Jackson Vocational Interest Survey measuring 34 vocational interest dimensions which can be reduced to seven factors (six vocational interest factors and one work style factor). Both the scales and factors were examined for possible significant correlations with social desirability and self-monitoring. Volunteer participants ( N = 779) aged 14 to 92 years completed the JCE, a social desirability scale, and a self-monitoring scale. Social desirability did not correlate significantly with the JCE scales and factors. Self-monitoring was found to correlate significantly with only a few of the JCE dimensions, including the performing arts, dominant leadership, and law scales as well as the business factor. Interestingly, the accountability JCE work style scale, which assesses a preference to work in an environment requiring high levels of honesty, had a significant negative correlation with self-monitoring. These results add to the validity of the JCE and add information to the area of vocational interest assessment.

Spironolactone Add-on for Preventing or Slowing the Progression of Diabetic Nephropathy: A Meta-analysis.

PubMed

Hou, Jing; Xiong, Weiquan; Cao, Ling; Wen, Xiangqiong; Li, Ailing

2015-09-01

The aim of this meta-analysis was to evaluate the benefits and potential adverse effects of adding spironolactone to standard antidiabetic/renoprotective/antihypertensive (AD/RP/AHT) treatment in patients with diabetic nephropathy (DN). PubMed/MEDLINE and Web of Knowledge were searched for relevant randomized, controlled studies (RCTs) or quasi-RCTs of the effects of adding spironolactone to standard AD/RP/AHT treatment in patients with DN. Results were summarized with a random-effects model or a fixed-effects model. According to the outcomes measured (benefits and risks of adding spironolactone to standard AD/RP/AHT treatment), compared with controls, the addition of spironolactone significantly decreased end-of-treatment (EOT) 24-hour urinary albumin/protein excretion and significantly increased percentage reduction from baseline in urinary albumin/creatinine ratio (UACR), although it did not significantly affect EOT UACR. The addition of spironolactone further led to a significantly greater reduction from baseline in glomerular filtration rate (GFR)/estimated (e) GFR, although it did not significantly affect EOT GFR/eGFR. Further, the addition of spironolactone significantly reduced EOT in-office, 24-hour, and daytime systolic and diastolic blood pressure (SBP and DBP, respectively) and led to significantly greater reductions from baseline in in-office SBP and DBP, although it did not significantly affect nighttime SBP or DBP. Finally, the addition of spironolactone significantly increased mean serum/plasma potassium levels and the risk for hyperkalemia. Spironolactone could be added to preexisting AD/RP/AHT therapy in patients with DN to prevent or slow DN progression by reducing proteinuria. The addition of spironolactone would likely provide even more beneficial effect in patients with DN and hypertension due to the BP reduction associated with spironolactone use. However, the beneficial effects of spironolactone add-on should be weighed against its potential risks, especially hyperkalemia. The long-term effects of spironolactone add-on on renal outcomes and mortality need to be studied. Copyright © 2015. Published by Elsevier Inc.

Preliminary results for the design, fabrication, and performance of a backside-illuminated avalanche drift detector

NASA Astrophysics Data System (ADS)

Qiao, Yun; Liang, Kun; Chen, Wen-Fei; Han, De-Jun

2013-10-01

The detection of low-level light is a key technology in various experimental scientific studies. As a photon detector, the silicon photomultiplier (SiPM) has gradually become an alternative to the photomultiplier tube (PMT) in many applications in high-energy physics, astroparticle physics, and medical imaging because of its high photon detection efficiency (PDE), good resolution for single-photon detection, insensitivity to magnetic field, low operating voltage, compactness, and low cost. However, primarily because of the geometric fill factor, the PDE of most SiPMs is not very high; in particular, for those SiPMs with a high density of micro cells, the effective area is small, and the bandwidth of the light response is narrow. As a building block of the SiPM, the concept of the backside-illuminated avalanche drift detector (ADD) was first proposed by the Max Planck Institute of Germany eight years ago; the ADD is promising to have high PDE over the full energy range of optical photons, even ultraviolet light and X-ray light, and because the avalanche multiplication region is very small, the ADD is beneficial for the fabrication of large-area SiPMs. However, because of difficulties in design and fabrication, no significant progress had been made, and the concept had not yet been verified. In this paper, preliminary results in the design, fabrication, and performance of a backside-illuminated ADD are reported; the difficulties in and limitations to the backside-illuminated ADD are analyzed.

A single competency-based education and training and competency-based career framework for the Australian health workforce: discussing the potential value add

PubMed Central

Brownie, Sharon Mary; Thomas, Janelle

2014-01-01

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project’s genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers’ commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia’s current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented. PMID:25279384

Commentary: Causes and consequences of male adult sexual assault.

PubMed

Wall, Barry W

2011-01-01

Bullock and Beckson add to a growing body of literature on the negative consequences of adult sexual assault on male victims. There are similarities as well as important differences between male sexual assault victims and their female counterparts. Their analyses of societal contributions and myths about adult male sexual assault and of the difficulties that male victims experience in accessing and interacting with the medical and legal systems improve professional understanding of this complex subject.

Defending the Driniumor. Covering Force Operations in New Guinea, 1944 (Leavenworth Papers, Number 9)

DTIC Science & Technology

1984-02-01

remains Robert Ross Smith’s The Approach to the Philippines . This Leavenworth Paper adds tactical detail to a single phase of the complex operations...divisions, supported by the U.S. Pacific Fleet, attack Hollandia on 15 April as a step toward MacArt the Philippines . One week later, the JCS...controlling the southern approach to the Philippines and the Caroline Islands. The Japanese primary defense line, decided at an imperial conference on

Human Factors Lessons Learned from Flight Testing Wingless Lifting Body Vehicles

NASA Technical Reports Server (NTRS)

Merlin, Peter William

2014-01-01

Since the 1960s, NASA, the Air Force, and now private industry have attempted to develop an operational human crewed reusable spacecraft with a wingless, lifting body configuration. This type of vehicle offers increased mission flexibility and greater reentry cross range than capsule type craft, and is particularly attractive due to the capability to land on a runway. That capability, however, adds complexity to the human factors engineering requirements of developing such aircraft.

Postdeployment User Guide: Transition Workbook for Combat Veterans

DTIC Science & Technology

2009-12-07

including pork, and especially fatty cuts (eg, prime, chuck). 4. CARBOHYDRATES • Eat whole grains , fresh fruits , and vegetables that are high in fiber...periods of time without eating. Have a healthy snack between meals. 4. Increase complex carbohydrates (eg, whole grains ) and starches in your diet ...back to baseline at some point or having a particularly bad stretch does not mean you have to start again. It just means you may need to add some

NEAMS-IPL MOOSE Midyear Framework Activities

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

Permann, Cody; Alger, Brian; Peterson, John

The MOOSE Framework is a modular pluggable framework for building complex simulations. The ability to add new objects with custom syntax is a core capability that makes MOOSE a powerful platform for coupling multiple applications together within a single environment. The creation of a new, more standardized JSON syntax output improves the external interfaces for generating graphical components or for validating input file syntax. The design of this interface and the requirements it satisfies are covered in this short report.

Effect of ezetimibe add-on therapy over 52 weeks extension analysis of prospective randomized trial (RESEARCH study) in type 2 diabetes subjects.

PubMed

Sakamoto, Kentaro; Kawamura, Mitsunobu; Watanabe, Takayuki; Ashidate, Keiko; Kohro, Takahide; Tanaka, Akira; Mori, Yasumichi; Tagami, Motoki; Hirano, Tsutomu; Yamazaki, Tsutomu; Shiba, Teruo

2017-06-24

Lowering cholesterol levels decreases the risk of atherosclerotic diseases. Effective ways to stably reduce LDL-C level are warranted in type 2 diabetic patients, a high-risk population for CVD, with various anti-diabetic therapeutic background. The RESEARCH study focuses on LDL-C reduction in this population along with modifications of the lipid profiles. We evaluated long-term ezetimibe add-on therapy in T2DM patients with hypercholesterolemia. In a randomized, multicenter, open-label, prospective study, a total of 109 T2DM patients not attaining LDL-C target value despite first-line dose statin (10 mg of atorvastatin or 1 mg of pitavastatin) therapy in Japan were recruited. We investigated the difference in cholesterol lowering effect between ezetimibe (10 mg) add-on statin (EAT) group and double-dose statin (DST) group. Changes of parameters related to atherosclerotic event risks were assessed. The reduction of LDL-C was larger in the EAT group (28.3%) than in the DST group (9.2%) at 52 weeks as well as the primary endpoint of 12 weeks. EAT achieved significant lower levels of TC and apo B, respectively. Both treatments attained significant reduction in sd-LDL-C or hsCRP on this long-term basis. Notably, sd-LDL-C in EAT reduced as low as 36.1 ± 14.9 mg/dl to reach near the threshold (35.0 mg/dl) for atherosclerosis with significantly higher achievement rate (55.6%) than DST treatment. Simultaneously, hsCRP reduction by EAT attained as low value as 0.52 ± 0.43 mg/l. In the present 52-week long-term period, ezetimibe add-on therapy showed a robust advantage in lowering LDL-C and in attaining target LDL-C values compared with the doubling of statin dose. Moreover, it's meaningful that sd-LDL, powerfully atherogenic lipoprotein, exhibited prominent decrease consistently prominently by ezetimibe add-on therapy. DM patients with hypercholesterolemia are at high risk for CAD, and adding ezetimibe onto usual-dose statin treatment in Japan has been suggested as the first-line therapy for those DM patients who failed to attain the target LDL-C value (UMIN000002593).

Tertiary tilting and dismemberment of the laramide arc and related hydrothermal systems, Sierrita Mountain, Arizona

USGS Publications Warehouse

Stavast, W.J.A.; Butler, R.P.; Seedorff, E.; Barton, M.D.; Ferguson, C.A.

2008-01-01

Multiple lines of evidence, including new and published geologic mapping and paleomagnetic and geobarometric determinations, demonstrate that the rocks and large porphyry copper systems of the Sierrita Mountains in southern Arizona were dismembered and tilted 50?? to 60?? to the south by Tertiary normal faulting. Repetition of geologic features and geobarometry indicate that the area is segmented into at least three major structural blocks, and the present surface corresponds to oblique sections through the Laramide plutonic-hydrothermal complex, ranging in paleodepth from ???1 to ???12 km. These results add to an evolving view of a north-south extensional domain at high angles to much extension in the southern Basin and Range, contrast with earlier interpretations that the Laramide systems are largely upright and dismembered by thrust faults, highlight the necessity of restoring Tertiary rotations before interpreting Laramide structural and hydrothermal features, and add to the broader understanding of pluton emplacement and evolution of porphyry copper systems. ?? 2008 Society of Economic Geologists, Inc.

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

Zhang Xuenan; Zhang Yundong; Tian He

We propose to employ the storage of light in a dynamically tuned add-drop resonator to realize an optical gyroscope of ultrahigh sensitivity and compact size. Taking the impact of the linewidth of incident light on the sensitivity into account, we investigate the effect of rotation on the propagation of a partially coherent light field in this dynamically tuned slow-light structure. It is demonstrated that the fundamental trade-off between the rotation-detection sensitivity and the linewidth will be overcome and the sensitivity-linewidth product will be enhanced by two orders of magnitude in comparison to that of the corresponding static slow-light structure. Furthermore,more » the optical gyroscope employing the storage of light in the dynamically tuned add-drop resonator can acquire ultrahigh sensitivity by extremely short fiber length without a high-performance laser source of narrow linewidth and a complex laser frequency stabilization system. Thus the proposal in this paper provides a promising and feasible scheme to realize highly sensitive and compact integrated optical gyroscopes by slow-light structures.« less

The need for monetary information within corporate water accounting.

PubMed

Burritt, Roger L; Christ, Katherine L

2017-10-01

A conceptual discussion is provided about the need to add monetary data to water accounting initiatives and how best to achieve this if companies are to become aware of the water crisis and to take actions to improve water management. Analysis of current water accounting initiatives reveals the monetary business case for companies to improve water management is rarely considered, there being a focus on physical information about water use. Three possibilities emerge for mainstreaming the integration of monetization into water accounting: add-on to existing water accounting frameworks and tools, develop new tools which include physical and monetary information from the start, and develop environmental management accounting (EMA) into a water-specific application and set of tools. The paper appraises these three alternatives and concludes that development of EMA would be the best way forward. Suggestions for further research include the need to examine the use of a transdisciplinary method to address the complexities of water accounting. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sub-antimicrobial Doxycycline for Periodontitis Reduces Hemoglobin A1c in Subjects with Type 2 Diabetes: a Pilot Study

PubMed Central

Engebretson, Steven P.; Hey-Hadavi, Judith

2011-01-01

In vitro and animal studies suggest a possible role for the tetracycline class of drugs in the inhibition of non-enzymatic protein glycation. We conducted a 3-month, randomized placebo-controlled pilot clinical trial of conventional sub-gingival debridement, (periodontal therapy) combined with either a three month regimen of sub-antimicrobial-dose doxycycline (SDD), a two week regimen of antimicrobial-dose doxycycline (ADD), or placebo in 45 patients with long-standing type 2 diabetes (mean duration 9 years) and untreated chronic periodontitis. Subjects were taking stable doses of oral hypoglycemic medications and/or insulin. Treatment response was assessed by measuring hemoglobin A1c (HbA1c),plasma glucose, and clinical periodontal disease measures. At one-month and three-month follow-up, clinical measures of periodontitis were decreased in all groups(data to be presented elsewhere). At three months, mean HbA1c levels in the SDD group were reduced 0.9% unitsfrom 7.2% units ± 2.2(±SD), to 6.3% units ±1.1, which represents a 12.5% improvement. In contrast, there was no significant change in HbA1c in the ADD (7.5%± 2.0 to 7.8%± 2.1) or placebo (8.5%± 2.0 to 8.5%± 2.6) groups. Mean HbA1c change from baseline was significantly greater in the SDD group compared with the ADD group (p=0.04) but not placebo (p=0.22). Moreover, a larger proportion of subjects in the SDD group experienced improvement (p<0.05) compared to the ADD or placebo groups. Mean plasma glucose levels were not significantly different between or within the groups. The results of this pilot study suggest that the treatment of periodontitis with sub-gingival debridement and 3-months of daily sub-antimicrobial-dose doxycycline may decrease HbA1c in patients with type 2 diabetes taking normally prescribed hypoglycemic agents. PMID:21782948

Does One Size Fit Everyone? Replacement Dose of Levothyroxine in Long-standing Primary Hypothyroidism in Adults

PubMed Central

Singh, Rekha

2017-01-01

Objectives: The recommended starting dose of levothyroxine (LT4) in primary hypothyroidism is 1.6 μg/kg body weight and is based on presumption of minimal residual thyroid function in autoimmune hypothyroidism. This study aimed at finding the range and determining factors for LT4 dose in long-standing hypothyroidism. Methods: A cross-sectional study of individuals with primary autoimmune hypothyroidism on LT4 replacement was done between March 2015 and January 2016. Individuals enrolled were euthyroid based on recent serum thyroid-stimulating hormone. The inclusion criteria included LT4 intake in the morning empty stomach, maintenance of at least 1-h food gap, not on medications known to hamper LT4 absorption within 4 h of dosing, diagnosis of hypothyroidism at least for 1 year, and on a minimum 25 μg LT4. P < 0.05 was considered statistically significant. Results: A total of 346 individuals (290 women and 56 men; 214 premenopausal and 76 postmenopausal women) were enrolled. The mean duration of hypothyroidism and age were 5.7 years and 42.1 years, respectively. The range and mean of absolute LT4 daily dose (ADD), LT4 dose based on body weight (D/W), and LT4 dose based on ideal body weight (D/IBW) were 25–200 μg daily and 77.1 μg, 0.3–2.82 μg/kg and 1.21 μg/kg, and 0.42–3.5 μg/kg and 1.58 μg/kg, respectively. Duration of hypothyroidism was significant predictors of ADD, D/W, and D/IBW. Gender-based difference in ADD and D/IBW was explained by gender difference in anthropometry. Conclusion: Long-standing primary autoimmune hypothyroidism has variable dose requirement of LT4 for achieving euthyroidism and may be dependent on the degree of residual functional thyroid. Duration of hypothyroidism was significant positive predictor for either ADD, D/W, or D/IBW. PMID:28553595

Neuroendocrine and Inflammatory Responses to Losartan and Continuous Positive Airway Pressure in Patients with Hypertension and Obstructive Sleep Apnea. A Randomized Controlled Trial.

PubMed

Thunström, Erik; Manhem, Karin; Yucel-Lindberg, Tülay; Rosengren, Annika; Lindberg, Caroline; Peker, Yüksel

2016-11-01

Blood pressure reduction in response to antihypertensive agents is less for patients with obstructive sleep apnea (OSA). Increased sympathetic and inflammatory activity, as well as alterations in the renin-angiotensin-aldosterone system, may play a role in this context. To address the cardiovascular mechanisms involved in response to an angiotensin II receptor antagonist, losartan, and continuous positive airway pressure (CPAP) as add-on treatment for hypertension and OSA. Newly diagnosed hypertensive patients with or without OSA (allocated in a 2:1 ratio for OSA vs. no OSA) were treated with losartan 50 mg daily during a 6-week two-center, open-label, prospective, case-control, parallel-design study. In the second 6-week, sex-stratified, open-label, randomized, parallel-design study, all subjects with OSA continued to receive losartan and were randomly assigned to either CPAP as add-on therapy or to no CPAP (1:1 ratio for CPAP vs. no CPAP). Study subjects without OSA were followed in parallel while they continued to take losartan. Blood samples were collected at baseline, after 6 weeks, and after 12 weeks for analysis of renin, aldosterone, noradrenaline, adrenaline, and inflammatory markers. Fifty-four patients with OSA and 35 without OSA were included in the first 6-week study. Losartan significantly increased renin levels and reduced aldosterone levels in the group without OSA. There was no significant decrease in aldosterone levels among patients with OSA. Add-on CPAP treatment tended to lower aldosterone levels, but reductions were more pronounced in measures of sympathetic activity. No significant changes in inflammatory markers were observed following treatment with losartan and CPAP. Hypertensive patients with OSA responded to losartan treatment with smaller reductions in aldosterone compared with hypertensive patients without OSA. Sympathetic system activity seemed to respond primarily to add-on CPAP treatment in patients with newly discovered hypertension and OSA. Clinical trial registered with www.clinicaltrials.gov (NCT00701428).

Paradigm Shifts in Breast Care Delivery: Impact of Imaging in a Multidisciplinary Environment.

PubMed

Krishnamurthy, Savitri; Bevers, Therese; Kuerer, Henry M; Smith, Benjamin; Yang, Wei Tse

2017-02-01

The practice of breast imaging in a collaborative multidisciplinary environment adds significant value to outcomes in women's health care. In this article, we describe multidisciplinary considerations in breast cancer screening and early detection, the impact of imaging and histopathologic findings in the diagnostic evaluation and management of breast abnormalities, and the contribution of imaging to surgical and radiation therapy planning for the breast cancer patient. The multidisciplinary delivery of breast care for women that incorporates screening, diagnosis of borderline and high-risk lesions, and management of the breast cancer patient adds considerable value to outcomes in health care.

Minimalist Model Systems Reveal Similarities and Differences between Membrane Interaction Modes of MCL1 and BAK*

PubMed Central

Landeta, Olatz; Landajuela, Ane; Garcia-Saez, Ana; Basañez, Gorka

2015-01-01

Proteins belonging to the BCL2 family are key modulators of apoptosis that establish a complex network of interactions among themselves and with other cellular factors to regulate cell fate. It is well established that mitochondrial membranes are the main locus of action of all BCL2 family proteins, but it is difficult to obtain a precise view of how BCL2 family members operate at the native mitochondrial membrane environment during apoptosis. Here, we used minimalist model systems and multiple fluorescence-based techniques to examine selected membrane activities of MCL1 and BAK under apoptotic-like conditions. We show that three distinct apoptosis-related factors (i.e. the BCL2 homology 3 ligand cBID, the mitochondrion-specific lipid cardiolipin, and membrane geometrical curvature) all promote membrane association of BCL2-like structural folds belonging to both MCL1 and BAK. However, at the same time, the two proteins exhibited distinguishing features in their membrane association modes under apoptotic-like conditions. In addition, scanning fluorescence cross-correlation spectroscopy and FRET measurements revealed that the BCL2-like structural fold of MCL1, but not that of BAK, forms stable heterodimeric complexes with cBID in a manner adjustable by membrane cardiolipin content and curvature degree. Our results add significantly to a growing body of evidence indicating that the mitochondrial membrane environment plays a complex and active role in the mode of action of BCL2 family proteins. PMID:25987560

Visual acuity from far to near and contrast sensitivity in eyes with a diffractive multifocal intraocular lens with a low addition power.

PubMed

Hayashi, Ken; Manabe, Shin-Ichi; Hayashi, Hideyuki

2009-12-01

To compare visual acuity from far to near, contrast visual acuity, and acuity in the presence of glare (glare visual acuity) between an aspheric diffractive multifocal intraocular lens (IOL) with a low addition (add) power (+3.0 diopters) and a monofocal IOL. Hayashi Eye Hospital, Fukuoka, Japan. This prospective study comprised patients having implantation of an aspheric diffractive multifocal ReSTOR SN6AD1 IOL with a +3.0 D add (multifocal group) or a monofocal AcrySof IQ SN60WF IOL (monofocal group). Visual acuity from far to near distances, contrast acuity, and glare acuity were evaluated 3 months postoperatively. Each IOL group comprised 64 eyes of 32 patients. For monocular and binocular visual acuity, the mean uncorrected and distance-corrected intermediate acuity at 0.5 m and the near acuity at 0.3 m were significantly better in the multifocal group than in the monofocal group (P

Scapular Stabilization and Muscle Strength in Manual Wheelchair Users with Spinal Cord Injury and Subacromial Impingement.

PubMed

Wilbanks, Susan R; Bickel, C Scott

2016-01-01

Background: Manual wheelchair users with spinal cord injury (SCI) are frequently diagnosed with subacromial impingement. Objective: To determine whether the pattern of muscle imbalance and impaired scapular stabilization in able-bodied (AB) adults with impingement is different from that in manual wheelchair users with SCI and impingement. Methods: The following measurements were collected from 22 adults with subacromial impingement (11 SCI, 11 AB): ratio of normalized muscle electrical activity of upper and lower trapezius (UT:LT) during arm abduction; force during abduction, adduction, internal rotation, external rotation, and push and pull; ratios of force for abduction to adduction (AB:ADD), internal to external rotation (IR:ER), and push to pull (PUSH:PULL). Results: Shoulders with impingement had significantly higher UT:LT activation (1.46 ± 0.52) than shoulders without impingement (0.93 ± 0.45) ( P = .006), regardless of wheelchair user status. Significant differences between AB participants and those with SCI were observed for ABD:ADD ( P = .005), PUSH:PULL ( P = .012), and pull strength ( P = .043). Participants with SCI had a significantly greater ABD:ADD (1.37 ± 0.36) than AB participants (1.04 ± 0.22) ( P = .002) and a significantly greater PUSH:PULL (1.53 ± 0.36) than AB participants (1.26 ± 0.18) ( P = .005) because of decreased strength in adduction ( P = .021) and pull ( P = .013). Conclusions: Strategies targeting the posterior shoulder girdle for AB adults are appropriate for manual wheelchair users with SCI and impingement and should focus on scapular retractors and arm adductors with emphasis on scapular depression and posterior tilting.

Efficacy and Safety of Vildagliptin as an Add-On Therapy in Inadequately Controlled Type 2 Diabetes Patients Treated With Basal Insulin.

PubMed

Saito, Daisuke; Kanazawa, Akio; Shigihara, Nayumi; Sato, Fumihiko; Uchida, Toyoyoshi; Sato, Junko; Goto, Hiromasa; Miyatsuka, Takeshi; Ikeda, Fuki; Ogihara, Takeshi; Ohmura, Chie; Watada, Hirotaka

2017-03-01

The aim of this study was to investigate the efficacy and safety of vildagliptin as an add-on therapy for patients with type 2 diabetes mellitus inadequately controlled with basal insulin. Twenty-four patients treated with basal insulin and oral anti-diabetes drugs were randomly allocated into two groups: the control group (did not receive any add-on drugs) and vildagliptin group (received vildagliptin 100 mg/day for 6 months). The primary outcome was changes in hemoglobin A1c (HbA1c) from baseline to end of study. Treatment with vildagliptin significantly reduced HbA1c from 8.1±0.7% at baseline to 7.1±0.7% (P < 0.01), while there was no significant change of HbA1c in the control group. Vildagliptin group showed significant reduction of HbA1c compared with control group (-1.0±0.3% vs. 0.2±0.8%, P < 0.01). In addition, vildagliptin group showed a significant increase in 1,5-anhydroglucitol compared with the control group (4.5 ± 3.4 vs. 0.5 ± 4.1 μg/mL, P < 0.05). Mild hypoglycemia was reported in one patient of the vildagliptin group and two patients of the control group. Vildagliptin improved glycemic control without increasing hypoglycemia in Japanese type 2 diabetes inadequately controlled with basal insulin treatment and other oral anti-diabetes drugs. This study was registered with UMIN (University Hospital Medical Information Network ID#000010849).

Effects of rasagiline on freezing of gait in Parkinson's disease - an open-label, multicenter study.

PubMed

Cibulcik, Frantisek; Benetin, Jan; Kurca, Egon; Grofik, Milan; Dvorak, Miloslav; Richter, Denis; Donath, Vladimir; Kothaj, Jan; Minar, Michal; Valkovic, Peter

2016-12-01

Freezing of gait is a disabling symptom in advanced Parkinson's disease. Positive effects have been suggested with MAO-B inhibitors. We report on an open label clinical study on the efficacy of rasagiline as add-on therapy on freezing of gait and quality of life in patients with Parkinson's disease. Forty two patients with freezing of gait were treated with 1 mg rasagiline daily as an add-on therapy. Patients were assessed at baseline and after 1, 2 and 3 months of treatment. Freezing of gait severity was assessed using the Freezing of Gait Questionnaire, motor impairment by the modified MDS UPDRS part III, and quality of life using the PDQ-39 questionnaire. Patients treated with rasagiline had a statistically significant decrease in FoG-Q score and modified MDS UPDRS score after 1, 2 and 3 months of therapy. A moderately strong (r = 0.686, P = 0.002) correlation between the effects on mobility and freezing of gait was found. We also observed a statistically significant improvement in global QoL and in the subscales mobility, ADL, stigma and bodily discomfort in patients after 3 months of rasagiline therapy. A significant correlation (r = 0.570, P = 0.02) between baseline FoG-Q score and the baseline score for the PDQ Mobility subscale was found. In our study rasagiline as add-on antiparkinsonian therapy significantly improved mobility, freezing of gait and quality of life. The positive effect on freezing of gait appears to be related to improvement of mobility.

Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: A pilot, triple-blind, randomized clinical trial.

PubMed

Nejatbakhsh, Fatemeh; Karegar-Borzi, Hossein; Amin, Gholamreza; Eslaminejad, Alireza; Hosseini, Mostafa; Bozorgi, Mahbubeh; Gharabaghi, Mehrnaz Asadi

2017-01-20

In Traditional Iranian Medicine (TIM), Squill (Drimia maritima (L.) Stearn) Oxymel was utilized in the treatment of asthma. Squill has been reported to exert anti-inflammatory, anti-oxidant, anti-cholinergic, and mucus secretion modulating effects. This study aimed to make a preliminary evaluation of the efficacy and safety of an add-on Squill Oxymel treatment in patients with moderate to severe persistent asthma. In a 6-week, triple-blind, randomized, placebo-controlled trial, 60 patients with stable moderate to severe persistent asthma were randomly allocated to receive either 10ml syrup of Squill Oxymel, simple oxymel, or a placebo 2 times a day, as an add-on to their routine treatment (inhaled corticosteroids and β2 agonists). Spirometry and plethysmography were performed on patients to evaluate the effect of the treatment at baseline and end of intervention. Forced Expiratory Volume in first second (FEV1) was considered the primary outcome. St. George's respiratory questionnaire (SGRQ) was also used for the subjective evaluation of patients' responses. Fifty-four patients completed the study. The results showed significant improvement in spirometry parameters, especially FEV1 (1.54±.38 vs. 2.11±.49l), in the Squill Oxymel group compared with the other groups. The increases in FEV1 liter, FEV1%, FEV1/FVC%, and MEF 25-75% during the intervention were significantly higher in the Squill Oxymel group than in the other groups (p<.001). However, the improvement of plethysmographic parameters showed no significant difference between the study groups (p>.05). The SGRQ scores (symptoms, activity, and total score) were significantly improved after intervention in both the Squill Oxymel and the simple honey oxymel groups (p<.001), but not in the placebo group. Nausea and vomiting was reported in 5 patients in Squill oxymel and simple oxymel groups. No other serious adverse event was observed. The results of the current study show preliminary evidence for the efficacy and safety of the add-on treatment of Squill Oxymel in patients with moderate to severe persistent asthma. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Evolution and the complexity of bacteriophages.

