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Sample records for add-on controls option

  1. 40 CFR Table 1b to Subpart Dddd of... - Add-on Control Systems Compliance Options

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Compliance Options For each of the following process units . . . You must comply with one of the following... sources only); pressurized refiners; primary tube dryers; secondary tube dryers; reconstituted wood... entering the control device are greater than or equal to 10 ppmvd. a You may choose to subtract...

  2. 40 CFR Table 1b to Subpart Dddd of... - Add-on Control Systems Compliance Options

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Compliance Options For each of the following process units . . . You must comply with one of the following... sources only); pressurized refiners; primary tube dryers; secondary tube dryers; reconstituted wood... entering the control device are greater than or equal to 10 ppmvd. a You may choose to subtract...

  3. 40 CFR Table 1b to Subpart Dddd of... - Add-on Control Systems Compliance Options

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Compliance Options For each of the following process units . . . You must comply with one of the following... sources only); pressurized refiners; primary tube dryers; secondary tube dryers; reconstituted wood... entering the control device are greater than or equal to 10 ppmvd. a You may choose to subtract...

  4. 40 CFR Table 1b to Subpart Dddd of... - Add-on Control Systems Compliance Options

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Options For each of the following process units . . . You must comply with one of the following six...); pressurized refiners; primary tube dryers; secondary tube dryers; reconstituted wood product board coolers (at... are greater than or equal to 10 ppmvd. a You may choose to subtract methane from THC as...

  5. 40 CFR Table 1b to Subpart Dddd of... - Add-on Control Systems Compliance Options

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Options For each of the following process units . . . You must comply with one of the following six...); pressurized refiners; primary tube dryers; secondary tube dryers; reconstituted wood product board coolers (at... are greater than or equal to 10 ppmvd. a You may choose to subtract methane from THC as...

  6. Randomized Controlled Trials of Add-On Antidepressants in Schizophrenia

    PubMed Central

    Joffe, Grigori; Stenberg, Jan-Henry

    2015-01-01

    Background: Despite adequate treatment with antipsychotics, a substantial number of patients with schizophrenia demonstrate only suboptimal clinical outcome. To overcome this challenge, various psychopharmacological combination strategies have been used, including antidepressants added to antipsychotics. Methods: To analyze the efficacy of add-on antidepressants for the treatment of negative, positive, cognitive, depressive, and antipsychotic-induced extrapyramidal symptoms in schizophrenia, published randomized controlled trials assessing the efficacy of adjunctive antidepressants in schizophrenia were reviewed using the following parameters: baseline clinical characteristics and number of patients, their on-going antipsychotic treatment, dosage of the add-on antidepressants, duration of the trial, efficacy measures, and outcomes. Results: There were 36 randomized controlled trials reported in 41 journal publications (n=1582). The antidepressants used were the selective serotonin reuptake inhibitors, duloxetine, imipramine, mianserin, mirtazapine, nefazodone, reboxetin, trazodone, and bupropion. Mirtazapine and mianserin showed somewhat consistent efficacy for negative symptoms and both seemed to enhance neurocognition. Trazodone and nefazodone appeared to improve the antipsychotics-induced extrapyramidal symptoms. Imipramine and duloxetine tended to improve depressive symptoms. No clear evidence supporting selective serotonin reuptake inhibitors’ efficacy on any clinical domain of schizophrenia was found. Add-on antidepressants did not worsen psychosis. Conclusions: Despite a substantial number of randomized controlled trials, the overall efficacy of add-on antidepressants in schizophrenia remains uncertain mainly due to methodological issues. Some differences in efficacy on several schizophrenia domains seem, however, to exist and to vary by the antidepressant subgroups—plausibly due to differences in the mechanisms of action. Antidepressants may not worsen

  7. 40 CFR 75.34 - Units with add-on emission controls.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Units with add-on emission controls... add-on emission controls. (a) The owner or operator of an affected unit equipped with add-on SO2 and... which the add-on emission controls are documented to be operating properly, as described in the...

  8. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I establish the emission capture... with Add-on Controls Option § 63.4966 How do I establish the emission capture system and add-on control... to § 63.4965. (c) Carbon adsorbers. If your add-on control device is a carbon adsorber, establish...

  9. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I establish the emission capture... Rate with Add-on Controls Option § 63.4767 How do I establish the emission capture system and add-on...) Carbon adsorbers. If your add-on control device is a carbon adsorber, establish the operating...

  10. 40 CFR 63.4965 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME PTC 19.10-1981, “Flue and Exhaust Gas... device emission destruction or removal efficiency? 63.4965 Section 63.4965 Protection of Environment... Controls Option § 63.4965 How do I determine the add-on control device emission destruction or...

  11. 40 CFR 63.4166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME, PTC 19.10-1981, “Flue and... device emission destruction or removal efficiency? 63.4166 Section 63.4166 Protection of Environment... Controls Option § 63.4166 How do I determine the add-on control device emission destruction or...

  12. 40 CFR 63.4166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME, PTC 19.10-1981, “Flue and... device emission destruction or removal efficiency? 63.4166 Section 63.4166 Protection of Environment... Controls Option § 63.4166 How do I determine the add-on control device emission destruction or...

  13. 40 CFR 63.4166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME, PTC 19.10-1981, “Flue and... device emission destruction or removal efficiency? 63.4166 Section 63.4166 Protection of Environment... Controls Option § 63.4166 How do I determine the add-on control device emission destruction or...

  14. 40 CFR 63.4965 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME PTC 19.10-1981, “Flue and Exhaust Gas... device emission destruction or removal efficiency? 63.4965 Section 63.4965 Protection of Environment... Controls Option § 63.4965 How do I determine the add-on control device emission destruction or...

  15. 40 CFR 63.4965 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME PTC 19.10-1981, “Flue and Exhaust Gas... device emission destruction or removal efficiency? 63.4965 Section 63.4965 Protection of Environment... Controls Option § 63.4965 How do I determine the add-on control device emission destruction or...

  16. Efficacy and safety of alirocumab as add-on therapy in high-cardiovascular-risk patients with hypercholesterolemia not adequately controlled with atorvastatin (20 or 40 mg) or rosuvastatin (10 or 20 mg): design and rationale of the ODYSSEY OPTIONS Studies.

    PubMed

    Robinson, Jennifer G; Colhoun, Helen M; Bays, Harold E; Jones, Peter H; Du, Yunling; Hanotin, Corinne; Donahue, Stephen

    2014-10-01

    The phase 3 ODYSSEY OPTIONS studies (OPTIONS I, NCT01730040; OPTIONS II, NCT01730053) are multicenter, multinational, randomized, double-blind, active-comparator, 24-week studies evaluating the efficacy and safety of alirocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, as add-on therapy in ∼ 650 high-cardiovascular (CV)-risk patients whose low-density lipoprotein cholesterol (LDL-C) levels are ≥100 mg/dL or ≥70 mg/dL according to the CV-risk category, high and very high CV risk, respectively, with atorvastatin (20-40 mg/d) or rosuvastatin (10-20 mg/d). Patients are randomized to receive alirocumab 75 mg via a single, subcutaneous, 1-mL injection by prefilled pen every 2 weeks (Q2W) as add-on therapy to atorvastatin (20-40 mg) or rosuvastatin (10-20 mg); or to receive ezetimibe 10 mg/d as add-on therapy to statin; or to receive statin up-titration; or to switch from atorvastatin to rosuvastatin (OPTIONS I only). At week 12, based on week 8 LDL-C levels, the alirocumab dose may be increased from 75 mg to 150 mg Q2W if LDL-C levels remain ≥100 mg/dL or ≥70 mg/dL in patients with high or very high CV risk, respectively. The primary efficacy endpoint in both studies is difference in percent change in calculated LDL-C from baseline to week 24 in the alirocumab vs control arms. The studies may provide guidance to inform clinical decision-making when patients with CV risk require additional lipid-lowering therapy to further reduce LDL-C levels. The flexibility of the alirocumab dosing regimen allows for individualized therapy based on the degree of LDL-C reduction required to achieve the desired LDL-C level. PMID:25269777

  17. Efficacy and Safety of Alirocumab as Add-on Therapy in High–Cardiovascular-Risk Patients With Hypercholesterolemia Not Adequately Controlled With Atorvastatin (20 or 40 mg) or Rosuvastatin (10 or 20 mg): Design and Rationale of the ODYSSEY OPTIONS Studies

    PubMed Central

    Robinson, Jennifer G; Colhoun, Helen M; Bays, Harold E; Jones, Peter H; Du, Yunling; Hanotin, Corinne; Donahue, Stephen

    2014-01-01

    The phase 3 ODYSSEY OPTIONS studies (OPTIONS I, NCT01730040; OPTIONS II, NCT01730053) are multicenter, multinational, randomized, double-blind, active-comparator, 24-week studies evaluating the efficacy and safety of alirocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, as add-on therapy in ∼ 650 high-cardiovascular (CV)-risk patients whose low-density lipoprotein cholesterol (LDL-C) levels are ≥100 mg/dL or ≥70 mg/dL according to the CV-risk category, high and very high CV risk, respectively, with atorvastatin (20–40 mg/d) or rosuvastatin (10–20 mg/d). Patients are randomized to receive alirocumab 75 mg via a single, subcutaneous, 1-mL injection by prefilled pen every 2 weeks (Q2W) as add-on therapy to atorvastatin (20–40 mg) or rosuvastatin (10–20 mg); or to receive ezetimibe 10 mg/d as add-on therapy to statin; or to receive statin up-titration; or to switch from atorvastatin to rosuvastatin (OPTIONS I only). At week 12, based on week 8 LDL-C levels, the alirocumab dose may be increased from 75 mg to 150 mg Q2W if LDL-C levels remain ≥100 mg/dL or ≥70 mg/dL in patients with high or very high CV risk, respectively. The primary efficacy endpoint in both studies is difference in percent change in calculated LDL-C from baseline to week 24 in the alirocumab vs control arms. The studies may provide guidance to inform clinical decision-making when patients with CV risk require additional lipid-lowering therapy to further reduce LDL-C levels. The flexibility of the alirocumab dosing regimen allows for individualized therapy based on the degree of LDL-C reduction required to achieve the desired LDL-C level. PMID:25269777

  18. Efficacy and safety of alirocumab as add-on therapy in high-cardiovascular-risk patients with hypercholesterolemia not adequately controlled with atorvastatin (20 or 40 mg) or rosuvastatin (10 or 20 mg): design and rationale of the ODYSSEY OPTIONS Studies.

    PubMed

    Robinson, Jennifer G; Colhoun, Helen M; Bays, Harold E; Jones, Peter H; Du, Yunling; Hanotin, Corinne; Donahue, Stephen

    2014-10-01

    The phase 3 ODYSSEY OPTIONS studies (OPTIONS I, NCT01730040; OPTIONS II, NCT01730053) are multicenter, multinational, randomized, double-blind, active-comparator, 24-week studies evaluating the efficacy and safety of alirocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, as add-on therapy in ∼ 650 high-cardiovascular (CV)-risk patients whose low-density lipoprotein cholesterol (LDL-C) levels are ≥100 mg/dL or ≥70 mg/dL according to the CV-risk category, high and very high CV risk, respectively, with atorvastatin (20-40 mg/d) or rosuvastatin (10-20 mg/d). Patients are randomized to receive alirocumab 75 mg via a single, subcutaneous, 1-mL injection by prefilled pen every 2 weeks (Q2W) as add-on therapy to atorvastatin (20-40 mg) or rosuvastatin (10-20 mg); or to receive ezetimibe 10 mg/d as add-on therapy to statin; or to receive statin up-titration; or to switch from atorvastatin to rosuvastatin (OPTIONS I only). At week 12, based on week 8 LDL-C levels, the alirocumab dose may be increased from 75 mg to 150 mg Q2W if LDL-C levels remain ≥100 mg/dL or ≥70 mg/dL in patients with high or very high CV risk, respectively. The primary efficacy endpoint in both studies is difference in percent change in calculated LDL-C from baseline to week 24 in the alirocumab vs control arms. The studies may provide guidance to inform clinical decision-making when patients with CV risk require additional lipid-lowering therapy to further reduce LDL-C levels. The flexibility of the alirocumab dosing regimen allows for individualized therapy based on the degree of LDL-C reduction required to achieve the desired LDL-C level.

  19. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I establish the emission capture... with Add-on Controls Option § 63.4167 How do I establish the emission capture system and add-on control... test to determine destruction efficiency according to § 63.4166. (c) Carbon adsorbers. If your...

  20. 40 CFR 63.3556 - 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I establish the emission capture.../outlet Concentration Option § 63.3556 How do I establish the emission capture system and add-on control... the emission stream for leakage. (d) Carbon adsorbers. If your add-on control device is a...

  1. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I establish the emission capture... Add-on Controls Option § 63.3546 How do I establish the emission capture system and add-on control... valves during internal inspections; and/or actual testing of the emission stream for leakage. (d)...

  2. 40 CFR 63.3546 - 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I establish the emission capture... Emission Rate with Add-on Controls Option § 63.3546 How do I establish the emission capture system and add... the emission stream for leakage. (d) Carbon adsorbers. If your add-on control device is a...

  3. 40 CFR 63.4767 - 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I establish the emission capture... for the Emission Rate with Add-on Controls Option § 63.4767 How do I establish the emission capture...) Carbon adsorbers. If your add-on control device is a carbon adsorber, establish the operating...

  4. 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I establish the emission capture... Emission Rate with Add-on Controls Option § 63.4966 How do I establish the emission capture system and add... to § 63.4965. (c) Carbon adsorbers. If your add-on control device is a carbon adsorber, establish...

  5. 40 CFR 63.3545 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... also use as an alternative to Method 3B the manual method for measuring the oxygen, carbon dioxide, and... device emission destruction or removal efficiency? 63.3545 Section 63.3545 Protection of Environment... Option § 63.3545 How do I determine the add-on control device emission destruction or removal...

  6. 40 CFR 63.4766 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... also use as an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide... device emission destruction or removal efficiency? 63.4766 Section 63.4766 Protection of Environment... Option § 63.4766 How do I determine the add-on control device emission destruction or removal...

  7. 40 CFR 63.3545 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... also use as an alternative to Method 3B the manual method for measuring the oxygen, carbon dioxide, and... device emission destruction or removal efficiency? 63.3545 Section 63.3545 Protection of Environment... Option § 63.3545 How do I determine the add-on control device emission destruction or removal...

  8. 40 CFR 63.4766 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... also use as an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide... device emission destruction or removal efficiency? 63.4766 Section 63.4766 Protection of Environment... Option § 63.4766 How do I determine the add-on control device emission destruction or removal...

  9. 40 CFR 63.3545 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... also use as an alternative to Method 3B the manual method for measuring the oxygen, carbon dioxide, and... device emission destruction or removal efficiency? 63.3545 Section 63.3545 Protection of Environment... Option § 63.3545 How do I determine the add-on control device emission destruction or removal...

  10. 40 CFR 75.34 - Units with add-on emission controls.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... assurance/quality control program for the unit, required by section 1 in appendix B of this part. To provide... parametric data to verify the proper operation of the SO2 or NOX add-on emission controls during each hour, as described in paragraph (d) of this section. For any missing data hour(s) in which such...

  11. 40 CFR 75.34 - Units with add-on emission controls.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Units with add-on emission controls. 75.34 Section 75.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.34 Units...

  12. 40 CFR 75.34 - Units with add-on emission controls.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Units with add-on emission controls. 75.34 Section 75.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.34 Units...

  13. Add-on simple adaptive control improves performance of classical control design

    NASA Astrophysics Data System (ADS)

    Weiss, Haim; Rusnak, Ilan

    2014-12-01

    The Simple Adaptive Control (SAC) controls an augmented plant that comprises the true plant with parallel feed-forward. The Almost Strictly Positive Real (ASPR) property of the augmented plant leads to asymptotic following. Prior publications have shown that, based only on the prior knowledge on stabilizability properties of systems (usually available), the parallel feed-forward configuration (PFC) allows adaptive control of realistic systems, even if they are both unstable and non-minimum phase. However, it was commonly thought that the PFC addition requires a price when compared with good linear time invariant (LTI) designs that do not use any addition to the plant. The paper shows that the use of SAC with PFC as Add-On to LTI system design improves the performance. Although SAC directly controls the augmented error, it always gives improved performance, i.e., smaller tracking error and reduced sensitivity to plant disturbance, with respect to the best LTI controller.

  14. 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I establish the emission capture... Emission Rate with Add-on Controls Option § 63.4167 How do I establish the emission capture system and add... test to determine destruction efficiency according to § 63.4166. (c) Carbon adsorbers. If your...

  15. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Operating Limits if Using Add-On Control Devices and Capture System 1 Table 1 to Subpart JJJJ of Part 63 Protection of Environment... Limits if Using Add-On Control Devices and Capture System If you are required to comply with...

  16. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Operating Limits if Using Add-on Control Devices and Capture System 1 Table 1 to Subpart SSSS of Part 63 Protection of Environment... Using Add-on Control Devices and Capture System If you are required to comply with operating limits...

  17. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Operating Limits if Using Add-On Control Devices and Capture System 2 Table 2 to Subpart OOOO of Part 63 Protection of Environment... OOOO of Part 63—Operating Limits if Using Add-On Control Devices and Capture System If you are...

  18. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Operating Limits if Using Add-on Control Devices and Capture System 1 Table 1 to Subpart SSSS of Part 63 Protection of Environment... Using Add-on Control Devices and Capture System If you are required to comply with operating limits...

  19. 40 CFR 63.9323 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the add-on control device simultaneously, using either Method 25 or 25A of appendix A to 40 CFR part... both the inlet and outlet measurements. (1) Use Method 25 of appendix A to 40 CFR part 60 if the add-on.... (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to select sampling sites...

  20. 40 CFR 63.4363 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I establish the add-on control... § 63.4363 How do I establish the add-on control device operating limits during the performance test... specified in § 63.4292. (a) Thermal oxidizers. If your add-on control device is a thermal...

  1. Alirocumab as Add-On to Atorvastatin Versus Other Lipid Treatment Strategies: ODYSSEY OPTIONS I Randomized Trial

    PubMed Central

    Gaudet, Daniel; Weiss, Robert; Ruiz, Juan Lima; Watts, Gerald F.; Gouni-Berthold, Ioanna; Robinson, Jennifer; Zhao, Jian; Hanotin, Corinne; Donahue, Stephen

    2015-01-01

    Context: Despite current standard of care, many patients at high risk of cardiovascular disease (CVD) still have elevated low-density lipoprotein cholesterol (LDL-C) levels. Alirocumab is a fully human monoclonal antibody inhibitor of proprotein convertase subtilisin/kexin type 9. Objective: The objective of the study was to compare the LDL-C-lowering efficacy of adding alirocumab vs other common lipid-lowering strategies. Design, Patients, and Interventions: Patients (n = 355) with very high CVD risk and LDL-C levels of 70 mg/dL or greater or high CVD risk and LDL-C of 100 mg/dL or greater on baseline atorvastatin 20 or 40 mg were randomized to one of the following: 1) add-on alirocumab 75 mg every 2 weeks (Q2W) sc; 2) add-on ezetimibe 10 mg/d; 3) double atorvastatin dose; or 4) for atorvastatin 40 mg regimen only, switch to rosuvastatin 40 mg. For patients not achieving protocol-defined LDL-C goals, the alirocumab dose was increased (blinded) at week 12 to 150 mg Q2W. Main Outcome Measure: The primary end point was percentage change in calculated LDL-C from baseline to 24 weeks (intent to treat). Results: Among atorvastatin 20 and 40 mg regimens, respectively, add-on alirocumab reduced LDL-C levels by 44.1% and 54.0% (P < .001 vs all comparators); add-on ezetimibe, 20.5% and 22.6%; doubling of atorvastatin dose, 5.0% and 4.8%; and switching atorvastatin 40 mg to rosuvastatin 40 mg, 21.4%. Most alirocumab-treated patients (87.2% and 84.6%) achieved their LDL-C goals. Most alirocumab-treated patients (86%) maintained their 75-mg Q2W regimen. Treatment-emergent adverse events occurred in 65.4% of alirocumab patients vs 64.4% ezetimibe and 63.8% double atorvastatin/switch to rosuvastatin (data were pooled). Conclusions: Adding alirocumab to atorvastatin provided significantly greater LDL-C reductions vs adding ezetimibe, doubling atorvastatin dose, or switching to rosuvastatin and enabled greater LDL-C goal achievement. PMID:26030325

  2. 40 CFR 63.3174 - What are the requirements for a capture system or add-on control device which is not taken into...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... system or add-on control device which is not taken into account when demonstrating compliance with the... Electrodeposition Primer Emission Limitations § 63.3174 What are the requirements for a capture system or add-on... limitations? You may have capture systems or add-on control devices which you choose not to take into...

  3. 40 CFR 63.3174 - 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

    ... system or add-on control device which is not taken into account when demonstrating compliance with the... Electrodeposition Primer Emission Limitations § 63.3174 What are the requirements for a capture system or add-on... limitations? You may have capture systems or add-on control devices which you choose not to take into...

  4. 40 CFR 63.4362 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... organic compounds as carbon in the vent gas, as determined by Method 25 or Method 25A, ppmv, dry basis... gaseous organic emissions mass flow rate at the outlet(s) of the add-on control device, using Equation 1... paragraphs (a)(1) through (5) of this section. (1) Use Method 1 or 1A of appendix A to 40 CFR part 60,...

  5. 40 CFR 63.3545 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... appendix A to 40 CFR part 60 to subtract methane emissions from measured total gaseous organic mass... = Concentration of organic compounds as carbon in the vent gas, as determined by Method 25 or Method 25A, ppmvd... gaseous organic emissions mass flow rate at the inlet(s) to the add-on control device, using Equation 1...

  6. 40 CFR 63.9323 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... device emission destruction or removal efficiency? 63.9323 Section 63.9323 Protection of Environment... Pollutants for Engine Test Cells/Stands Testing and Initial Compliance Requirements § 63.9323 How do I determine the add-on control device emission destruction or removal efficiency? You must use the...

  7. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Operating Limits for Capture Systems... 63—Operating Limits for Capture Systems and Add-On Control Devices If you are required to comply with... consistent with the manufacturer's recommendations. 3. Regenerative carbon adsorber a. The total...

  8. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true Operating Limits for Capture Systems... Subpart IIII of Part 63—Operating Limits for Capture Systems and Add-On Control Devices If you are... consistent with the manufacturer's recommendations. 3. Regenerative carbon adsorber a. The total...

  9. 40 CFR 63.4362 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME, PTC 19.10-1981, “Flue and... device emission destruction or removal efficiency? 63.4362 Section 63.4362 Protection of Environment... § 63.4362 How do I determine the add-on control device emission destruction or removal efficiency?...

  10. 40 CFR 63.4965 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide, and carbon... device emission destruction or removal efficiency? 63.4965 Section 63.4965 Protection of Environment....4965 How do I determine the add-on control device emission destruction or removal efficiency? You...

  11. 40 CFR 63.4166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... also use as an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide... device emission destruction or removal efficiency? 63.4166 Section 63.4166 Protection of Environment....4166 How do I determine the add-on control device emission destruction or removal efficiency? (a)...

  12. 40 CFR 63.4166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... also use as an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide... device emission destruction or removal efficiency? 63.4166 Section 63.4166 Protection of Environment....4166 How do I determine the add-on control device emission destruction or removal efficiency? (a)...

  13. 40 CFR 63.4362 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME, PTC 19.10-1981, “Flue and... device emission destruction or removal efficiency? 63.4362 Section 63.4362 Protection of Environment... Requirements § 63.4362 How do I determine the add-on control device emission destruction or removal...

  14. 40 CFR 63.4362 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME, PTC 19.10-1981, “Flue and... device emission destruction or removal efficiency? 63.4362 Section 63.4362 Protection of Environment... Requirements § 63.4362 How do I determine the add-on control device emission destruction or removal...

  15. 40 CFR 63.3545 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... an alternative to Method 3B the manual method for measuring the oxygen, carbon dioxide, and carbon... device emission destruction or removal efficiency? 63.3545 Section 63.3545 Protection of Environment... How do I determine the add-on control device emission destruction or removal efficiency? You must...

  16. 40 CFR 63.4362 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME, PTC 19.10-1981, “Flue and... device emission destruction or removal efficiency? 63.4362 Section 63.4362 Protection of Environment... Requirements § 63.4362 How do I determine the add-on control device emission destruction or removal...

  17. 40 CFR 63.4965 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide, and carbon... device emission destruction or removal efficiency? 63.4965 Section 63.4965 Protection of Environment....4965 How do I determine the add-on control device emission destruction or removal efficiency? You...

  18. Effects of add-on mirtazapine on neurocognition in schizophrenia: a double-blind, randomized, placebo-controlled study.

    PubMed

    Stenberg, Jan-Henry; Terevnikov, Viatcheslav; Joffe, Marina; Tiihonen, Jari; Tchoukhine, Evgueni; Burkin, Mark; Joffe, Grigori

    2010-05-01

    Mirtazapine added to antipsychotics appears to improve the clinical picture of schizophrenia, including both negative and positive symptoms. This study explored the effect of adjunctive mirtazapine on neurocognition in patients with schizophrenia who had shown an insufficient response to first-generation antipsychotics (FGAs). Thirty-seven schizophrenia patients, who were at least moderately ill despite their FGA treatment, received add-on mirtazapine (n=19) or placebo (n=18) in a 6-wk double-blind, randomized trial. Widely used neuropsychological tests were performed to explore visual-spatial functions, verbal and visual memory, executive functions, verbal fluency and general mental and psychomotor speed. The data were analysed on the modified intent-to-treat basis with last observation carried forward. False discovery rate was applied to correct for multiple testing. Mirtazapine outperformed placebo in the domains of visual-spatial ability and general mental speed/attentional control as assessed by, correspondingly, Block Design and Stroop dots. The difference in the degree of change (i.e. change while on mirtazapine minus that on placebo) was 18.6% (p=0.044) and 11.1% (p=0.044), respectively. Adjunctive mirtazapine might offer a safe, effective and cost-saving option as a neurocognitive enhancer for FGA-treated schizophrenia patients. Mirtazapine+FGA combinations may become especially useful in light of the currently increasing attention towards FGAs. Larger and longer studies that incorporate functional outcomes, as well as comparisons with second-generation antipsychotics are, however, still needed for more definite conclusions. PMID:19941694

  19. 40 CFR 63.4566 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... outlet of the add-on control device simultaneously, using either Method 25 or 25A of appendix A to 40 CFR...) through (5) of this section. (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to... to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or...