PubMed

Serwer, Philip

2007-03-13

The genomes of both long-genome (> 200 Kb) bacteriophages and long-genome eukaryotic viruses have cellular gene homologs whose selective advantage is not explained. These homologs add genomic and possibly biochemical complexity. Understanding their significance requires a definition of complexity that is more biochemically oriented than past empirically based definitions. Initially, I propose two biochemistry-oriented definitions of complexity: either decreased randomness or increased encoded information that does not serve immediate needs. Then, I make the assumption that these two definitions are equivalent. This assumption and recent data lead to the following four-part hypothesis that explains the presence of cellular gene homologs in long bacteriophage genomes and also provides a pathway for complexity increases in prokaryotic cells: (1) Prokaryotes underwent evolutionary increases in biochemical complexity after the eukaryote/prokaryote splits. (2) Some of the complexity increases occurred via multi-step, weak selection that was both protected from strong selection and accelerated by embedding evolving cellular genes in the genomes of bacteriophages and, presumably, also archaeal viruses (first tier selection). (3) The mechanisms for retaining cellular genes in viral genomes evolved under additional, longer-term selection that was stronger (second tier selection). (4) The second tier selection was based on increased access by prokaryotic cells to improved biochemical systems. This access was achieved when DNA transfer moved to prokaryotic cells both the more evolved genes and their more competitive and complex biochemical systems. I propose testing this hypothesis by controlled evolution in microbial communities to (1) determine the effects of deleting individual cellular gene homologs on the growth and evolution of long genome bacteriophages and hosts, (2) find the environmental conditions that select for the presence of cellular gene homologs, (3) determine which, if any, bacteriophage genes were selected for maintaining the homologs and (4) determine the dynamics of homolog evolution. This hypothesis is an explanation of evolutionary leaps in general. If accurate, it will assist both understanding and influencing the evolution of microbes and their communities. Analysis of evolutionary complexity increase for at least prokaryotes should include analysis of genomes of long-genome bacteriophages.

Risk Analysis of On-Orbit Spacecraft Refueling Concepts

NASA Technical Reports Server (NTRS)

Cirillo, William M.; Stromgren, Chel; Cates, Grant R.

2010-01-01

On-orbit refueling of spacecraft has been proposed as an alternative to the exclusive use of Heavy-lift Launch Vehicles to enable human exploration beyond Low Earth Orbit (LEO). In these scenarios, beyond LEO spacecraft are launched dry (without propellant) or partially dry into orbit, using smaller or fewer element launch vehicles. Propellant is then launched into LEO on separate launch vehicles and transferred to the spacecraft. Refueling concepts are potentially attractive because they reduce the maximum individual payload that must be placed in Earth orbit. However, these types of approaches add significant complexity to mission operations and introduce more uncertainty and opportunities for failure to the mission. In order to evaluate these complex scenarios, the authors developed a Monte Carlo based discrete-event model that simulates the operational risks involved with such strategies, including launch processing delays, transportation system failures, and onorbit element lifetimes. This paper describes the methodology used to simulate the mission risks for refueling concepts, the strategies that were evaluated, and the results of the investigation. The results of the investigation show that scenarios that employ refueling concepts will likely have to include long launch and assembly timelines, as well as the use of spare tanker launch vehicles, in order to achieve high levels of mission success through Trans Lunar Injection.

Ethanol-Induced Effects on Sting Extension Response and Punishment Learning in the Western Honey Bee (Apis mellifera)

PubMed Central

Giannoni-Guzmán, Manuel A.; Giray, Tugrul; Agosto-Rivera, Jose Luis; Stevison, Blake K.; Freeman, Brett; Ricci, Paige; Brown, Erika A.; Abramson, Charles I.

2014-01-01

Acute ethanol administration is associated with sedation and analgesia as well as behavioral disinhibition and memory loss but the mechanisms underlying these effects remain to be elucidated. During the past decade, insects have emerged as important model systems to understand the neural and genetic bases of alcohol effects. However, novel assays to assess ethanol's effects on complex behaviors in social or isolated contexts are necessary. Here we used the honey bee as an especially relevant model system since bees are typically exposed to ethanol in nature when collecting standing nectar crop of flowers, and there is recent evidence for independent biological significance of this exposure for social behavior. Bee's inhibitory control of the sting extension response (SER) and a conditioned-place aversion assay were used to study ethanol effects on analgesia, behavioral disinhibition, and associative learning. Our findings indicate that although ethanol, in a dose-dependent manner, increases SER thresholds (analgesic effects), it disrupts the ability of honey bees to inhibit SER and to associate aversive stimuli with their environment. These results suggest that ethanol's effects on analgesia, behavioral disinhibition and associative learning are common across vertebrates and invertebrates. These results add to the use of honey bees as an ethanol model to understand ethanol's effects on complex, socially relevant behaviors. PMID:24988309

Toolkits Control Motion of Complex Robotics

NASA Technical Reports Server (NTRS)

2010-01-01

That space is a hazardous environment for humans is common knowledge. Even beyond the obvious lack of air and gravity, the extreme temperatures and exposure to radiation make the human exploration of space a complicated and risky endeavor. The conditions of space and the space suits required to conduct extravehicular activities add layers of difficulty and danger even to tasks that would be simple on Earth (tightening a bolt, for example). For these reasons, the ability to scout distant celestial bodies and perform maintenance and construction in space without direct human involvement offers significant appeal. NASA has repeatedly turned to complex robotics for solutions to extend human presence deep into space at reduced risk and cost and to enhance space operations in low Earth orbit. At Johnson Space Center, engineers explore the potential applications of dexterous robots capable of performing tasks like those of an astronaut during extravehicular activities and even additional ones too delicate or dangerous for human participation. Johnson's Dexterous Robotics Laboratory experiments with a wide spectrum of robot manipulators, such as the Mitsubishi PA-10 and the Robotics Research K-1207i robotic arms. To simplify and enhance the use of these robotic systems, Johnson researchers sought generic control methods that could work effectively across every system.

The kinetochore prevents centromere-proximal crossover recombination during meiosis

PubMed Central

Vincenten, Nadine; Kuhl, Lisa-Marie; Lam, Isabel; Oke, Ashwini; Kerr, Alastair RW; Hochwagen, Andreas; Fung, Jennifer; Keeney, Scott; Vader, Gerben; Marston, Adèle L

2015-01-01

During meiosis, crossover recombination is essential to link homologous chromosomes and drive faithful chromosome segregation. Crossover recombination is non-random across the genome, and centromere-proximal crossovers are associated with an increased risk of aneuploidy, including Trisomy 21 in humans. Here, we identify the conserved Ctf19/CCAN kinetochore sub-complex as a major factor that minimizes potentially deleterious centromere-proximal crossovers in budding yeast. We uncover multi-layered suppression of pericentromeric recombination by the Ctf19 complex, operating across distinct chromosomal distances. The Ctf19 complex prevents meiotic DNA break formation, the initiating event of recombination, proximal to the centromere. The Ctf19 complex independently drives the enrichment of cohesin throughout the broader pericentromere to suppress crossovers, but not DNA breaks. This non-canonical role of the kinetochore in defining a chromosome domain that is refractory to crossovers adds a new layer of functionality by which the kinetochore prevents the incidence of chromosome segregation errors that generate aneuploid gametes. DOI: http://dx.doi.org/10.7554/eLife.10850.001 PMID:26653857

Reporting the national antimicrobial consumption in Danish pigs: influence of assigned daily dosage values and population measurement.

PubMed

Dupont, Nana; Fertner, Mette; Kristensen, Charlotte Sonne; Toft, Nils; Stege, Helle

2016-05-03

Transparent calculation methods are crucial when investigating trends in antimicrobial consumption over time and between populations. Until 2011, one single standardized method was applied when quantifying the Danish pig antimicrobial consumption with the unit "Animal Daily Dose" (ADD). However, two new methods for assigning values for ADDs have recently emerged, one implemented by DANMAP, responsible for publishing annual reports on antimicrobial consumption, and one by the Danish Veterinary and Food Administration (DVFA), responsible for the Yellow Card initiative. In addition to new ADD assignment methods, Denmark has also experienced a shift in the production pattern, towards a larger export of live pigs. The aims of this paper were to (1) describe previous and current ADD assignment methods used by the major Danish institutions and (2) to illustrate how ADD assignment method and choice of population and population measurement affect the calculated national antimicrobial consumption in pigs (2007-2013). The old VetStat ADD-values were based on SPCs in contrast to the new ADD-values, which were based on active compound, concentration and administration route. The new ADD-values stated by both DANMAP and DVFA were only identical for 48 % of antimicrobial products approved for use in pigs. From 2007 to 2013, the total number of ADDs per year increased by 9 % when using the new DVFA ADD-values, but decreased by 2 and 7 % when using the new DANMAP ADD-values or the old VetStat ADD-values, respectively. Through 2007 to 2013, the production of pigs increased from 26.1 million pigs per year with 18 % exported live to 28.7 million with 34 % exported live. In the same time span, the annual pig antimicrobial consumption increased by 22.2 %, when calculated using the new DVFA ADD-values and pigs slaughtered per year as population measurement (13.0 ADDs/pig/year to 15.9 ADDs/pig/year). However, when based on the old VetStat ADD values and pigs produced per year (including live export), a 10.9 % decrease was seen (10.6 ADDs/pig/year to 9.4 ADDs/pig/year). The findings of this paper clearly highlight that calculated national antimicrobial consumption is highly affected by chosen population measurement and the applied ADD-values.

USP <800> Adds Significant Safety Standards: Facility Upgrades Needed to Protect Employees From Hazardous Drugs.

PubMed

Beans, Bruce E

2017-05-01

The new USP standard for handling hazardous drugs (HDs) will require millions of dollars in capital outlays for facility and equipment upgrades and also requires in-depth assessments of each HD that facilities handle, significant workflow and work practice changes, and thorough staff training.

Attention Deficit Disorder. NICHCY Briefing Paper.

ERIC Educational Resources Information Center

Fowler, Mary

This briefing paper uses a question-and-answer format to provide basic information about children with attention deficit disorder (ADD). Questions address the following concerns: nature and incidence of ADD; causes of ADD; signs of ADD (impulsivity, hyperactivity, disorganization, social skill deficits); the diagnostic ADD assessment; how to get…

Gender characteristics of cerebral hemodynamics during complex cognitive functioning.

PubMed

Misteli, Maria; Duschek, Stefan; Richter, André; Grimm, Simone; Rezk, Markus; Kraehenmann, Rainer; Boeker, Heinz; Seifritz, Erich; Schuepbach, Daniel

2011-06-01

Functional Transcranial Doppler sonography (fTCD) has been applied to assess peak mean cerebral blood flow velocity (MFV) with a high temporal resolution during cognitive activation. Yet, little attention has been devoted to gender-related alterations of MFV, including spectral analysis. In healthy subjects, fTCD was used to investigate a series of cerebral hemodynamic parameters in the middle cerebral arteries (MCA) during the Trail Making Tests (TMT), a means of selective attention and complex cognitive functioning. In females, there was a frequency peak at 0.375 Hz in both MCA, and we observed a dynamic shift in hemispheric dominance during that condition. Further, after the start phase, there was an MFV decline during complex functioning for the entire sample. These novel results suggest condition-specific features of cerebral hemodynamics in females, and it adds to the notion that gender is a fundamental confounder of brain physiology. Copyright © 2011 Elsevier Inc. All rights reserved.

Environmental Decision Making on Acid Mine Drainage Issues in South Africa: An Argument for the Precautionary Principle.

PubMed

Morodi, T J; Mpofu, Charles

2017-06-28

This paper examines the issue of acid mine drainage in South Africa and environmental decision making processes that could be taken to mitigate the problem in the context of both conventional risk assessment and the precautionary principle. It is argued that conventional risk assessment protects the status quo and hence cannot be entirely relied upon as an effective tool to resolve environmental problems in the context of South Africa, a developing country with complex environmental health concerns. The complexity of the environmental issues is discussed from historical and political perspectives. An argument is subsequently made that the precautionary principle is an alternative tool, and its adoption can be used to empower local communities. This work, therefore, adds to new knowledge by problematising conventional risk assessment and proposing the framing of the acid mine drainage issues in a complex and contextual scenario of a developing country-South Africa.

Progress in the Analysis of Complex Atmospheric Particles.

PubMed

Laskin, Alexander; Gilles, Mary K; Knopf, Daniel A; Wang, Bingbing; China, Swarup

2016-06-12

This article presents an overview of recent advances in field and laboratory studies of atmospheric particles formed in processes of environmental air-surface interactions. The overarching goal of these studies is to advance predictive understanding of atmospheric particle composition, particle chemistry during aging, and their environmental impacts. The diversity between chemical constituents and lateral heterogeneity within individual particles adds to the chemical complexity of particles and their surfaces. Once emitted, particles undergo transformation via atmospheric aging processes that further modify their complex composition. We highlight a range of modern analytical approaches that enable multimodal chemical characterization of particles with both molecular and lateral specificity. When combined, these approaches provide a comprehensive arsenal of tools for understanding the nature of particles at air-surface interactions and their reactivity and transformations with atmospheric aging. We discuss applications of these novel approaches in recent studies and highlight additional research areas to explore the environmental effects of air-surface interactions.

Robotics: The next step?

PubMed

Broeders, Ivo A M J

2014-02-01

Robotic systems were introduced 15 years ago to support complex endoscopic procedures. The technology is increasingly used in gastro-intestinal surgery. In this article, literature on experimental- and clinical research is reviewed and ergonomic issues are discussed. literature review was based on Medline search using a large variety of search terms, including e.g. robot(ic), randomized, rectal, oesophageal, ergonomics. Review articles on relevant topics are discussed with preference. There is abundant evidence of supremacy in performing complex endoscopic surgery tasks when using the robot in an experimental setting. There is little high-level evidence so far on translation of these merits to clinical practice. Robotic systems may appear helpful in complex gastro-intestinal surgery. Moreover, dedicated computer based technology integrated in telepresence systems opens the way to integration of planning, diagnostics and therapy. The first high tech add-ons such as near infrared technology are under clinical evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bread, beer and wine: yeast domestication in the Saccharomyces sensu stricto complex.

PubMed

Sicard, Delphine; Legras, Jean-Luc

2011-03-01

Yeasts of the Saccharomyces sensu stricto species complex are able to convert sugar into ethanol and CO(2) via fermentation. They have been used for thousands years by mankind for fermenting food and beverages. In the Neolithic times, fermentations were probably initiated by naturally occurring yeasts, and it is unknown when humans started to consciously add selected yeast to make beer, wine or bread. Interestingly, such human activities gave rise to the creation of new species in the Saccharomyces sensu stricto complex by interspecies hybridization or polyploidization. Within the S. cerevisiae species, they have led to the differentiation of genetically distinct groups according to the food process origin. Although the evolutionary history of wine yeast populations has been well described, the histories of other domesticated yeasts need further investigation. Copyright © 2011 Académie des sciences. Published by Elsevier SAS. All rights reserved.

Mapping the Habitable Zone of Exoplanets with a 2D Energy Balance Model

NASA Astrophysics Data System (ADS)

Moon, Nicole Taylor; Dr. Lisa Kaltenegger, Dr. Ramses Ramirez

2018-01-01

Traditionally, the habitable zone has been defined as the distance at which liquid water could exist on the surface of a rocky planet. However, different complexity models (simplified and fast:1D, and complex and time-intense:3D) models derive different boundaries for the habitable zone. The goal of this project was to test a new intermediate complexity 2D Energy Balance model, add a new ice albedo feedback mechanism, and derive the habitable zone boundaries. After completing this first project, we also studied how other feedback mechanisms, such as the presence of clouds and the carbonate-silicate cycle, effected the location of the habitable zone boundaries using this 2D model. This project was completed as part of a 2017 summer REU program hosted by Cornell's Center for Astrophysics and Plantary Sciecne and in partnership with the Carl Sagan Institute.

Progressive but Previously Untreated CLL Patients with Greater Array CGH Complexity Exhibit a Less Durable Response to Chemoimmunotherapy

PubMed Central

Kay, Neil E.; Eckel-Passow, Jeanette E.; Braggio, Esteban; VanWier, Scott; Shanafelt, Tait D.; Van Dyke, Daniel L.; Jelinek, Diane F.; Tschumper, Renee C.; Kipps, Thomas; Byrd, John C.; Fonseca, Rafael

2010-01-01

To better understand the implications of genomic instability and outcome in B-cell CLL, we sought to address genomic complexity as a predictor of chemosensitivity and ultimately clinical outcome in this disease. We employed array-based comparative genomic hybridization (aCGH), using a one-million probe array and identified gains and losses of genetic material in 48 patients treated on a chemoimmunotherapy (CIT) clinical trial. We identified chromosomal gain or loss in ≥6% of the patients on chromosomes 3, 8, 9, 10, 11, 12, 13, 14 and 17. Higher genomic complexity, as a mechanism favoring clonal selection, was associated with shorter progression-free survival and predicted a poor response to treatment. Of interest, CLL cases with loss of p53 surveillance showed more complex genomic features and were found both in patients with a 17p13.1 deletion and in the more favorable genetic subtype characterized by the presence of 13q14.1 deletion. This aCGH study adds information on the association between inferior trial response and increasing genetic complexity as CLL progresses. PMID:21156228

Benzocaine complexation with p-sulfonic acid calix[n]arene: experimental ((1) H-NMR) and theoretical approaches.

PubMed

Arantes, Lucas M; Varejão, Eduardo V V; Pelizzaro-Rocha, Karin J; Cereda, Cíntia M S; de Paula, Eneida; Lourenço, Maicon P; Duarte, Hélio A; Fernandes, Sergio A

2014-05-01

The aim of this work was to study the interaction between the local anesthetic benzocaine and p-sulfonic acid calix[n]arenes using NMR and theoretical calculations and to assess the effects of complexation on cytotoxicity of benzocaine. The architectures of the complexes were proposed according to (1) H NMR data (Job plot, binding constants, and ROESY) indicating details on the insertion of benzocaine in the cavity of the calix[n]arenes. The proposed inclusion compounds were optimized using the PM3 semiempirical method, and the electronic plus nuclear repulsion energy contributions were performed at the DFT level using the PBE exchange/correlation functional and the 6-311G(d) basis set. The remarkable agreement between experimental and theoretical approaches adds support to their use in the structural characterization of the inclusion complexes. In vitro cytotoxic tests showed that complexation intensifies the intrinsic toxicity of benzocaine, possibly by increasing the water solubility of the anesthetic and favoring its partitioning inside of biomembranes. © 2013 John Wiley & Sons A/S.

The validity of anthropometric leg muscle volume estimation across a wide spectrum: From able-bodied adults to individuals with a spinal cord injury

PubMed Central

Venturelli, Massimo; Jeong, Eun-Kee; Richardson, Russell S.

2014-01-01

The assessment of muscle volume, and changes over time, have significant clinical and research-related implications. Methods to assess muscle volume vary from simple and inexpensive to complex and expensive. Therefore this study sought to examine the validity of muscle volume estimated simply by anthropometry compared with the more complex proton magnetic resonance imaging (1H-MRI) across a wide spectrum of individuals including those with a spinal cord injury (SCI), a group recognized to exhibit significant muscle atrophy. Accordingly, muscle volume of the thigh and lower leg of eight subjects with a SCI and eight able-bodied subjects (controls) was determined by anthropometry and 1H-MRI. With either method, muscle volumes were significantly lower in the SCI compared with the controls (P < 0.05) and, using pooled data from both groups, anthropometric measurements of muscle volume were strongly correlated to the values assessed by 1H-MRI in both the thigh (r2 = 0.89; P < 0.05) and lower leg (r2 = 0.98; P < 0.05). However, the anthropometric approach systematically overestimated muscle volume compared with 1H-MRI in both the thigh (mean bias = 2407cm3) and the lower (mean bias = 170 cm3) leg. Thus with an appropriate correction for this systemic overestimation, muscle volume estimated from anthropometric measurements is a valid approach and provides acceptable accuracy across a spectrum of adults with normal muscle mass to a SCI and severe muscle atrophy. In practical terms this study provides the formulas that add validity to the already simple and inexpensive anthropometric approach to assess muscle volume in clinical and research settings. PMID:24458749

Longitudinal associations between key dietary behaviors and weight gain over time: Transitions through the adolescent years

PubMed Central

Laska, Melissa N.; Murray, David M.; Lytle, Leslie A.; Harnack, Lisa J.

2012-01-01

Previous studies have yielded inconsistent results in documenting the association between key dietary factors and adolescent weight change over time. The purpose of this study was to examine the extent to which changes in adolescent sugar-sweetened beverage, diet soda, breakfast and fast food consumption were associated with changes in BMI and percent body fat (PBF), both cross-sectionally and longitudinally. Our sample included 693 Minnesota adolescents followed over two years. Adjusting for physical activity, puberty, race, socio-economic status, age, and total energy intake, cross-sectional findings indicated that for both males and females, diet soda consumption was significantly and positively associated with BMI and PBF, and breakfast intake was significantly and negatively associated with BMI and PBF among girls. In longitudinal analyses, however, there were no significant associations after adjusting for the number of tests performed. This study adds to previous research through its methodological strengths, including adjustment for physical activity and energy intake assessed using state-of-the-art methods (i.e., accelerometers and 24-hour dietary recalls), as well as its evaluation of both BMI and PBF. Additional research is needed to better understand the complex constellation of factors that contribute to adolescent weight gain over time. PMID:21701567

Preliminary efficacy, safety, pharmacokinetics, pharmacodynamics and quality of life study of pegylated recombinant human arginase 1 in patients with advanced hepatocellular carcinoma.

PubMed

Yau, Thomas; Cheng, Paul N; Chan, Pierre; Chen, Li; Yuen, Jimmy; Pang, Roberta; Fan, Sheung Tat; Wheatley, Denys N; Poon, Ronnie T

2015-04-01

This study was designed to evaluate the efficacy, safety profile, pharmacokinetics, pharmacodynamics and quality of life of pegylated recombinant human arginase 1 (Peg-rhAgr1) in patients with advanced hepatocellular carcinoma (HCC). Patients were given weekly doses of Peg-rhAgr1 (1600 U/kg). Tumour response was assessed every 8 weeks using RECIST 1.1 and modified RECIST criteria. A total of 20 patients were recruited, of whom 15 were deemed evaluable for treatment efficacy. Eighteen patients (90%) were hepatitis B carriers. Median age was 61.5 (range 30-75). Overall disease control rate was 13%, with 2 of the 15 patients achieving stable disease for >8 weeks. The median progression-free survival (PFS) was 1.7 (95% CI: 1.67-1.73) months, with median overall survival (OS) of all 20 enrolled patients being 5.2 (95% CI: 3.3-12.0) months. PFS was significantly prolonged in patients with adequate arginine depletion (ADD) >2 months versus those who had ≤2 months of ADD (6.4 versus 1.7 months; p = 0.01). The majority of adverse events (AEs) were grade 1/2 non-hematological toxicities. Transient liver dysfunctions (25%) were the most commonly reported serious AEs and likely due to disease progression. Pharmacokinetic and pharmacodynamic data showed that Peg-rhAgr1 induced rapid and sustained arginine depletion. The overall quality of life of the enrolled patients was well preserved. Peg-rhAgr1 is well tolerated with a good toxicity profile in patients with advanced HCC. A weekly dose of 1600 U/kg is sufficient to induce ADD. Significantly longer PFS times were recorded for patients who had ADD for >2 months.

Depression and social phobia secondary to alcohol dependence.

PubMed

Olgiati, Paolo; Liappas, Ioannis; Malitas, Petros; Piperi, Christina; Politis, Antonis; Tzavellas, Elias O; Zisaki, Aikaterini; Ferrari, Barbara; De Ronchi, Diana; Kalofoutis, Anastasios; Serretti, Alessandro

2007-01-01

According to the self-medication hypothesis, individuals with depression and anxiety disorders use alcohol to control their symptoms and subsequently become dependent. Conversely, alcohol dependence disorder (ADD) can cause or exacerbate psychiatric disorders. This study analyzed the characteristics of depression and social phobia secondary to ADD. (1) What is their functional impact? (2) Are they independent or associated conditions? (3) Do they completely remit in abstinent individuals? (4) Is the remission of one disorder associated with the remission of the other disorder? Sixty-four inpatients with ADD were evaluated with depression and anxiety disorder scales upon admission to hospital and after 5 weeks of detoxification. Baseline comparisons differentiated patients with a Hamilton Rating Scale for Depression (HDRS) score > 35 (n = 50; 78%) from those with an HDRS score < or = 35 by higher levels of generalized anxiety and lower global functioning. Patients with generalized social phobia [Leibowitz Social Anxiety Scale (LSAS) score > 60: n = 20; 31.2%] were not distinguishable from those with an LSAS score < or = 60 by depressive and anxiety disorder symptoms. In postdetoxification assessment, patients who remitted from depression (HDRS score < 7: n = 35; 54.6%) had a lower generalized anxiety and marginally higher levels of hypochondriasis compared to nonremitter subjects (HDRS score > or = 7). Patients who remitted from social phobia (LSAS score < 30: n = 32; 50%) did not significantly differ from nonremitter subjects in depressive and anxiety disorder symptoms. Generalized anxiety (Hamilton Rating Scale for Anxiety) and hypochondriasis (Whiteley Index) were the significant predictors of global functioning (Global Assessment Scale). Depression and social phobia secondary to ADD are independent conditions that do not completely remit after cessation of drinking. Specific treatments are needed to reduce residual depressive and anxiety symptoms in abstinent alcoholics. 2008 S. Karger AG, Basel

Is there any relationship between ADHD symptoms and choosing sports education at the university?

PubMed

Gökçen, Cem; Unal, Ahmet; Alpak, Gökay; Cöpoglu, Umit Sertan; Abakay, Ugur; Bayar, Hasan; Bülbül, Feridun

2013-01-01

The goal of our study was to compare the incidence of Attention Deficit Hyperactivity Disorder (ADHD) observed in students at the School of Physical Education and Sports (SPES), which is a school that provides higher education in athletics, with that observed in students studying in other departments of the university. Our hypothesis was that people with ADHD most commonly turn to sports. The study enrolled 318 (75.7% of 420) students who were studying in the SPES of Gaziantep University; 277 students from the medical, nursing, administration, and engineering faculties were enrolled to serve as a control group. All students enrolled in the study were informed about the study before the lesson, and the students who agreed to participate provided written consent. Scales used in this study were: a sociodemographic information form which was prepared by the investigators, the Wender-Utah Rating Scale (WURS), and the Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale (ADD/ADHD). WURS scores were significantly higher (25.07 +/- 15.15 versus 21.37 +/- 14.28; p = 0.002) in the SPES group than the control group. In addition, the percentage of subjects with a WURS score above the cut-off of 36 was higher in the SPES group than the control group (22.4% versus 15.2%; p: 0.028). The two groups were not significantly different in terms of the subscales of the ADD/ADHD scale. A correlation was found between the educational achievement of the students in the SPES group and the ADD/ADHD-inattention subscale (r = .111, p = 0.015) and WURS scale (r = .113, p = 0.011). More systematic studies with larger samples in this domain will be useful in obtaining a clearer picture regarding professional attraction of people with ADHD to sports.

Energy supplies and future engines for land, sea, and air.

PubMed

Hidy, George M; Chow, Judith C; England, Glen C; Legge, Alan H; Lloyd, Alan C; Watson, John G

2012-11-01

The 2012 Critical Review Discussion complements Wilson, (2012), provides pointers to more detailed treatments of different topics and adds additional dimensions to the area of "energy". These include broader aspects of technologies driven by fuel resources and environmental issues, the concept of energy technology innovation, evolution in transportation resources, and complexities of energy policies addressing carbon taxes or carbon trading. National and global energy data bases are identified and evaluated and conversion factors are given to allow their comparability.

Simulation modeling for the health care manager.

PubMed

Kennedy, Michael H

2009-01-01

This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.

United States Air Force Summer Research Program 1991. Graduate Student Research Program (GSRP) Reports. Volume 6. Armstrong Laboratory, Wilford Hall Medical Center

DTIC Science & Technology

1992-01-09

necrosis and thus maintain viability during acute condi- tions of ischemia and compartmental syndrome . It is not known. how- ever, if HBO will continue...adds considerable incentive for flexible database design. Adding to the complexity of the database are emitter sector coverage, radiating power, and...rather, it supplements the time-weighted average(TWA) limit where there are recognized acute effects from a substance whose toxic effects are

Experiments on the emergence of human communication.

PubMed

Steels, Luc

2006-08-01

Children learn language from their parents and then use the acquired system throughout the rest of their life with little change. At least that is commonly assumed. But a recent paper by Galantucci adds to the growing evidence that adults (and children) are able to create and negotiate complex communication systems from scratch and relatively quickly, without a prior model. This raises questions of what cognitive mechanisms are implied in this joint construction of communication systems, and what the implications are for the origins of human language.

Mobility-Dependent Motion Planning for High Speed Robotic Vehicles

DTIC Science & Technology

2008-07-25

of the vehicle’s mobility in such type of terrain. Moreover, autonomous driv- ing of wheeled vehicles at high speeds adds a new level of complexity due...dynamic effects such as wheel slip, skidding, ballistic behavior, rollover, and vehicle-terrain interaction phenomena. Navigation algorithms must also...description of mobility was defined as the probability that for a given 6 ini ial v 10 ity at an initial po ition h robo will hav a non-n gative ve- loci y

Lost in Maps: Regionalization and Indigenous Health Services.

PubMed

Lavoie, Josée G; Kornelsen, Derek; Boyer, Yvonne; Wylie, Lloy

The settlement of the land now known as Canada meant the erasure - sometimes from ignorance, often purposeful - of Indigenous place-names, and understandings of territory and associated obligations. The Canadian map with its three territories and ten provinces, electoral boundaries and districts, reflects boundaries that continue to fragment Indigenous nations and traditional lands. Each fragment adds institutional requirements and organizational complexities that Indigenous nations must engage with when attempting to realize the benefits taken for granted under the Canadian social contract.

Trade and the environment: Discussion

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

Lutz, E.

1992-12-01

The author presents a synopsis of several papers on the issue of international trade and the environment. The papers address the following topics: the complex interrelationships of international trade, environment, and poverty in developing countries; environmental aspects of economic relations between nations; and the debate between environmentalists and free trade advocates. The author also adds comments about the US embargo on Mexican yellow-fin tuna imports, concluding that this unilateral embargo action, while initially creating tentions, may have provided a useful impetus to working out a multinational environmental standard.