  20. 40 CFR 63.4566 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... outlet of the add-on control device simultaneously, using either Method 25 or 25A of appendix A to 40 CFR...) through (5) of this section. (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to... to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or...

  1. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide, and carbon... emissions and add-on control device emission destruction or removal efficiency? 63.3555 Section 63.3555... add-on control device emission destruction or removal efficiency? You must use the procedures and...

  2. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide, and carbon... emissions and add-on control device emission destruction or removal efficiency? 63.3555 Section 63.3555... add-on control device emission destruction or removal efficiency? You must use the procedures and...

  3. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... an alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide, and carbon... emissions and add-on control device emission destruction or removal efficiency? 63.3555 Section 63.3555... add-on control device emission destruction or removal efficiency? You must use the procedures and...

  4. TEST DESIGN FOR ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) OF ADD-ON NOX CONTROL UTILIZING OZONE INJECTION

    EPA Science Inventory

    The paper discusses the test design for environmental technology verification (ETV) of add-0n nitrogen oxides (NOx) control utilizing ozone injection. (NOTE: ETV is an EPA-established program to enhance domestic and international market acceptance of new or improved commercially...

  5. 40 CFR 75.34 - Units with add-on emission controls.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Missing Data Substitution Procedures § 75.34 Units with.../or NOX emission controls shall provide substitute data in accordance with paragraphs (a)(1), through (a)(5) of this section for each hour in which quality-assured data from the outlet SO2 and/or...

  6. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... appendix A to 40 CFR part 60 to subtract methane emissions from measured total gaseous organic mass... organic compounds as carbon in the vent gas, as determined by Method 25 or Method 25A, ppmvd. Qsd... gaseous organic emissions mass flow rate at the inlet(s) to the add-on control device, using Equation 1...

  7. N-Acetylcysteine in the Treatment of Pediatric Trichotillomania: A Randomized, Double-Blind, Placebo-Controlled Add-On Trial

    ERIC Educational Resources Information Center

    Bloch, Michael H.; Panza, Kaitlyn E.; Grant, Jon E.; Pittenger, Christopher; Leckman, James F.

    2013-01-01

    Objective: To examine the efficacy of N-acetylcysteine (NAC) for the treatment of pediatric trichotillomania (TTM) in a double-blind, placebo-controlled, add-on study. Method: A total of 39 children and adolescents aged 8 to 17 years with pediatric trichotillomania were randomly assigned to receive NAC or matching placebo for 12 weeks. Our primary…

  8. 40 CFR 63.3555 - How do I determine the outlet THC emissions and add-on control device emission destruction or...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... alternative to Method 3B, the manual method for measuring the oxygen, carbon dioxide, and carbon monoxide... emissions and add-on control device emission destruction or removal efficiency? 63.3555 Section 63.3555... device emission destruction or removal efficiency? You must use the procedures and test methods in...

  9. 40 CFR 63.9324 - 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

    ...) Thermal oxidizers. If your add-on control device is a thermal oxidizer, establish the operating limits... runs. You must monitor the temperature in the firebox of the thermal oxidizer or immediately downstream... test. This average combustion temperature is the minimum operating limit for your thermal oxidizer....

  10. 40 CFR 63.4363 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... specified in § 63.4292. (a) Thermal oxidizers. If your add-on control device is a thermal oxidizer... the three test runs. You must monitor the temperature in the firebox of the thermal oxidizer or... performance test. This average temperature is the minimum operating limit for your thermal oxidizer....

  11. 40 CFR 63.3966 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... simultaneously, using either Method 25 or 25A of appendix A to 40 CFR part 60. (1) Use Method 25 if the add-on... 1A of appendix A to 40 CFR part 60, as appropriate, to select sampling sites and velocity traverse points. (2) Use Method 2, 2A, 2C, 2D, 2F, or 2G of appendix A to 40 CFR part 60, as appropriate,...

  12. 40 CFR 63.3966 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... simultaneously, using either Method 25 or 25A of appendix A to 40 CFR part 60. (1) Use Method 25 if the add-on... 1A of appendix A to 40 CFR part 60, as appropriate, to select sampling sites and velocity traverse points. (2) Use Method 2, 2A, 2C, 2D, 2F, or 2G of appendix A to 40 CFR part 60, as appropriate,...

  13. Exhaled Nitric Oxide Fraction as an Add-On to ACQ-7 for Not Well Controlled Asthma Detection

    PubMed Central

    Plaza, Vicente; Ramos-Barbón, David; Muñoz, Ana María; Fortuna, Ana María; Crespo, Astrid; Murio, Cristina; Palomino, Rosa

    2013-01-01

    Background The measurement of fractional nitric oxide concentration in exhaled breath (FeNO), a noninvasive indicator of airway inflammation, remains controversial as a tool to assess asthma control. Guidelines currently limit asthma control assessment to symptom and spirometry based appraisals such as the Asthma Control Questionnaire-7 (ACQ-7). We aimed at determining whether adding FeNO to ACQ-7 improves current asthma clinical control assessment, through enhanced detection of not well controlled asthma. Methods Asthmatic subjects, classified as not well controlled as per ACQ-7 on regular clinical practice, were included in a prospective, multicenter fashion, and had their maintenance treatment adjusted on visit 1. On follow-up (visit 2) four weeks later, the subjects were reevaluated as controlled or not well controlled using ACQ-7 versus a combination of FeNO and ACQ-7. Results Out of 381 subjects enrolled, 225 (59.1%) had not well controlled asthma on visit 2 as determined by ACQ-7, and 264 (69.3%) as per combined FeNO and ACQ-7. The combination of FeNO to ACQ-7 increased by 14.8% the detection of not well controlled asthma following maintenance therapy adjustment. Conclusions The addition of FeNO to ACQ-7 increased the detectability of not well controlled asthma upon adjustment of maintenance therapy. Adding a measure of airway inflammation to usual symptom and spirometry based scores increases the efficacy of current asthma clinical control assessment. PMID:24204742

  14. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Control Devices and Capture System 2 Table 2 to Subpart OOOO of Part 63 Protection of Environment... Pollutants: Printing, Coating, and Dyeing of Fabrics and Other Textiles Pt. 63, Subpt. OOOO, Table 2 Table 2... operating limits in the following table: For the following device . . . You must meet the...

  15. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Control Devices and Capture System 1 Table 1 to Subpart JJJJ of Part 63 Protection of Environment... Pollutants: Paper and Other Web Coating Pt. 63, Subpt. JJJJ, Table 1 Table 1 to Subpart JJJJ of Part 63... operating limits by § 63.3321, you must comply with the applicable operating limits in the following...

  16. Dapagliflozin add-on to metformin in type 2 diabetes inadequately controlled with metformin: a randomized, double-blind, placebo-controlled 102-week trial

    PubMed Central

    2013-01-01

    Background Management of type 2 diabetes with metformin often does not provide adequate glycemic control, thereby necessitating add-on treatment. In a 24-week clinical trial, dapagliflozin, an investigational sodium glucose cotransporter 2 inhibitor, improved glycemic control in patients inadequately controlled with metformin. The present study is an extension that was undertaken to evaluate dapagliflozin as long-term therapy in this population. Methods This was a long-term extension (total 102 weeks) of a 24-week phase 3, multicenter, randomized, placebo-controlled, double-blind, parallel-group trial. Patients were randomly assigned (1:1:1:1) to blinded daily treatment (placebo, or dapagliflozin 2.5 to 5, or 10 mg) plus open-label metformin (≥1,500 mg). The previously published primary endpoint was change from baseline in glycated hemoglobin (HbA1c) at 24 weeks. This paper reports the follow-up to week 102, with analysis of covariance model performed at 24 weeks with last observation carried forward; a repeated measures analysis was utilized to evaluate changes from baseline in HbA1c, fasting plasma glucose (FPG), and weight. Results A total of 546 patients were randomized to 1 of the 4 treatments. The completion rate for the 78-week double-blind extension period was lower for the placebo group (63.5%) than for the dapagliflozin groups (68.3% to 79.8%). At week 102, mean changes from baseline HbA1c (8.06%) were +0.02% for placebo compared with -0.48% (P = 0.0008), -0.58% (P <0.0001), and -0.78% (P <0.0001) for dapagliflozin 2.5 to 5, and 10 mg, respectively. In addition, all dapagliflozin groups had sustained reductions from baseline in FPG (-1.07 to -1.47 mmol/l) and body weight (-1.10 to -1.74 kg) at 102 weeks, whereas increases were noted in placebo-treated patients for both of these outcomes. Events of hypoglycemia were rare and were not severe. Evidence suggestive of genital infection was reported in 11.7% to 14.6% of dapagliflozin patients and 5.1% of

  17. Double-blind, randomized sham controlled study of deep-TMS add-on treatment for negative symptoms and cognitive deficits in schizophrenia.

    PubMed

    Rabany, Liron; Deutsch, Lisa; Levkovitz, Yechiel

    2014-07-01

    Negative symptoms and cognitive deficits are considered core symptoms of schizophrenia, yet treatment for them remains inadequate. Deep-transcranial magnetic stimulation (TMS) is a novel technology that enables non-invasive stimulation of deep layers of the prefrontal cortex. Preliminary evidence suggests that deep-TMS could be effective in the treatment of negative symptoms and cognitive deficits. The current study is the first double-blind, randomized sham-controlled study to examine the feasibility of deep-TMS add-on treatment for negative symptoms and cognitive deficits in schizophrenia. Twenty daily H1 deep-TMS treatments (20Hz, 120% MT) were delivered, in a double-blind, randomized sham-controlled design (n=30). Extensive clinical and cognitive assessments were carried out throughout the study and for an additional one month follow-up period. The results indicate that at the end of the treatment period, negative symptoms (as indicated by the Scale for the Assessment of Negative Symptoms (SANS)) significantly reduced in the TMS group (-7.7), but not in the sham group (-1.9). Differences between the groups were not statistically significant.

  18. Lithium as add-on to quetiapine XR in adult patients with acute mania: a 6-week, multicenter, double-blind, randomized, placebo-controlled study.

    PubMed

    Bourin, Michel S; Severus, Emanuel; Schronen, Juan P; Gass, Peter; Szamosi, Johan; Eriksson, Hans; Chandrashekar, Hongally

    2014-01-01

    Quetiapine extended release (XR) and lithium are treatments with proven efficacy in acute mania. This randomized study evaluated the efficacy and safety of lithium or placebo as add-on to quetiapine XR in adult patients with manic or mixed symptoms of bipolar I disorder. In this 6-week, double-blind study (Trial D144AC00003), adult patients with DSM-IV-TR-diagnosed bipolar I disorder (current episode manic or mixed), a Young Mania Rating Scale (YMRS) total score ≥20, and score ≥4 on two of four core YMRS items were administered quetiapine XR (400 to 800 mg/day) and randomly assigned to receive add-on lithium (600 to 1,800 mg/day) or placebo. The primary efficacy end point was change in the YMRS total score from baseline to day 43, analyzed using a mixed-model for repeated measures (MMRM) approach. Secondary efficacy and safety end points were also measured. Rating scales were administered by trained staff. Three hundred fifty-six patients treated with quetiapine XR were randomized to add-on lithium (n = 173) or placebo (n = 183). Two hundred ninety-one patients (81.7%) completed the study. At day 43, least squares mean change in YMRS total score was -22.8 for add-on lithium and -20.1 for add-on placebo, a statistically significant treatment group difference of -2.69 (p < 0.001). On secondary measures, add-on lithium was associated with significant improvements in response, remission, illness severity, and overall illness versus add-on placebo (p < 0.05). The number needed to treat was 9.1 for response and 7.9 for remission for add-on lithium compared with add-on placebo. Lithium in combination with quetiapine XR was generally well tolerated, with a similar profile to quetiapine XR in combination with placebo. The addition of lithium to quetiapine XR therapy was associated with significantly greater efficacy than placebo as add-on and was generally well tolerated in patients with acute bipolar I mania. This study was registered under Clinicaltrials

  19. Efficacy of Zinc Sulfate as an Add-on Therapy to Risperidone Versus Risperidone Alone in Patients With Schizophrenia: A Double-Blind Randomized Placebo-Controlled Trial

    PubMed Central

    Mortazavi, Mehran; Farzin, Davood; Zarhghami, Mehran; Hosseini, Seyed Hamzeh; Mansoori, Parisa; Nateghi, Gholamreza

    2015-01-01

    Background: Zinc can modulate fast-excitatory transmission, facilitate the release of amino butyric acid and potentiate nicotinic acetylcholine receptors. There are also emerging evidences discussing the implication of these neurotransmitters in pathophysiology of schizophrenia. Objectives: The purpose of this study was to evaluate the efficacy of Zn sulfate as an add-on therapy in the treatment of schizophrenia in a 6-week, double-blind and placebo-controlled trial. Patients and Methods: Eligible participants were 30 inpatients with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. Patients were randomly allocated into two equal groups; one group of patients received risperidone 6 mg/day plus capsules of Zn sulfate (each containing 50 mg elemental Zn) three times a day and another group received risperidone 6 mg/day plus placebo. The Positive and Negative Syndrome Scale (PANSS) was applied to assess the psychotic symptoms and aggression risk at baseline, week 2, 4, and 6 of the study. Results: The results of this study showed that both protocols significantly decreased the scores on all subscales of the PANSS and supplemental aggression risk subscale as well as PANSS total score over the study. However, this improvement was significantly higher in Zn sulfate receiving group compared to the placebo group. No major clinical side-effects were detected. Conclusions: It may be concluded that Zn is an effective adjuvant agent in the management of patients with schizophrenia. PMID:26576178

  20. The effect of add-on memantine on global function and quality of life in schizophrenia: A randomized, double-blind, controlled, clinical trial

    PubMed Central

    Omranifard, Victoria; Rajabi, Fatemeh; Mohammadian-Sichani, Maryam; Maracy, Mohammad

    2015-01-01

    Background: Schizophrenia severely influences function and quality of life. The benefit of newer antipsychotics in improving the quality of life in schizophrenia still remains controversial. The aim of the present study is to evaluate the effect of memantine on global function and quality of life in patients with schizophrenia. Materials and Methods: This was a randomized controlled trial on inpatient cases of schizophrenia in Noor University Hospital, Isfahan, Iran. A number of 64 patients were selected through sequential sampling; patients were randomly allocated in intervention and placebo groups. The intervention group was treated with memantine plus previously administered, stabled-dose, atypical antipsychotic, while the control group received placebo plus previously administered, stabled-dose, atypical antipsychotic. Memantine administration was initiated at 5 mg daily; the dosage was increased at weekly intervals by 5 mg and finally up-titrated to 20 mg daily within 4 weeks. All patients were assessed by means of Global Assessment of Functioning (GAF) and quality of life scale (QLS) initially and every four weeks to the end of the 12th week. Results: Analysis of baseline GAF and QLS scores showed no significant differences between the two groups (P = 0.081 and P = 0.225, respectively). GAF and QLS scores increased in both groups; but it was higher in the intervention group. The difference between the two groups was statistically significant. (P < 0.001 and P < 0.001, respectively) memantine was well tolerated, with no significant side effects. Conclusion: Add-on memantine was significantly effective in improving the global function of patients as well as their quality of life. PMID:26605240

  1. Semi-individualised Chinese medicine treatment as an adjuvant management for diabetic nephropathy: a pilot add-on, randomised, controlled, multicentre, open-label pragmatic clinical trial

    PubMed Central

    Chan, Kam Wa; Ip, Tai Pang; Kwong, Alfred Siu Kei; Lui, Sing Leung; Chan, Gary Chi Wang; Cowling, Benjamin John; Yiu, Wai Han; Wong, Dickson Wai Leong; Liu, Yang; Feng, Yibin; Tan, Kathryn Choon Beng; Chan, Loretta Yuk Yee; Leung, Joseph Chi Kam; Lai, Kar Neng; Tang, Sydney Chi Wai

    2016-01-01

    Introduction Diabetes mellitus and diabetic nephropathy (DN) are prevalent and costly to manage. DN is the leading cause of end-stage kidney disease. Conventional therapy blocking the renin–angiotensin system has only achieved limited effect in preserving renal function. Recent observational data show that the use of Chinese medicine (CM), a major form of traditional medicine used extensively in Asia, could reduce the risk of end-stage kidney disease. However, existing clinical practice guidelines are weakly evidence-based and the effect of CM remains unclear. This trial explores the effect of an existing integrative Chinese–Western medicine protocol for the management of DN. Objective To optimise parameters and assess the feasibility for a subsequent phase III randomised controlled trial through preliminary evaluation on the effect of an adjuvant semi-individualised CM treatment protocol on patients with type 2 diabetes with stages 2–3 chronic kidney disease and macroalbuminuria. Methods and analysis This is an assessor-blind, add-on, randomised, controlled, parallel, multicentre, open-label pilot pragmatic clinical trial. 148 patients diagnosed with DN will be recruited and randomised 1:1 to a 48-week additional semi-individualised CM treatment programme or standard medical care. Primary end points are the changes in estimated glomerular filtration rate and spot urine albumin-to-creatinine ratio between baseline and treatment end point. Secondary end points include fasting blood glucose, glycated haemoglobin, brain natriuretic peptide, fasting insulin, C peptide, fibroblast growth factor 23, urinary monocyte chemotactic protein-1, cystatin C, nephrin, transforming growth factor-β1 and vascular endothelial growth factor. Adverse events are monitored through self-completed questionnaire and clinical visits. Outcomes will be analysed by regression models. Enrolment started in July 2015. Ethics and registration This protocol is approved by the Institutional

  2. Ephedrine as add-on therapy for patients with myasthenia gravis: protocol for a series of randomised, placebo-controlled n-of-1 trials

    PubMed Central

    Vrinten, Charlotte; Lipka, Alexander F; van Zwet, Erik W; Schimmel, Kirsten J M; Cornel, Martina C; Kuijpers, Marja R; Hekster, Yechiel A; Weinreich, Stephanie S; Verschuuren, Jan J G M

    2015-01-01

    Introduction Myasthenia gravis (MG), a rare neuromuscular disease, is often initially treated using acetylcholinesterase inhibitors. Patients who do not respond adequately depend on the use of corticosteroids or other immunosuppressive medication, but these may have serious side effects. Clinical observations suggest that ephedrine can diminish, postpone or even prevent the need for immunosuppressive therapy when added to acetylcholinesterase inhibitors or low-dose prednisone. In the Netherlands, ephedrine is not licensed for MG nor is reimbursement guaranteed. MG is a rare condition, and ephedrine might be indicated only in a subset of patients. Thus, randomised controlled trials comparing large groups are difficult to conduct. We, therefore, aim to aggregate data from a small series of n-of-1 trials (also known as single patient trials) to assess the effect of ephedrine as add-on treatment for MG. Methods and analysis Single-centre, placebo-controlled, double-blind, randomised, multiple crossover n-of-1 studies in 4 adult patients with generalised MG who show inadequate improvement on pyridostigmine and/or immunosuppressive drugs. Each n-of-1 trial has 3 cycles of two 5-day intervention periods. Treatment: 25 mg ephedrine or placebo, twice daily. Main outcome measure: Quantitative Myasthenia Gravis (QMG) test. Statistical analysis: fixed effects linear model for QMG for all patients combined. Secondary outcome measures: Clinical: effects on MG-Composite and MG-Activities of Daily Living (MG-ADL) scales; QMG at individual level; adverse events. Acceptability of trial design: number of patients eligible and enrolled; number of treatment cycles completed; patients’ and caregivers’ experiences. Ethics and dissemination This study was approved by the Medical Ethics Committee of Leiden University Medical Center, No. P14.108. Results of the trial will be reported in a peer-reviewed publication. Regulatory stakeholders will comment on the suitability of the trial

  3. Acarbose improves glycemic control as add-on or monotherapy in Indian type-2 diabetes: Findings from the GlucoVIP multinational observational study

    PubMed Central

    Philip, Elizabeth; Sundaram, Meenakshi L.; Das, Rupam; Chauhan, Sushil Kumar; Deshpande, Sandeep; Ambhore, Sanjay; Rathod, Rahul; Manjrekar, Pravin

    2013-01-01

    Objective: To investigate the efficacy and tolerability of the anti-diabetic agent acarbose (Glucobay®) as add-on or monotherapy in a range of patients with type-2 diabetes mellitus (T2DM), including those with cardiovascular morbidities in India. Materials and Methods: This was a part of a prospective, non-interventional, non-controlled, multicentre, multinational, observational study. The study included patients of either gender if they were aged at least 18 years and had untreated or pre-treated type-2 diabetes mellitus (T2DM) or impaired glucose tolerance and no acarbose treatment within the 3 months before study inclusion. Results: In total, 1996 Indian patients were included in the effectiveness and 2010 in the safety analysis. Patients received acarbose (25-150 mg/day). The mean age of the patients was 50.1 years and the mean BMI was 27.2 kg/m2. Mean 2-h post-prandial plasma glucose (PPG) value and fasting blood glucose (FBG) decreased from 243.9 to 169.5 mg/dl and 158.3 to 120.4 mg/dl, respectively after the last follow-up of 12.4 weeks. The mean HbA1c value at initial visit was 8.4% and was 7.4% at the last follow-up visit. FBG, PPG and HbA1c deceased in 90.6%, 94.4% and 52.4% patients respectively, by the last follow-up visit. The mean decrease in weight and waist circumference was 1.4 kg and 1.6 cm, respectively by the last follow-up visit. Physicians assessed the efficacy of drug as positive response in “very good to good” in 91.08%, “sufficient” in 7.92% and “insufficient” in 0.90% of patients. Also, continuation of Acarbose was reported in 97.09% of patients. Adverse events were reported in 2.74% and drug-related adverse events were reported in 2.19% of patients. Majority of them were gastrointestinal adverse events but were not serious. Conclusion: Acarbose is effective and safe in Indian patients with T2DM. Further, it helps in weight reduction and has very good compliance in patients with T2DM. PMID:24910836

  4. TECHNOLOGICAL OPTIONS FOR ACID RAIN CONTROL

    EPA Science Inventory

    The paper discusses technological options for acid rain control. Compliance with Title IV of the Clean Air Act Amendments of 1990 will require careful scrutiny of a number of issues before selecting control options to reduce sulfur dioxide (SO2) and nitrogen oxide (NOx) emissions...

  5. TECHNOLOGICAL OPTIONS FOR ACID RAIN CONTROL

    EPA Science Inventory

    Discussed are acid rain control options available to the electric utility industry. They include coal switching, flue gas desulfurization, and such emerging lower cost technologies as Limestone Injection Multistage Burners (LIMB) and Advanced Silicate (ADVACATE), both developed ...

  6. Technological options for acid rain control

    SciTech Connect

    Princiotta, F.T.; Sedman, C.B.

    1993-01-01

    The paper discusses technological options for acid rain control. Compliance with Title IV of the Clean Air Act Amendments of 1990 will require careful scrutiny of a number of issues before selecting control options to reduce sulfur dioxide (SO2) and nitrogen oxide (NOx) emissions. One key consideration is the effect of fuel switching or control technology upon the existing dust collector, with additional air toxics legislation looming ahead. A number of likely SO2 and NOx retrofit technologies and estimated costs are presented, along with results of retrofit case studies. New hybrid particulate controls are also being developed to meet future requirements.

  7. 40 CFR Table 4 to Subpart Kkkk of... - Operating Limits If Using the Emission Rate With Add-on Controls Option or the Control Efficiency...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the...). i. Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.3547(d) or § 63.3557(d); andii. Maintaining the total...

  8. 40 CFR Table 4 to Subpart Kkkk of... - Operating Limits If Using the Emission Rate With Add-on Controls Option or the Control Efficiency...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the total... the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle... regeneration and any cooling cycle, must not exceed the carbon bed temperature limit established according...

  9. 40 CFR Table 4 to Subpart Kkkk of... - Operating Limits If Using the Emission Rate With Add-on Controls Option or the Control Efficiency...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the...). i. Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.3547(d) or § 63.3557(d); andii. Maintaining the total...

  10. 40 CFR Table 4 to Subpart Kkkk of... - Operating Limits If Using the Emission Rate With Add-on Controls Option or the Control Efficiency...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., 2.b, and 2.c of this table. 4. Carbon adsorber a. The total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the total... at or above the mass flow limit. b. The temperature of the carbon bed, after completing...

  11. 40 CFR Table 4 to Subpart Kkkk of... - Operating Limits If Using the Emission Rate With Add-on Controls Option or the Control Efficiency...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... items in 2.a, 2.b, and 2.c of this table. 4. Carbon adsorber a. The total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the... desorbing gas mass flow at or above the mass flow limit. b. The temperature of the carbon bed,...

  12. 12-week, placebo-controlled trial of add-on riluzole in the treatment of childhood-onset obsessive-compulsive disorder.

    PubMed

    Grant, Paul J; Joseph, Lisa A; Farmer, Cristan A; Luckenbaugh, David A; Lougee, Lorraine C; Zarate, Carlos A; Swedo, Susan E

    2014-05-01

    Many children with childhood-onset obsessive-compulsive disorder (OCD) fail to respond adequately to standard therapies. Evidence from preclinical and clinical studies suggests that the glutamatergic neurotransmitter system might be an alternative treatment target. This study examined the efficacy of riluzole, a glutamatergic modulator, as an adjunctive therapy for children with treatment-resistant OCD. In a 12-week, double-blind, placebo-controlled study, 60 treatment-resistant children and adolescents (mean age=14.5 ± 2.4 years), with moderate to severe OCD (mean Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS)=28.2 ± 3.7), 17 of whom also had concomitant autism spectrum disorder, were randomized to receive riluzole (final dose of 100 mg/day) or placebo in addition to the existing treatment regimen. Fifty-nine subjects completed the randomized trial. Primary outcome measures were changes on the CY-BOCS, the Clinical Global Impressions Scale, and the Children's Global Assessment Scale. Riluzole was fairly well tolerated, although it was associated with one case of pancreatitis and five instances of slight increases in transaminases. All subjects showed significant reductions in CY-BOCS scores during treatment; however, there was no significant difference between placebo and riluzole on any of the primary or secondary outcome measures. The study failed to demonstrate superiority of riluzole over placebo as an adjunctive treatment for children with childhood-onset OCD. However, future studies may show benefits for less treatment-refractory children with fewer concomitant medications.