An Overview of Advanced Data Acquisition System (ADAS)

NASA Technical Reports Server (NTRS)

Mata, Carlos T.; Steinrock, T. (Technical Monitor)

2001-01-01

The paper discusses the following: 1. Historical background. 2. What is ADAS? 3. R and D status. 4. Reliability/cost examples (1, 2, and 3). 5. What's new? 6. Technical advantages. 7. NASA relevance. 8. NASA plans/options. 9. Remaining R and D. 10. Applications. 11. Product benefits. 11. Commercial advantages. 12. intellectual property. Aerospace industry requires highly reliable data acquisition systems. Traditional Acquisition systems employ end-to-end hardware and software redundancy. Typically, redundancy adds weight, cost, power consumption, and complexity.

Vildagliptin: a new oral treatment for type 2 diabetes mellitus

PubMed Central

Mathieu, Chantal; Degrande, Evy

2008-01-01

Vildagliptin is a new oral antidiabetic agent that enhances pancreatic islet cell responsiveness to glucose. An extensive clinical program involving approximately 22,000 patients and 7000 patient-years of exposure to vildagliptin has shown that the agent is well tolerated and efficacious in improving glycemic control in patients with type 2 diabetes mellitus (T2DM). Monotherapy trials have shown that significant HbA1c lowering is accompanied by body weight-neutral and lipid-neutral effects, low risk of edema, and low risk of hypoglycemia. These characteristics make vildagliptin a favorable partner for combination therapy. Studies of vildagliptin as an add-on to metformin have shown significant improvements in glycemic control (comparable to that of thiazolidinedione add-on), with the combination being well tolerated and associated with low risks for hypoglycemia and adverse effects on weight or lipid levels. Good tolerability and clinically relevant improvements in glycemic control have also been observed with vildagliptin as an add-on treatment to sulfonylurea, thiazolidinedione, or insulin treatment or in initial combination treatment with pioglitazone. Improved β-cell function and glycemic control have been shown with vildagliptin in subjects with impaired glucose tolerance and in T2DM patients with mild hyperglycemia, with some evidence in the latter suggesting the potential for modifying disease course. PMID:19337548

Involvement of the MAPK pathway in the pressure-induced synovial metaplasia procedure for the temporomandibular joint.

PubMed

Wu, M J; Lu, H P; Gu, Z Y; Zhou, Y Q

2016-06-20

Abnormal pressure is an important factor that contributes to bone adaptation in the temporomandibular joint (TMJ). We determined the effect of the mitogen-activated protein kinases (MAPK) pathway on the pressure-induced synovial metaplasia procedure for the TMJ, both in vitro and in vivo. Synovial fibroblasts (SFs) were exacted from rat TMJs and exposed to different hydrostatic pressures. The protein extracts were analyzed to determine the activation of ERK1/2, JNK, and p38. Surgical anterior disc displacement (ADD) was also performed on Japanese rabbits, and the proteins of TMJ were isolated to analyze pressure-induced MAPK activation after 1, 2, 4, and 8 weeks. The results showed that the activation of ERK1/2 and JNK in SFs significantly changed with increasing hydrostatic pressure, whereas p38 activation did not change. Moreover, p38 was activated in animals 1 week after surgical ADD. The levels of p38 gradually increased after 2 and 4 weeks, and then slightly decreased but remained higher than in the control 8 weeks after surgical ADD. Nevertheless, JNK was rarely activated after the ADD treatment. Our findings suggest the involvement of MAPK activation in the pressure-induced synovial metaplasia procedure with pressure loading in TMJ.

Using protein-protein interactions for refining gene networks estimated from microarray data by Bayesian networks.

PubMed

Nariai, N; Kim, S; Imoto, S; Miyano, S

2004-01-01

We propose a statistical method to estimate gene networks from DNA microarray data and protein-protein interactions. Because physical interactions between proteins or multiprotein complexes are likely to regulate biological processes, using only mRNA expression data is not sufficient for estimating a gene network accurately. Our method adds knowledge about protein-protein interactions to the estimation method of gene networks under a Bayesian statistical framework. In the estimated gene network, a protein complex is modeled as a virtual node based on principal component analysis. We show the effectiveness of the proposed method through the analysis of Saccharomyces cerevisiae cell cycle data. The proposed method improves the accuracy of the estimated gene networks, and successfully identifies some biological facts.

KSC-07pd2373

NASA Image and Video Library

2007-08-24

KENNEDY SPACE CENTER, FLA. -- A close-up view of the LO2 feed line bracket with the BX265foam insulation and super lightweight ablator, or SLA, cork insulation removed. The BX265 foam insulation will later be reapplied without the SLA. The tank is scheduled to fly on Space Shuttle Discovery in October 2007 on mission STS-120. Discovery's crew will add the module Harmony that will serve as a port for installing additional international laboratories. Harmony will be the first expansion of the living and working space on the complex since the Russian Pirs airlock was installed in 2001. The mission also will move the first set of solar arrays installed on the station to a permanent location on the complex and redeploy them. Photo credit: NASA/Jim Grossmann

Floodlights illuminate view of Skylab 3 vehicle at Pad B, Launch Complex 39

NASA Image and Video Library

1973-07-20

S73-32568 (20 July 1973) --- Floodlights illuminate this nighttime view of the Skylab 3/Saturn 1B space vehicle at Pad B, Launch Complex 39, Kennedy Space Center, Florida, during prelaunch preparations. The reflection is the water adds to the scene. In addition to the Command/Service Module and its launch escapte system, the Skylab 3 space vehicle consists of the Saturn 1B first (S-1B) stage and the Saturn 1B second (S-IVB) stage. The crew for the scheduled 59-day Skylab 3 mission in Earth orbit will be astronauts Alan L. Bean, Owen K. Garriott and Jack R. Lousma. Skylab 3 was launched on July 28, 1973. Photo credit: NASA

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

Fehrenbacher, Jennifer S.; Russell, Ann D.; Davis, Catherine V.

Mg/Ca ratios of planktic foraminifera are commonly used to reconstruct past ocean temperatures. However, intrashell Mg/Ca ratios exhibit a pattern of alternating high and low Mg-bands in many species. Whereas mechanisms controlling Mg variability are poorly constrained, recent experiments demonstrate that it is paced by the diurnal light/dark cycle in Orbulina universa, which forms a terminal shell of simple spherical geometry. It is unknown whether Mg-heterogeneity is diurnally paced in species with complex shell morphologies, or is the result of growth processes. Here, we show that high Mg/Ca-calcite also forms at night in cultured specimens of the multi-chambered planktic foraminiferamore » Neogloboquadrina dutertrei. Our results demonstrate that N. dutertrei adds a significant amount of calcite, and nearly all Mg-bands, after the final chamber forms. Furthermore, these results have implications for interpreting patterns of calcification in N. dutertrei, and possibly other foraminifera species, and suggests diurnal Mg-banding is an intrinsic component of biomineralization in planktic foraminifera.« less

Link between light-triggered Mg-banding and chamber formation in the planktic foraminifera Neogloboquadrina dutertrei

NASA Astrophysics Data System (ADS)

Fehrenbacher, Jennifer S.; Russell, Ann D.; Davis, Catherine V.; Gagnon, Alexander C.; Spero, Howard J.; Cliff, John B.; Zhu, Zihua; Martin, Pamela

2017-05-01

The relationship between seawater temperature and the average Mg/Ca ratios in planktic foraminifera is well established, providing an essential tool for reconstructing past ocean temperatures. However, many species display alternating high and low Mg-bands within their shell walls that cannot be explained by temperature alone. Recent experiments demonstrate that intrashell Mg variability in Orbulina universa, which forms a spherical terminal shell, is paced by the diurnal light/dark cycle. Whether Mg-heterogeneity is also diurnally paced in species with more complex shell morphologies is unknown. Here we show that high Mg/Ca-calcite forms at night in cultured specimens of the multi-chambered species Neogloboquadrina dutertrei. Our results demonstrate that N. dutertrei adds a significant amount of calcite, and nearly all Mg-bands, after the final chamber forms. These results have implications for interpreting patterns of calcification in N. dutertrei and suggest that diurnal Mg-banding is an intrinsic component of biomineralization in planktic foraminifera.

Internal Waves in the East Australian Current

NASA Astrophysics Data System (ADS)

Alford, Matthew H.; Sloyan, Bernadette M.; Simmons, Harper L.

2017-12-01

Internal waves, which drive most ocean turbulence and add "noise" to lower-frequency records, interact with low-frequency current systems and topography in yet poorly known ways. Taking advantage of a heavily instrumented, 14 month mooring array, internal waves in the East Australian Current (EAC) are examined for the first time. Internal wave horizontal kinetic energy (HKE) is within a factor of 2 of the Garrett-Munk (1976) spectrum. Continuum internal waves, near-inertial waves, and internal tides together constitute a significant percentage of the total velocity variance. Mode-1 internal tide energy fluxes are southward and much smaller than energy times group velocity, consistent with reflection at the continental slope of incident waves generated from near New Caledonia and the Solomon Islands. Internal tide HKE is highly phase variable, consistent with refraction by the variable EAC. Mode-1 near-inertial wave energy fluxes are of comparable magnitude and are equatorward and episodic, consistent with generation by storms farther poleward. These processes are considered together in the complex environment of the EAC.

A system dynamics approach to understanding the One Health concept

PubMed Central

Liu, Wenbao; Anderson, Benjamin D.; Liu, Xiaorong; Gray, Gregory C.

2017-01-01

There have been many terms used to describe the One Health concept, including movement, strategy, framework, agenda, approach, among others. However, the inter-relationships of the disciplines engaged in the One Health concept have not been well described. To identify and better elucidate the internal feedback mechanisms of One Health, we employed a system dynamics approach. First, a systematic literature review was conducted via searches in PubMed, Web of Knowledge, and ProQuest with the search terms: ‘One Health’ and (concept* or approach*). In addition, we used the HistCite® tool to add significant articles on One Health to the library. Then, of the 2368 articles identified, 19 were selected for evaluating the inter-relationships of disciplines engaged in One Health. Herein, we report a visually rich, theoretical model regarding interactions of various disciplines and complex problem descriptors engaged in One Health problem solving. This report provides a conceptual framework for future descriptions of the interdisciplinary engagements involved in One Health. PMID:28877267

Hormonal and dietary factors in acne vulgaris versus controls.

PubMed

Stewart, Thomas Jonathan; Bazergy, Carl

2018-01-01

Background : Acne vulgaris is an inflammatory skin disorder with not as yet fully understood pathogenesis. In this controlled study, we assessed acne vulgaris patients for several possible pathogenic factors such as vitamin D deficiency, vegan diet, increased body mass index (BMI) and positive anti-transglutaminase antibody. Methods : We screened 10 years of records at a family medicine clinic for patients diagnosed with acne vulgaris. In eligible subjects, we collected data regarding 25-hydroxylvitamin D levels, BMI, dietary preference and serum IgA tissue transglutaminase levels. Controls were age- (+/- 12 months) and sex-matched patients seen during the study period without a diagnosis of acne vulgaris. Results : 453 patients were given a diagnosis of acne vulgaris during the study period. Compared with controls, we found significant associations between vitamin D deficiency (<50nmol/L), and/or positive transglutaminase antibody level (>4.0U/mL) and a diagnosis of acne vulgaris. Conclusions : Our study adds important information to the current body of literature in pursuit of elucidating the pathogenesis of this complex multifactorial disease.

µ-XRF Studies on the Colour Brilliance in Ancient Wool Carpets

PubMed Central

Meyer, Markus; Borca, Camelia N.; Huthwelker, Thomas; Bieber, Manfred; Meßlinger, Karl; Fink, Rainer H.

2017-01-01

Many handmade ancient and recent oriental wool carpets show outstanding brilliance and persistence of colour that is not achieved by common industrial dyeing procedures. Anthropologists have suggested the influence of wool fermentation prior to dyeing as key technique to achieve the high dyeing quality. By means of μ-XRF elemental mapping of mordant metals we corroborate this view and show a deep and homogenous penetration of colourants into fermented wool fibres. Furthermore we are able to apply this technique and prove that the fermentation process for ancient specimens cannot be investigated by standard methods due to the lack of intact cuticle layers. This finding suggests a broad range of further investigations that will contribute to a deeper understanding of the development of traditional dyeing techniques. Spectroscopic studies add information on the oxidation states of the metal ions within the respective mordant-dye-complexes and suggest a partial charge transfer as basis for a significant colour change when Fe mordants are used. PMID:29109824

Examining age-related movement representations for sequential (fine-motor) finger movements.

PubMed

Gabbard, Carl; Caçola, Priscila; Bobbio, Tatiana

2011-12-01

Theory suggests that imagined and executed movement planning relies on internal models for action. Using a chronometry paradigm to compare the movement duration of imagined and executed movements, we tested children aged 7-11 years and adults on their ability to perform sequential finger movements. Underscoring this tactic was our desire to gain a better understanding of the age-related ability to create internal models for action requiring fine-motor movements. The task required number recognition and ordering and was presented in three levels of complexity. Results for movement duration indicated that 7-year-olds and adults were different from the other groups with no statistical distinction between 9- and 11-year-olds. Correlation analysis indicated a significant relationship between imagined and executed actions. These results are the first to document the increasing convergence between imagined and executed movements in the context of fine-motor behavior; a finding that adds to our understanding of action representation in children. Copyright © 2011 Elsevier Inc. All rights reserved.

The business of palliative medicine--part 4: Potential impact of an acute-care palliative medicine inpatient unit in a tertiary care cancer center.

PubMed

Walsh, Declan

2004-01-01

In this study, a hematology/oncology computerized discharge database was qualitatively and quantitatively reviewed using an empirical methodology. The goal was to identify potential patients for admission to a planned acute-care, palliative medicine inpatient unit. Patients were identified by the International Classifications of Disease (ICD-9) codes. A large heterogenous population, comprising up to 40 percent of annual discharges from the Hematology/Oncology service, was identified. If management decided to add an acute-care, palliative medicine unit to the hospital, these are the patients who would benefit. The study predicted a significant change in patient profile, acuity, complexity, and resource utilization in current palliative care services. This study technique predicted the actual clinical load of the acute-care unit when it opened and was very helpful in program development. Our model predicted that 695 patients would be admitted to the acute-care palliative medicine unit in the first year of operation; 655 patients were actually admitted during this time.

Fatigue Damage of Collagenous Tissues: Experiment, Modeling and Simulation Studies

PubMed Central

Martin, Caitlin; Sun, Wei

2017-01-01

Mechanical fatigue damage is a critical issue for soft tissues and tissue-derived materials, particularly for musculoskeletal and cardiovascular applications; yet, our understanding of the fatigue damage process is incomplete. Soft tissue fatigue experiments are often difficult and time-consuming to perform, which has hindered progress in this area. However, the recent development of soft-tissue fatigue-damage constitutive models has enabled simulation-based fatigue analyses of tissues under various conditions. Computational simulations facilitate highly controlled and quantitative analyses to study the distinct effects of various loading conditions and design features on tissue durability; thus, they are advantageous over complex fatigue experiments. Although significant work to calibrate the constitutive models from fatigue experiments and to validate predictability remains, further development in these areas will add to our knowledge of soft-tissue fatigue damage and will facilitate the design of durable treatments and devices. In this review, the experimental, modeling, and simulation efforts to study collagenous tissue fatigue damage are summarized and critically assessed. PMID:25955007

Benchmark tests for a Formula SAE Student car prototyping

NASA Astrophysics Data System (ADS)

Mariasiu, Florin

2011-12-01

Aerodynamic characteristics of a vehicle are important elements in its design and construction. A low drag coefficient brings significant fuel savings and increased engine power efficiency. In designing and developing vehicles trough computer simulation process to determine the vehicles aerodynamic characteristics are using dedicated CFD (Computer Fluid Dynamics) software packages. However, the results obtained by this faster and cheaper method, are validated by experiments in wind tunnels tests, which are expensive and were complex testing equipment are used in relatively high costs. Therefore, the emergence and development of new low-cost testing methods to validate CFD simulation results would bring great economic benefits for auto vehicles prototyping process. This paper presents the initial development process of a Formula SAE Student race-car prototype using CFD simulation and also present a measurement system based on low-cost sensors through which CFD simulation results were experimentally validated. CFD software package used for simulation was Solid Works with the FloXpress add-on and experimental measurement system was built using four piezoresistive force sensors FlexiForce type.

Structural and molecular basis of mismatch correction and ribavirin excision from coronavirus RNA.

PubMed

Ferron, François; Subissi, Lorenzo; Silveira De Morais, Ana Theresa; Le, Nhung Thi Tuyet; Sevajol, Marion; Gluais, Laure; Decroly, Etienne; Vonrhein, Clemens; Bricogne, Gérard; Canard, Bruno; Imbert, Isabelle

2018-01-09

Coronaviruses (CoVs) stand out among RNA viruses because of their unusually large genomes (∼30 kb) associated with low mutation rates. CoVs code for nsp14, a bifunctional enzyme carrying RNA cap guanine N7-methyltransferase (MTase) and 3'-5' exoribonuclease (ExoN) activities. ExoN excises nucleotide mismatches at the RNA 3'-end in vitro, and its inactivation in vivo jeopardizes viral genetic stability. Here, we demonstrate for severe acute respiratory syndrome (SARS)-CoV an RNA synthesis and proofreading pathway through association of nsp14 with the low-fidelity nsp12 viral RNA polymerase. Through this pathway, the antiviral compound ribavirin 5'-monophosphate is significantly incorporated but also readily excised from RNA, which may explain its limited efficacy in vivo. The crystal structure at 3.38 Å resolution of SARS-CoV nsp14 in complex with its cofactor nsp10 adds to the uniqueness of CoVs among RNA viruses: The MTase domain presents a new fold that differs sharply from the canonical Rossmann fold.

Complexity analysis of fetal heart rate preceding intrauterine demise.

PubMed

Schnettler, William T; Goldberger, Ary L; Ralston, Steven J; Costa, Madalena

2016-08-01

Visual non-stress test interpretation lacks the optimal specificity and observer-agreement of an ideal screening tool for intrauterine fetal demise (IUFD) syndrome prevention. Computational methods based on traditional heart rate variability have also been of limited value. Complexity analysis probes properties of the dynamics of physiologic signals that are otherwise not accessible and, therefore, might be useful in this context. To explore the association between fetal heart rate (FHR) complexity analysis and subsequent IUFD. Our specific hypothesis is that the complexity of the fetal heart rate dynamics is lower in the IUFD group compared with controls. This case-control study utilized cases of IUFD at a single tertiary-care center among singleton pregnancies with at least 10min of continuous electronic FHR monitoring on at least 2 weekly occasions in the 3 weeks immediately prior to fetal demise. Controls delivered a live singleton beyond 35 weeks' gestation and were matched to cases by gestational age, testing indication, and maternal age in a 3:1 ratio. FHR data was analyzed using the multiscale entropy (MSE) method to derive their complexity index. In addition, pNNx, a measure of short-term heart rate variability, which in adults is ascribable primarily to cardiac vagal tone modulation, was also computed. 211 IUFDs occurred during the 9-year period of review, but only 6 met inclusion criteria. The median gestational age at the time of IUFD was 35.5 weeks. Three controls were matched to each case for a total of 24 subjects, and 87 FHR tracings were included for analysis. The median gestational age at the first fetal heart rate tracing was similar between groups (median [1st-3rd quartiles] weeks: IUFD cases: 34.7 (34.4-36.2); controls: 35.3 (34.4-36.1); p=.94). The median complexity of the cases' tracings was significantly less than the controls' (12.44 [8.9-16.77] vs. 17.82 [15.21-22.17]; p<.0001). Furthermore, the cases' median complexity decreased as gestation advanced whereas the controls' median complexity increased over time. However, this difference was not statistically significant [-0.83 (-2.03 to 0.47) vs. 0.14 (-1.25 to 0.94); p=.62]. The degree of short-term variability of FHR tracings, as measured by the pNN metric, was significantly lower (p<.005) for the controls (1.1 [0.8-1.3]) than the IUFD cases (1.3 [1.1-1.6]). FHR complexity analysis using multiscale entropy analysis may add value to other measures in detecting and monitoring pregnancies at the highest risk for IUFD. The decrease in complexity and short-term variability seen in the IUFD cases may reflect perturbations in neuroautonomic control due to multiple maternal-fetal factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Exploring the optimum step size for defocus curves.

PubMed

Wolffsohn, James S; Jinabhai, Amit N; Kingsnorth, Alec; Sheppard, Amy L; Naroo, Shehzad A; Shah, Sunil; Buckhurst, Phillip; Hall, Lee A; Young, Graeme

2013-06-01

To evaluate the effect of reducing the number of visual acuity measurements made in a defocus curve on the quality of data quantified. Midland Eye, Solihull, United Kingdom. Evaluation of a technique. Defocus curves were constructed by measuring visual acuity on a distance logMAR letter chart, randomizing the test letters between lens presentations. The lens powers evaluated ranged between +1.50 diopters (D) and -5.00 D in 0.50 D steps, which were also presented in a randomized order. Defocus curves were measured binocularly with the Tecnis diffractive, Rezoom refractive, Lentis rotationally asymmetric segmented (+3.00 D addition [add]), and Finevision trifocal multifocal intraocular lenses (IOLs) implanted bilaterally, and also for the diffractive IOL and refractive or rotationally asymmetric segmented (+3.00 D and +1.50 D adds) multifocal IOLs implanted contralaterally. Relative and absolute range of clear-focus metrics and area metrics were calculated for curves fitted using 0.50 D, 1.00 D, and 1.50 D steps and a near add-specific profile (ie, distance, half the near add, and the full near-add powers). A significant difference in simulated results was found in at least 1 of the relative or absolute range of clear-focus or area metrics for each of the multifocal designs examined when the defocus-curve step size was increased (P<.05). Faster methods of capturing defocus curves from multifocal IOL designs appear to distort the metric results and are therefore not valid. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Lamotrigine add-on for drug-resistant partial epilepsy.

PubMed

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

2001-01-01

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

Lamotrigine add-on for drug-resistant partial epilepsy.

PubMed

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

2000-01-01

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

DART: Delta Advanced Reusable Transport. An alternate manned space system proposal

NASA Technical Reports Server (NTRS)

1991-01-01

The Delta Advanced Reusable Transport (DART) craft is being developed to add, multiple, rapid, and cost effective space access to the U.S. capability and to further the efforts towards a permanent space presence. The DART craft provides an augmentative and an alternative system to the Shuttle. As a supplement launch vehicle, the DART adds low cost and easily accessible transport of crew and cargo to specific space destinations to the U.S. program. This adds significant opportunities for manned rated missions that do not require Shuttle capabilities. In its alternative role, the DART can provide emergency space access and satellite repair, the continuation of scientific research, and the furthering of U.S. manned efforts in the event of Shuttle incapabilities. In addition, the DART is being designed for Space Station Freedom compatibility, including its use as a 'lifeboat' emergency reentry craft for Freedom astronauts, as well as the transport of crew and cargo for station resupply.

A Framework for Dynamic Constraint Reasoning Using Procedural Constraints

NASA Technical Reports Server (NTRS)

Jonsson, Ari K.; Frank, Jeremy D.

1999-01-01

Many complex real-world decision and control problems contain an underlying constraint reasoning problem. This is particularly evident in a recently developed approach to planning, where almost all planning decisions are represented by constrained variables. This translates a significant part of the planning problem into a constraint network whose consistency determines the validity of the plan candidate. Since higher-level choices about control actions can add or remove variables and constraints, the underlying constraint network is invariably highly dynamic. Arbitrary domain-dependent constraints may be added to the constraint network and the constraint reasoning mechanism must be able to handle such constraints effectively. Additionally, real problems often require handling constraints over continuous variables. These requirements present a number of significant challenges for a constraint reasoning mechanism. In this paper, we introduce a general framework for handling dynamic constraint networks with real-valued variables, by using procedures to represent and effectively reason about general constraints. The framework is based on a sound theoretical foundation, and can be proven to be sound and complete under well-defined conditions. Furthermore, the framework provides hybrid reasoning capabilities, as alternative solution methods like mathematical programming can be incorporated into the framework, in the form of procedures.

Biochemical conversion of sugarcane straw hemicellulosic hydrolyzate supplemented with co-substrates for xylitol production.

PubMed

Hernández-Pérez, A F; Costa, I A L; Silva, D D V; Dussán, K J; Villela, T R; Canettieri, E V; Carvalho, J A; Soares Neto, T G; Felipe, M G A

2016-01-01

Biotechnological production of xylitol is an attractive route to add value to a sugarcane biorefinery, through utilization of the hemicellulosic fraction of sugarcane straw, whose availability is increasing in Brazil. Herein, supplementation of the sugarcane straw hemicellulosic hydrolyzate (xylose 57gL(-1)) with maltose, sucrose, cellobiose or glycerol was proposed, and their effect as co-substrates on xylitol production by Candida guilliermondii FTI 20037 was studied. Sucrose (10gL(-1)) and glycerol (0.7gL(-1)) supplementation led to significant increase of 8.88% and 6.86% on xylose uptake rate (1.11gL(-1)h(-1) and 1.09gL(-1)), respectively, but only with sucrose, significant increments of 12.88% and 8.69% on final xylitol concentration (36.11gL(-1)) and volumetric productivity (0.75gL(-1)h(-1)), respectively, were achieved. Based on these results, utilization of complex sources of sucrose, derived from agro-industries, as nutritional supplementation for xylitol production can be proposed as a strategy for improving the yeast performance and reducing the cost of this bioprocess by replacing more expensive nutrients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychological distress and the role of significant others in a population of gay/bisexual men in the era of HIV.

PubMed

Britton, P J; Zarski, J J; Hobfoll, S E

1993-01-01

This study, based on The Conservation of Resources Theory (COR), explores the relationship between social resources and psychological distress, as reported by gay/bisexual men who are at varying degrees of risk for HIV. This study involves theory-based stress research, and adds to the body of literature that addresses social support and gay men. Specific emphasis was placed on the process of social support by significant others in relationship to the devastating impact HIV has on the gay/bisexual community. The investigators employed an ex-post facto design that was guided by past and present theoretical and empirical data, and by specific research hypotheses. The findings suggest that facets of social support appear to be interactively related to the perceived threat of HIV in predicting distress. In general, this study supports COR theory in that resources were related to the experience of psychological distress, yet it emphasizes that the relationship between support and gay men is complex, and thus generalizations from findings based on research with the majority culture may not apply to a population of gay/bisexual men. Implications for future research are also provided.

Influence of anxiety on memory performance in temporal lobe epilepsy

PubMed Central

Brown, Franklin C.; Westerveld, Michael; Langfitt, John T.; Hamberger, Marla; Hamid, Hamada; Shinnar, Shlomo; Sperling, Michael R.; Devinsky, Orrin; Barr, William; Tracy, Joseph; Masur, David; Bazil, Carl W.; Spencer, Susan S.

2013-01-01

This study examined the degree to which anxiety contributed to inconsistent material-specific memory difficulties among 243 temporal lobe epilepsy patients from the Multisite Epilepsy Study. Visual memory performance on the Rey Complex Figure Test (RCFT) was lower for those with high versus low level of anxiety, but was not found to be related to side of TLE. Verbal memory on the California Verbal Learning Test (CVLT) was significantly lower for left than right TLE patients with low anxiety, but equally impaired for those with high anxiety. These results suggest that we can place more confidence in the ability of verbal memory tests like the CVLT to lateralize to left TLE for those with low anxiety, but that verbal memory will be less likely to produce lateralizing information for those with high anxiety. This suggests that more caution is needed when interpreting verbal memory tests for those with high anxiety. These results indicated that RCFT performance was significantly affected by anxiety and did not lateralize to either side, regardless of anxiety level. This study adds to the existing literature which suggests that drawing-based visual memory tests do not lateralize among TLE patients, regardless of anxiety level. PMID:24291525

Framing climate change and spatial planning: how risk communication can be improved.

PubMed

de Boer, J

2007-01-01

Taking the role of frames into account may significantly add to the tools that have been developed for communication and learning on complex risks and benefits. As part of a larger multidisciplinary study into climate-related forms of sense-making this paper explores which frames are used by the citizens of Western European countries and, in particular, the Netherlands. Three recent multi-national public opinion surveys were analysed to examine beliefs about climate change in the context of beliefs about energy technology and concerns about other environmental issues, such as natural disasters. It appeared that many citizens had only vague ideas about the energy situation and that these do not constitute an unequivocal frame for climate issues. In contrast, the results suggest that the long-lasting rainfall and severe floods in Central Europe have had a significant impact. Climate change was often framed in a way that articulates its associations with rain- and river-based problems. This result is extremely important for risk communication, because especially in the Netherlands with its vulnerable coastal zones climate change may produce many more consequences than rain- and river-based problems only.

PLOT3D Export Tool for Tecplot

NASA Technical Reports Server (NTRS)

Alter, Stephen

2010-01-01

The PLOT3D export tool for Tecplot solves the problem of modified data being impossible to output for use by another computational science solver. The PLOT3D Exporter add-on enables the use of the most commonly available visualization tools to engineers for output of a standard format. The exportation of PLOT3D data from Tecplot has far reaching effects because it allows for grid and solution manipulation within a graphical user interface (GUI) that is easily customized with macro language-based and user-developed GUIs. The add-on also enables the use of Tecplot as an interpolation tool for solution conversion between different grids of different types. This one add-on enhances the functionality of Tecplot so significantly, it offers the ability to incorporate Tecplot into a general suite of tools for computational science applications as a 3D graphics engine for visualization of all data. Within the PLOT3D Export Add-on are several functions that enhance the operations and effectiveness of the add-on. Unlike Tecplot output functions, the PLOT3D Export Add-on enables the use of the zone selection dialog in Tecplot to choose which zones are to be written by offering three distinct options - output of active, inactive, or all zones (grid blocks). As the user modifies the zones to output with the zone selection dialog, the zones to be written are similarly updated. This enables the use of Tecplot to create multiple configurations of a geometry being analyzed. For example, if an aircraft is loaded with multiple deflections of flaps, by activating and deactivating different zones for a specific flap setting, new specific configurations of that aircraft can be easily generated by only writing out specific zones. Thus, if ten flap settings are loaded into Tecplot, the PLOT3D Export software can output ten different configurations, one for each flap setting.