  13. Mine Drainage Generation and Control Options.

    PubMed

    Wei, Xinchao; Rodak, Carolyn M; Zhang, Shicheng; Han, Yuexin; Wolfe, F Andrew

    2016-10-01

    This review provides a snapshot of papers published in 2015 relevant to the topic of mine drainage generation and control options. The review is broken into 3 sections: Generation, Prediction and Prevention, and Treatment Options. The first section, mine drainage generation, focuses on the characterization of mine drainage and the environmental impacts. As such, it is broken into three subsections focused on microbiological characterization, physiochemical characterization, and environmental impacts. The second section of the review is divided into two subsections focused on either the prediction or prevention of acid mine drainage. The final section focuses on treatment options for mine drainage and waste sludge. The third section contains subsections on passive treatment, biological treatment, physiochemical treatment, and a new subsection on beneficial uses for mine drainage and treatment wastes.

  14. Mine Drainage Generation and Control Options.

    PubMed

    Wei, Xinchao; Rodak, Carolyn M; Zhang, Shicheng; Han, Yuexin; Wolfe, F Andrew

    2016-10-01

    This review provides a snapshot of papers published in 2015 relevant to the topic of mine drainage generation and control options. The review is broken into 3 sections: Generation, Prediction and Prevention, and Treatment Options. The first section, mine drainage generation, focuses on the characterization of mine drainage and the environmental impacts. As such, it is broken into three subsections focused on microbiological characterization, physiochemical characterization, and environmental impacts. The second section of the review is divided into two subsections focused on either the prediction or prevention of acid mine drainage. The final section focuses on treatment options for mine drainage and waste sludge. The third section contains subsections on passive treatment, biological treatment, physiochemical treatment, and a new subsection on beneficial uses for mine drainage and treatment wastes. PMID:27620096

  15. 40 CFR Table 1 to Subpart Pppp of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not...); and i. Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.4568(d); andii. Maintaining the total regeneration desorbing gas mass...

  16. 40 CFR Table 1 to Subpart Rrrr of... - Operating Limits if Using the Emission Rate With Add-on Controls Option

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below.... measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according § 63.4967(d); andii. maintaining the total regeneration desorbing gas mass flow at...

  17. 40 CFR Table 1 to Subpart Rrrr of... - Operating Limits if Using the Emission Rate With Add-on Controls Option

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below.... measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according § 63.4967(d); andii. maintaining the total regeneration desorbing gas mass flow at...

  18. 40 CFR Table 1 to Subpart Nnnn of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not.... measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.4168(d); andii. maintaining the total regeneration desorbing gas mass flow at...

  19. 40 CFR Table 3 to Subpart Qqqq of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the total regeneration desorbing gas mass flow limit established according to § 63.4767(c) i. Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow...

  20. 40 CFR Table 1 to Subpart Nnnn of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not.... measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.4168(d); andii. maintaining the total regeneration desorbing gas mass flow at...

  1. 40 CFR Table 1 to Subpart Rrrr of... - Operating Limits if Using the Emission Rate With Add-on Controls Option

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below.... measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according § 63.4967(d); andii. maintaining the total regeneration desorbing gas mass flow at...

  2. 40 CFR Table 1 to Subpart Mmmm of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... nitrogen) mass flow for each regeneration cycle according to § 63.3968(d); andii. Maintaining the total... carbon adsorber a. The total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the total regeneration desorbing gas mass flow...

  3. 40 CFR Table 1 to Subpart Nnnn of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not.... measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.4168(d); andii. maintaining the total regeneration desorbing gas mass flow at...

  4. 40 CFR Table 1 to Subpart Mmmm of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... nitrogen) mass flow for each regeneration cycle according to § 63.3968(d); andii. Maintaining the total... carbon adsorber a. The total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the total regeneration desorbing gas mass flow...

  5. 40 CFR Table 1 to Subpart Mmmm of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not...); and i. Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.3968(d); andii. Maintaining the total regeneration desorbing gas mass...

  6. 40 CFR Table 1 to Subpart Pppp of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not...); and i. Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.4568(d); andii. Maintaining the total regeneration desorbing gas mass...

  7. 40 CFR Table 3 to Subpart Qqqq of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the total regeneration desorbing gas mass flow limit established according to § 63.4767(c) i. Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow...

  8. 40 CFR Table 1 to Subpart Pppp of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not...); and i. Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.4568(d); andii. Maintaining the total regeneration desorbing gas mass...

  9. 40 CFR Table 3 to Subpart Qqqq of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the total regeneration desorbing gas mass flow limit established according to § 63.4767(c) i. Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow...

  10. 40 CFR Table 1 to Subpart Mmmm of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... according to § 63.3967(b) (for magnet wire coating machines, temperature can be monitored before or after... for magnet wire coating machines after) the catalyst bed at or above the temperature limit. b. Ensure.... The average combustion temperature in any 3-hour period must not fall below the combustion...

  11. 40 CFR Table 3 to Subpart Qqqq of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... inspection and maintenance plan developed according to § 63.4767(b)(3) and (4). 3. Carbon absorber a. The total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration... gas mass flow at or above the mass flow limit. b. The temperature of the carbon bed, after...

  12. 40 CFR Table 1 to Subpart Pppp of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Method 204 of appendix M to 40 CFR part 51. i. See items 6.a.i and 6.a.ii. 7. Emission capture system... practicable consistent with the manufacturer's recommendations. 3. Regenerative carbon adsorber a. The total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must...

  13. 40 CFR Table 1 to Subpart Nnnn of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... soon as practicable consistent with the manufacturer's recommendations. 3. carbon adsorber a. the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not... above the mass flow limit. b. the temperature of the carbon bed, after completing each regeneration...

  14. 40 CFR Table 1 to Subpart Pppp of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Method 204 of appendix M to 40 CFR part 51. i. See items 6.a.i and 6.a.ii. 7. Emission capture system... practicable consistent with the manufacturer's recommendations. 3. Regenerative carbon adsorber a. The total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must...

  15. 40 CFR Table 1 to Subpart Mmmm of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... carbon adsorber a. The total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below the total regeneration desorbing gas mass flow limit... regeneration desorbing gas mass flow at or above the mass flow limit. b. The temperature of the carbon...

  16. 40 CFR Table 3 to Subpart Qqqq of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... inspection and maintenance plan developed according to § 63.4767(b)(3) and (4). 3. Carbon absorber a. The total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration... gas mass flow at or above the mass flow limit. b. The temperature of the carbon bed, after...

  17. 40 CFR Table 1 to Subpart Nnnn of... - Operating Limits if Using the Emission Rate With Add-On Controls Option

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... soon as practicable consistent with the manufacturer's recommendations. 3. carbon adsorber a. the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not... above the mass flow limit. b. the temperature of the carbon bed, after completing each regeneration...

  18. 40 CFR Table 1 to Subpart Rrrr of... - Operating Limits if Using the Emission Rate With Add-on Controls Option

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., as established in Method 204 of appendix M to 40 CFR part 51 i. collecting the direction of air flow...; and either i. collecting the direction of air flow, and either the facial velocity of air through all... § 63.4967(f)(2); andii. maintaining the facial velocity of air flow through all natural draft...

  19. 40 CFR Table 1 to Subpart Rrrr of... - Operating Limits if Using the Emission Rate With Add-on Controls Option

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., as established in Method 204 of appendix M to 40 CFR part 51 i. collecting the direction of air flow...; and either i. collecting the direction of air flow, and either the facial velocity of air through all... § 63.4967(f)(2); andii. maintaining the facial velocity of air flow through all natural draft...

  20. Add-on unidirectional elastic metamaterial plate cloak

    PubMed Central

    Lee, Min Kyung; Kim, Yoon Young

    2016-01-01

    Metamaterial cloaks control the propagation of waves to make an object invisible or insensible. To manipulate elastic waves in space, a metamaterial cloak is typically embedded in a base system that includes or surrounds a target object. The embedding is undesirable because it structurally weakens or permanently alters the base system. In this study, we propose a new add-on metamaterial elastic cloak that can be placed over and mechanically coupled with a base structure without embedding. We designed an add-on type annular metamaterial plate cloak through conformal mapping, fabricated it and performed cloaking experiments in a thin-plate with a hole. Experiments were performed in a thin plate by using the lowest symmetric Lamb wave centered at 100 kHz. As a means to check the cloaking performance of the add-on elastic plate cloak, possibly as a temporary stress reliever or a so-called “stress bandage”, the degree of stress concentration mitigation and the recovery from the perturbed wave field due to a hole were investigated. PMID:26860896

  1. Add-on unidirectional elastic metamaterial plate cloak.

    PubMed

    Lee, Min Kyung; Kim, Yoon Young

    2016-01-01

    Metamaterial cloaks control the propagation of waves to make an object invisible or insensible. To manipulate elastic waves in space, a metamaterial cloak is typically embedded in a base system that includes or surrounds a target object. The embedding is undesirable because it structurally weakens or permanently alters the base system. In this study, we propose a new add-on metamaterial elastic cloak that can be placed over and mechanically coupled with a base structure without embedding. We designed an add-on type annular metamaterial plate cloak through conformal mapping, fabricated it and performed cloaking experiments in a thin-plate with a hole. Experiments were performed in a thin plate by using the lowest symmetric Lamb wave centered at 100 kHz. As a means to check the cloaking performance of the add-on elastic plate cloak, possibly as a temporary stress reliever or a so-called "stress bandage", the degree of stress concentration mitigation and the recovery from the perturbed wave field due to a hole were investigated. PMID:26860896

  2. Add-on unidirectional elastic metamaterial plate cloak

    NASA Astrophysics Data System (ADS)

    Lee, Min Kyung; Kim, Yoon Young

    2016-02-01

    Metamaterial cloaks control the propagation of waves to make an object invisible or insensible. To manipulate elastic waves in space, a metamaterial cloak is typically embedded in a base system that includes or surrounds a target object. The embedding is undesirable because it structurally weakens or permanently alters the base system. In this study, we propose a new add-on metamaterial elastic cloak that can be placed over and mechanically coupled with a base structure without embedding. We designed an add-on type annular metamaterial plate cloak through conformal mapping, fabricated it and performed cloaking experiments in a thin-plate with a hole. Experiments were performed in a thin plate by using the lowest symmetric Lamb wave centered at 100 kHz. As a means to check the cloaking performance of the add-on elastic plate cloak, possibly as a temporary stress reliever or a so-called “stress bandage”, the degree of stress concentration mitigation and the recovery from the perturbed wave field due to a hole were investigated.

  3. What’s next after metformin? focus on sulphonylurea: add-on or combination therapy

    PubMed Central

    Lim, Phei C.; Chong, Chee P.

    2015-01-01

    Introduction: The pathophysiology of type 2 diabetes (T2DM) mainly focused on insulin resistance and insulin deficiency over the past decades. Currently, the pathophysiologies expanded to ominous octet and guidelines were updated with newer generation of antidiabetic drug classes. However, many patients had yet to achieve their target glycaemic control. Although all the guidelines suggested metformin as first line, there was no definite consensus on the second line drug agents as variety of drug classes were recommended. Objectives: The aim of this review was to evaluate the drug class after metformin especially sulphonylurea and issues around add-on or fixed dose combination therapy. Methods: Extensive literature search for English language articles, clinical practice guidelines and references was performed using electronic databases. Results: Adding sulphonylurea to metformin targeted both insulin resistance and insulin deficiency. Sulphonylurea was efficacious and cheaper than thiazolidinedione, dipeptidyl peptidase-4 inhibitor, glucagon-like peptide 1 analogue and insulin. The main side effect of sulphonylurea was hypoglycaemia but there was no effect on the body weight when combining with metformin. Fixed dose sulphonylurea/metformin was more efficacious at lower dose and reported to have fewer side effects with better adherence. Furthermore, fixed dose combination was cheaper than add-on therapy. In conclusion, sulphonylurea was feasible as the second line agent after metformin as the combination targeted on two pathways, efficacious, cost-effective and had long safety history. Fixed dose combination tablet could improve patient’s adherence and offered an inexpensive and more efficacious option regardless of original or generic product as compared to add-on therapy. PMID:26445623

  4. Celecoxib Adjunctive Treatment to Antipsychotics in Schizophrenia: A Review of Randomized Clinical Add-On Trials.

    PubMed

    Marini, Stefano; De Berardis, Domenico; Vellante, Federica; Santacroce, Rita; Orsolini, Laura; Valchera, Alessandro; Girinelli, Gabriella; Carano, Alessandro; Fornaro, Michele; Gambi, Francesco; Martinotti, Giovanni; Di Giannantonio, Massimo

    2016-01-01

    Schizophrenia is a severe, chronic and debilitating mental disorder. Past literature has reported various hypotheses about the psychopathology of schizophrenia. Recently, a growing literature has been trying to explain the role of inflammation in the etiopathogenesis of schizophrenia. In the past, numerous immune modulation and anti-inflammatory treatment options have been proposed for schizophrenia, but sometimes the results were inconsistent. Electronic search was carried out in November 2015. PubMed and Scopus databases have been used to find studies to introduce in this review. Only randomized-placebo-controlled add-on trials were taken into account. In this way, six articles were obtained for the discussion. Celecoxib showed beneficial effects mostly in early stages of schizophrenia. In chronic schizophrenia, the data are controversial, possibly in part for methodological reasons. PMID:27524864

  5. Celecoxib Adjunctive Treatment to Antipsychotics in Schizophrenia: A Review of Randomized Clinical Add-On Trials

    PubMed Central

    De Berardis, Domenico; Vellante, Federica; Santacroce, Rita; Orsolini, Laura; Valchera, Alessandro; Girinelli, Gabriella; Carano, Alessandro; Fornaro, Michele; Gambi, Francesco; Martinotti, Giovanni; Di Giannantonio, Massimo

    2016-01-01

    Schizophrenia is a severe, chronic and debilitating mental disorder. Past literature has reported various hypotheses about the psychopathology of schizophrenia. Recently, a growing literature has been trying to explain the role of inflammation in the etiopathogenesis of schizophrenia. In the past, numerous immune modulation and anti-inflammatory treatment options have been proposed for schizophrenia, but sometimes the results were inconsistent. Electronic search was carried out in November 2015. PubMed and Scopus databases have been used to find studies to introduce in this review. Only randomized-placebo-controlled add-on trials were taken into account. In this way, six articles were obtained for the discussion. Celecoxib showed beneficial effects mostly in early stages of schizophrenia. In chronic schizophrenia, the data are controversial, possibly in part for methodological reasons. PMID:27524864

  6. Add-on prolonged-release melatonin for cognitive function and sleep in mild to moderate Alzheimer’s disease: a 6-month, randomized, placebo-controlled, multicenter trial

    PubMed Central

    Wade, Alan G; Farmer, Mildred; Harari, Gil; Fund, Naama; Laudon, Moshe; Nir, Tali; Frydman-Marom, Anat; Zisapel, Nava

    2014-01-01

    Purpose A link between poor sleep quality and Alzheimer’s disease (AD) has recently been suggested. Since endogenous melatonin levels are already reduced at preclinical AD stages, it is important to ask whether replenishing the missing hormone would be beneficial in AD and whether any such effects would be related to the presence of sleep disorder in patients. Patients and methods The effects of add-on prolonged-release melatonin (PRM) (2 mg) to standard therapy on cognitive functioning and sleep were investigated in 80 patients (men [50.7%], women [49.3%], average age 75.3 years [range, 52–85 years]) diagnosed with mild to moderate AD, with and without insomnia comorbidity, and receiving standard therapy (acetylcholinesterase inhibitors with or without memantine). In this randomized, double-blind, parallel-group study, patients were treated for 2 weeks with placebo and then randomized (1:1) to receive 2 mg of PRM or placebo nightly for 24 weeks, followed by 2 weeks placebo. The AD Assessment Scale–Cognition (ADAS-Cog), Instrumental Activities of Daily Living (IADL), Mini–Mental State Examination (MMSE), sleep, as assessed by the Pittsburgh Sleep Quality Index (PSQI) and a daily sleep diary, and safety parameters were measured. Results Patients treated with PRM (24 weeks) had significantly better cognitive performance than those treated with placebo, as measured by the IADL (P=0.004) and MMSE (P=0.044). Mean ADAS-Cog did not differ between the groups. Sleep efficiency, as measured by the PSQI, component 4, was also better with PRM (P=0.017). In the comorbid insomnia (PSQI ≥6) subgroup, PRM treatment resulted in significant and clinically meaningful effects versus the placebo, in mean IADL (P=0.032), MMSE score (+1.5 versus −3 points) (P=0.0177), and sleep efficiency (P=0.04). Median ADAS-Cog values (−3.5 versus +3 points) (P=0.045) were significantly better with PRM. Differences were more significant at longer treatment duration. PRM was well

  7. Bed Bugs: Clinical Relevance and Control Options

    PubMed Central

    Dwyer, Dominic E.; Peñas, Pablo F.; Russell, Richard C.

    2012-01-01

    Summary: Since the late 1990s, bed bugs of the species Cimex lectularius and Cimex hemipterus have undergone a worldwide resurgence. These bed bugs are blood-sucking insects that readily bite humans. Cutaneous reactions may occur and can start out as small macular lesions that can develop into distinctive wheals of around 5 cm in diameter, which are accompanied by intense itching. Occasionally, bullous eruptions may result. If bed bugs are numerous, the patient can present with widespread urticaria or eythematous rashes. Often, bites occur in lines along the limbs. Over 40 pathogens have been detected in bed bugs, but there is no definitive evidence that they transmit any disease-causing organisms to humans. Anemia may result when bed bugs are numerous, and their allergens can trigger asthmatic reactions. The misuse of chemicals and other technologies for controlling bed bugs has the potential to have a deleterious impact on human health, while the insect itself can be the cause of significant psychological trauma. The control of bed bugs is challenging and should encompass a multidisciplinary approach utilizing nonchemical means of control and the judicious use of insecticides. For accommodation providers, risk management procedures should be implemented to reduce the potential of bed bug infestations. PMID:22232375

  8. 40 CFR 63.5810 - What are my options for meeting the standards for open molding and centrifugal casting operations...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Emissions Standards for Hazardous Air Pollutants: Reinforced Plastic Composites Production Options for... subpart WWWW of 40 CFR part 63. If you are using an add-on control device to reduce HAP emissions,...

  9. 40 CFR 63.5810 - What are my options for meeting the standards for open molding and centrifugal casting operations...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... for Hazardous Air Pollutants: Reinforced Plastic Composites Production Options for Meeting Standards... subpart WWWW of 40 CFR part 63. If you are using an add-on control device to reduce HAP emissions,...

  10. 40 CFR 63.5810 - What are my options for meeting the standards for open molding and centrifugal casting operations...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Emissions Standards for Hazardous Air Pollutants: Reinforced Plastic Composites Production Options for... subpart WWWW of 40 CFR part 63. If you are using an add-on control device to reduce HAP emissions,...

  11. 40 CFR 63.5810 - What are my options for meeting the standards for open molding and centrifugal casting operations...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Emissions Standards for Hazardous Air Pollutants: Reinforced Plastic Composites Production Options for... subpart WWWW of 40 CFR part 63. If you are using an add-on control device to reduce HAP emissions,...

  12. D0 HVAC System Controls Evaluation of Upgrade Options

    SciTech Connect

    Markley, D.; Simon, P.; /Fermilab

    1998-05-05

    This engineering note documents three different options for upgrading the Dzero HVAC control system. All three options leave the current field hardware and field devices intact and upgrade the computer control hardware and software. Dzero will be heading into a physics run starting in 2000. This physics run could last several years. The Dzero HVAC system is an integral part of climate control and electronics cooling. The current HVAC control system is based upon a 1985 Johnson Controls System. In order to enter the next long-term physics run with a solid HVAC control system, the current control system needs to be upgraded. This proposal investigates three options: (1) Replacement to the next generation of Johnson Controls Hardware and Software with the Johnson Controls operator interface - FESS; (2) Replacement to the next generation of Johnson Controls Hardware and Software with the FIX32 Operator Interface - FESS/Dzero; and (3) Replacement with a commercially available Programmable Logic Controller (PLC) WITH THE FIX 32 Operator Interface - Dzero.

  13. 40 CFR 63.5701 - What are my options for complying with the open molding emission limit?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... procedures described in § 63.5710. Compliance with this option is based on a 12-month rolling average. (2... and gel coats that meet the organic HAP content requirements in Table 2 to this subpart. Compliance with this option is based on a 12-month rolling average. (c) Add-on control option. Use an...

  14. Sensitivity analysis of the add-on price estimate for the silicon web growth process

    NASA Technical Reports Server (NTRS)

    Mokashi, A. R.

    1981-01-01

    The web growth process, a silicon-sheet technology option, developed for the flat plate solar array (FSA) project, was examined. Base case data for the technical and cost parameters for the technical and commercial readiness phase of the FSA project are projected. The process add on price, using the base case data for cost parameters such as equipment, space, direct labor, materials and utilities, and the production parameters such as growth rate and run length, using a computer program developed specifically to do the sensitivity analysis with improved price estimation are analyzed. Silicon price, sheet thickness and cell efficiency are also discussed.

  15. Wastewater and sludge control-technology options for synfuels industries

    SciTech Connect

    Castaldi, F.J.; Harrison, W.; Ford, D.L.

    1981-02-01

    The options examined were those of zero discharge, partial water reuse with restricted discharge of treated effluents, and unrestricted discharge of treated effluents. Analysis of cost data and performance-analyses data for several candidate secondary-wastewater-treatment unit processes indicated that combined activated-sludge/powdered-activated-carbon (AS/PAC) treatment incorporating wet-air-oxidation carbon regeneration is the most cost-effective control technology available for the removal of organic material from slagging, fixed-bed process wastewaters. Bench-scale treatability and organic-constituent removal studies conducted on process quench waters from a pilot-scale, slagging, fixed-bed gasifer using lignite as feedstock indicated that solvent extraction followed by AS/PAC treatment reduces levels of extractable and chromatographable organics to less than 1 ..mu..g/L in the final effluent. Levels of conventional pollutants also were effectively reduced by AS/PAC to the minimum water-quality standards for most receiving waters. The most favored and most cost-effective treatment option is unrestricted discharge of treated effluents with ultimate disposal of biosludges and landfilling of gasifier ash and slag. This option requires a capital expenditure of $8,260,000 and an annual net operating cost of $2,869,000 in 1978 dollars, exclusive of slag disposal. The net energy requirement of 19.6 x 10/sup 6/ kWh/year, or 15.3 kWh/1000 gal treated, is less than 6% of the equivalent energy demand associated with the zero-discharge option.

  16. Stereovision Imaging in Smart Mobile Phone Using Add on Prisms

    NASA Astrophysics Data System (ADS)

    Bar-Magen Numhauser, Jonathan; Zalevsky, Zeev

    2014-03-01

    In this work we present the use of a prism-based add on component installed on top of a smart phone to achieve stereovision capabilities using iPhone mobile operating system. Through these components and the combination of the appropriate application programming interface and mathematical algorithms the obtained results will permit the analysis of possible enhancements for new uses to such system, in a variety of areas including medicine and communications.

  17. Controlled Ecological Life Support Systems (CELSS) conceptual design option study

    NASA Technical Reports Server (NTRS)

    Oleson, Melvin; Olson, Richard L.

    1986-01-01

    Results are given of a study to explore options for the development of a Controlled Ecological Life Support System (CELSS) for a future Space Station. In addition, study results will benefit the design of other facilities such as the Life Sciences Research Facility, a ground-based CELSS demonstrator, and will be useful in planning longer range missions such as a lunar base or manned Mars mission. The objectives were to develop weight and cost estimates for one CELSS module selected from a set of preliminary plant growth unit (PGU) design options. Eleven Space Station CELSS module conceptual PGU designs were reviewed, components and subsystems identified and a sensitivity analysis performed. Areas where insufficient data is available were identified and divided into the categories of biological research, engineering research, and technology development. Topics which receive significant attention are lighting systems for the PGU, the use of automation within the CELSS system, and electric power requirements. Other areas examined include plant harvesting and processing, crop mix analysis, air circulation and atmosphere contaminant flow subsystems, thermal control considerations, utility routing including accessibility and maintenance, and nutrient subsystem design.

  18. Patients' preferences for treatment outcomes of add-on antiepileptic drugs: a conjoint analysis.

    PubMed

    Manjunath, Ranjani; Yang, Jui-Chen; Ettinger, Alan B

    2012-08-01

    To understand the relative importance of the outcomes of add-on antiepileptic drugs (AEDs) and the willingness of patients with epilepsy to accept therapeutic trade-offs between seizure control and tolerability, we administered a Web-enabled, choice-format conjoint survey to patients with a self-reported physician diagnosis of epilepsy and symptoms of partial seizures. Patients answered nine choice questions to evaluate treatment outcomes of two different hypothetical add-on AEDs. Patients were first asked to choose the better of the two medicines and then asked a follow-up question about whether or not they would add the selected AED to their current treatment regimen. Our study demonstrated that patients with epilepsy consider seizure reduction to be the top priority when ranking it against the reduction or elimination of side effects. This study aids in better understanding of patients' AED treatment preferences and may aid in management of epilepsy.

  19. Study protocol of Prednisone in episodic Cluster Headache (PredCH): a randomized, double-blind, placebo-controlled parallel group trial to evaluate the efficacy and safety of oral prednisone as an add-on therapy in the prophylactic treatment of episodic cluster headache with verapamil

    PubMed Central

    2013-01-01

    Background Episodic cluster headache (ECH) is a primary headache disorder that severely impairs patient’s quality of life. First-line therapy in the initiation of a prophylactic treatment is verapamil. Due to its delayed onset of efficacy and the necessary slow titration of dosage for tolerability reasons prednisone is frequently added by clinicians to the initial prophylactic treatment of a cluster episode. This treatment strategy is thought to effectively reduce the number and intensity of cluster attacks in the beginning of a cluster episode (before verapamil is effective). This study will assess the efficacy and safety of oral prednisone as an add-on therapy to verapamil and compare it to a monotherapy with verapamil in the initial prophylactic treatment of a cluster episode. Methods and design PredCH is a prospective, randomized, double-blind, placebo-controlled trial with parallel study arms. Eligible patients with episodic cluster headache will be randomized to a treatment intervention with prednisone or a placebo arm. The multi-center trial will be conducted in eight German headache clinics that specialize in the treatment of ECH. Discussion PredCH is designed to assess whether oral prednisone added to first-line agent verapamil helps reduce the number and intensity of cluster attacks in the beginning of a cluster episode as compared to monotherapy with verapamil. Trial registration German Clinical Trials Register DRKS00004716 PMID:23889923

  20. Add-on laser reading device for a camera phone

    NASA Astrophysics Data System (ADS)

    Mäkinen, Jukka-Tapani; Niemelä, Karri; Vasama, Hannu; Mattila, Rauno; Aikio, Mika; Aikio, Sanna; Aikio, Janne

    2005-09-01

    A novel add-on device to a mobile camera phone has been developed. The prototype system contains both laser and LED illumination as well as imaging optics. Main idea behind the device is to have a small printable diffractive ROM (Read Only Memory) element, which can be read by illuminating it with a laser-beam and recording the resulting datamatrix pattern with a camera phone. The element contains information in the same manner as a traditional bar-code, but due to the 2D-pattern and diffractive nature of the tag, a much larger amount of information can be packed on a smaller area. Optical and mechanical designs of the prototype device have been made in such a way that the system can be used in three different modes: as a laser reader, as a telescope and as a microscope.