Clinical evaluation of a combination therapy of imepitoin with phenobarbital in dogs with refractory idiopathic epilepsy.

PubMed

Neßler, Jasmin; Rundfeldt, Chris; Löscher, Wolfgang; Kostic, Draginja; Keefe, Thomas; Tipold, Andrea

2017-01-25

Imepitoin was tested as a combination treatment with phenobarbital in an open-label mono-centre cohort study in dogs with drug-resistant epilepsy. Diagnosis of idiopathic epilepsy was based on clinical findings, magnetic resonance imaging and cerebrospinal fluid analysis. Three cohorts were treated. In cohort A, dogs not responding to phenobarbital with or without established add-on treatment of potassium bromide or levetiracetam were treated add-on with imepitoin, starting at 10 mg/kg BID, with titration allowed to 30 mg/kg BID. In cohort B, the only difference to cohort A was that the starting dose of imepitoin was reduced to 5 mg/kg BID. In cohort C, animals not responding to imepitoin at >20 mg/kg BID were treated with phenobarbital add-on starting at 0.5 mg/kg BID. The add-on treatment resulted in a reduction in monthly seizure frequency (MSF) in all three cohorts. A reduction of ≥50% was obtained in 36-42% of all animals, without significant difference between cohorts. The lower starting dose of 5 mg/kg BID imepitoin was better tolerated, and an up-titration to on average of 15 mg/kg BID was sufficient in cohort A and B. In cohort C, a mean add-on dose of 1.5 mg/kg BID phenobarbital was sufficient to achieve a clinically meaningful effect. Six dogs developed a clinically meaningful increase in MSF of ≥ 50%, mostly in cohort A. Neither imepitoin nor phenobarbital add-on treatment was capable of suppressing cluster seizure activity, making cluster seizure activity an important predictor for drug-resistance. A combination treatment of imepitoin and phenobarbital is a useful treatment option for a subpopulation of dogs with drug-resistant epilepsy, a low starting dose with 5 mg/kg BID is recommended.

Add-on lacosamide: a retrospective study on the relationship between serum concentration, dosage, and adverse events.

PubMed

Hillenbrand, Barbara; Wisniewski, Ilona; Jürges, Uta; Steinhoff, Bernhard J

2011-11-01

We performed a retrospective study in patients with poorly controlled epilepsy treated with add-on lacosamide (LCM) to investigate the relationship of LCM-related adverse events with LCM serum concentration and weight-dependent dosage. We collected serum concentrations, weight-related dosages, and occurrences of the seven most frequent adverse events according to the randomized double-blind, placebo-controlled trials. Seventy of 131 patients could be sufficiently evaluated. LCM serum concentrations and weight-related dosages in patients with and without typical adverse events did not differ significantly. Closer analysis of the data suggested that dizziness as the leading adverse event occurred significantly more often if LCM was combined with classic sodium channel blockers. There was a significant correlation between LCM serum concentrations and co-medication, so there is still evidence for dependent variables that might have a relevant impact in individual cases. However, our data do not allow definition of a safety range for LCM. Copyright © 2011 Elsevier Inc. All rights reserved.

Ruthenium(II) Complexes Containing Lutidine-Derived Pincer CNC Ligands: Synthesis, Structure, and Catalytic Hydrogenation of C-N bonds.

PubMed

Hernández-Juárez, Martín; López-Serrano, Joaquín; Lara, Patricia; Morales-Cerón, Judith P; Vaquero, Mónica; Álvarez, Eleuterio; Salazar, Verónica; Suárez, Andrés

2015-05-11

A series of Ru complexes containing lutidine-derived pincer CNC ligands have been prepared by transmetalation with the corresponding silver-carbene derivatives. Characterization of these derivatives shows both mer and fac coordination of the CNC ligands depending on the wingtips of the N-heterocyclic carbene fragments. In the presence of tBuOK, the Ru-CNC complexes are active in the hydrogenation of a series of imines. In addition, these complexes catalyze the reversible hydrogenation of phenantridine. Detailed NMR spectroscopic studies have shown the capability of the CNC ligand to be deprotonated and get involved in ligand-assisted activation of dihydrogen. More interestingly, upon deprotonation, the Ru-CNC complex 5 e(BF4 ) is able to add aldimines to the metal-ligand framework to yield an amido complex. Finally, investigation of the mechanism of the hydrogenation of imines has been carried out by means of DFT calculations. The calculated mechanism involves outer-sphere stepwise hydrogen transfer to the C-N bond assisted either by the pincer ligand or a second coordinated H2 molecule. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

77 FR 6476 - Modification of Significant New Uses of Tris Carbamoyl Triazine

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-08

.... Revises the hazard communication requirements under Sec. 721.72 to add the human health hazard and... hood or helmet, or tight- fitting face piece (either half-face or full-face). (ii) Hazard communication...). ACTION: Final rule. SUMMARY: EPA is finalizing an amendment to the significant new use rule (SNUR) under...

76 FR 20377 - Applications and Amendments to Facility Operating Licenses Involving Proposed No Significant...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

... amendment requests approval of the Exelon Cyber Security Plan, provides an Implementation Schedule, and adds... require Exelon to fully implement and maintain in effect all provisions of the approved Cyber Security..., Revision 6, ``Cyber Security Plan for Nuclear Power Reactors.'' Basis for proposed no significant hazards...

Feasibility and Clinical Utility of High-definition Transcranial Direct Current Stimulation in the Treatment of Persistent Hallucinations in Schizophrenia.

PubMed

Bose, A; Shivakumar, V; Chhabra, H; Parlikar, R; Sreeraj, V S; Dinakaran, D; Narayanaswamy, J C; Venkatasubramanian, G

2017-12-01

Persistent auditory verbal hallucination is a clinically significant problem in schizophrenia. Recent studies suggest a promising role for add-on transcranial direct current stimulation (tDCS) in treatment. An optimised version of tDCS, namely high-definition tDCS (HD-tDCS), uses smaller electrodes arranged in a 4x1 ring configuration and may offer more focal and predictable neuromodulation than conventional tDCS. This case report illustrates the feasibility and clinical utility of add-on HD-tDCS over the left temporoparietal junction in a 4x1 ring configuration to treat persistent auditory verbal hallucination in schizophrenia.

Thermal Protection Supplement for Reducing Interface Thermal Mismatch

NASA Technical Reports Server (NTRS)

Stewart, David A. (Inventor); Leiser, Daniel B. (Inventor)

2017-01-01

A thermal protection system that reduces a mismatch of thermal expansion coefficients CTE between a first material layer (CTE1) and a second material layer (CTE2) at a first layer-second layer interface. A portion of aluminum borosilicate (abs) or another suitable additive (add), whose CTE value, CTE(add), satisfies (CTE(add)-CTE1)(CTE(add)-CTE2)<0, is distributed with variable additive density,.rho.(z;add), in the first material layer and/or in the second material layer, with.rho.(z;add) near the materials interface being relatively high (alternatively, relatively low) and.rho.(z;add) in a region spaced apart from the interface being relatively low (alternatively, relatively high).

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

PubMed

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

2015-10-01

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

Blood Pressure Response to Losartan and Continuous Positive Airway Pressure in Hypertension and Obstructive Sleep Apnea.

PubMed

Thunström, Erik; Manhem, Karin; Rosengren, Annika; Peker, Yüksel

2016-02-01

Obstructive sleep apnea (OSA) is common in people with hypertension, particularly resistant hypertension. Treatment with an antihypertensive agent alone is often insufficient to control hypertension in patients with OSA. To determine whether continuous positive airway pressure (CPAP) added to treatment with an antihypertensive agent has an impact on blood pressure (BP) levels. During the initial 6-week, two-center, open, prospective, case-control, parallel-design study (2:1; OSA/no-OSA), all patients began treatment with an angiotensin II receptor antagonist, losartan, 50 mg daily. In the second 6-week, sex-stratified, open, randomized, parallel-design study of the OSA group, all subjects continued to receive losartan and were randomly assigned to either nightly CPAP as add-on therapy or no CPAP. Twenty-four-hour BP monitoring included assessment every 15 minutes during daytime hours and every 20 minutes during the night. Ninety-one patients with untreated hypertension underwent a home sleep study (55 were found to have OSA; 36 were not). Losartan significantly reduced systolic, diastolic, and mean arterial BP in both groups (without OSA: 12.6, 7.2, and 9.0 mm Hg; with OSA: 9.8, 5.7, and 6.1 mm Hg). Add-on CPAP treatment had no significant changes in 24-hour BP values but did reduce nighttime systolic BP by 4.7 mm Hg. All 24-hour BP values were reduced significantly in the 13 patients with OSA who used CPAP at least 4 hours per night. Losartan reduced BP in OSA, but the reductions were less than in no-OSA. Add-on CPAP therapy resulted in no significant changes in 24-hour BP measures except in patients using CPAP efficiently. Clinical trial registered with www.clinicaltrials.gov (NCT00701428).​

The role of cyclothymia in atypical depression: toward a data-based reconceptualization of the borderline-bipolar II connection.

PubMed

Perugi, Giulio; Toni, Cristina; Travierso, Maria Chiara; Akiskal, Hagop S

2003-01-01

Recent data, including our own, indicate significant overlap between atypical depression and bipolar II. Furthermore, the affective fluctuations of patients with these disorders are difficult to separate, on clinical grounds, from cyclothymic temperamental and borderline personality disorders. The present analyses are part of an ongoing Pisa-San Diego investigation to examine whether interpersonal sensitivity, mood reactivity and cyclothymic mood swings constitute a common diathesis underlying the atypical depression-bipolar II-borderline personality constructs. We examined in a semi-structured format 107 consecutive patients who met criteria for major depressive episode with DSM-IV atypical features. Patients were further evaluated on the basis of the Atypical Depression Diagnostic Scale (ADDS), the Hopkins Symptoms Check-list (HSCL-90), and the Hamilton Rating Scale for Depression (HRSD), coupled with its modified form for reverse vegetative features as well as Axis I and SCID-II evaluated Axis II comorbidity, and cyclothymic dispositions ('APA Review', American Psychiatric Press, Washington DC, 1992). Seventy-eight percent of atypical depressives met criteria for bipolar spectrum-principally bipolar II-disorder. Forty-five patients who met the criteria for cyclothymic temperament, compared with the 62 who did not, were indistinguishable on demographic, familial and clinical features, but were significantly higher in lifetime comorbidity for panic disorder with agoraphobia, alcohol abuse, bulimia nervosa, as well as borderline and dependent personality disorders. Cyclothymic atypical depressives also scored higher on the ADDS items of maximum reactivity of mood, interpersonal sensitivity, functional impairment, avoidance of relationships, other rejection avoidance, and on the interpersonal sensitivity, phobic anxiety, paranoid ideation and psychoticism of the HSCL-90 factors. The total number of cyclothymic traits was significantly correlated with 'maximum' reactivity of mood and interpersonal sensitivity. A significant correlation was also found between interpersonal sensitivity and 'usual' and 'maximum' reactivity of mood. Correlational study. Mood lability and interpersonal sensitivity traits appear to be related by a cyclothymic temperamental diathesis which, in turn, appears to underlie the complex pattern of anxiety, mood and impulsive disorders which atypical depressive, bipolar II and borderline patients display clinically. We submit that conceptualizing these constructs as being related will make patients in this realm more accessible to pharmacological and psychological interventions geared to their common temperamental attributes. More generally, we submit that the construct of borderline personality disorder is better covered by more conventional diagnostic entities.

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

PubMed

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

2004-12-10

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

Decision-making deficits in normal elderly persons associated with executive personality disturbances.

PubMed

Nguyen, Christopher M; Barrash, Joseph; Koenigs, Anna L; Bechara, Antoine; Tranel, Daniel; Denburg, Natalie L

2013-11-01

The problems that some community-dwelling elderly persons develop in real-world decision-making may have disastrous consequences for their health and financial well-being. Investigations across the adult life span have identified personality as an important individual differences variable that is related to decision-making ability. The aim of this study was to investigate the relationship between personality characteristics, as rated by an informant, and complex decision-making performance among elderly persons. It was hypothesized that deficits in decision-making would be associated with personality characteristics reflecting weak executive functioning (Lack of Planning, Poor Judgment, Lack of Persistence, Perseveration, Lack of Initiative, Impulsivity, and Indecisiveness). Fifty-eight elderly persons participated. Their health and cognitive status were deemed intact via comprehensive neuropsychological evaluation. The Iowa Scales of Personality, completed by an informant, was used to assess personality characteristics, and the Iowa Gambling Task, completed by the participant, was used to assess complex decision-making abilities. Longstanding disturbances in executive personality characteristics were found to be associated with poor decision-making, and these disturbances remained predictive of poor decision-making even after taking into consideration demographic, neuropsychological, and mood factors. Acquired personality disturbances did not add significantly to prediction after longstanding disturbances were taken into account. Disturbances in other dimensions of personality were not significantly associated with poor decision-making. Our study suggests that attentiveness to the personality correlates of difficulties with aspects of executive functioning over the adult years could enhance the ability to identify older individuals at risk for problems with real-world decision-making.

Decision-Making Deficits in Normal Elderly Persons Associated with Executive Personality Disturbances

PubMed Central

Nguyen, Christopher M.; Barrash, Joseph; Koenigs, Anna L.; Bechara, Antoine; Tranel, Daniel; Denburg, Natalie L.

2014-01-01

Background The problems that some community-dwelling elderly develop in real-world decision-making may have disastrous consequences for their health and financial well-being. Investigations across the adult life span have identified personality as an important individual differences variable that is related to decision-making ability. The aim of this study was to investigate the relationship between personality characteristics, as rated by an informant, and complex decision-making performance among elders. It was hypothesized that deficits in decision-making would be associated with personality characteristics reflecting weak executive functioning (Lack of Planning, Poor Judgment, Lack of Persistence, Perseveration, Lack of Initiative, Impulsivity, and Indecisiveness). Methods Fifty-eight elderly persons participated. Their health and cognitive status were deemed intact via comprehensive neuropsychological evaluation. The Iowa Scales of Personality, completed by an informant, was used to assess personality characteristics, and the Iowa Gambling Task, completed by the participant, was used to assess complex decision-making abilities. Results Longstanding disturbances in executive personality characteristics were found to be associated with poor decision-making, and these disturbances remained predictive of poor decision-making even after taking into consideration demographic, neuropsychological, and mood factors. Acquired personality disturbances did not add significantly to prediction after longstanding disturbances were taken into account. Disturbances in other dimensions of personality were not significantly associated with poor decision-making. Conclusions Our study suggests that attentiveness to the personality correlates of difficulties with aspects of executive functioning over the adult years could enhance the ability to identify older individuals at risk for problems with real-world decision-making. PMID:23906413

Acute management of priapism in men.

PubMed

Tay, Yeng K; Spernat, Daniel; Rzetelski-West, Kathryn; Appu, Sree; Love, Chris

2012-04-01

What's known on the subject? and What does the study add? Priapism is a rare event. However, various medications and medical conditions may increase the risk. Priapism can be ischaemic, non-ischaemic or stuttering. It is paramount to distinguish the type of priapism, as misdiagnosis may lead to significant morbidity. Ischaemic priapism represents a compartment syndrome of the penis and is therefore a medical emergency. A delay in management may significantly affect future erectile function. Stuttering priapism represents recurrent subacute episodes of ischaemic priapism, which may lead to erectile dysfunction. Thus episodes must be minimised. Non-ischaemic priapism is not a medical emergency. However, misdiagnosis and injection with sympathomimetic agents can result in system absorption and toxicity. This review article provides a summary of the evaluation and management of priapism. Furthermore, a step by step flow chart is provided to guide the clinician through the assessment and management of this complex issue. To review the literature regarding ischaemic, non-ischaemic and stuttering priapism. To provide management recommendations. A Medline search was carried out to identify all relevant papers with management guidelines for priapism. Ischaemic priapism represents a compartment syndrome of the penis and urgent intervention is required to decrease the risk of erectile dysfunction. Non-ischaemic priapism is not a medical emergency; however, it can result in erectile dysfunction. The treatment objective for stuttering priapism is to reduce future episodes with systemic treatments, whilst treating each ischaemic episode as an emergency. Priapism is a complex condition that requires expert care to prevent complications and irreversible erectile dysfunction. © 2012 THE AUTHOR. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

Quantifying the hidden healthcare cost of diabetes mellitus in Australian hospital patients.

PubMed

Karahalios, Amalia; Somarajah, Gowri; Hamblin, Peter S; Karunajeewa, Harin; Janus, Edward D

2018-03-01

Diabetes mellitus in hospital inpatients is most commonly present as a comorbidity rather than as the primary diagnosis. In some hospitals, the prevalence of comorbid diabetes mellitus across all inpatients exceeds 30%, which could add to complexity of care and resource utilisation. However, whether and to what extent comorbid diabetes mellitus contributes indirectly to greater hospitalisation costs is ill-defined. To determine the attributable effect of comorbid diabetes mellitus on hospital resource utilisation in a General Internal Medical service in Melbourne, Australia. We extracted data from a database of all General Internal Medical discharge episodes from July 2012 to June 2013. We fitted multivariable regression models to compare patients with diabetes mellitus to those without diabetes mellitus with respect to hospitalisation cost, length of stay, admissions per year and inpatient mortality. Of 4657 patients 1519 (33%) had diabetes mellitus, for whom average hospitalisation cost (AUD9910) was higher than those without diabetes mellitus (AUD7805). In multivariable analysis, this corresponded to a 1.22-fold (95% confidence interval (CI) 1.12-1.33, P < 0.001) higher cost. Mean length of stay for those with diabetes was 8.2 days versus 6.8 days for those without diabetes, with an adjusted 1.19-fold greater odds (95% CI 1.06-1.33, P = 0.001) of staying an additional day. Number of admissions and mortality were similar. Comorbid diabetes mellitus adds significantly to hospitalisation duration and costs in medical inpatients. Moreover, diabetes mellitus patients with chronic complications had a greater-still cost and hospitalisation duration compared to those without diabetes mellitus. © 2017 Royal Australasian College of Physicians.

The timing of drug funding announcements relative to elections: a case study involving dementia medications.

PubMed

Gill, Sudeep S; Gupta, Neeraj; Bell, Chaim M; Rochon, Paula A; Austin, Peter C; Laupacis, Andreas

2013-01-01

Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections represent an especially powerful form of political pressure. We examined the temporal relationship between decisions to add one class of drugs to publicly funded formularies in Canada's ten provinces and elections in these jurisdictions. Dates of provincial formulary listings for cholinesterase inhibitors, which are drugs used to treat Alzheimer's disease and related dementias, were compared to the dates of provincial elections. Medical journal articles, media reports, and proceedings from provincial legislatures were reviewed to assemble information on the chronology of events. We tested whether there was a statistically significant increase in the probability of drug funding announcements within the 60-day intervals preceding provincial elections. Decisions to fund the cholinesterase inhibitors were made over a nine-year span from 1999 to 2007 in the ten provinces. In four of ten provinces, the drugs were added to formularies in a time period closely preceding a provincial election (P = 0.032); funding announcements in these provinces were made between 2 and 47 days prior to elections. Statements made in provincial legislatures highlight the key role of political pressures in these funding announcements. Impending elections appeared to affect the timing of drug funding announcements in this case study. Despite an established structure for evidence-based decision-making, drug funding remains a complex process open to influence from many sources. Awareness of such influences is critical to maintain effective drug policy and public health decision-making.

Falling Behind: International Scrutiny of the Peaceful Atom

DTIC Science & Technology

2008-02-01

confused with critical masses .5 Significant quantity values currently in use by the IAEA are given in Table 1. In a previous Natural Resources... actinides and fission products would not add significantly to the plutonium mass , the state could divert the spiked plutonium to a small clandestine...and manufacturing processes and should not be 152 confused with critical masses . Significant quantities are used in establishing the quantity

Losigamone add-on therapy for partial epilepsy.

PubMed

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

2012-06-13

Epilepsy is a common neurologic disorder, affecting approximately 50 million people worldwide; nearly a third of these people are not well controlled by a single antiepileptic drug and usually require treatment with a combination of two or more antiepileptic drugs. In recent years, many newer antiepileptic drugs have been investigated as add-on therapy for partial epilepsy; losigamone is one of these drugs and is the focus of this systematic review. To investigate the efficacy and safety of losigamone when used as an add-on therapy for partial epilepsy. We searched the Cochrane Epilepsy Group Specialized Register (1 May 2012), the Cochrane Central Register of Controlled Trials (CENTRAL Issue 4 of 12, The Cochrane Library, 2012) and MEDLINE (1 May 2012). We searched trials registers and contacted the manufacturer of losigamone and authors of included studies for additional information. There were no language restrictions. Randomized controlled add-on trials comparing losigamone with placebo for partial epilepsy. Two review authors independently assessed trial quality and extracted data. The primary outcomes were 50% or greater reduction in seizure frequency and seizure freedom; the secondary outcomes were treatment withdrawal and adverse events. Results are presented as risk ratios (RR) with 95% confidence intervals (CIs) or 99% CIs (for the individual listed adverse events to make an allowance for multiple testing). Two trials involving a total of 467 patients were eligible for inclusion. Both trials assessed losigamone 1200 or 1500 mg/d as an add-on therapy for partial epilepsy. One trial was assessed as being of good methodologic quality while the other was of uncertain quality. For the efficacy outcomes, results did show patients taking losigamone were significantly more likely to achieve a 50% or greater reduction in seizure frequency (RR 1.75; 95% CI 1.14 to 2.72), but associated with a significant increase of treatment withdrawal when compared with those taking placebo (RR 2.16; 95% CI 1.28 to 3.67). For the safety outcomes, results indicated the proportion of patients who experienced adverse events in the losigamone group was higher than the placebo group (RR 1.34; 95% CI 1.00 to 1.80), dizziness was the only adverse event significantly in relation to losigamone (RR 3.82; 99% CI 1.69 to 8.64). The proportion of patients achieving seizure freedom was not reported in either trial report. A subgroup analysis according to different doses of losigamone showed that a higher dose of losigamone (1500 mg/d) is associated with a greater reduction in seizure frequency than lower doses, but is also associated with more dropouts due to adverse events. The results of this review showed losigamone can reduce seizure frequency but was associated with more treatment withdrawals when used as an add-on therapy for people with partial epilepsy. However, trials included were of short-term duration and uncertain quality. Future well-designed randomized, double-blind, placebo-controlled trials with a longer-term duration are needed.

Weather delay costs to trucking.

DOT National Transportation Integrated Search

2012-11-01

Estimates of the nations freight sector of transportation range to upwards of $600 billion of total gross domestic product with 70 percent of total value and 60 percent of total weight moving by truck. Weather-related delays can add significantly ...

Anomalies in T Cell Function Are Associated With Individuals at Risk of Mycobacterium abscessus Complex Infection

PubMed Central

Lutzky, Viviana P.; Ratnatunga, Champa N.; Smith, Daniel J.; Kupz, Andreas; Doolan, Denise L.; Reid, David W.; Thomson, Rachel M.; Bell, Scott C.; Miles, John J.

2018-01-01

The increasing global incidence and prevalence of non-tuberculous mycobacteria (NTM) infection is of growing concern. New evidence of person-to-person transmission of multidrug-resistant NTM adds to the global concern. The reason why certain individuals are at risk of NTM infections is unknown. Using high definition flow cytometry, we studied the immune profiles of two groups that are at risk of Mycobacterium abscessus complex infection and matched controls. The first group was cystic fibrosis (CF) patients and the second group was elderly individuals. CF individuals with active M. abscessus complex infection or a history of M. abscessus complex infection exhibited a unique surface T cell phenotype with a marked global deficiency in TNFα production during mitogen stimulation. Importantly, immune-based signatures were identified that appeared to predict at baseline the subset of CF individuals who were at risk of M. abscessus complex infection. In contrast, elderly individuals with M. abscessus complex infection exhibited a separate T cell phenotype underlined by the presence of exhaustion markers and dysregulation in type 1 cytokine release during mitogen stimulation. Collectively, these data suggest an association between T cell signatures and individuals at risk of M. abscessus complex infection, however, validation of these immune anomalies as robust biomarkers will require analysis on larger patient cohorts. PMID:29942313

Anomalies in T Cell Function Are Associated With Individuals at Risk of Mycobacterium abscessus Complex Infection.

PubMed

Lutzky, Viviana P; Ratnatunga, Champa N; Smith, Daniel J; Kupz, Andreas; Doolan, Denise L; Reid, David W; Thomson, Rachel M; Bell, Scott C; Miles, John J

2018-01-01

The increasing global incidence and prevalence of non-tuberculous mycobacteria (NTM) infection is of growing concern. New evidence of person-to-person transmission of multidrug-resistant NTM adds to the global concern. The reason why certain individuals are at risk of NTM infections is unknown. Using high definition flow cytometry, we studied the immune profiles of two groups that are at risk of Mycobacterium abscessus complex infection and matched controls. The first group was cystic fibrosis (CF) patients and the second group was elderly individuals. CF individuals with active M. abscessus complex infection or a history of M. abscessus complex infection exhibited a unique surface T cell phenotype with a marked global deficiency in TNFα production during mitogen stimulation. Importantly, immune-based signatures were identified that appeared to predict at baseline the subset of CF individuals who were at risk of M. abscessus complex infection. In contrast, elderly individuals with M. abscessus complex infection exhibited a separate T cell phenotype underlined by the presence of exhaustion markers and dysregulation in type 1 cytokine release during mitogen stimulation. Collectively, these data suggest an association between T cell signatures and individuals at risk of M. abscessus complex infection, however, validation of these immune anomalies as robust biomarkers will require analysis on larger patient cohorts.

Fibromyalgia, mood disorders, and intense creative energy: A1AT polymorphisms are not always silent.

PubMed

Schmechel, Donald E; Edwards, Christopher L

2012-12-01

Persons with single copies of common alpha-1-antitrypsin polymorphisms such as S and Z are often considered "silent carriers". Published evidence however supports a complex behavioral phenotype or trait - intense creative energy ("ICE")-associated with A1AT polymorphisms. We now confirm that phenotype and present an association of fibromyalgia syndrome (FMS) and A1AT in a consecutive series of neurological patients. This is a retrospective case control series of 3176 consecutive patients presenting to Duke University Memory Clinic (747 patients) and to regional community-based Caldwell Hospital Neurology and Memory center (2429 patients). Work-up included medical history and examination, psychological evaluation, and genetic analysis. Chronic widespread pain (CWP) or FMS were diagnosed according to clinical guidelines, mostly as secondary diagnoses. Neurological patients carrying A1AT polymorphisms were common (ca 16% prevalence) and carriers had significantly higher use of inhaler and anxiolytic medications. Patients with ICE phenotype had a significantly higher proportion of A1AT polymorphisms (42%) compared to non-ICE patients (13%). Presence of CWP or FMS was common (14-22%) with average age at presentation of 56 years old and mostly female gender (82%). Patients with CWP/FMS had again significantly higher proportion of A1AT polymorphisms (38%) compared to other neurological patients (13%). Patients with anxiety disorders, bipolar I or bipolar II disorders or PTSD also had increased proportion of A1AT polymorphisms and significant overlap with ICE and FMS phenotype. Significant reductions in CWP/FMS prevalence are seen in apolipoprotein E4 carriers and methylene tetrahydrofolate reductase (MTHFR) mutation homozygotes. Since ICE phenotype is reported as a lifelong behavioral attribute, the presumption is that A1AT carriers have fundamental differences in brain development and inflammatory response. In support of this concept is finding those persons reporting a diagnosis of juvenile rheumatoid or idiopathic arthritis (JRA, JIA) had a significantly high proportion of A1AT polymorphisms (63%), suggesting a spectrum for JRA to later FMS presentations. Likewise, persons reporting a history of attention deficit disorder (ADD) had an increased proportion of A1AT polymorphisms (26%) compared to non-ADD persons (13%). Toxic environmental exposures are common (23%) and associated with diagnoses of PSP, PPA, FTD, FTD-PD, PD and ADVD. A1AT carriers were increased in cases of toxic exposure and PSP, PPA and FTD-PD. Our findings support the ICE behavioral phenotype for A1AT polymorphism carriers and the reported association with anxiety and bipolar spectrum disorders. We now extend that phenotype to apparent vulnerability to inflammatory muscle disease in a spectrum from JRA to fibromyalgia (FMS) and specific behavioral subsets of ADD, PTSD, and specific late onset neurological syndromes (FTD-PD and PPA). High and low risk FMS subsets can be defined using A1AT, MTHFR and APOE genotyping. Clinical diagnoses associated with A1AT polymorphisms included fibromyalgia, JRA/JIA, bipolar disorder, PTSD, primary progressive aphasia and FTDPD, but not most Alzheimer Disease subtypes. These results support an extended phenotype for A1AT mutation carriers beyond liver and lung vulnerability to selective advantages: ICE phenotype and disadvantages: fibromyalgia, affective disorders, and selected late onset neurological syndromes. Copyright © 2012 Elsevier Inc. All rights reserved.

Mortality of Dandy-Walker syndrome in the United States: Analysis by race, gender, and insurance status.

PubMed

McClelland, Shearwood; Ukwuoma, Onyinyechi I; Lunos, Scott; Okuyemi, Kolawole S

2015-01-01

Dandy-Walker syndrome (DWS) is a congenital disorder often diagnosed in early childhood. Typically manifesting with signs/symptoms of increased intracranial pressure, DWS is catastrophic unless timely neurosurgical care can be administered via cerebrospinal fluid (CSF) drainage. The rates of mortality, adverse discharge disposition (ADD), and CSF drainage in DWS may not be uniform regardless of race, gender or insurance status; such differences could reflect disparities in access to neurosurgical care. This study examines these issues on a nationwide level. The Kids' Inpatient Database spanning 1997-2003 was used for analysis. Only patients admitted for DWS (ICD-9-CM = 742.3) were included. Multivariate analysis was adjusted for several variables, including patient age, race, sex, admission type, primary payer, income, and hospital volume. More than 14,000 DWS patients were included. Increasing age predicted reduced mortality (OR = 0.87; P < 0.05), ADD (OR = 0.96; P < 0.05), and decreased likelihood of receiving CSF drainage (OR = 0.86; P < 0.0001). Elective admission type predicted reduced mortality (OR = 0.29; P = 0.0008), ADD (OR = 0.68; P < 0.05), and increased CSF drainage (OR = 2.02; P < 0.0001). African-American race (OR = 1.20; P < 0.05) and private insurance (OR = 1.18; P < 0.05) each predicted increased likelihood of receiving CSF drainage, but were not predictors of mortality or ADD. Gender, income, and hospital volume were not significant predictors of DWS outcome. Increasing age and elective admissions each decrease mortality and ADD associated with DWS. African-American race and private insurance status increase access to CSF drainage. These findings contradict previous literature citing African-American race as a risk factor for mortality in DWS, and emphasize the role of private insurance in obtaining access to potentially lifesaving operative care.

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

PubMed

Fayyazi Bordbar, Mohammad Reza; Talaei, Ali

2013-10-01

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

Long-term adherence to the New Nordic Diet and the effects on body weight, anthropometry and blood pressure: a 12-month follow-up study.

PubMed

Poulsen, Sanne Kellebjerg; Crone, Charlotte; Astrup, Arne; Larsen, Thomas Meinert

2015-02-01

The New Nordic Diet (NND) has induced weight loss in a 26-week controlled intervention. We aim to investigate whether high compliance and satisfaction can be maintained after the active intervention is discontinued thereby maintaining the health effects. After 26 weeks of intervention with NND or Average Danish Diet (ADD), 147 participants (mean age 43 years and mean BMI 29.1 kg/m²) were followed for further 52 weeks. All participants were encouraged to follow NND but without further guidance. The study is registered with ClinicalTrials.gov, study id NCT01195610. One hundred and ten participants (75%) completed the follow-up. Among participants previously randomised to NND (NND group), dietary compliance and satisfaction decreased from 4.3 to 3.0 and from 4.8 to 4.0, respectively (both p < 0.0001) (1-5 point scale). Among those originally randomised to ADD (ADD group), satisfaction with NND was significantly higher than with ADD during follow-up (3.3 vs. 2.5, p = 0.026). Weight losses during intervention of -6.2 kg and -3.0 kg were followed by regains of 4.6 kg (SE 0.5) and 1.1 kg (SE 0.7) for the NND group and ADD group, respectively [adjusted difference; mean (95 % CI): 1.8 kg (0.1-3.4), p = 0.041]. Across diet groups, every 1 score higher in compliance with NND was associated with 0.90 kg less body weight regain (p = 0.026) and those who increased physical activity regained 3.4 kg less compared to those who did not (p < 0.0001). NND provides higher satisfaction, and body weight regain is reduced with higher compliance with NND and increased physical activity.

Pirfenidone in patients with rapidly progressive interstitial lung disease associated with clinically amyopathic dermatomyositis

NASA Astrophysics Data System (ADS)

Li, Ting; Guo, Li; Chen, Zhiwei; Gu, Liyang; Sun, Fangfang; Tan, Xiaoming; Chen, Sheng; Wang, Xiaodong; Ye, Shuang

2016-09-01

To evaluate the efficacy of pirfenidone in patients with rapidly progressive interstitial lung disease (RPILD) related to clinically amyopathic dermatomyositis (CADM), we conducted an open-label, prospective study with matched retrospective controls. Thirty patients diagnosed with CADM-RPILD with a disease duration <6 months at Renji Hospital South Campus from June 2014 to November 2015 were prospectively enrolled and treated with pirfenidone at a target dose of 1800 mg/d in addition to conventional treatment, such as a glucocorticoid and/or other immunosuppressants. Matched patients without pirfenidone treatment (n = 27) were retrospectively selected as controls between October 2012 and September 2015. We found that the pirfenidone add-on group displayed a trend of lower mortality compared with the control group (36.7% vs 51.9%, p = 0.2226). Furthermore, the subgroup analysis indicated that the pirfenidone add-on had no impact on the survival of acute ILD patients (disease duration <3 months) (50% vs 50%, p = 0.3862) while for subacute ILD patients (disease duration 3-6 months), the pirfenidone add-on (n = 10) had a significantly higher survival rate compared with the control subgroup (n = 9) (90% vs 44.4%, p = 0.0450). Our data indicated that the pirfenidone add-on may improve the prognosis of patients with subacute ILD related to CADM.

Pirfenidone in patients with rapidly progressive interstitial lung disease associated with clinically amyopathic dermatomyositis.

PubMed

Li, Ting; Guo, Li; Chen, Zhiwei; Gu, Liyang; Sun, Fangfang; Tan, Xiaoming; Chen, Sheng; Wang, Xiaodong; Ye, Shuang

2016-09-12

To evaluate the efficacy of pirfenidone in patients with rapidly progressive interstitial lung disease (RPILD) related to clinically amyopathic dermatomyositis (CADM), we conducted an open-label, prospective study with matched retrospective controls. Thirty patients diagnosed with CADM-RPILD with a disease duration <6 months at Renji Hospital South Campus from June 2014 to November 2015 were prospectively enrolled and treated with pirfenidone at a target dose of 1800 mg/d in addition to conventional treatment, such as a glucocorticoid and/or other immunosuppressants. Matched patients without pirfenidone treatment (n = 27) were retrospectively selected as controls between October 2012 and September 2015. We found that the pirfenidone add-on group displayed a trend of lower mortality compared with the control group (36.7% vs 51.9%, p = 0.2226). Furthermore, the subgroup analysis indicated that the pirfenidone add-on had no impact on the survival of acute ILD patients (disease duration <3 months) (50% vs 50%, p = 0.3862); while for subacute ILD patients (disease duration 3-6 months), the pirfenidone add-on (n = 10) had a significantly higher survival rate compared with the control subgroup (n = 9) (90% vs 44.4%, p = 0.0450). Our data indicated that the pirfenidone add-on may improve the prognosis of patients with subacute ILD related to CADM.

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

PubMed

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

2015-01-01

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

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

NASA Astrophysics Data System (ADS)

Guo, Kaikai; Zheng, Guoan

2017-03-01

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

IC-tagged proteins are able to interact with each other and perform complex reactions when integrated into muNS-derived inclusions.

PubMed

Brandariz-Nuñez, Alberto; Otero-Romero, Iria; Benavente, Javier; Martinez-Costas, Jose M

2011-09-20

We have recently developed a versatile tagging system (IC-tagging) that causes relocation of the tagged proteins to ARV muNS-derived intracellular globular inclusions. In the present study we demonstrate (i) that the IC-tag can be successfully fused either to the amino or carboxyl terminus of the protein to be tagged and (ii) that IC-tagged proteins are able to interact between them and perform complex reactions that require such interactions while integrated into muNS inclusions, increasing the versatility of the IC-tagging system. Also, our studies with the DsRed protein add some light on the structure/function relationship of the evolution of DsRed chromophore. Copyright © 2011 Elsevier B.V. All rights reserved.

KSC-07pd2371

NASA Image and Video Library

2007-08-24

KENNEDY SPACE CENTER, FLA. -- The super lightweight ablator, or SLA, cork insulation has been removed from the external tank and a United Space Alliance external tank technician sands off the residue from the LO2 feed line bracket. The BX265 foam insulation will later be reapplied without the SLA. The tank is scheduled to fly on Space Shuttle Discovery in October 2007 on mission STS-120. Discovery's crew will add the module Harmony that will serve as a port for installing additional international laboratories. Harmony will be the first expansion of the living and working space on the complex since the Russian Pirs airlock was installed in 2001. The mission also will move the first set of solar arrays installed on the station to a permanent location on the complex and redeploy them. Photo credit: NASA/Jim Grossmann

Engineering of routes to heparin and related polysaccharides.

PubMed

Bhaskar, Ujjwal; Sterner, Eric; Hickey, Anne Marie; Onishi, Akihiro; Zhang, Fuming; Dordick, Jonathan S; Linhardt, Robert J

2012-01-01

Anticoagulant heparin has been shown to possess important biological functions that vary according to its fine structure. Variability within heparin's structure occurs owing to its biosynthesis and animal tissue-based recovery and adds another dimension to its complex polymeric structure. The structural variations in chain length and sulfation patterns mediate its interaction with many heparin-binding proteins, thereby eliciting complex biological responses. The advent of novel chemical and enzymatic approaches for polysaccharide synthesis coupled with high throughput combinatorial approaches for drug discovery have facilitated an increased effort to understand heparin's structure-activity relationships. An improved understanding would offer potential for new therapeutic development through the engineering of polysaccharides. Such a bioengineering approach requires the amalgamation of several different disciplines, including carbohydrate synthesis, applied enzymology, metabolic engineering, and process biochemistry.

Bacillus cereus Certhrax ADP-ribosylates Vinculin to Disrupt Focal Adhesion Complexes and Cell Adhesion*

PubMed Central

Simon, Nathan C.; Barbieri, Joseph T.

2014-01-01

Bacillus cereus is often associated with mild to moderate gastroenteritis; however, some recent isolates cause inhalational anthrax-like diseases and death. These potential emerging human pathogens express multiple virulence factors. B. cereus strain G9241 expresses anthrax toxin, several polysaccharide capsules, and the novel ADP-ribosyltransferase, Certhrax. In this study, we show that Certhrax ADP-ribosylates Arg-433 of vinculin, a protein that coordinates actin cytoskeleton and extracellular matrix interactions. ADP-ribosylation of vinculin disrupted focal adhesion complexes and redistributed vinculin to the cytoplasm. Exogenous vinculin rescued these phenotypes. This provides a mechanism for strain G9241 to breach host barrier defenses and promote bacterial growth and spread. Certhrax is the first bacterial toxin to add a post-translational modification to vinculin to disrupt the actin cytoskeleton. PMID:24573681

KSC-07pd2370

NASA Image and Video Library

2007-08-24

KENNEDY SPACE CENTER, FLA. -- Now that the foam insulation is removed from the external tank, the crack in the super lightweight ablator, or SLA, cork insulation is visible as had been observed previously by X-rays. The BX265 foam insulation will later be reapplied without the SLA. The tank is scheduled to fly on Space Shuttle Discovery in October 2007 on mission STS-120. Discovery's crew will add the module Harmony that will serve as a port for installing additional international laboratories. Harmony will be the first expansion of the living and working space on the complex since the Russian Pirs airlock was installed in 2001. The mission also will move the first set of solar arrays installed on the station to a permanent location on the complex and redeploy them. Photo credit: NASA/Jim Grossmann

Materials Manufactured from 3D Printed Synthetic Biology Arrays

NASA Technical Reports Server (NTRS)

Gentry, Diana; Micks, Ashley

2013-01-01

Many complex, biologically-derived materials have extremely useful properties (think wood or silk), but are unsuitable for space-related applications due to production, manufacturing, or processing limitations. Large-scale ecosystem-based production, such as raising and harvesting trees for wood, is impractical in a self-contained habitat such as a space station or potential Mars colony. Manufacturing requirements, such as the specialized equipment needed to harvest and process cotton, add too much upmass for current launch technology. Cells in nature are already highly specialized for making complex biological materials on a micro scale. We envision combining these strengths with the recently emergent technologies of synthetic biology and 3D printing to create 3D-structured arrays of cells that are bioengineered to secrete different materials in a specified three-dimensional pattern.

Diversity in the Archean Biosphere: New Insights from NanoSIMS

NASA Astrophysics Data System (ADS)

Oehler, Dorothy Z.; Robert, François; Walter, Malcolm R.; Sugitani, Kenichiro; Meibom, Anders; Mostefaoui, Smail; Gibson, Everett K.

2010-05-01

The origin of organic microstructures in the ˜3 Ga Farrel Quartzite is controversial due to their relatively poor state of preservation, the Archean age of the cherts in which they occur, and the unusual spindle-like morphology of some of the forms. To provide more insight into the significance of these microstructures, nano-scale secondary ion mass spectrometry (NanoSIMS) maps of carbon, nitrogen, sulfur, silicon, and oxygen were obtained for spheroidal and spindle-shaped constituents of the Farrel Quartzite assemblage. Results suggest that the structures are all bona fide ˜3 Ga microfossils. The spindles demonstrate an architecture that is remarkable for 3 Ga organisms. They are relatively large, robust, and morphologically complex. The NanoSIMS element maps corroborate their complexity by demonstrating an intricate, internal network of organic material that fills many of the spindles and extends continuously from the body of these structures into their spearlike appendages. Results from this study combine with previous morphological and chemical analyses to argue that the microstructures in the Farrel Quartzite comprise a diverse assemblage of Archean microfossils. This conclusion adds to a growing body of geochemical, stromatolitic, and morphological evidence that indicates the Archean biosphere was varied and well established by at least ˜3 Ga. Together, the data paint a picture of Archean evolution that is one of early development of morphological and chemical complexity. The evidence for Archean evolutionary innovation may augur well for the possibility that primitive life on other planets could adapt to adverse conditions by ready development of diversity in form and biochemistry.

Informatics in radiology (infoRAD): navigating the fifth dimension: innovative interface for multidimensional multimodality image navigation.

PubMed

Rosset, Antoine; Spadola, Luca; Pysher, Lance; Ratib, Osman

2006-01-01

The display and interpretation of images obtained by combining three-dimensional data acquired with two different modalities (eg, positron emission tomography and computed tomography) in the same subject require complex software tools that allow the user to adjust the image parameters. With the current fast imaging systems, it is possible to acquire dynamic images of the beating heart, which add a fourth dimension of visual information-the temporal dimension. Moreover, images acquired at different points during the transit of a contrast agent or during different functional phases add a fifth dimension-functional data. To facilitate real-time image navigation in the resultant large multidimensional image data sets, the authors developed a Digital Imaging and Communications in Medicine-compliant software program. The open-source software, called OsiriX, allows the user to navigate through multidimensional image series while adjusting the blending of images from different modalities, image contrast and intensity, and the rate of cine display of dynamic images. The software is available for free download at http://homepage.mac.com/rossetantoine/osirix. (c) RSNA, 2006.

Anorectal closing mechanisms.

PubMed

Wilson, P M

1977-05-28

The thrust of this contribution is contained in an analysis of the refined sealing devices which supplement the co-operative interactions between the anorectum and its surroundings. They include an active smooth-muscle complex which, with elastic tissue, is closely related to vascular anal cushions. These, when distended, plug the anal lumen and complete continence. Additional objectives are: (i) to draw attention to new concepts on the nature of haemorrhoids; (ii) to add illustrations to support the idea of tripartite sealing plugs in the form of anal "cushions"; (iii) to note discrepancies in the literature on the exact siting of the pectinate/dentate line in the anal canal which have a bearing on the theory of the anal cushion; (iv) to give reasons why the musculus submucosae ani should not be termed Treitz's muscle; (v) to review some morphological, pressure, motility and electromyographic sutdies of the neuromusculature of the anorectal region in normal subjects and in patients with haemorrhoids; and (vi) to add explanations and suggestions to fit the concept of the anal cushion into a broader framework of use to the surgeon.

A novel NDUFV1 gene mutation in complex I deficiency in consanguineous siblings with brainstem lesions and Leigh syndrome.

PubMed

Vilain, C; Rens, C; Aeby, A; Balériaux, D; Van Bogaert, P; Remiche, G; Smet, J; Van Coster, R; Abramowicz, M; Pirson, I

2012-09-01

Although deficiency of complex I of the mitochondrial respiratory chain is a frequent cause of encephalopathy in children, only a few mutations have been reported in each of its subunits. In the absence of families large enough for conclusive segregation analysis and of robust functional testing, it is difficult to unequivocally show the causality of the observed mutations and to delineate genotype-phenotype correlations, making additional observations necessary. We observed two consanguineous siblings with an early-onset encephalopathy, medulla, brainstem and mesencephalon lesions on brain magnetic resonance imaging and death before 8 months of age, caused by a complex I deficiency. We used a homozygosity mapping approach and identified a missense mutation in the NDUFV1 gene. The mutation, p.Arg386His, affects a highly conserved residue, contiguous to a cysteine residue known to coordinate an Fe ion. This observation adds to our understanding of complex I deficiency disease. It validates the important role of Arg386 and therefore supports the current molecular model of iron-sulfur clusters in NDUFV1. © 2011 John Wiley & Sons A/S.

Fault diagnosis of sensor networked structures with multiple faults using a virtual beam based approach

NASA Astrophysics Data System (ADS)

Wang, H.; Jing, X. J.

2017-07-01

This paper presents a virtual beam based approach suitable for conducting diagnosis of multiple faults in complex structures with limited prior knowledge of the faults involved. The "virtual beam", a recently-proposed concept for fault detection in complex structures, is applied, which consists of a chain of sensors representing a vibration energy transmission path embedded in the complex structure. Statistical tests and adaptive threshold are particularly adopted for fault detection due to limited prior knowledge of normal operational conditions and fault conditions. To isolate the multiple faults within a specific structure or substructure of a more complex one, a 'biased running' strategy is developed and embedded within the bacterial-based optimization method to construct effective virtual beams and thus to improve the accuracy of localization. The proposed method is easy and efficient to implement for multiple fault localization with limited prior knowledge of normal conditions and faults. With extensive experimental results, it is validated that the proposed method can localize both single fault and multiple faults more effectively than the classical trust index subtract on negative add on positive (TI-SNAP) method.

Comparison of seating, powered characteristics and functions and costs of electrically powered wheelchairs in a general population of users.

PubMed

Dolan, Michael John; Bolton, Megan Jennifer; Henderson, Graham Iain

2017-10-26

To profile and compare the seating and powered characteristics and functions of electrically powered wheelchairs (EPWs) in a general user population including equipment costs. Case notes of adult EPW users of a regional NHS service were reviewed retrospectively. Seating equipment complexity and type were categorized using the Edinburgh classification. Powered characteristics and functions, including control device type, were recorded. 482 cases were included; 53.9% female; mean duration EPW use 8.1 years (SD 7.4); rear wheel drive 88.0%; hand joystick 94.8%. Seating complexity: low 73.2%, medium 18.0%, high 8.7%. Most prevalent diagnoses: multiple sclerosis (MS) 25.3%, cerebral palsy (CP) 18.7%, muscular dystrophy (8.5%). Compared to CP users, MS users were significantly older at first use, less experienced, more likely to have mid-wheel drive and less complex seating. Additional costs for muscular dystrophy and spinal cord injury users were 3-4 times stroke users. This is the first large study of a general EPW user population using a seating classification. Significant differences were found between diagnostic groups; nevertheless, there was also high diversity within each group. The differences in provision and the equipment costs across diagnostic groups can be used to improve service planning. Implications for Rehabilitation At a service planning level, knowledge of a population's diagnostic group and age distribution can be used to inform decisions about the number of required EPWs and equipment costs. At a user level, purchasing decisions about powered characteristics and functions of EPWs and specialised seating equipment need to be taken on a case by case basis because of the diversity of users' needs within diagnostic groups. The additional equipment costs for SCI and MD users are several times those of stroke users and add between 60 and 70% of the cost of basic provision.

Casuist BDI-Agent: A New Extended BDI Architecture with the Capability of Ethical Reasoning

NASA Astrophysics Data System (ADS)

Honarvar, Ali Reza; Ghasem-Aghaee, Nasser

Since the intelligent agent is developed to be cleverer, more complex, and yet uncontrollable, a number of problems have been recognized. The capability of agents to make moral decisions has become an important question, when intelligent agents have developed more autonomous and human-like. We propose Casuist BDI-Agent architecture which extends the power of BDI architecture. Casuist BDI-Agent architecture combines CBR method in AI and bottom up casuist approach in ethics in order to add capability of ethical reasoning to BDI-Agent.

Tracking single particle rotation: Probing dynamics in four dimensions

DOE PAGES

Anthony, Stephen Michael; Yu, Yan

2015-04-29

Direct visualization and tracking of small particles at high spatial and temporal resolution provides a powerful approach to probing complex dynamics and interactions in chemical and biological processes. Analysis of the rotational dynamics of particles adds a new dimension of information that is otherwise impossible to obtain with conventional 3-D particle tracking. In this review, we survey recent advances in single-particle rotational tracking, with highlights on the rotational tracking of optically anisotropic Janus particles. Furthermore, strengths and weaknesses of the various particle tracking methods, and their applications are discussed.

The effect of the electronic medical record on nurses' work.

PubMed

Robles, Jane

2009-01-01

The electronic medical record (EMR) is a workplace reality for most nurses. Its advantages include a single consolidated record for each person; capacity for data interfaces and alerts; improved interdisciplinary communication; and evidence-based decision support. EMRs can add to work complexity, by forcing better documentation of previously unrecorded data and/or because of poor design. Well-designed and well-implemented computerized provider order entry (CPOE) systems can streamline nurses' work. Generational differences in acceptance of and facility with EMRs can be addressed through open, healthy communication.

Effect of Cu(2+)-complexation on the scavenging ability of chrysin towards photogenerated singlet molecular oxygen (O2((1)Δg)). Possible biological implications.

PubMed

Muñoz, Vanesa A; Ferrari, Gabriela V; Montaña, M Paulina; Miskoski, Sandra; García, Norman A

2016-09-01

Visible-light irradiation of aqueous-ethanolic solutions of Riboflavin (Rf) in the individual presence of the flavone chrysin (Chr) and its complex with Cu(2+) ([Chr2Cu]; 2:1 L:M) generates singlet molecular oxygen O2((1)Δg), that concomitantly interact with both flavone derivatives. Overall (kt) and reactive (kr) rate constants in the order of 10(7)M(-1)s(-1) were determined for the process. Metal chelation greatly enhances the scavenging ability of [Chr2Cu] towards O2((1)Δg) through a mechanism dominated, in >80%, by the physical component. In this way, practically all O2((1)Δg) is deactivated by the complex without significant loss of the quencher. The isolated flavone quenches O2((1)Δg) in a prevailing reactive fashion. The very low value exhibited by [Chr2Cu] for the kr/kt ratio constitutes a positive quality for antioxidative protectors in biological media, where elevated local concentration and high reactivity of significant molecules make them initial targets for O2((1)Δg) aggression. Finally, two interesting properties in the field of free radicals scavenging by [Chr2Cu] must be mentioned. In first place metal chelation itself, in the obvious sense of free metal ion withdrawal from the oxidizable medium, prevents the initiation of a free radical-mediated oxidation processes through mechanisms of Fenton or lipid peroxidation. In addition, the incorporation of Cu adds to [Chr2Cu] the ability of a free radical scavenger, already described for similar Cu-chelate compounds. This collection of beneficial properties positions the complex as a remarkably promising bioprotector towards ROS-mediated oxidation. A quantification of the efficiency on the initial anti-oxidative effect exerted by Chr and [Chr2Cu] towards tryptophan was carried out. The amino acid is an archetypal molecular model, commonly employed to monitor oxidative degradation of proteinaceous media. It was efficiently photoprotected against O2((1)Δg)-mediated photooxidation by [Chr2Cu]. Copyright © 2016. Published by Elsevier B.V.

Analysis and evaluation in the production process and equipment area of the low-cost solar array project

NASA Technical Reports Server (NTRS)

Wolf, M.; Goldman, H.

1981-01-01

The attributes of the various metallization processes were investigated. It is shown that several metallization process sequences will lead to adequate metallization for large area, high performance solar cells at a metallization add on price in the range of $6. to 12. m squared, or 4 to $.8/W(peak), assuming 15% efficiency. Conduction layer formation by thick film silver or by tin or tin/lead solder leads to metallization add-on prices significantly above the $6. to 12/m squared range c.) The wet chemical processes of electroless and electrolytic plating for strike/barrier layer and conduction layer formation, respectively, seem to be most cost effective.

2017 National Household Travel Survey - California Add-On |

Science.gov Websites

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

Etiology of Attention Disorders: A Neurological/Genetic Perspective.

ERIC Educational Resources Information Center

Grantham, Madeline Kay

This paper explores the historical origins of attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) as a neurological disorder, current neurological and genetic research concerning the etiology of ADD/ADHD, and implications for diagnosis and treatment. First, ADD/ADHD is defined and then the origins of ADD/ADHD as a…

Health and labour force participation of older people in Europe: what do objective health indicators add to the analysis?

PubMed

Kalwij, Adriaan; Vermeulen, Frederic

2008-05-01

This paper studies labour force participation of older individuals in 11 European countries. The data are drawn from the new Survey of Health, Ageing and Retirement in Europe (SHARE). We examine the value added of objective health indicators in relation to potentially endogenous self-reported health. We approach the endogeneity of self-reported health as an omitted variables problem. In line with the literature on the reliability of self-reported health ambiguous results are obtained. In some countries self-reported health does a fairly good job and controlling for objective health indicators does not add much to the analysis. In other countries, however, the results show that objective health indicators add significantly to the analysis and that self-reported health is endogenous due to omitted objective health indicators. These latter results illustrate the multi-dimensional nature of health and the need to control for objective health indicators when analysing the relation between health status and labour force participation. This makes an instrumental variables approach to deal with the endogeneity of self-reported health less appropriate.

Desorden Deficitario de la Atencion. Segunda Edicion. NICHCY Briefing Paper [and] El Desorden Deficitario de la Atencion: Una Bibliografia de Materiales en Ingles y Espanol (Attention Deficit Disorder. Second Edition. NICHCY Briefing Paper [and] Attention Deficit Disorder: A Bibliography of Materials in English and Spanish).

ERIC Educational Resources Information Center

Fowler, Mary

This briefing paper uses a question-and-answer format to provide basic information about children with attention deficit disorder (ADD). Questions address the following concerns: nature and incidence of ADD; causes of ADD; signs of ADD (impulsivity, hyperactivity, disorganization, social skill deficits); the diagnostic ADD assessment; how to…

Modeling two-phase flow in three-dimensional complex flow-fields of proton exchange membrane fuel cells

NASA Astrophysics Data System (ADS)

Kim, Jinyong; Luo, Gang; Wang, Chao-Yang

2017-10-01

3D fine-mesh flow-fields recently developed by Toyota Mirai improved water management and mass transport in proton exchange membrane (PEM) fuel cell stacks, suggesting their potential value for robust and high-power PEM fuel cell stack performance. In such complex flow-fields, Forchheimer's inertial effect is dominant at high current density. In this work, a two-phase flow model of 3D complex flow-fields of PEMFCs is developed by accounting for Forchheimer's inertial effect, for the first time, to elucidate the underlying mechanism of liquid water behavior and mass transport inside 3D complex flow-fields and their adjacent gas diffusion layers (GDL). It is found that Forchheimer's inertial effect enhances liquid water removal from flow-fields and adds additional flow resistance around baffles, which improves interfacial liquid water and mass transport. As a result, substantial improvements in high current density cell performance and operational stability are expected in PEMFCs with 3D complex flow-fields, compared to PEMFCs with conventional flow-fields. Higher current density operation required to further reduce PEMFC stack cost per kW in the future will necessitate optimizing complex flow-field designs using the present model, in order to efficiently remove a large amount of product water and hence minimize the mass transport voltage loss.

The Case for Adopting the "Species Complex" Nomenclature for the Etiologic Agents of Cryptococcosis.

PubMed

Kwon-Chung, Kyung J; Bennett, John E; Wickes, Brian L; Meyer, Wieland; Cuomo, Christina A; Wollenburg, Kurt R; Bicanic, Tihana A; Castañeda, Elizabeth; Chang, Yun C; Chen, Jianghan; Cogliati, Massimo; Dromer, Françoise; Ellis, David; Filler, Scott G; Fisher, Matthew C; Harrison, Thomas S; Holland, Steven M; Kohno, Shigeru; Kronstad, James W; Lazera, Marcia; Levitz, Stuart M; Lionakis, Michail S; May, Robin C; Ngamskulrongroj, Popchai; Pappas, Peter G; Perfect, John R; Rickerts, Volker; Sorrell, Tania C; Walsh, Thomas J; Williamson, Peter R; Xu, Jianping; Zelazny, Adrian M; Casadevall, Arturo

2017-01-01

Cryptococcosis is a potentially lethal disease of humans/animals caused by Cryptococcus neoformans and Cryptococcus gattii . Distinction between the two species is based on phenotypic and genotypic characteristics. Recently, it was proposed that C. neoformans be divided into two species and C. gattii into five species based on a phylogenetic analysis of 115 isolates. While this proposal adds to the knowledge about the genetic diversity and population structure of cryptococcosis agents, the published genotypes of 2,606 strains have already revealed more genetic diversity than is encompassed by seven species. Naming every clade as a separate species at this juncture will lead to continuing nomenclatural instability. In the absence of biological differences between clades and no consensus about how DNA sequence alone can delineate a species, we recommend using " Cryptococcus neoformans species complex" and " C. gattii species complex" as a practical intermediate step, rather than creating more species. This strategy recognizes genetic diversity without creating confusion.

Pathomechanisms in rheumatoid arthritis--time for a string theory?