  1. A subsurface add-on for standard atomic force microscopes.

    PubMed

    Verbiest, G J; van der Zalm, D J; Oosterkamp, T H; Rost, M J

    2015-03-01

    The application of ultrasound in an Atomic Force Microscope (AFM) gives access to subsurface information. However, no commercially AFM exists that is equipped with this technique. The main problems are the electronic crosstalk in the AFM setup and the insufficiently strong excitation of the cantilever at ultrasonic (MHz) frequencies. In this paper, we describe the development of an add-on that provides a solution to these problems by using a special piezo element with a lowest resonance frequency of 2.5 MHz and by separating the electronic connection for this high frequency piezo element from all other connections. In this sense, we support researches with the possibility to perform subsurface measurements with their existing AFMs and hopefully pave also the way for the development of a commercial AFM that is capable of imaging subsurface features with nanometer resolution.

  2. A subsurface add-on for standard atomic force microscopes

    SciTech Connect

    Verbiest, G. J.; Zalm, D. J. van der; Oosterkamp, T. H.; Rost, M. J.

    2015-03-15

    The application of ultrasound in an Atomic Force Microscope (AFM) gives access to subsurface information. However, no commercially AFM exists that is equipped with this technique. The main problems are the electronic crosstalk in the AFM setup and the insufficiently strong excitation of the cantilever at ultrasonic (MHz) frequencies. In this paper, we describe the development of an add-on that provides a solution to these problems by using a special piezo element with a lowest resonance frequency of 2.5 MHz and by separating the electronic connection for this high frequency piezo element from all other connections. In this sense, we support researches with the possibility to perform subsurface measurements with their existing AFMs and hopefully pave also the way for the development of a commercial AFM that is capable of imaging subsurface features with nanometer resolution.

  3. Space station systems technology study (add-on task). Volume 2: Trade study and technology selection

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The current Space Station Systems Technology Study add on task was an outgrowth of the Advanced Platform Systems Technology Study (APSTS) that was completed in April 1983 and the subsequent Space Station System Technology Study completed in April 1984. The first APSTS proceeded from the identification of 106 technology topics to the selection of five for detailed trade studies. During the advanced platform study, the technical issues and options were evaluated through detailed trade processes, individual consideration was given to costs and benefits for the technologies identified for advancement, and advancement plans were developed. An approach similar to that was used in the subsequent study, with emphasis on system definition in four specific technology areas to facilitate a more in depth analysis of technology issues.

  4. Analysis of iaq control options and the effects of sources and sinks

    SciTech Connect

    Sparks, L.E.

    1991-01-01

    The paper gives results of an analysis of indoor air quality (IAQ) control options, with emphasis on the interactions between IAQ control options and source and sink characteristics. Indoor air pollution has become an important environmental problem. It is generally recognized that IAQ in many buildings needs to be improved. Options for improving IAQ include increased ventilation, more effective use of ventilation, use of air cleaners, elimination of sources, and modification of sources.

  5. Proportional Transaction Costs in the Robust Control Approach to Option Pricing: The Uniqueness Theorem

    SciTech Connect

    El Farouq, Naïma; Bernhard, Pierre

    2015-10-15

    We prove the missing uniqueness theorem for the viscosity solution of a quasi-variational inequality related to a minimax impulse control problem modeling the option pricing with proportional transactions costs. This result makes our robust control approach of option pricing in the interval market model essentially complete.

  6. Compilation of Quality Control Findings: Information on Policy Options.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Reston, VA.

    Five options to simplify the needs assessment formula for Pell Grants are discussed, along with validation alternatives. Analysis focuses on three main effects of simplifications (data element reduction): the impact on the distribution of total Pell funds, the impact on individuals receiving Pell awards, and the impact of reducing error in the…

  7. Taking Control: Non-Surgical Treatment Options for Urinary Incontinence in Women

    MedlinePlus

    ... UI? Taking Control: Non-surgical Treatment Options for Urinary Incontinence in Women What is UI? “Taking Control” (5- ... own home. Page 0 Page 2 What is urinary incontinence (UI)? Taking Control (5-minute video) Click on ...

  8. Genotype variant associated with add-on memantine in bipolar II disorder.

    PubMed

    Lee, Sheng-Yu; Chen, Shiou-Lan; Chang, Yun-Hsuan; Chen, Shih-Heng; Chu, Chun-Hsieh; Huang, San-Yuan; Tzeng, Nian-Sheng; Wang, Chen-Lin; Wang, Liang-Jen; Lee, I Hui; Yeh, Tzung Lieh; Yang, Yen Kuang; Hong, Jau-Shyong; Lu, Ru-Band

    2014-02-01

    Memantine is a non-competitive N-methyl-d-asparate (NMDA) receptor antagonist with a mood-stabilizing effect. We investigated whether using valproic acid (VPA) plus add-on memantine to treat bipolar II disorder (BP-II) is more effective than using VPA alone (VPA + Pbo). We also evaluated, in BP-II patients, the association between the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism with treatment response to VPA + add-on memantine and to VPA + Pbo. In this randomized, double-blind, controlled 12 wk study, BP-II patients undergoing regular VPA treatments were randomly assigned to a group: VPA + Memantine (5 mg/day) (n = 115) or VPA + Pbo (n = 117). The Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) were used to evaluate clinical response during week 0, 1, 2, 4, 8 and 12. The genotypes of the BDNF Val66Met polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. To adjust within-subject dependence over repeated assessments, multiple linear regression with generalized estimating equation methods was used to analyze the effects of the BDNF Val66Met polymorphism on the clinical performance of memantine. Both groups showed significantly decreased YMRS and HDRS scores after 12 wk of treatment; the differences between groups were non-significant. When stratified by the BDNF Val66Met genotypes, significantly greater decreases in HDRS scores were found in the VPA + memantine group in patients with the Val Met genotype (p = 0.004). We conclude that the BDNF Val66Met polymorphism influenced responses to add-on memantine by decreasing depressive symptoms in patients with BP-II.

  9. Population Control of Self-Replicating Systems: Option C

    NASA Technical Reports Server (NTRS)

    Mccord, R. L.

    1983-01-01

    From the conception and development of the theory of self-replicating automata by John von Neumann, others have expanded on his theories. In 1980, Georg von Tiesenhausen and Wesley A. Darbro developed a report which is a "first' in presenting the theories in a conceptualized engineering setting. In that report several options involving self-replicating systems are presented. One of the options allows each primary to generate n replicas, one in each sequential time frame after its own generation. Each replica is limited to a maximum of m ancestors. This study involves determining the state vector of the replicas in an efficient manner. The problem is cast in matrix notation, where F = fij is a non-diagonalizable matrix. Any element fij represents the number of elements of type j = (c,d) in time frame k+1 generated from type i = (a,b) in time frame k. It is then shown that the state vector is: bar F(k)=bar F (non-zero) X F sub K = bar F (non-zero) xmx J sub kx m sub-1 where J is a matrix in Jordan form having the same eigenvalues as F. M is a matrix composed of the eigenvectors and the generalized eigenvectors of F.

  10. Add-on LABA in a separate inhaler as asthma step-up therapy versus increased dose of ICS or ICS/LABA combination inhaler

    PubMed Central

    Colice, Gene; Israel, Elliot; Roche, Nicolas; Postma, Dirkje S.; Guilbert, Theresa W.; van Aalderen, Willem M.C.; Grigg, Jonathan; Hillyer, Elizabeth V.; Thomas, Victoria; Martin, Richard J.

    2016-01-01

    Asthma management guidelines recommend adding a long-acting β2-agonist (LABA) or increasing the dose of inhaled corticosteroid (ICS) as step-up therapy for patients with uncontrolled asthma on ICS monotherapy. However, it is uncertain which option works best, which ICS particle size is most effective, and whether LABA should be administered by separate or combination inhalers. This historical, matched cohort study compared asthma-related outcomes for patients (aged 12–80 years) prescribed step-up therapy as a ≥50% extrafine ICS dose increase or add-on LABA, via either a separate inhaler or a fine-particle ICS/LABA fixed-dose combination (FDC) inhaler. Risk-domain asthma control was the primary end-point in comparisons of cohorts matched for asthma severity and control during the baseline year. After 1:2 cohort matching, the increased extrafine ICS versus separate ICS+LABA cohorts included 3232 and 6464 patients, respectively, and the fine-particle ICS/LABA FDC versus separate ICS+LABA cohorts included 7529 and 15 058 patients, respectively (overall mean age 42 years; 61–62% females). Over one outcome year, adjusted OR (95% CI) for achieving asthma control were 1.25 (1.13–1.38) for increased ICS versus separate ICS+LABA and 1.06 (1.05–1.09) for ICS/LABA FDC versus separate ICS+LABA. For patients with asthma, increased dose of extrafine-particle ICS, or add-on LABA via ICS/LABA combination inhaler, is associated with significantly better outcomes than ICS+LABA via separate inhalers. PMID:27730200

  11. Thermal Vacuum Control Systems Options for Test Facilities

    NASA Technical Reports Server (NTRS)

    Marchetti, John

    2008-01-01

    This presentation suggests several Thermal Vacuum System (TVAC) control design approach methods for TVAC facilities. Over the past several years many aerospace companies have or are currently upgrading their TVAC testing facilities whether it be by upgrading old equipment or purchasing new. In doing so they are updating vacuum pumping and thermal capabilities of their chambers as well as their control systems. Although control systems are sometimes are considered second to the vacuum or thermal system upgrade process, they should not be taken lightly and must be planned and implemented with the equipment it is to control. Also, emphasis should be placed on how the operators will use the system as well as the requirements of "their" customers. Presented will be various successful methods of TVAC control systems from Programmable Logic Controller (PLC) based to personal computer (PC) based control.

  12. Control and pollution prevention options for ammonia emissions

    SciTech Connect

    Phillips, J.

    1995-04-01

    In response to requests for guidance concerning technologies available for the control and prevention of ammonia emissions, the Control Technology Center (CTC) initiated a review of current and potential methods for ammonia emissions control. A review of various industries has identified significant sources of ammonia to be fertilizer production, coke production using the by-product recovery method, fossil fuel combustion, livestock management, and refrigeration using ammonia as a refrigerant. Control methods implemented by these sources include wet scrubbers, condensate strippers, recovery and recycle of exhaust streams, capture systems, and good maintenance practices. The report discusses each industry process identified above, concentrating on the sources of ammonia emissions and the controls and pollution prevention (P2) methods applied. Other industries may have minor ammonia emissions but they are not addressed in this report because neither control technologies nor P2 are applied.

  13. New DEA rules expand options for controlled substance disposal.

    PubMed

    Peterson, David M

    2015-03-01

    Prescription drug abuse and overdose are rapidly growing problems in the United States. The United States federal Disposal of Controlled Substances Rule became effective 9 October 2014, implementing the Secure and Responsible Drug Disposal Act of 2010 (Disposal Act). These regulations target escalating prescription drug misuse by reducing accumulation of unused controlled substances that may be abused, diverted or accidentally ingested. Clinical areas that can now participate in collecting unused controlled substances include retail pharmacies, hospitals or clinics with an onsite pharmacy, and narcotic treatment programs. Collection methods include placing a controlled substance collection receptacle or instituting a mail-back program. Because prompt onsite destruction of collected items is required of mail-back programs, collection receptacles are more likely to be used in clinical areas. Retail pharmacies and hospitals or clinics with an onsite pharmacy may also place and maintain collection receptacles at long-term care facilities. The Act and Rule are intended to increase controlled substance disposal methods and expand local involvement in collection of unused controlled substances. Potential barriers to participating in controlled substance collection include acquisition of suitable collection receptacles and liners, lack of available space meeting the necessary criteria, lack of employee time for verification and inventory requirements, and program costs.

  14. REVIEW OF CONTROL OPTIONS FOR METHYL BROMIDE IN COMMODITY TREATMENT

    EPA Science Inventory

    The report describes recent developments in the control of methyl bromide (MeBr) and discusses technical considerations and requirements for and economic feasibility of recovery. (NOTE: MeBr, fumigant for agricultural commodities, is an ozone depleting chemical. The U.S. EPA has ...

  15. 40 CFR 63.5810 - What are my options for meeting the standards for open molding and centrifugal casting operations...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... centrifugal casting, or site-specific organic HAP emissions factors discussed in § 63.5796. The emission... to this subpart, or a site-specific emissions factor, is multiplied by the add-on control factor to... 40 Protection of Environment 12 2010-07-01 2010-07-01 true What are my options for meeting...