PubMed

Weyand, Cornelia M; Goronzy, Jörg J

2006-04-01

RA is a quintessential autoimmune disease with a growing number of cells, mediators, and pathways implicated in this tissue-injurious inflammation. Now Kuhn and colleagues have provided convincing evidence that autoantibodies reacting with citrullinated proteins, known for their sensitivity and specificity as biomarkers in RA, enhance tissue damage in collagen-induced arthritis (see the related article beginning on page 961). This study adds yet another soldier to the growing army of autoaggressive mechanisms that underlie RA. With great success researchers have dismantled the pathogenic subunits of RA, adding gene to gene, molecule to molecule, and pathway to pathway in an ever more complex scheme of dysfunction. The complexity of the emerging disease model leaves us speechless. It seems that with this wealth of data available, we need to develop a new theory for this disease. We may want to seek guidance from our colleagues in physics and mathematics who have successfully integrated their knowledge of elementary particles and the complexity of their interacting forces by formulating the string theory.

Progress in the Analysis of Complex Atmospheric Particles

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

Laskin, Alexander; Gilles, Mary K.; Knopf, Daniel A.

2016-06-16

This manuscript presents an overview on recent advances in field and laboratory studies of atmospheric particles formed in processes of environmental air-surfaces interactions. The overarching goal of these studies is to advance predictive understanding of atmospheric particle composition, particle chemistry during aging, and their environmental impacts. The diversity between chemical constituents and lateral heterogeneity within individual particles adds to the chemical complexity of particles and their surfaces. Once emitted, particles undergo transformation via atmospheric aging processes that further modify their complex composition. We highlight a range of modern analytical approaches that enable multi-modal chemical characterization of particles with both molecularmore » and lateral specificity. When combined, they provide a comprehensive arsenal of tools for understanding the nature of particles at air-surface interactions and their reactivity and transformations with atmospheric aging. We discuss applications of these novel approaches in recent studies and highlight additional research areas to explore environmental effects of air-surface interactions.« less

Therapeutic Jurisprudence in Health Research: Enlisting Legal Theory as a Methodological Guide in an Interdisciplinary Case Study of Mental Health and Criminal Law.

PubMed

Ferrazzi, Priscilla; Krupa, Terry

2015-09-01

Studies that seek to understand and improve health care systems benefit from qualitative methods that employ theory to add depth, complexity, and context to analysis. Theories used in health research typically emerge from social science, but these can be inadequate for studying complex health systems. Mental health rehabilitation programs for criminal courts are complicated by their integration within the criminal justice system and by their dual health-and-justice objectives. In a qualitative multiple case study exploring the potential for these mental health court programs in Arctic communities, we assess whether a legal theory, known as therapeutic jurisprudence, functions as a useful methodological theory. Therapeutic jurisprudence, recruited across discipline boundaries, succeeds in guiding our qualitative inquiry at the complex intersection of mental health care and criminal law by providing a framework foundation for directing the study's research questions and the related propositions that focus our analysis. © The Author(s) 2014.

Channel-transporter complexes: an emerging theme in cell signaling.

PubMed

Abbott, Geoffrey W

2016-11-01

In a recent edition of Biochemical Journal, Mistry et al. described the discovery of a novel protein complex, formed from the epithelial sodium channel (ENaC) and the sodium chloride cotransporter (NCC) [Mistry et al. (2016) Biochem. J. 473, 3237–3252]. The importance of these two proteins in the regulation of salt balance and blood pressure has long been known, as has their overlapping expression in the distal convoluted tubule of the kidney. The new study by Mistry et al. now demonstrates their physical interaction in the kidney and when heterologously co-expressed. Furthermore, the authors demonstrate some degree of functional co-dependence between ENaC and NCC, with pharmacological inhibition of the latter diminishing activity of the former when the two are co-assembled. This novel and potentially important interaction adds to a growing number of recently identified channel-transporter ('chansporter') complexes, which together constitute an emerging theme in cell signaling. © 2016 The Author(s); published by Portland Press Limited on behalf of the Biochemical Society.

Pathomechanisms in rheumatoid arthritis — time for a string theory?

PubMed Central

Weyand, Cornelia M.; Goronzy, Jörg J.

2006-01-01

RA is a quintessential autoimmune disease with a growing number of cells, mediators, and pathways implicated in this tissue-injurious inflammation. Now Kuhn and colleagues have provided convincing evidence that autoantibodies reacting with citrullinated proteins, known for their sensitivity and specificity as biomarkers in RA, enhance tissue damage in collagen-induced arthritis (see the related article beginning on page 961). This study adds yet another soldier to the growing army of autoaggressive mechanisms that underlie RA. With great success researchers have dismantled the pathogenic subunits of RA, adding gene to gene, molecule to molecule, and pathway to pathway in an ever more complex scheme of dysfunction. The complexity of the emerging disease model leaves us speechless. It seems that with this wealth of data available, we need to develop a new theory for this disease. We may want to seek guidance from our colleagues in physics and mathematics who have successfully integrated their knowledge of elementary particles and the complexity of their interacting forces by formulating the string theory. PMID:16585957

Progress in the analysis of complex atmospheric particles

DOE PAGES

Laskin, Alexander; Gilles, Mary K.; Knopf, Daniel A.; ...

2016-06-01

This study presents an overview of recent advances in field and laboratory studies of atmospheric particles formed in processes of environmental air-surface interactions. The overarching goal of these studies is to advance predictive understanding of atmospheric particle composition, particle chemistry during aging, and their environmental impacts. The diversity between chemical constituents and lateral heterogeneity within individual particles adds to the chemical complexity of particles and their surfaces. Once emitted, particles undergo transformation via atmospheric aging processes that further modify their complex composition. We highlight a range of modern analytical approaches that enable multimodal chemical characterization of particles with both molecularmore » and lateral specificity. When combined, these approaches provide a comprehensive arsenal of tools for understanding the nature of particles at air-surface interactions and their reactivity and transformations with atmospheric aging. We discuss applications of these novel approaches in recent studies and highlight additional research areas to explore the environmental effects of air-surface interactions.« less

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

Science.gov Websites

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

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

ERIC Educational Resources Information Center

Richard, Gail J.; Russell, Joy L.

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

Response inhibition in Attention deficit disorder and neurofibromatosis type 1 – clinically similar, neurophysiologically different

PubMed Central

Bluschke, Annet; von der Hagen, Maja; Papenhagen, Katharina; Roessner, Veit; Beste, Christian

2017-01-01

There are large overlaps in cognitive deficits occurring in attention deficit disorder (ADD) and neurodevelopmental disorders like neurofibromatosis type 1 (NF1). This overlap is mostly based on clinical measures and not on in-depth analyses of neuronal mechanisms. However, the consideration of such neuronal underpinnings is crucial when aiming to integrate measures that can lead to a better understanding of the underlying mechanisms. Inhibitory control deficits, for example, are a hallmark in ADD, but it is unclear how far there are similar deficits in NF1. We thus compared adolescent ADD and NF1 patients to healthy controls in a Go/Nogo task using behavioural and neurophysiological measures. Clinical measures of ADD-symptoms were not different between ADD and NF1. Only patients with ADD showed increased Nogo errors and reductions in components reflecting response inhibition (i.e. Nogo-P3). Early perceptual processes (P1) were changed in ADD and NF1. Clinically, patients with ADD and NF1 thus show strong similarities. This is not the case in regard to underlying cognitive control processes. This shows that in-depth analyses of neurophysiological processes are needed to determine whether the overlap between ADD and NF1 is as strong as assumed and to develop appropriate treatment strategies. PMID:28262833

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

PubMed

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

2018-06-01

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

Dipeptidyl peptidase-4 inhibitors or sodium glucose co-transporter-2 inhibitors as an add-on to insulin therapy: A comparative review

PubMed Central

Singh, Awadhesh Kumar; Singh, Ritu

2016-01-01

The gradual decline in β-cell function is inevitable in type 2 diabetes mellitus and therefore, substantial proportions of patients require insulin subsequently, in order to achieve optimal glucose control. While weight gain, hypoglycemia, and fluid retention especially during dose intensification is a known limitation to insulin therapy, these adverse effects also reduce patient satisfaction and treatment adherence. It is also possible that the benefits of intensive control achieved by insulin therapy, perhaps get nullified by the weight gain and hypoglycemia. In addition, improvement in plasma glucose or glycated hemoglobin (HbA1c) itself is associated with weight gain. Notably, studies have already suggested that reduction in body weight by ~3–5%, may allow a significantly better glycemic control. Thus, a class of drugs, which can reduce HbA1c effectively, yet are weight neutral or preferably reduce body weight, could be the most sought out strategy as an add-on therapy to insulin. While sulfonylureas (SUs) are associated with weight gain and hypoglycemia, pioglitazone increases body weight and fluid retention. Moreover, SUs are not recommended once premix or prandial insulin is commenced. The addition of newer agents, such as glucagon-like peptide-1 receptor agonist to insulin certainly appears to be an effective tool in reducing both HbA1c and body weight as is evident across the studies; however, this approach incurs an additional injection as well as cost. Dipeptidyl peptidase-4 inhibitors (DPP-4I) and sodium-glucose co-transporter-2 inhibitors (SGLT-2I) are other exciting options, as an add-on to insulin therapy primarily because these are oral drugs and do not possess any intrinsic potential of hypoglycemia. Furthermore, these are either weight neutral or induce significant weight loss. This review article aims to comparatively analyze the safety and efficacy of DPP-4I and SGLT-2I, as an add-on therapy to insulin. PMID:26904466

Efficacy and Safety of Dapagliflozin or Dapagliflozin Plus Saxagliptin Versus Glimepiride as Add-on to Metformin in Patients With Type 2 Diabetes.

PubMed

Müller-Wieland, Dirk; Kellerer, Monika; Cypryk, Katarzyna; Skripova, Dasa; Rohwedder, Katja; Johnsson, Eva; Garcia-Sanchez, Ricardo; Kurlyandskaya, Raisa; David Sjöström, C; Jacob, Stephan; Seufert, Jochen; Dronamraju, Nalina; Csomós, Katalin

2018-06-27

To compare efficacy and safety of dapagliflozin ± saxagliptin with glimepiride as add-on to metformin in patients with type 2 diabetes. This 52-week, multicenter, double-blind, active-controlled study (NCT02471404) randomized (1:1:1) patients (n=939; HbA 1C 7.5-10.5%) on metformin monotherapy (≥1500 mg/day) to add-on dapagliflozin 10 mg, dapagliflozin 10 mg plus saxagliptin 5 mg, or glimepiride 1-6 mg (titrated). The primary efficacy end point was change in HbA 1C from baseline to week 52. Baseline mean age, diabetes duration and HbA 1C were 58.4 years, 7.0 years and 8.3%, respectively. Adjusted mean HbA 1C change from baseline was -1.20% with dapagliflozin plus saxagliptin and -0.82% with dapagliflozin, vs. -0.99% with glimepiride (mean dose at week 52: 4.6 mg). Changes in body weight (-3.2 kg and -3.5 k vs +1.8 kg) and systolic blood pressure (SBP; -6.4 mmHg and -5.6 mmHg vs -1.6 mmHg) were significantly greater with dapagliflozin plus saxagliptin and dapagliflozin vs glimepiride; FPG decreased significantly with dapagliflozin plus saxagliptin vs glimepiride (-2.1 mmol/L vs -1.5 mmol/L) and was similar for dapagliflozin (-1.6 mmol/L) vs glimepiride. Confirmed hypoglycemia incidence was lower with dapagliflozin regimens than with glimepiride (0 and 1 vs 13 patients) and fewer patients required rescue. Genital infections were more frequent with dapagliflozin; other AE profiles were similar. Dapagliflozin, saxagliptin and metformin improved glycemic control compared with glimepiride plus metformin; add-on of dapagliflozin alone showed similar efficacy to glimepiride. Both dapagliflozin regimens decreased body weight and SBP, with lower hypoglycemia incidence compared with glimepiride. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

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

PubMed

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

2013-12-01

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

Treatment of Early-Age Mania: Outcomes for Partial and Nonresponders to Initial Treatment.

PubMed

Walkup, John T; Wagner, Karen Dineen; Miller, Leslie; Yenokyan, Gayane; Luby, Joan L; Joshi, Paramjit T; Axelson, David A; Robb, Adelaide; Salpekar, Jay A; Wolf, Dwight; Sanyal, Abanti; Birmaher, Boris; Vitiello, Benedetto; Riddle, Mark A

2015-12-01

The Treatment of Early Age Mania (TEAM) study evaluated lithium, risperidone, and divalproex sodium (divalproex) in children with bipolar I disorder who were naive to antimanic medication, or were partial or nonresponders to 1 of 3 study medications. This report evaluates the benefit of either an add-on or a switch of antimanic medications for an 8-week trial period in partial responders and nonresponders, respectively. TEAM is a randomized, controlled trial of individuals (N = 379) aged 6 to 15 years (mean ± SD = 10.2 ± 2.7 years) with DSM-IV bipolar I disorder (mixed or manic phase). Participants (n = 154) in this report were either nonresponders or partial responders to 1 of the 3 study medications. Nonresponders (n = 89) were randomly assigned to 1 of the other 2 antimanic medications and cross-tapered. Partial responders (n = 65) were randomly assigned to 1 of 2 other antimanic medications as an add-on to their initial medication. Adverse event (AE) rates are reported only for the add-on group. Response rate for children switched to risperidone (47.6%) was higher than for those switched to either lithium (12.8%; p = .005; number needed to treat [NNT] = 3; 95% CI = 1.71-9.09) or divalproex (17.2%; p = .03; NNT = 3; 95% CI = 1.79-20.10); response rate for partial responders who added risperidone (53.3%) was higher than for those who added divalproex (0%; p = .0002; NNT = 2; 95% CI = 1.27-3.56) and trended higher for lithium (26.7%; p = .07; NNT = 4). Reported AEs in the add-on group were largely consistent with the known AE profile for the second medication. Weight gain (kg) was observed for all add-on medications: lithium add-on (n = 29 of 30) = 1.66 ± 1.97; risperidone add-on (n = 15 of 15) = 2.8 ± 1.34; divalproex add-on (n = 19 of 20) = 1.42 ± 1.96. There was no evidence at the 5% significance level that the average weight gain was different by study medication for partial responders (p = .07, 1-way analysis of variance). Risperidone appears to be more useful than lithium or divalproex for children with bipolar I disorder and other comorbid conditions who are nonresponders or partial responders to an initial antimanic medication trial. Clinical trial registration information-Study of Outcome and Safety of Lithium, Divalproex and Risperidone for Mania in Children and Adolescents (TEAM); http://clinicaltrials.gov/; NCT00057681. Copyright © 2015. Published by Elsevier Inc.

Determination of brace forces caused by construction loads and wind loads during bridge construction : [summary].

DOT National Transportation Integrated Search

2014-04-01

Bridges are constructed in stages as pilings, : columns, girders, decks, and other components : are added. At each stage, the structure must be : stable. Girders, which add significant weight to : the developing structure, rest on elastomeric : beari...

Using SpaceClaimTD Direct for Modeling Components with Complex Geometries for the Thermal Desktop-Based Advanced Stirling Radioisotope Generator Model

NASA Technical Reports Server (NTRS)

Fabanich, William A., Jr.

2014-01-01

SpaceClaim/TD Direct has been used extensively in the development of the Advanced Stirling Radioisotope Generator (ASRG) thermal model. This paper outlines the workflow for that aspect of the task and includes proposed best practices and lessons learned. The ASRG thermal model was developed to predict component temperatures and power output and to provide insight into the prime contractor's thermal modeling efforts. The insulation blocks, heat collectors, and cold side adapter flanges (CSAFs) were modeled with this approach. The model was constructed using mostly TD finite difference (FD) surfaces/solids. However, some complex geometry could not be reproduced with TD primitives while maintaining the desired degree of geometric fidelity. Using SpaceClaim permitted the import of original CAD files and enabled the defeaturing/repair of those geometries. TD Direct (a SpaceClaim add-on from CRTech) adds features that allowed the "mark-up" of that geometry. These so-called "mark-ups" control how finite element (FE) meshes are to be generated through the "tagging" of features (e.g. edges, solids, surfaces). These tags represent parameters that include: submodels, material properties, material orienters, optical properties, and radiation analysis groups. TD aliases were used for most tags to allow analysis to be performed with a variety of parameter values. "Domain-tags" were also attached to individual and groups of surfaces and solids to allow them to be used later within TD to populate objects like, for example, heaters and contactors. These tools allow the user to make changes to the geometry in SpaceClaim and then easily synchronize the mesh in TD without having to redefine the objects each time as one would if using TDMesher. The use of SpaceClaim/TD Direct helps simplify the process for importing existing geometries and in the creation of high fidelity FE meshes to represent complex parts. It also saves time and effort in the subsequent analysis.

Vadose Zone Fate and Transport Simulation of Chemicals Associated with Coal Seam Gas Extraction

NASA Astrophysics Data System (ADS)

Simunek, J.; Mallants, D.; Jacques, D.; Van Genuchten, M.

2017-12-01

The HYDRUS-1D and HYDRUS (2D/3D) computer software packages are widely used finite element models for simulating the one-, and two- or three-dimensional movement of water, heat, and multiple solutes in variably-saturated media, respectively. While the standard HYDRUS models consider only the fate and transport of individual solutes or solutes subject to first-order degradation reactions, several specialized HYDRUS add-on modules can simulate far more complex biogeochemical processes. The objective of this presentation is to provide an overview of the HYDRUS models and their add-on modules, and to demonstrate applications of the software to the subsurface fate and transport of chemicals involved in coal seam gas extraction and water management operations. One application uses the standard HYDRUS model to evaluate the natural soil attenuation potential of hydraulic fracturing chemicals and their transformation products in case of an accidental release. By coupling the processes of retardation, first-order degradation and convective-dispersive transport of the biocide bronopol and its degradation products, we demonstrated how natural attenuation reduces initial concentrations by more than a factor of hundred in the top 5 cm of the vadose zone. A second application uses the UnsatChem module to explore the possible use of coal seam gas produced water for sustainable irrigation. Simulations with different irrigation waters (untreated, amended with surface water, and reverse osmosis treated) provided detailed results regarding chemical indicators of soil and plant health, notably SAR, EC and sodium concentrations. A third application uses the coupled HYDRUS-PHREEQC module to analyze trace metal transport involving cation exchange and surface complexation sorption reactions in the vadose zone leached with coal seam gas produced water following some accidental water release scenario. Results show that the main process responsible for trace metal migration is complexation of naturally present trace metals with inorganic ligands such as (bi)carbonate that enter the soil upon infiltration with alkaline produced water.

Using SpaceClaim/TD Direct for Modeling Components with Complex Geometries for the Thermal Desktop-Based Advanced Stirling Radioisotope Generator Model

NASA Technical Reports Server (NTRS)

Fabanich, William

2014-01-01

SpaceClaim/TD Direct has been used extensively in the development of the Advanced Stirling Radioisotope Generator (ASRG) thermal model. This paper outlines the workflow for that aspect of the task and includes proposed best practices and lessons learned. The ASRG thermal model was developed to predict component temperatures and power output and to provide insight into the prime contractors thermal modeling efforts. The insulation blocks, heat collectors, and cold side adapter flanges (CSAFs) were modeled with this approach. The model was constructed using mostly TD finite difference (FD) surfaces solids. However, some complex geometry could not be reproduced with TD primitives while maintaining the desired degree of geometric fidelity. Using SpaceClaim permitted the import of original CAD files and enabled the defeaturing repair of those geometries. TD Direct (a SpaceClaim add-on from CRTech) adds features that allowed the mark-up of that geometry. These so-called mark-ups control how finite element (FE) meshes were generated and allowed the tagging of features (e.g. edges, solids, surfaces). These tags represent parameters that include: submodels, material properties, material orienters, optical properties, and radiation analysis groups. TD aliases were used for most tags to allow analysis to be performed with a variety of parameter values. Domain-tags were also attached to individual and groups of surfaces and solids to allow them to be used later within TD to populate objects like, for example, heaters and contactors. These tools allow the user to make changes to the geometry in SpaceClaim and then easily synchronize the mesh in TD without having to redefine these objects each time as one would if using TD Mesher.The use of SpaceClaim/TD Direct has helped simplify the process for importing existing geometries and in the creation of high fidelity FE meshes to represent complex parts. It has also saved time and effort in the subsequent analysis.

Measured dose to ovaries and testes from Hodgkin's fields and determination of genetically significant dose

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

Niroomand-Rad, A.; Cumberlin, R.

The purpose of this study was to determine the genetically significant dose from therapeutic radiation exposure with Hodgkin's fields by estimating the doses to ovaries and testes. Phantom measurements were performed to verify estimated doses to ovaries and testes from Hodgkin's fields. Thermoluminescent LiF dosimeters (TLD-100) of 1 x 3 x 3 mm[sup 3] dimensions were embedded in phantoms and exposed to standard mantle and paraaortic fields using Co-60, 4 MV, 6 MV, and 10 MV photon beams. The results show that measured doses to ovaries and testes are about two to five times higher than the corresponding graphically estimatedmore » doses for Co-60 and 4 MVX photon beams as depicted in ICRP publication 44. In addition, the measured doses to ovaries and testes are about 30% to 65% lower for 10 MV photon beams than for their corresponding Co-60 photon beams. The genetically significant dose from Hodgkin's treatment (less than 0.01 mSv) adds about 4% to the genetically significant dose contribution to medical procedures and adds less than 1% to the genetically significant dose from all sources. Therefore, the consequence to society is considered to be very small. The consequences for the individual patient are, likewise, small. 28 refs., 3 figs., 5 tabs.« less

Changes in biomarkers of bone turnover in an aripiprazole add-on or switching study.

PubMed

Lodhi, Rohit J; Masand, Salaj; Malik, Amna; Shivakumar, Kuppuswami; McAllister, Victoria D M; O'Keane, Veronica; Young, Leah C; Heald, Adrian H; Sherwood, Roy A; Aitchison, Katherine J

2016-02-01

The association between mental illness and osteoporosis and fractures is particularly pronounced in psychotic disorders. Antipsychotic use has previously been described to affect bone density. A 52-week follow-up of patients switched to aripiprazole or with aripiprazole added on, conducting a specific analysis of markers of bone turnover: urinary NTX (a biomarker of bone resorption) and serum BSAP (a biomarker of bone formation). Baseline and serial measurements of bone markers NTX, BSAP and of hormones prolactin, oestrogen and testosterone were done at weeks 0 and 1, 2, 6, 12, 26 and 52, respectively. NTX concentration reduced over time but this did not reach significance in the whole group (log-NTX: β=-0.0012, p=0.142). For BSAP the addition of or replacement with aripiprazole produced a significant reduction (log-BSAP: β=-0.00039, p=0.002). Analysis with prolactin similarly showed a significant reduction (log-prolactin: β=-0.0024, p<0.001); other hormones did not change significantly. Sensitivity analysis to compare the switchers to aripiprazole versus the "add-on" showed that the former group had a significant reduction in NTX. We found that switching to aripiprazole was associated with changes in molecular biomarkers of bone resorption, indicating a more favourable profile for bone health. Copyright © 2015 Elsevier B.V. All rights reserved.

An epigenetic switch regulates de novo DNA methylation at a subset of pluripotency gene enhancers during embryonic stem cell differentiation.

PubMed

Petell, Christopher J; Alabdi, Lama; He, Ming; San Miguel, Phillip; Rose, Richard; Gowher, Humaira

2016-09-19

Coordinated regulation of gene expression that involves activation of lineage specific genes and repression of pluripotency genes drives differentiation of embryonic stem cells (ESC). For complete repression of pluripotency genes during ESC differentiation, chromatin at their enhancers is silenced by the activity of the Lsd1-Mi2/NuRD complex. The mechanism/s that regulate DNA methylation at these enhancers are largely unknown. Here, we investigated the affect of the Lsd1-Mi2/NuRD complex on the dynamic regulatory switch that induces the local interaction of histone tails with the Dnmt3 ATRX-DNMT3-DNMT3L (ADD) domain, thus promoting DNA methylation at the enhancers of a subset of pluripotency genes. This is supported by previous structural studies showing a specific interaction between Dnmt3-ADD domain with H3K4 unmethylated histone tails that is disrupted by histone H3K4 methylation and histone acetylation. Our data suggest that Dnmt3a activity is triggered by Lsd1-Mi2/NuRD-mediated histone deacetylation and demethylation at these pluripotency gene enhancers when they are inactivated during mouse ESC differentiation. Using Dnmt3 knockout ESCs and the inhibitors of Lsd1 and p300 histone modifying enzymes during differentiation of E14Tg2A and ZHBTc4 ESCs, our study systematically reveals this mechanism and establishes that Dnmt3a is both reader and effector of the epigenetic state at these target sites. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

An epigenetic switch regulates de novo DNA methylation at a subset of pluripotency gene enhancers during embryonic stem cell differentiation

PubMed Central

Petell, Christopher J.; Alabdi, Lama; He, Ming; San Miguel, Phillip; Rose, Richard; Gowher, Humaira

2016-01-01

Coordinated regulation of gene expression that involves activation of lineage specific genes and repression of pluripotency genes drives differentiation of embryonic stem cells (ESC). For complete repression of pluripotency genes during ESC differentiation, chromatin at their enhancers is silenced by the activity of the Lsd1-Mi2/NuRD complex. The mechanism/s that regulate DNA methylation at these enhancers are largely unknown. Here, we investigated the affect of the Lsd1-Mi2/NuRD complex on the dynamic regulatory switch that induces the local interaction of histone tails with the Dnmt3 ATRX-DNMT3-DNMT3L (ADD) domain, thus promoting DNA methylation at the enhancers of a subset of pluripotency genes. This is supported by previous structural studies showing a specific interaction between Dnmt3-ADD domain with H3K4 unmethylated histone tails that is disrupted by histone H3K4 methylation and histone acetylation. Our data suggest that Dnmt3a activity is triggered by Lsd1-Mi2/NuRD-mediated histone deacetylation and demethylation at these pluripotency gene enhancers when they are inactivated during mouse ESC differentiation. Using Dnmt3 knockout ESCs and the inhibitors of Lsd1 and p300 histone modifying enzymes during differentiation of E14Tg2A and ZHBTc4 ESCs, our study systematically reveals this mechanism and establishes that Dnmt3a is both reader and effector of the epigenetic state at these target sites. PMID:27179026

Add-on anticholinergic therapy for residual nocturia in patients with lower urinary tract symptoms receiving α1-blocker treatment: a multi-centre, prospective, randomised study.

PubMed

Yokoyama, Osamu; Tsujimura, Akira; Akino, Hironobu; Segawa, Naoki; Tamada, Satoshi; Oguchi, Naoki; Kitagawa, Yasuhide; Tsuji, Hidenori; Watanabe, Akihiko; Inamoto, Teruo; Shimizu, Nobutaka; Fujiuchi, Yasuyoshi; Katsuoka, Yoji; Azuma, Haruhito; Matsuda, Tadashi; Namiki, Mikio; Uemura, Hirotsugu; Okuyama, Akihiko; Nonomura, Norio; Fuse, Hideki; Nakatani, Tatsuya

2015-05-01

To evaluate the efficacy and safety of imidafenacin (IM), a novel short half-life anticholinergic, as add-on therapy for male LUTS with nocturia and nocturnal polyuria. This multicenter, prospective, randomized, open-labelled study was conducted and involved men who had frequency, urgency, and nocturia despite receiving a stable dose of α1-blocker for ≥1 month. Subjects were randomised to control (α1-blocker alone), IM twice/day (α1-blocker +0.1 mg imidafenacin twice daily), or IM nightly (α1-blocker plus 0.1 mg imidafenacin nightly) group; the treatment period was 8 weeks. Primary endpoints included improvements in night-time frequency and Nocturia Quality of Life Questionnaire (N-QOL) scores. Secondary endpoints included changes from the baseline in frequency volume chart variables, and post-void residual volume. Compared with the controls, IM twice/day and IM nightly patients had a significantly lower night-time frequency (changes from baseline: 0.1 ± 0.8 in control, -0.6 ± 0.9 in IM twice/day, and -0.4 ± 1.0 in IM nightly, p = 0.5227, 0.0006 and 0.0143, respectively). The hours of undisturbed sleep and N-QOL score were significantly improved in IM twice/day group, though not IM nightly group. Nocturnal urine volume was significantly reduced in IM nightly group, although total urine volume remained unchanged. A short half-life anticholinergic is suggested to be safe and effective as an add-on therapy for residual nocturia in patients with male LUTS receiving α1-blocker treatment. Anticholinergic administration nightly could reduce the nocturnal urine volume.

Retrospective comparison of voglibose or acarbose as an add-on therapy to sulfonylureas in Western Indian patients with uncontrolled overweight/obese type 2 diabetes.

PubMed

Talaviya, Praful A; Saboo, Banshi D; Dodiya, Hardik G; Rao, Shaival K; Joshi, Shashank R; Modh, Vipul B; Ghadiya, Sneha V

2016-01-01

The study was aimed to investigate the effect of voglibose or acarbose as an add-on treatment in overweight/obese type 2 diabetes (T2DM) patients who are uncontrolled with metformin and sulfonylureas (SUs) in Western part of India. A retrospective study included 77 participants (BMI≥25kg/m(2); HbA1c level>8% and<9.5%) with overweight/obese T2DM. These participants were treated with either voglibose or acarbose. Glycemic parameters (fasting blood glucose and glycated hemoglobin [HbA1c]), bodyweight, BMI and lipid parameters were evaluated at baseline, 3-month, 6-month and 9-month of treatment. Adverse events were also captured at respective time points. Voglibose showed significant reduction in HbA1c and bodyweight with short duration of treatment (6 months; P<0.05 and 9 months; P<0.01) whereas acarbose showed significant reduction with longer duration of treatment (9 months; P<0.05) when compared with baseline. Moreover, both treatment groups were reported with reduction in BMI. Further, significant improvement in lipid parameters except LDL and HDL were observed in both treatment groups when compared with baseline. None of participant was discontinued due to side effects of the treatment. In addition, the frequency of hypoglycemia was decreased in both treatment groups. Voglibose or acarbose as an add-on treatment with metformin and sulfonylureas in uncontrolled obese/overweight T2DM provides desired glycemic control, reduces bodyweight and improves lipid parameters with good tolerability profile. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

No evidence for an effect on brain atrophy rate of atorvastatin add-on to interferon β1b therapy in relapsing-remitting multiple sclerosis (the ARIANNA study).

PubMed

Lanzillo, Roberta; Quarantelli, Mario; Pozzilli, Carlo; Trojano, Maria; Amato, Maria Pia; Marrosu, Maria G; Francia, Ada; Florio, Ciro; Orefice, Giuseppe; Tedeschi, Gioacchino; Bellantonio, Paolo; Annunziata, Pasquale; Grimaldi, Luigi M; Comerci, Marco; Brunetti, Arturo; Bonavita, Vincenzo; Alfano, Bruno; Marini, Stefano; Brescia Morra, Vincenzo

2016-08-01

A previous phase 2 trial has suggested that statins might delay brain atrophy in secondary progressive multiple sclerosis. The objective of this study was to evaluate the effect of atorvastatin add-on therapy on cerebral atrophy in relapsing-remitting multiple sclerosis. This randomised, placebo-controlled study compared atorvastatin 40 mg or placebo add-on therapy to interferon β1b for 24 months. Brain magnetic resonance imaging, multiple sclerosis functional composite score, Rao neuropsychological battery and expanded disability status scale were evaluated over 24 months. A total of 154 patients were randomly assigned, 75 in the atorvastatin and 79 in the placebo arms, with a comparable drop-out rate (overall 23.4%). Brain atrophy over 2 years was not different in the two arms (-0.38% and -0.32% for the atorvastatin and placebo groups, respectively). Relapse rate, expanded disability status scale, multiple sclerosis functional composite score or cognitive changes were not different in the two arms. Patients withdrawing from the study had a higher number of relapses in the previous 2 years (P=0.04) and a greater probability of relapsing within 12 months. Our results suggest that the combination of atorvastatin and interferon β1b is not justified in early relapsing-remitting multiple sclerosis and adds to the body of evidence indicating an absence of significant radiological and clinical benefit of statins in relapsing-remitting multiple sclerosis. © The Author(s), 2015.

Cultivating interpretive thinking through enacting narrative pedagogy.

PubMed

Scheckel, Martha M; Ironside, Pamela M

2006-01-01

Teachers and educational researchers in nursing have persisted in their attempts to teach students critical thinking and to evaluate the effectiveness of these efforts. Yet, despite the plethora of studies investigating critical thinking, there is a paucity of research providing evidence that teachers' efforts improve students' thinking. The purpose of this interpretive phenomenological study is to explicate how students' thinking can be extended when teachers use Narrative Pedagogy. Specifically, the theme Cultivating Interpretive Thinking refers to how teachers' use of Narrative Pedagogy moves beyond the critical thinking movement's emphasis on analytical thinking (i.e., problem solving). Cultivating Interpretive Thinking offers an innovative approach for teaching and learning thinking that attends to students' embodied, reflective, and pluralistic thinking experiences. Teachers who cultivate interpretive thinking add complexity to students' thinking to better prepare them for challenging, complex, and unpredictable clinical environments.

Arm injury produces long-term behavioral and neural hypersensitivity in octopus.

PubMed

Alupay, Jean S; Hadjisolomou, Stavros P; Crook, Robyn J

2014-01-13

Cephalopod molluscs are the most neurally and behaviorally complex invertebrates, with brains rivaling those of some vertebrates in size and complexity. This has fostered the opinion that cephalopods, particularly octopuses, may experience vertebrate-like pain when injured. However, it is not known whether octopuses possess nociceptors or if their somatic sensory neurons exhibit sensitization after injury. Here we show that the octopus Abdopus aculeatus expresses nocifensive behaviors including arm autotomy, and displays marked neural hyperexcitability both in injured and uninjured arms for at least 24h after injury. These findings do not demonstrate that octopuses experience pain-like states; instead they add to the minimal existing literature on how cephalopods receive, process, and integrate noxious sensory information, potentially informing and refining regulations governing use of cephalopods in scientific research. Published by Elsevier Ireland Ltd.

KSC-07pd2368

NASA Image and Video Library

2007-08-24

KENNEDY SPACE CENTER, FLA. -- A United Space Alliance external tank technician maps out the cutting area of the liquid oxygen (LO2) feed line bracket where BX265 foam insulation and super lightweight ablator, or SLA, cork insulation is to be removed. The BX265 foam insulation will later be reapplied without the SLA. The tank is scheduled to fly on Space Shuttle Discovery in October 2007 on mission STS-120. Discovery's crew will add the module Harmony that will serve as a port for installing additional international laboratories. Harmony will be the first expansion of the living and working space on the complex since the Russian Pirs airlock was installed in 2001. The mission also will move the first set of solar arrays installed on the station to a permanent location on the complex and redeploy them. Photo credit: NASA/Jim Grossmann

KSC-07pd2369

NASA Image and Video Library

2007-08-24

KENNEDY SPACE CENTER, FLA. -- A United Space Alliance external tank technician has completed the removal of a layer of BX265 foam insulation from the LO2 feed line bracket on the external tank. The BX265 foam insulation will later be reapplied without the super lightweight ablator, or SLA, cork insulation. The tank is scheduled to fly on Space Shuttle Discovery in October 2007 on mission STS-120. Discovery's crew will add the module Harmony that will serve as a port for installing additional international laboratories. Harmony will be the first expansion of the living and working space on the complex since the Russian Pirs airlock was installed in 2001. The mission also will move the first set of solar arrays installed on the station to a permanent location on the complex and redeploy them. Photo credit: NASA/Jim Grossmann

Design of Improved Arithmetic Logic Unit in Quantum-Dot Cellular Automata

NASA Astrophysics Data System (ADS)

Heikalabad, Saeed Rasouli; Gadim, Mahya Rahimpour

2018-06-01

The quantum-dot cellular automata (QCA) can be replaced to overcome the limitation of CMOS technology. An arithmetic logic unit (ALU) is a basic structure of any computer devices. In this paper, design of improved single-bit arithmetic logic unit in quantum dot cellular automata is presented. The proposed structure for ALU has AND, OR, XOR and ADD operations. A unique 2:1 multiplexer, an ultra-efficient two-input XOR and a low complexity full adder are used in the proposed structure. Also, an extended design of this structure is provided for two-bit ALU in this paper. The proposed structure of ALU is simulated by QCADesigner and simulation result is evaluated. Evaluation results show that the proposed design has best performance in terms of area, complexity and delay compared to the previous designs.

Optical network scaling: roles of spectral and spatial aggregation.

PubMed

Arık, Sercan Ö; Ho, Keang-Po; Kahn, Joseph M

2014-12-01

As the bit rates of routed data streams exceed the throughput of single wavelength-division multiplexing channels, spectral and spatial traffic aggregation become essential for optical network scaling. These aggregation techniques reduce network routing complexity by increasing spectral efficiency to decrease the number of fibers, and by increasing switching granularity to decrease the number of switching components. Spectral aggregation yields a modest decrease in the number of fibers but a substantial decrease in the number of switching components. Spatial aggregation yields a substantial decrease in both the number of fibers and the number of switching components. To quantify routing complexity reduction, we analyze the number of multi-cast and wavelength-selective switches required in a colorless, directionless and contentionless reconfigurable optical add-drop multiplexer architecture. Traffic aggregation has two potential drawbacks: reduced routing power and increased switching component size.

Design of Improved Arithmetic Logic Unit in Quantum-Dot Cellular Automata

NASA Astrophysics Data System (ADS)

Heikalabad, Saeed Rasouli; Gadim, Mahya Rahimpour

2018-03-01

The quantum-dot cellular automata (QCA) can be replaced to overcome the limitation of CMOS technology. An arithmetic logic unit (ALU) is a basic structure of any computer devices. In this paper, design of improved single-bit arithmetic logic unit in quantum dot cellular automata is presented. The proposed structure for ALU has AND, OR, XOR and ADD operations. A unique 2:1 multiplexer, an ultra-efficient two-input XOR and a low complexity full adder are used in the proposed structure. Also, an extended design of this structure is provided for two-bit ALU in this paper. The proposed structure of ALU is simulated by QCADesigner and simulation result is evaluated. Evaluation results show that the proposed design has best performance in terms of area, complexity and delay compared to the previous designs.

Bridging the Policy-Implementation Gap in Federal Health Systems: Lessons from the Nigerian Experience

PubMed Central

Sokpo, Emmanuel

2014-01-01

The Partnership for Reviving Routine Immunization in Northern Nigeria - Maternal, Newborn and Child Health initiative supports efforts by the government of Nigeria to bridge primary health care (PHC) policies and services at three levels of government: federal, state and local. The paper suggests that understandings informed by complexity theory and complex adaptive systems have been helpful in shaping policy and programme design across these levels. To illustrate this, three initiatives are explored: Bringing PHC under one roof, enhancing access to funding provided by the Global Alliance for Vaccines and Immunization, and strengthening the midwives service scheme. These initiatives have demonstrated how concepts and experience developed at subnational level can influence national policy and practice, and how work at subnational levels can add value to nationally conceived and nationally driven plans for PHC. PMID:28299131

A combined nurse-pharmacist managed pain clinic: joint venture of public and private sectors.

PubMed

Hadi, Muhammad Abdul; Alldred, David Phillip; Briggs, Michelle; Closs, S José

2012-02-01

Chronic pain has become one of the most prevalent problems in primary care. The management of chronic pain is complex and often requires a multidisciplinary approach. The limited capacity of general practitioners to manage chronic pain and long waiting time for secondary care referrals further add to the complexity of chronic pain management. Restricted financial and skilled human capital make it hard for healthcare systems across the world to establish and maintain multidisciplinary pain clinics, in spite of their documented effectiveness. Affordability and accessibility to such multidisciplinary pain clinics is often problematic for patients. The purpose of this paper is to share our experience and relevant research evidence of a community based combined nurse-pharmacist managed pain clinic. The pain clinic serves as an example of public-private partnership in healthcare.

Toward cognitive robotics

NASA Astrophysics Data System (ADS)

Laird, John E.

2009-05-01

Our long-term goal is to develop autonomous robotic systems that have the cognitive abilities of humans, including communication, coordination, adapting to novel situations, and learning through experience. Our approach rests on the recent integration of the Soar cognitive architecture with both virtual and physical robotic systems. Soar has been used to develop a wide variety of knowledge-rich agents for complex virtual environments, including distributed training environments and interactive computer games. For development and testing in robotic virtual environments, Soar interfaces to a variety of robotic simulators and a simple mobile robot. We have recently made significant extensions to Soar that add new memories and new non-symbolic reasoning to Soar's original symbolic processing, which should significantly improve Soar abilities for control of robots. These extensions include episodic memory, semantic memory, reinforcement learning, and mental imagery. Episodic memory and semantic memory support the learning and recalling of prior events and situations as well as facts about the world. Reinforcement learning provides the ability of the system to tune its procedural knowledge - knowledge about how to do things. Mental imagery supports the use of diagrammatic and visual representations that are critical to support spatial reasoning. We speculate on the future of unmanned systems and the need for cognitive robotics to support dynamic instruction and taskability.

The speech aversion hypothesis has explanatory power in a Minimal Speech Approach to aloof, non-verbal, severe autism.

PubMed

Whittaker, Christopher A

2012-01-01

In the search for 'pure autism', non-verbal children labeled aloof, Severely Autistic with Developmental Disabilities (ASA/DD), are routinely excluded from psychological research. This exclusion is predicated on the claim that they are indistinguishable from those with SLD/PMLD, which is refuted through a discussion of the extant literature. A novel, falsifiable, speech aversion hypothesis is proposed: "aloof, non-verbal young children (<7 years), with severe autism (CARS≥37), but without significant dysmorphic features, will show aversive reactions to complex speech (>2-3 words), but not to a silent interlocutor, or one imitating their vocalizations, in proximal encounters." Implications are examined by deconstructing the presenting symptoms of ASA/DD in response to the hypothesis. Supporting evidence is drawn from: Minimal Speech Approach (MSA) research showing high levels of spontaneous requests for social routines; a reinterpretation of still-face research as a still-(silent)-face paradigm; auditory processing MMN data employing EEG/MEG; and possible links to epileptiform activity and verbal auditory agnosia. Guidelines are established for future research. This hypothesis, if corroborated, would add to the auditory processing anomalies seen in severe autism and lead to synergies of existing and new areas of research, with significant theoretical, therapeutic, and educational implications. Copyright © 2011 Elsevier Ltd. All rights reserved.

Thiaminase activity in native freshwater mussels

USGS Publications Warehouse

Blakeslee, Carrie J.; Sweet, Stephanie; Galbraith, Heather S.; Honeyfield, Dale C.

2015-01-01

Thiamine (vitamin B1) deficiency in the Great Lakes has been attributed to elevated levels of thiaminase I enzyme activity in invasive prey species; however, few studies have investigated thiaminase activity in native prey species. Some of the highest levels of thiaminase activity have been measured in invasive dreissenid mussels with little understanding of background levels contributed by native freshwater mussels (Bivalvia: Unionidae). In this study, thiaminase activity was measured in two freshwater mussel species, Elliptio complanata and Strophitus undulatus, from the Delaware and Susquehanna River drainage basins located in north eastern United States. Thiaminase activity was also measured in gravid and non-gravid S. undulatus. Average thiaminase activity differed significantly between species (7.2 and 42.4 μmol/g/min, for E. complanata and S. undulatus respectively) with no differences observed between drainage basins. Gravid S. undulatus had significantly lower thiaminase activity (28.0 μmol/g/min) than non-gravid mussels (42.4 μmol/g/min). Our results suggest that a suite of factors may regulate thiaminase activity in freshwater mussels and that native freshwater mussel thiaminase activity is within the range observed for invasive dreissenids. These results add to our understanding of the complexities in identifying the ecological conditions that set the stage for thiamine deficiency.

Influence of anxiety on memory performance in temporal lobe epilepsy.

PubMed

Brown, Franklin C; Westerveld, Michael; Langfitt, John T; Hamberger, Marla; Hamid, Hamada; Shinnar, Shlomo; Sperling, Michael R; Devinsky, Orrin; Barr, William; Tracy, Joseph; Masur, David; Bazil, Carl W; Spencer, Susan S

2014-02-01

This study examined the degree to which anxiety contributed to inconsistent material-specific memory difficulties among 243 patients with temporal lobe epilepsy from the Multisite Epilepsy Study. Visual memory performance on the Rey Complex Figure Test (RCFT) was poorer for those with high versus low levels of anxiety but was not found to be related to the TLE side. The verbal memory score on the California Verbal Learning Test (CVLT) was significantly lower for patients with left-sided TLE than for patients with right-sided TLE with low anxiety levels but equally impaired for those with high anxiety levels. These results suggest that we can place more confidence in the ability of verbal memory tests like the CVLT to lateralize to left-sided TLE for those with low anxiety levels, but that verbal memory will be less likely to produce lateralizing information for those with high anxiety levels. This suggests that more caution is needed when interpreting verbal memory tests for those with high anxiety levels. These results indicated that RCFT performance was significantly affected by anxiety and did not lateralize to either side, regardless of anxiety levels. This study adds to the existing literature which suggests that drawing-based visual memory tests do not lateralize among patients with TLE, regardless of anxiety levels. © 2013.

The Moderating Role of Age in Responses to Direct-to-Consumer Prescription Drug Advertising.

PubMed

Ball, Jennifer G; Manika, Danae; Stout, Patricia A

2016-01-01

Age is an important factor that can influence processing of and response to health messages. Many studies examining evaluations of and responses to direct-to-consumer prescription drug advertising (DTCA) have incorporated age as a predictor variable, moderating variable, or sample criterion. However, findings have been inconsistent. This study attempts to add clarity to this body of research by assessing age differences in the antecedent factors of various DTCA outcomes. A multigroup structural equation modeling analysis revealed several significant differences in variable relationships between older (50+) and younger (<50) adults. Overall, older adults exhibited greater complexity in their consideration of DTCA than younger adults in terms of the sheer number of significant relationships within the model. In particular, trust in mediated health information sources and trust in one's physician appeared to be more relevant predictors for older adults. Trust in DTCA was also distinguished as having an inverse relationship with behavioral intentions among older adults while showing a straightforward positive association with attention among younger adults. Further analysis indicated that health status accounted for some but not all of the age differences. It is suggested that younger adults are more open to seeking additional information following DTCA exposure, whereas older adults remain ambivalent.

"I had no idea what a complicated business eating is…": a qualitative study of the impact of dysphagia during stroke recovery.

PubMed

Moloney, Jennifer; Walshe, Margaret

2018-06-01

Persons with dysphagia following stroke may experience uncomfortable symptoms such as persistent coughing, choking and poor salivary management. They may also spend long periods of time unable to eat or drink or with restrictions on oral intake. Experiences of dysphagia post-stroke are richly described in unsolicited narratives such as autobiographies on the stroke event, which often include details of the author's journey through their stroke recovery. The aim of this study is to use autobiographical accounts to explore the experiences of those living with dysphagia following stroke. Published autobiographies narrating the author's experiences of living with dysphagia following stroke were sourced. Ten autobiographies were retrieved and the texts were manually inspected. All references to eating, drinking and swallowing were extracted and pooled to form the data set. A qualitative approach using a six-step interpretive phenomenological analysis process was taken to analyze this data set. A wide range of interconnected themes emerged from the data, allowing further synthesis into six overarching super-ordinate themes. These six super-ordinate themes were: "physical consequences of dysphagia"; "process of recovery"; "coping and adjusting"; "changed relationships"; "society" and "control". This study highlights the unique contribution of autobiographical accounts in developing our understanding of living with dysphagia following stroke. The findings emphasize the significant emotional and social impact of dysphagia during the stroke recovery process and add further depth to our understanding of the experience of this clinical group. Implications for Rehabilitation Autobiographical accounts often hold valuable first-hand information on patient perspectives and journeys, which when viewed through the eyes of a qualitative researcher, can add depth to our understanding of particular healthcare experiences. Persons who experience dysphagia as a result of stroke travel a complex rehabilitation journey, involving the interaction of many physical, emotional and social considerations. Healthcare professionals should be aware of not only the physical, but also the significant psychosocial consequences of living with dysphagia following stroke. Further research is required in this field, so that the experiences of these persons can be better understood and findings can be used to contribute to high-quality and evidence-based service delivery.

Integrating technology into complex intervention trial processes: a case study.

PubMed

Drew, Cheney J G; Poile, Vincent; Trubey, Rob; Watson, Gareth; Kelson, Mark; Townson, Julia; Rosser, Anne; Hood, Kerenza; Quinn, Lori; Busse, Monica

2016-11-17

Trials of complex interventions are associated with high costs and burdens in terms of paperwork, management, data collection, validation, and intervention fidelity assessment occurring across multiple sites. Traditional data collection methods rely on paper-based forms, where processing can be time-consuming and error rates high. Electronic source data collection can potentially address many of these inefficiencies, but has not routinely been used in complex intervention trials. Here we present the use of an on-line system for managing all aspects of data handling and for the monitoring of trial processes in a multicentre trial of a complex intervention. We custom built a web-accessible software application for the delivery of ENGAGE-HD, a multicentre trial of a complex physical therapy intervention. The software incorporated functionality for participant randomisation, data collection and assessment of intervention fidelity. It was accessible to multiple users with differing levels of access depending on required usage or to maintain blinding. Each site was supplied with a 4G-enabled iPad for accessing the system. The impact of this system was quantified through review of data quality and collation of feedback from site coordinators and assessors through structured process interviews. The custom-built system was an efficient tool for collecting data and managing trial processes. Although the set-up time required was significant, using the system resulted in an overall data completion rate of 98.5% with a data query rate of 0.1%, the majority of which were resolved in under a week. Feedback from research staff indicated that the system was highly acceptable for use in a research environment. This was a reflection of the portability and accessibility of the system when using the iPad and its usefulness in aiding accurate data collection, intervention fidelity and general administration. A combination of commercially available hardware and a bespoke online database designed to support data collection, intervention fidelity and trial progress provides a viable option for streamlining trial processes in a multicentre complex intervention trial. There is scope to further extend the system to cater for larger trials and add further functionality such as automatic reporting facilities and participant management support. ISRCTN65378754 , registered on 13 March 2014.

Retention of Habitat Complexity Minimizes Disassembly of Reef Fish Communities following Disturbance: A Large-Scale Natural Experiment

PubMed Central

Emslie, Michael J.; Cheal, Alistair J.; Johns, Kerryn A.

2014-01-01

High biodiversity ecosystems are commonly associated with complex habitats. Coral reefs are highly diverse ecosystems, but are under increasing pressure from numerous stressors, many of which reduce live coral cover and habitat complexity with concomitant effects on other organisms such as reef fishes. While previous studies have highlighted the importance of habitat complexity in structuring reef fish communities, they employed gradient or meta-analyses which lacked a controlled experimental design over broad spatial scales to explicitly separate the influence of live coral cover from overall habitat complexity. Here a natural experiment using a long term (20 year), spatially extensive (∼115,000 kms2) dataset from the Great Barrier Reef revealed the fundamental importance of overall habitat complexity for reef fishes. Reductions of both live coral cover and habitat complexity had substantial impacts on fish communities compared to relatively minor impacts after major reductions in coral cover but not habitat complexity. Where habitat complexity was substantially reduced, species abundances broadly declined and a far greater number of fish species were locally extirpated, including economically important fishes. This resulted in decreased species richness and a loss of diversity within functional groups. Our results suggest that the retention of habitat complexity following disturbances can ameliorate the impacts of coral declines on reef fishes, so preserving their capacity to perform important functional roles essential to reef resilience. These results add to a growing body of evidence about the importance of habitat complexity for reef fishes, and represent the first large-scale examination of this question on the Great Barrier Reef. PMID:25140801

Retention of habitat complexity minimizes disassembly of reef fish communities following disturbance: a large-scale natural experiment.

PubMed

Emslie, Michael J; Cheal, Alistair J; Johns, Kerryn A

2014-01-01

High biodiversity ecosystems are commonly associated with complex habitats. Coral reefs are highly diverse ecosystems, but are under increasing pressure from numerous stressors, many of which reduce live coral cover and habitat complexity with concomitant effects on other organisms such as reef fishes. While previous studies have highlighted the importance of habitat complexity in structuring reef fish communities, they employed gradient or meta-analyses which lacked a controlled experimental design over broad spatial scales to explicitly separate the influence of live coral cover from overall habitat complexity. Here a natural experiment using a long term (20 year), spatially extensive (∼ 115,000 kms(2)) dataset from the Great Barrier Reef revealed the fundamental importance of overall habitat complexity for reef fishes. Reductions of both live coral cover and habitat complexity had substantial impacts on fish communities compared to relatively minor impacts after major reductions in coral cover but not habitat complexity. Where habitat complexity was substantially reduced, species abundances broadly declined and a far greater number of fish species were locally extirpated, including economically important fishes. This resulted in decreased species richness and a loss of diversity within functional groups. Our results suggest that the retention of habitat complexity following disturbances can ameliorate the impacts of coral declines on reef fishes, so preserving their capacity to perform important functional roles essential to reef resilience. These results add to a growing body of evidence about the importance of habitat complexity for reef fishes, and represent the first large-scale examination of this question on the Great Barrier Reef.

Flood-deposited wood debris and its contribution to heterogeneity and regeneration in a semi-arid riparian landscape.

PubMed

Pettit, Neil E; Naiman, Robert J

2005-09-01

We investigated whether large woody debris (LWD) piles create nodes of environmental resources that contribute to the recovery of riparian vegetation and that also augment the heterogeneity and resilience of the riverine system. River and riparian systems are typified by a large degree of heterogeneity and complex interactions between abiotic and biotic elements. Disturbance such as floods re-distribute the resources, such as LWD, and thereby add greater complexity to the system. We examined this issue on a semi-arid savanna river where approximately a 100-year return interval flood in 2000 uprooted vegetation and deposited substantial LWD. We investigated the micro-environment within the newly established LWD piles and compared this with conditions at adjacent reference sites containing no LWD. We found soil nutrient concentrations to be significantly higher in LWD piles compared with the reference plots (total N +19%, available P +51%, and total C +36%). Environmental variables within LWD piles and reference sites varied with landscape position in the river-riparian landscape and with LWD pile characteristics. Observed differences were generally between piles located in the terrestrial and riparian areas as compared to piles located on the macro-channel floor. After 3 years the number and cover of woody species were significantly higher when associated with LWD piles, regardless of landscape position or pile type. We conclude that LWD piles formed after large floods act as resource nodes by accumulating fine sediments and by retaining soil nutrients and soil moisture. The subsequent influence of LWD deposition on riparian heterogeneity is discerned at several spatial scales including within and between LWD piles, across landscape positions and between channel types. LWD piles substantially influence the initial developmental of riparian vegetation as the system regenerates following large destructive floods.

Impact of Interlayer Dwell Time on Microstructure and Mechanical Properties of Nickel and Titanium Alloys

NASA Astrophysics Data System (ADS)

Foster, B. K.; Beese, A. M.; Keist, J. S.; McHale, E. T.; Palmer, T. A.

2017-09-01

Path planning in additive manufacturing (AM) processes has an impact on the thermal histories experienced at discrete locations in simple and complex AM structures. One component of path planning in directed energy deposition is the time required for the laser or heat source to return to a given location to add another layer of material. As structures become larger and more complex, the length of this interlayer dwell time can significantly impact the resulting thermal histories. The impact of varying dwell times between 0 and 40 seconds on the microstructural and mechanical properties of Inconel® 625 and Ti-6Al-4V builds has been characterized. Even though these materials display different microstructures and solid-state phase transformations, the addition of an interlayer dwell generally led to a finer microstructure in both materials that impacted the resulting mechanical properties. With the addition of interlayer dwell times up to 40 seconds in the Inconel® 625 builds, finer secondary dendrite arm spacing values, produced by changes in the thermal history, correspond to increased yield and tensile strengths. These mechanical properties did not appear to change significantly, however, for dwell times greater than 20 seconds in the Inconel® 625 builds, indicating that longer dwell times have a minimal impact. The addition of interlayer dwell times in Ti-6Al-4V builds resulted in a slight decrease in the measured alpha lath widths and a much more noticeable decrease in the width of prior beta grains. In addition, the yield and tensile values continued to increase, nearly reaching the values observed in the rolled plate substrate material with dwell times up to 40 seconds.

Visual light effects on mitochondria: The potential implications in relation to glaucoma.

PubMed

Osborne, Neville N; Núñez-Álvarez, Claudia; Del Olmo-Aguado, Susana; Merrayo-Lloves, Jesús

2017-09-01

Light of different wave-lengths have the potential to interact with four major mitochondrial protein complexes that are involved in the generation of ATP. Neurones of the central nervous system have an absolute dependence on mitochondrial generated ATP. Laboratory studies show that short-wave or blue light (400-480nm) that impinges on the retina affect flavin and cytochrome constituents associated with mitochondria to decrease the rate of ATP formation, stimulate ROS and results in cell death. This suggests that blue light could potentially have a negative influence on retinal ganglion cell (RGC) mitochondria that are abundant and not shielded by macular pigments as occurs for photoreceptor mitochondria. This might be of significance in glaucoma where it is likely that RGC mitochondria are already affected and therefore be more susceptible to blue light. Thus simply filtering out some natural blue light from entering the eye might be beneficial for the treatment of glaucoma. Long-wave or red light (650-800nm) affects mitochondrial complex IV or cytochrome oxidase to increase the rate of formation of ATP and ROS causing the generation of a number of beneficial factors. Significantly, laboratory studies show that increasing the normal amount of natural red light reaching rat RGC mitochondria in situ, subjected to ischemia, proved to be beneficial. A challenge now is to test whether extra red light delivered to the human retina can slow-down RGC loss in glaucoma. Such a methodology has also the advantage of being non-invasive. One very exciting possibility might be in the production of a lens where solar UV light is convertes to add to the amount of natural red light entering the eye. Copyright © 2016 Elsevier B.V. and Mitochondria Research Society. All rights reserved.

Prosthodontic Rehabilitation for a Patient with Down Syndrome: A Clinical Report.

PubMed

Alqahtani, Nasser M; Alsayed, Hussain D; Levon, John A; Brown, David T

2017-01-24

Patients with Down syndrome can present with a variety of oral manifestations such as hypodontia, periodontal disease, premature tooth loss, reduced salivary flow, crowding of teeth in both arches, and decreased occlusal vertical dimension. The intellectual ability of people with Down syndrome varies widely. They present with a mild-to-moderate intellectual disability that restricts their ability to communicate and adjust to their environment, which can add complexity in the overall dental treatment. There is little information in the literature regarding the prosthodontic rehabilitation for patients with Down syndrome in combination with dental implant placement. An implant-assisted removable partial dental prosthesis can be a cost-effective treatment alternative for carefully chosen patients with Down syndrome. This article presents the treatment of a 44-year-old male patient with Down syndrome and a moderate intellectual disability who presented with congenital and acquired tooth loss with significant occlusal discrepancies. The treatment included a prosthodontic approach that used a single dental implant, which will be described and illustrated in this article. © 2017 by the American College of Prosthodontists.

Deploying electromagnetic particle-in-cell (EM-PIC) codes on Xeon Phi accelerators boards

NASA Astrophysics Data System (ADS)

Fonseca, Ricardo

2014-10-01

The complexity of the phenomena involved in several relevant plasma physics scenarios, where highly nonlinear and kinetic processes dominate, makes purely theoretical descriptions impossible. Further understanding of these scenarios requires detailed numerical modeling, but fully relativistic particle-in-cell codes such as OSIRIS are computationally intensive. The quest towards Exaflop computer systems has lead to the development of HPC systems based on add-on accelerator cards, such as GPGPUs and more recently the Xeon Phi accelerators that power the current number 1 system in the world. These cards, also referred to as Intel Many Integrated Core Architecture (MIC) offer peak theoretical performances of >1 TFlop/s for general purpose calculations in a single board, and are receiving significant attention as an attractive alternative to CPUs for plasma modeling. In this work we report on our efforts towards the deployment of an EM-PIC code on a Xeon Phi architecture system. We will focus on the parallelization and vectorization strategies followed, and present a detailed performance evaluation of code performance in comparison with the CPU code.

Science, Policy, and Peer Review

NASA Astrophysics Data System (ADS)

Kennedy, D.

2006-12-01

These are intense times at the convergence between science and public policy. Because issues like climate change, stem cell research and environmental protection are being contested in choppy political water, political interests are being deployed to challenge science and researchers, and also to generate pseudo- scientific claims made in the interest of particular policy ends. In a number of cases reported in Science, administration officials have silenced their own employees, or withheld data selectively from draft reports. Added to that challenge to integrity, there is a new statutory environment that adds some complexity of its own. Beginning with the Data Quality Act, more familiarly the "Shelby Amendment," research results with significant economic impacts through regulation are now available through the Freedom of Information Act. Its successor, the Data Quality Act -- which opens a route of challenge to information released by government or gathered by others and used in advice or regulation has exposed scientists not only to having their primary data reanalyzed for the purposes of others, but to charges of research misconduct. These influences have made journal peer review more challenging in several ways, and I will outline some case examples.

Link between light-triggered Mg-banding and chamber formation in the planktic foraminifera Neogloboquadrina dutertrei

DOE PAGES

Fehrenbacher, Jennifer S.; Russell, Ann D.; Davis, Catherine V.; ...

2017-05-15

Mg/Ca ratios of planktic foraminifera are commonly used to reconstruct past ocean temperatures. However, intrashell Mg/Ca ratios exhibit a pattern of alternating high and low Mg-bands in many species. Whereas mechanisms controlling Mg variability are poorly constrained, recent experiments demonstrate that it is paced by the diurnal light/dark cycle in Orbulina universa, which forms a terminal shell of simple spherical geometry. It is unknown whether Mg-heterogeneity is diurnally paced in species with complex shell morphologies, or is the result of growth processes. Here, we show that high Mg/Ca-calcite also forms at night in cultured specimens of the multi-chambered planktic foraminiferamore » Neogloboquadrina dutertrei. Our results demonstrate that N. dutertrei adds a significant amount of calcite, and nearly all Mg-bands, after the final chamber forms. Furthermore, these results have implications for interpreting patterns of calcification in N. dutertrei, and possibly other foraminifera species, and suggests diurnal Mg-banding is an intrinsic component of biomineralization in planktic foraminifera.« less

An approach to efficient mobility management in intelligent networks

NASA Technical Reports Server (NTRS)

Murthy, K. M. S.

1995-01-01

Providing personal communication systems supporting full mobility require intelligent networks for tracking mobile users and facilitating outgoing and incoming calls over different physical and network environments. In realizing the intelligent network functionalities, databases play a major role. Currently proposed network architectures envision using the SS7-based signaling network for linking these DB's and also for interconnecting DB's with switches. If the network has to support ubiquitous, seamless mobile services, then it has to support additionally mobile application parts, viz., mobile origination calls, mobile destination calls, mobile location updates and inter-switch handovers. These functions will generate significant amount of data and require them to be transferred between databases (HLR, VLR) and switches (MSC's) very efficiently. In the future, the users (fixed or mobile) may use and communicate with sophisticated CPE's (e.g. multimedia, multipoint and multisession calls) which may require complex signaling functions. This will generate volumness service handling data and require efficient transfer of these message between databases and switches. Consequently, the network providers would be able to add new services and capabilities to their networks incrementally, quickly and cost-effectively.

Apomorphine effects on frog locomotor behavior.

PubMed

Chu, Joanne; Wilczynski, Walter

2007-05-16

The neuroanatomical pathways of the DA systems have been shown to be largely conserved across many vertebrate taxa. It is less certain whether the structural similarities seen between mammals and amphibians reflect a similar functional homology. DA is well known for its role in facilitating motor behaviors in mammals. We examined whether a similar role for DA exists in amphibians using the Northern Leopard Frog (Rana pipiens). We investigated the effects of the nonspecific DA agonist, apomorphine (APO) on a complex motor task that included two distinct components known to be differentially modulated by DA in mammals: swimming and climbing. We demonstrated that a high single dose of APO (20 mg/kg, body weight) strongly increased the amount of time spent completing the motor task. Furthermore, we showed that although APO did not significantly alter several aspects of swimming behavior, two aspects of climbing behavior were disrupted. Both climbing speed and climbing ability were impaired by APO treatment. These results increase our understanding of DA function in amphibians and add to our understanding of structure-function homologies of dopamine function across vertebrate taxa.

Lateral parabrachial nucleus mediates shortening of expiration during hypoxia.

PubMed

Song, Gang; Poon, Chi-Sang

2009-01-01

Acute hypoxia elicits complex time-dependent responses including rapid augmentation of inspiratory drive, shortening of inspiratory and expiratory durations (T(I), T(E)), and short-term potentiation and depression. The central pathways mediating these varied effects are largely unknown. Here, we show that the lateral parabrachial nucleus (LPBN) of the dorsolateral pons specifically mediates T(E)-shortening during hypoxia and not other hypoxic response components. Twelve urethane-anesthetized and vagotomized adult Sprague-Dawley rats were exposed to 1-min poikilocapnic hypoxia before and after unilateral kainic acid or bilateral electrolytic lesioning of the LPBN. Bilateral lesions resulted in a significant increase in baseline T(E) under hyperoxia. After unilateral or bilateral lesions, the decrease in T(E) during hypoxia was markedly attenuated without appreciable changes in all other hypoxic response components. These findings add to the mounting evidence that the central processing of peripheral chemoafferent inputs is segregated into parallel integrator and differentiator (low-pass and high-pass filter) pathways that separately modulate inspiratory drive, T(I), T(E) and resultant short-term potentiation and depression.

Impacts of Encouraging Dog Walking on Returns of Newly Adopted Dogs to a Shelter.

PubMed

Gunter, Lisa; Protopopova, Alexandra; Hooker, Steven P; Der Ananian, Cheryl; Wynne, Clive D L

2017-01-01

This study involved examining the ability of a postadoption intervention to reduce returns of newly adopted dogs to shelters by encouraging physical activity between adopters and their dogs. Guardians in the intervention group received emails with dog behavior and human activity advice as well as invitations to join weekly dog walks. Both the intervention and control groups completed surveys regarding outdoor activity with their dogs, their dog-walking habits, and perceptions of their dogs' behaviors. Adopter-dog pairs in the intervention group were not significantly more active than those in the control group, nor did they show a reduced incidence of returning their dogs. Guardians in both groups who reported higher obligation and self-efficacy in their dog walking were more active regardless of experimental condition; however, obligation, dog-walking self-efficacy, and perceptions about their dogs' on-leash behaviors did not predict rates of return to the shelter. These findings add to the understanding of shelter dog re-relinquishment and the effective utilization of resources postadoption, and they indicate further research is needed to address the complexities of this newly forming human-dog relationship.

The therapeutic alliance: a psychoanalytic perspective.

PubMed

Freebury, D R

1989-11-01

Psychoanalysis has long distinguished between the transference neurosis and that part of the communication between therapist and patient which depends upon a relatively intact part of the patient's ego. It has been proposed that it is this capacity of the patient that sustains the difficult work of dealing with communications which are the consequence of transference, and which often threaten the viability of the treatment. This quality has been referred to variously as the unobjectionable positive transference, rational transference, mature transference, therapeutic alliance and working alliance. The ever broadening scope of Psychoanalysis, along with our greater knowledge of early childhood development, has enhanced our understanding of the many influences affecting the treatment alliances. Newer views of the transference, which stress the significance of the therapists' contributions to the therapeutic dyad, make it clear that the therapeutic alliance can no longer be explained as some simple, reality based, conflict free, motivating force. It involves, rather, a complex interaction of several factors, to each of which one must add the therapists' reciprocal reactions. Psychotherapy outcome research will need to take all of these factors into consideration.

Long-ranged contributions to solvation free energies from theory and short-ranged models

PubMed Central

Remsing, Richard C.; Liu, Shule; Weeks, John D.

2016-01-01

Long-standing problems associated with long-ranged electrostatic interactions have plagued theory and simulation alike. Traditional lattice sum (Ewald-like) treatments of Coulomb interactions add significant overhead to computer simulations and can produce artifacts from spurious interactions between simulation cell images. These subtle issues become particularly apparent when estimating thermodynamic quantities, such as free energies of solvation in charged and polar systems, to which long-ranged Coulomb interactions typically make a large contribution. In this paper, we develop a framework for determining very accurate solvation free energies of systems with long-ranged interactions from models that interact with purely short-ranged potentials. Our approach is generally applicable and can be combined with existing computational and theoretical techniques for estimating solvation thermodynamics. We demonstrate the utility of our approach by examining the hydration thermodynamics of hydrophobic and ionic solutes and the solvation of a large, highly charged colloid that exhibits overcharging, a complex nonlinear electrostatic phenomenon whereby counterions from the solvent effectively overscreen and locally invert the integrated charge of the solvated object. PMID:26929375

77 FR 56896 - Self-Regulatory Organizations; EDGA Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-14

... the relevant flags, as described below, for orders that add liquidity to the EDGA book. Specifically... the following flags: Flag B for orders that add liquidity to the EDGA book in Tape B securities; Flag V for orders that add liquidity to the EDGA book in Tape A securities; Flag Y for orders that add...

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

Pregabalin as mono- or add-on therapy for patients with refractory chronic neuropathic pain: a post-marketing prescription-event monitoring study.

PubMed

Lampl, Christian; Schweiger, Christine; Haider, Bernhard; Lechner, Anita

2010-08-01

This observational study examined the outcome of two different therapeutic strategies in the treatment of chronic neuropathic pain by including pregabalin (PGB) as mono- or add-on therapy in one of two treatment options. Patients with a pain score of > or =4, refractory to usual care for neuropathic pain for at least 6 months, were allocated consecutively to one of two treatment strategies according to the decision of the physician: complete switch to a flexible-dosage, monotherapeutic or add-on therapy with pregabalin (PGB group), or change established doses and combinations of pre-existing mono- or combination therapy without pregabalin (non-PGB group). After 4 weeks (primary endpoint) a significant improvement in pain reduction was documented in both intention-to treat (ITT) analysis (PGB group, n = 85: mean pain score reduction of 3.53, SD 2.03, p < 0.001; non-PGB group, n = 102; mean pain score reduction of 2.83, SD 2.23, p < 0.001) and per-protocol (PP) analysis (PGB group, n = 79: mean pain score reduction 3.53 vs. 2.83, p < 0.05; non-PGB group, n = 81; 3.5 vs. 2.9, p < 0.05) compared to baseline. Comparison of the results observed in the two groups shows that patients in the PGB group achieved significantly greater pain reduction. These results demonstrate that PGB administered twice daily is superior to treatment regimes without PGB in reducing pain and pain-related interference in quality of life.

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

PubMed

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

2015-10-01

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

Early versus late GD-DTPA MRI enhancement in experimental glioblastomas.

PubMed

Farace, Paolo; Tambalo, Stefano; Fiorini, Silvia; Merigo, Flavia; Daducci, Alessandro; Nicolato, Elena; Conti, Giamaica; Degrassi, Anna; Sbarbati, Andrea; Marzola, Pasquina

2011-03-01

To compare early versus late enhancement in two glioblastoma models characterized by different infiltrative/edematous patterns. Three weeks after inoculation into nude mice of U87MG and U251 cells, T1-weighted images were acquired early (10.5 min), intermediate (21 min) and late (30.5 min) after a bolus injection of Gd-DTPA at 300 μ mol/kg dosage. EARLY(TH) and LATE(TH) were the corresponding volumes with an enhancement higher than a threshold TH, defined by the mean (μ) and standard deviation (σ) on a contralateral healthy area. ADD(TH) was the enhancing volume found in LATE(TH) but not in EARLY(TH). T2 imaging of both tumors was performed, and T2 mapping of U251. In all tumors, LATE(TH) was significantly higher than EARLY(TH) for TH ranging from μ+σ to μ+5σ. The ADD(TH) /EARLY(TH) ratio was not significantly different when U251 and U87MG tumors were compared. In the U87MG tumors, some enhancement was observed outside the regularly demarcated T2-hyperintense area. In the U251 tumors, irregularly T2 demarcated, a large portion of ADD(μ+3σ) had normal T2 values. At histology, U251 showed a higher infiltrative pattern than U87MG. In these models, the increase over time in the enhancing volume did not depend on the different infiltrative/edematous patterns and was not closely related with edema. Copyright © 2011 Wiley-Liss, Inc.

Formation of Carbamate Anions by the Gas-phase Reaction of Anilide Ions with CO2

NASA Astrophysics Data System (ADS)

Liu, Chongming; Nishshanka, Upul; Attygalle, Athula B.

2016-05-01

The anilide anion ( m/z 92) generated directly from aniline, or indirectly as a fragmentation product of deprotonated acetanilide, captures CO2 readily to form the carbamate anion ( m/z 136) in the collision cell, when CO2 is used as the collision gas in a tandem-quadrupole mass spectrometer. The gas-phase affinity of the anilide ion to CO2 is significantly higher than that of the phenoxide anion ( m/z 93), which adds to CO2 only very sluggishly. Our results suggest that the efficacy of CO2 capture depends on the natural charge density on the nitrogen atom, and relative nucleophilicity of the anilide anion. Generally, conjugate bases generated from aniline derivatives with proton affinities (PA) less than 350 kcal/mol do not tend to add CO2 to form gaseous carbamate ions. For example, the anion generated from p-methoxyaniline (PA = 367 kcal/mol) reacts significantly faster than that obtained from p-nitroaniline (PA = 343 kcal/mol). Although deprotonated p-aminobenzoic acid adds very poorly because the negative charge is now located primarily on the carboxylate group, it reacts more efficiently with CO2 if the carboxyl group is esterified. Moreover, mixture of CO2 and He as the collision gas was found to afford more efficient adduct formation than CO2 alone, or as mixtures made with nitrogen or argon, because helium acts as an effective "cooling" gas and reduces the internal energy of reactant ions.

Preliminary Lessons about Supporting Participation and Learning in Inclusive Classrooms

ERIC Educational Resources Information Center

Morningstar, Mary E.; Shogren, Karrie A.; Lee, Hyunjoo; Born, Kiara

2015-01-01

This descriptive study examined observational data collected in inclusive classrooms from six schools that were operating schoolwide inclusive policies and practices. Illustrative evidence of classroom practices supporting learning and participation of all students, including students with significant disabilities, adds to an understanding of…

Installation and early performance of a field test section of asphalt rubber concrete.

DOT National Transportation Integrated Search

1991-01-01

Asphalt rubber, which is produced by reacting asphalt cement and crumb rubber, is claimed to increase fatigue life and reduce rutting of asphalt concrete; however, the service life must be increased significantly to offset the additional coast of add...

The Effectiveness and Safety of a Homeopathic Medicinal Product in Pediatric Upper Respiratory Tract Infections With Fever

PubMed Central

van Haselen, Robert; Thinesse-Mallwitz, Manuela; Maidannyk, Vitaliy; Buskin, Stephen L.; Weber, Stephan; Keller, Thomas; Burkart, Julia; Klement, Petra

2016-01-01

We investigated the clinical effectiveness of a homeopathic add-on therapy in a pediatric subpopulation with upper respiratory tract infections (URTI) in a randomized, controlled, multinational clinical trial. Patients received either on-demand symptomatic standard treatment (ST-group) or the same ST plus a homeopathic medication (Influcid; IFC-group) for 7 days. Outcome assessment was based on symptom and fever resolution and the Wisconsin Upper Respiratory Symptom Survey–21 (WURSS-21). A total of 261 pediatric (<12 years) patients (130 IFC-group; 131 ST-group) were recruited in Germany and the Ukraine. The IFC-group used less symptomatic medication, symptoms resolved significantly earlier (P = .0001), had higher proportions of fever-free children from day 3 onwards, and the WURSS-assessed global disease severity was significantly less (P < .0001) during the entire URTI episode. One adverse event (vomiting) was possibly related to IFC. IFC as add-on treatment in pediatric URTI reduced global disease severity, shortened symptom resolution, and was safe in use. PMID:27493984

Postsynaptic density protein transcripts are differentially modulated by minocycline alone or in add-on to haloperidol: Implications for treatment resistant schizophrenia.

PubMed

Buonaguro, Elisabetta F; Tomasetti, Carmine; Chiodini, Paolo; Marmo, Federica; Latte, Gianmarco; Rossi, Rodolfo; Avvisati, Livia; Iasevoli, Felice; de Bartolomeis, Andrea

2017-04-01

In this study, we investigated whether minocycline, a second-generation tetracycline proposed as an add-on to antipsychotics in treatment-resistant schizophrenia (TRS), may affect the expression of Homer and Arc postsynaptic density (PSD) transcripts, implicated in synaptic regulation. Minocycline was administered alone or with haloperidol in rats exposed or not to ketamine, mimicking acute glutamatergic psychosis or naturalistic conditions, respectively. Arc expression was significantly reduced by minocycline compared with controls. Minocycline in combination with haloperidol also significantly reduced Arc expression compared with both controls and haloperidol alone. Moreover, haloperidol/minocycline combination significantly affected Arc expression in cortical regions, while haloperidol alone was ineffective on cortical gene expression. These results suggest that minocycline may strongly affect the expression of Arc as mediated by haloperidol, both in terms of quantitative levels and of topography of haloperidol-related expression. It is noteworthy that no significant pre-treatment effect was found, suggesting that pre-exposure to ketamine did not grossly affect gene expression. Minocycline was not found to significantly affect haloperidol-related Homer1a expression. No significant changes in Homer1b/c expression were observed. These results are consistent with previous observations that minocycline may modulate postsynaptic glutamatergic transmission, affecting distinct downstream pathways initiated by N-methyl-D-aspartate (NMDA) receptor modulation, i.e. Arc-mediated but not Homer1a-mediated pathways.

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

PubMed Central

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

2014-01-01

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

Responses of infaunal populations to benthoscape structure and the potential importance of transition zones

USGS Publications Warehouse

Zajac, R.N.; Lewis, R.S.; Poppe, L.J.; Twichell, D.C.; Vozarik, J.; DiGiacomo-Cohen, M. L.

2003-01-01

Relationships between population abundance and seafloor landscape, or benthoscape, structure were examined for 16 infaunal taxa in eastern Long Island Sound. Based on analyses of a side-scan sonar mosaic, the 19.4-km2 study area was comprised of six distinct large-scale (> km2) benthoscape elements, with varying levels of mesoscale (km2-m2) and small-scale (2) physical and biological habitat heterogeneity. Transition zones among elements varied from ~50 to 200 m in width, comprised ~32% of the benthoscape, and added to overall benthoscape heterogeneity. Population abundances of nine taxa varied significantly among the large-scale elements. Most species were found at high abundances only in one benthoscape element, but three had several foci of elevated abundances. Analyses of population responses to habitat heterogeneity at different spatial scales indicated that abundances of eight taxa varied significantly among spatial scales, but the significant scales were mixed among these species. Relatively large residual variations suggest significant amounts of mesoscale spatial variation were unaccounted for, varying from ~1 km2 to several m2. Responses to transition zones were mixed as well. Abundances of nine taxa varied significantly among transition zones and interiors of benthoscape elements, most with elevated abundances in transition zones. Our results show that infaunal populations exhibit complex and spatially varying patterns of abundance in relation to benthoscape structure and suggest that mesoscale variation may be particularly critical in this regard. Also, transition zones among benthoscape features add considerably to this variation and may be ecological important areas in seafloor environments.

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

Science.gov Websites

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Mail merge can be used to create personalized questionnaires in complex surveys.

PubMed

Taljaard, Monica; Chaudhry, Shazia Hira; Brehaut, Jamie C; Weijer, Charles; Grimshaw, Jeremy M

2015-10-16

Low response rates and inadequate question comprehension threaten the validity of survey results. We describe a simple procedure to implement personalized-as opposed to generically worded-questionnaires in the context of a complex web-based survey of corresponding authors of a random sample of 300 published cluster randomized trials. The purpose of the survey was to gather more detailed information about informed consent procedures used in the trial, over and above basic information provided in the trial report. We describe our approach-which allowed extensive personalization without the need for specialized computer technology-and discuss its potential application in similar settings. The mail merge feature of standard word processing software was used to generate unique, personalized questionnaires for each author by incorporating specific information from the article, including naming the randomization unit (e.g., family practice, school, worksite), and identifying specific individuals who may have been considered research participants at the cluster level (family doctors, teachers, employers) and individual level (patients, students, employees) in questions regarding informed consent procedures in the trial. The response rate was relatively high (64%, 182/285) and did not vary significantly by author, publication, or study characteristics. The refusal rate was low (7%). While controlled studies are required to examine the specific effects of our approach on comprehension, quality of responses, and response rates, we showed how mail merge can be used as a simple but useful tool to add personalized fields to complex survey questionnaires, or to request additional information required from study authors. One potential application is in eliciting specific information about published articles from study authors when conducting systematic reviews and meta-analyses.

Mortality of Dandy-Walker syndrome in the United States: Analysis by race, gender, and insurance status

PubMed Central

McClelland, Shearwood; Ukwuoma, Onyinyechi I.; Lunos, Scott; Okuyemi, Kolawole S.

2015-01-01

Background: Dandy-Walker syndrome (DWS) is a congenital disorder often diagnosed in early childhood. Typically manifesting with signs/symptoms of increased intracranial pressure, DWS is catastrophic unless timely neurosurgical care can be administered via cerebrospinal fluid (CSF) drainage. The rates of mortality, adverse discharge disposition (ADD), and CSF drainage in DWS may not be uniform regardless of race, gender or insurance status; such differences could reflect disparities in access to neurosurgical care. This study examines these issues on a nationwide level. Materials and Methods: The Kids’ Inpatient Database spanning 1997-2003 was used for analysis. Only patients admitted for DWS (ICD-9-CM = 742.3) were included. Multivariate analysis was adjusted for several variables, including patient age, race, sex, admission type, primary payer, income, and hospital volume. Results: More than 14,000 DWS patients were included. Increasing age predicted reduced mortality (OR = 0.87; P < 0.05), ADD (OR = 0.96; P < 0.05), and decreased likelihood of receiving CSF drainage (OR = 0.86; P < 0.0001). Elective admission type predicted reduced mortality (OR = 0.29; P = 0.0008), ADD (OR = 0.68; P < 0.05), and increased CSF drainage (OR = 2.02; P < 0.0001). African-American race (OR = 1.20; P < 0.05) and private insurance (OR = 1.18; P < 0.05) each predicted increased likelihood of receiving CSF drainage, but were not predictors of mortality or ADD. Gender, income, and hospital volume were not significant predictors of DWS outcome. Conclusion: Increasing age and elective admissions each decrease mortality and ADD associated with DWS. African-American race and private insurance status increase access to CSF drainage. These findings contradict previous literature citing African-American race as a risk factor for mortality in DWS, and emphasize the role of private insurance in obtaining access to potentially lifesaving operative care. PMID:25883477

Making the diagnosis of Sjögren's syndrome in patients with dry eye.

PubMed

Beckman, Kenneth A; Luchs, Jodi; Milner, Mark S

2016-01-01

Sjögren's syndrome (SS) is a chronic and progressive systemic autoimmune disease that often presents initially with symptoms of dry eye and dry mouth. Symptoms are often nonspecific and develop gradually, making diagnosis difficult. Patients with dry eye complaints warrant a step-wise evaluation for possible SS. Initial evaluation requires establishment of a dry eye diagnosis using a combination of patient questionnaires and objective ocular tests, including inflammatory biomarker testing. Additional work-up using the Schirmer test and tear film break-up time can differentiate between aqueous-deficient dry eye (ADDE) and evaporative dry eye. The presence of ADDE should trigger further work-up to differentiate between SS-ADDE and non-SS-ADDE. There are numerous non-ocular manifestations of SS, and monitoring for SS-related comorbid findings can aid in diagnosis, ideally in collaboration with a rheumatologist. The clinical work-up of SS can involve a variety of tests, including tear function tests, serological tests for autoantibody biomarkers, minor salivary gland and lacrimal gland biopsies. Examination of classic SS biomarkers (SS-A/Ro, SS-B/La, antinuclear antibody, and rheumatoid factor) is a convenient and non-invasive way of evaluating patients for the presence of SS, even years prior to confirmed diagnosis, although not all SS patients will test positive, particularly those with early disease. Recently, newer biomarkers have been identified, including autoantibodies to salivary gland protein-1, parotid secretory protein, and carbonic anhydrase VI, and may allow for earlier diagnosis of SS. A diagnostic test kit is commercially available (Sjö(®)), incorporating these new biomarkers along with the classic autoantibodies. This advanced test has been shown to identify SS patients who previously tested negative against traditional biomarkers only. All patients with clinically significant ADDE should be considered for serological assessment for SS, given the availability of new serological diagnostic tests and the potentially serious consequences of missing the diagnosis.

Making the diagnosis of Sjögren’s syndrome in patients with dry eye

PubMed Central

Beckman, Kenneth A; Luchs, Jodi; Milner, Mark S

2016-01-01

Sjögren’s syndrome (SS) is a chronic and progressive systemic autoimmune disease that often presents initially with symptoms of dry eye and dry mouth. Symptoms are often nonspecific and develop gradually, making diagnosis difficult. Patients with dry eye complaints warrant a step-wise evaluation for possible SS. Initial evaluation requires establishment of a dry eye diagnosis using a combination of patient questionnaires and objective ocular tests, including inflammatory biomarker testing. Additional work-up using the Schirmer test and tear film break-up time can differentiate between aqueous-deficient dry eye (ADDE) and evaporative dry eye. The presence of ADDE should trigger further work-up to differentiate between SS-ADDE and non-SS-ADDE. There are numerous non-ocular manifestations of SS, and monitoring for SS-related comorbid findings can aid in diagnosis, ideally in collaboration with a rheumatologist. The clinical work-up of SS can involve a variety of tests, including tear function tests, serological tests for autoantibody biomarkers, minor salivary gland and lacrimal gland biopsies. Examination of classic SS biomarkers (SS-A/Ro, SS-B/La, antinuclear antibody, and rheumatoid factor) is a convenient and non-invasive way of evaluating patients for the presence of SS, even years prior to confirmed diagnosis, although not all SS patients will test positive, particularly those with early disease. Recently, newer biomarkers have been identified, including autoantibodies to salivary gland protein-1, parotid secretory protein, and carbonic anhydrase VI, and may allow for earlier diagnosis of SS. A diagnostic test kit is commercially available (Sjö®), incorporating these new biomarkers along with the classic autoantibodies. This advanced test has been shown to identify SS patients who previously tested negative against traditional biomarkers only. All patients with clinically significant ADDE should be considered for serological assessment for SS, given the availability of new serological diagnostic tests and the potentially serious consequences of missing the diagnosis. PMID:26766898

ClearTK 2.0: Design Patterns for Machine Learning in UIMA

PubMed Central

Bethard, Steven; Ogren, Philip; Becker, Lee

2014-01-01

ClearTK adds machine learning functionality to the UIMA framework, providing wrappers to popular machine learning libraries, a rich feature extraction library that works across different classifiers, and utilities for applying and evaluating machine learning models. Since its inception in 2008, ClearTK has evolved in response to feedback from developers and the community. This evolution has followed a number of important design principles including: conceptually simple annotator interfaces, readable pipeline descriptions, minimal collection readers, type system agnostic code, modules organized for ease of import, and assisting user comprehension of the complex UIMA framework. PMID:29104966

ClearTK 2.0: Design Patterns for Machine Learning in UIMA.

PubMed

Bethard, Steven; Ogren, Philip; Becker, Lee

2014-05-01

ClearTK adds machine learning functionality to the UIMA framework, providing wrappers to popular machine learning libraries, a rich feature extraction library that works across different classifiers, and utilities for applying and evaluating machine learning models. Since its inception in 2008, ClearTK has evolved in response to feedback from developers and the community. This evolution has followed a number of important design principles including: conceptually simple annotator interfaces, readable pipeline descriptions, minimal collection readers, type system agnostic code, modules organized for ease of import, and assisting user comprehension of the complex UIMA framework.

Experience-based consulting: the value proposition.

PubMed

Pliner, Nicole; Thrall, James; Boland, Giles; Palumbo, Denise

2004-11-01

Consulting is a profession universally accepted and well entrenched throughout the business world. Whether it is providing objective analysis, supplying a specific expertise, managing a project, or simply adding extra manpower, consultants can add value. However, what are the attributes of a good consultant? In health care, with the rapid pace of emerging technologies, economic intricacies, and the complexities of clinical care, hands-on experience is the key. Recognizing the power of consultants with hands-on experience, the Department of Radiology at Massachusetts General Hospital launched the Radiology Consulting Group, an "experience-based" model for consulting that may potentially shift the profession's paradigm.

The Reactions of Polycyclic Aromatic Hydrocarbons with OH

NASA Technical Reports Server (NTRS)

Ricca, Alessandra; Bauschlicher, Charles W., Jr.; Arnold, James O. (Technical Monitor)

2000-01-01

The OH radical adds to naphthalene and naphthalene cation without a barrier. For the neutrals, the most favorable path for this intermediate is the loss of the OH, and the next most favorable option is the loss of an H atom to form the alcohol. For the cation, the most favorable path appears to be a hydrogen migration followed by the loss of a hydrogen to form the alcohol. The OH at carbon atom 1 is energetically most favorable for both the initial complex and final product. This is true for both the neutrals and cations.