  16. Low-Cost Options for Moderate Levels of Mercury Control

    SciTech Connect

    Sharon Sjostrom

    2008-02-09

    This is the final technical report for a three-site project that is part of an overall program funded by the U.S. Department of Energy's National Energy Technology Laboratory (DOE/NETL) and industry partners to obtain the necessary information to assess the feasibility and costs of controlling mercury from coal-fired utility plants. This report summarizes results from tests conducted at MidAmerican's Louisa Generating Station and Entergy's Independence Steam Electric Station (ISES) and sorbent screening at MidAmerican's Council Bluffs Energy Center (CBEC) (subsequently renamed Walter Scott Energy Center (WSEC)). Detailed results for Independence and Louisa are presented in the respective Topical Reports. As no full-scale testing was conducted at CBEC, screening updates were provided in the quarterly updates to DOE. ADA-ES, Inc., with support from DOE/NETL, EPRI, and other industry partners, has conducted evaluations of EPRI's TOXECON II{trademark} process and of high-temperature reagents and sorbents to determine the capabilities of sorbent/reagent injection, including activated carbon, for mercury control on different coals and air emissions control equipment configurations. An overview of each plant configuration is presented: (1) MidAmerican's Louisa Generating Station burns Powder River Basin (PRB) coal in its 700-MW Unit 1 and employs hot-side electrostatic precipitators (ESPs) with flue gas conditioning for particulate control. This part of the testing program evaluated the effect of reagents used in the existing flue gas conditioning on mercury removal. (2) MidAmerican's Council Bluffs Energy Center typically burns PRB coal in its 88-MW Unit 2. It employs a hot-side ESP for particulate control. Solid sorbents were screened for hot-side injection. (3) Entergy's Independence Steam Electric Station typically burns PRB coal in its 880-MW Unit 2. Various sorbent injection tests were conducted on 1/8 to 1/32 of the flue gas stream either within or in front of one

  17. NOx CONTROL OPTIONS AND INTEGRATION FOR US COAL FIRED BOILERS

    SciTech Connect

    Mike Bockelie; Marc Cremer; Kevin Davis; Temi Linjewile; Connie Senior; Hong-Shig Shim; Bob Hurt; Eric Eddings; Larry Baxter

    2003-01-30

    This is the tenth Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NO{sub x} control strategies and their possible impact on boiler performance for firing US coals. The Electric Power Research Institute (EPRI) is providing cofunding for this program. This program contains multiple tasks and good progress is being made on all fronts. During this quarter, progress was made on the computational simulation of a full-scale boiler with the purpose of understanding the potential impacts of burner operating conditions on soot and NO{sub x} generation. Sulfation tests on both the titania support and vanadia/titania catalysts were completed using BYU's in situ spectroscopy reactor this quarter. These experiments focus on the extent to which vanadia and titania sulfate in an SO{sub 2}-laden, moist environment. Construction of the CCS reactor system is essentially complete and the control hardware and software are largely in place. A large batch of vanadia/titania catalyst in powder form has been prepared for use in poisoning tests. During this quarter, minor modifications were made to the multi-catalyst slipstream reactor and to the control system. The slipstream reactor was installed at AEP's Rockport plant at the end of November 2002. In this report, we describe the reactor system, particularly the control system, which was created by REI specifically for the reactor, as well as the installation at Rockport.

  18. Low-Cost Options for Moderate Levels of Mercury Control

    SciTech Connect

    Sharon Sjostrom

    2006-03-31

    On March 15, 2005, EPA issued the Clean Air Mercury Rule, requiring phased-in reductions of mercury emissions from electric power generators. ADA-ES, Inc., with support from DOE/NETL and industry partners, is conducting evaluations of EPRI's TOXECON II{trademark} process and of high-temperature reagents and sorbents to determine the capabilities of sorbent/reagent injection, including activated carbon, for mercury control on different coals and air emissions control equipment configurations. DOE/NETL targets for total mercury removal are {ge}55% (lignite), {ge}65% (subbituminous), and {ge}80% (bituminous). Based on work done to date at various scales, meeting the removal targets appears feasible. However, work needs to progress to more thoroughly document and test these promising technologies at full scale. This is the final site report for tests conducted at MidAmerican's Louisa Station, one of three sites evaluated in this DOE/NETL program. The other two sites in the program are MidAmerican's Council Bluff Station and Entergy's Independence Station. MidAmerican's Louisa Station burns Powder River Basin (PRB) coal and employs hot-side electrostatic precipitators with flue gas conditioning for particulate control. This part of the testing program evaluated the effect of reagents used in the existing flue gas conditioning on mercury removal.

  19. Control system options and strategies for supercritical CO2 cycles.

    SciTech Connect

    Moisseytsev, A.; Kulesza, K. P.; Sienicki, J. J.; Nuclear Engineering Division; Oregon State Univ.

    2009-06-18

    The Supercritical Carbon Dioxide (S-CO{sub 2}) Brayton Cycle is a promising alternative to Rankine steam cycle and recuperated gas Brayton cycle energy converters for use with Sodium-Cooled Fast Reactors (SFRs), Lead-Cooled Fast Reactors (LFRs), as well as other advanced reactor concepts. The S-CO{sub 2} Brayton Cycle offers higher plant efficiencies than Rankine or recuperated gas Brayton cycles operating at the same liquid metal reactor core outlet temperatures as well as reduced costs or size of key components especially the turbomachinery. A new Plant Dynamics Computer Code has been developed at Argonne National Laboratory for simulation of a S-CO{sub 2} Brayton Cycle energy converter coupled to an autonomous load following liquid metal-cooled fast reactor. The Plant Dynamics code has been applied to investigate the effectiveness of a control strategy for the S-CO{sub 2} Brayton Cycle for the STAR-LM 181 MWe (400 MWt) Lead-Cooled Fast Reactor. The strategy, which involves a combination of control mechanisms, is found to be effective for controlling the S-CO{sub 2} Brayton Cycle over the complete operating range from 0 to 100 % load for a representative set of transient load changes. While the system dynamic analysis of control strategy performance for STARLM is carried out for a S-CO{sub 2} Brayton Cycle energy converter incorporating an axial flow turbine and compressors, investigations of the S-CO{sub 2} Brayton Cycle have identified benefits from the use of centrifugal compressors which offer a wider operating range, greater stability near the critical point, and potentially further cost reductions due to fewer stages than axial flow compressors. Models have been developed at Argonne for the conceptual design and performance analysis of centrifugal compressors for use in the SCO{sub 2} Brayton Cycle. Steady state calculations demonstrate the wider operating range of centrifugal compressors versus axial compressors installed in a S-CO{sub 2} Brayton Cycle as

  20. Propulsion Options for Primary Thrust and Attitude Control of Microspacecraft

    NASA Technical Reports Server (NTRS)

    deGroot, W. A.

    1998-01-01

    Order of magnitude decreases in the size of scientific satellites and spacecraft could provide concurrent decreases in mission costs because of lower launch and fabrication costs. Although many subsystems are amenable to dramatic size reductions, miniaturization of the propulsion subsystems is not straightforward. There are a range of requirements for both primary and attitude control propulsion, dictated by mission requirements, satellite size, and power restrictions. Many of the established propulsion technologies can not currently be applied to microspacecraft. Because of this, micro-electromechanical systems (MEMS) fabrication technology is being explored as a path for miniaturization.

  1. NOx CONTROL OPTIONS AND INTEGRATION FOR US COAL FIRED BOILERS

    SciTech Connect

    Mike Bockelie; Marc Cremer; Kevin Davis; Bob Hurt; Eric Eddings

    2001-07-27

    This is the third Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for firing US coals. The Electric Power Research Institute (EPRI) is providing cofunding for this program. This program contains multiple tasks and good progress is being made on all fronts. A Rich Reagent Injection (RRI) design has been developed for a cyclone fired utility boiler in which a field test of RRI will be performed later this year. Initial evaluations of RRI for PC fired boilers have been performed. Calibration tests have been developed for a corrosion probe to monitor waterwall wastage. Preliminary tests have been performed for a soot model within a boiler simulation program. Shakedown tests have been completed for test equipment and procedures that will be used to measure soot generation in a pilot scale test furnace. In addition, an initial set of controlled experiments for ammonia adsorption onto fly ash in the presence of sulfur have been performed that indicates the sulfur does enhance ammonia uptake.

  2. Options for water-level control in developed wetlands

    USGS Publications Warehouse

    Kelley, J. R.; Laubhan, M. K.; Reid, F. A.; Wortham, J. S.; Fredrickson, L. H.

    1993-01-01

    Wetland habitats in the United States currently are lost at a rate of 260,000 acres/year (105,218 ha/year). Consequently, water birds concentrate in fewer and smaller areas. Such concentrations may deplete food supplies and influence behavior, physiology, and survival. Continued losses increase the importance of sound management of the remaining wetlands because water birds depend on them. Human activities modified the natural hydrology of most remaining wetlands in the conterminous United States, and such hydrologic alterations frequently reduce wetland productivity. The restoration of original wetland functions and productivity often requires the development of water distribution and discharge systems to emulate natural hydrologic regimes. Construction of levees and correct placement of control structures and water-delivery and water-discharge systems are necessary to (1) create soil and water conditions for the germination of desirable plants, (2) control nuisance vegetation, (3) promote the production of invertebrates, and (4) make foods available for wildlife that depends of wetlands (Leaflets 13.2.1 and 13.4.6). This paper provides basic guidelines for the design of wetlands that benefit wildlife. If biological considerations are not incorporated into such designs, the capability of managing wetlands for water birds is reduced and costs often are greater. Although we address the development of palustrine wetlands in migration and wintering areas, many of the discussed principles are applicable to the development of other wetland types and in other locations.

  3. Controlling sickle cell disease in Ghana - ethics and options

    PubMed Central

    Kyerewaa Edwin, Ama; Edwin, Frank; Etwire, Victor

    2011-01-01

    Sickle Cell Disease (SCD) is a significant public health burden in Ghana. Recent studies indicate that 2% of Ghanaian newborns are affected by SCD; one in three Ghanaians has the hemoglobin S and/or C gene. As a means of controlling the disease, some authorities have recommended prenatal diagnosis (PND) and selective abortion. In the current era, SCD has a good prognosis and fairly reasonable quality of life. Advances in bone marrow transplantation have shown the disease is curable in selected patients. PND and selective abortion therefore raises a myriad of ethical dilemmas which are considered in this review. In the light of the demonstration of improved prognosis in recent times, PND and selective abortion appears to be applying capital punishment to the unborn child for “crimes” only the parents can be responsible for. In this review, we recommend control of SCD on three levels – preconception genetic testing and strategic reproductive choices, PND and education for carrier parents, and holistic management of persons with SCD. We emphasize the critical importance of self-management, especially self-awareness, in assuring a good quality of life for persons with SCD. We believe such an approach is cost-effective, and consistent with sound ethical principles and good conscience. PMID:22187596

  4. Controlling Sickle Cell Disease in Ghana--ethics and options.

    PubMed

    Kyerewaa Edwin, Ama; Edwin, Frank; Etwire, Victor

    2011-01-01

    Sickle Cell Disease (SCD) is a significant public health burden in Ghana. Recent studies indicate that 2% of Ghanaian newborns are affected by SCD; one in three Ghanaians has the hemoglobin S and/or C gene. As a means of controlling the disease, some authorities have recommended prenatal diagnosis (PND) and selective abortion. In the current era, SCD has a good prognosis and fairly reasonable quality of life. Advances in bone marrow transplantation have shown the disease is curable in selected patients. PND and selective abortion therefore raises a myriad of ethical dilemmas which are considered in this review. In the light of the demonstration of improved prognosis in recent times, PND and selective abortion appears to be applying capital punishment to the unborn child for "crimes" only the parents can be responsible for. In this review, we recommend control of SCD on three levels--preconception genetic testing and strategic reproductive choices, PND and education for carrier parents, and holistic management of persons with SCD. We emphasize the critical importance of self-management, especially self-awareness, in assuring a good quality of life for persons with SCD. We believe such an approach is cost-effective, and consistent with sound ethical principles and good conscience.

  5. NOx Control Options and Integration for US Coal Fired Boilers

    SciTech Connect

    Mike Bockelie; Kevin Davis; Connie Senior; Darren Shino; Dave Swenson; Larry Baxter; Calvin Bartholomew; William Hecker; Stan Harding

    2004-12-31

    This is the eighteenth Quarterly Technical Report for DOE Cooperative Agreement No: DEFC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. Safety equipment for ammonia for the SCR slipstream reactor at Plant Gadsden was installed. The slipstream reactor was started and operated for about 1400 hours during the last performance period. Laboratory analysis of exposed catalyst and investigations of the sulfation of fresh catalyst continued at BYU. Thicker end-caps for the ECN probes were designed and fabricated to prevent the warpage and failure that occurred at Gavin with the previous design. A refurbished ECN probe was successfully tested at the University of Utah combustion laboratory. Improvements were implemented to the software that controls the flow of cooling air to the ECN probes.

  6. NOx CONTROL OPTIONS AND INTEGRATION FOR US COAL FIRED BOILERS

    SciTech Connect

    Mike Bockelie; Marc Cremer; Kevin Davis; Bob Hurt; Eric Eddings

    2001-01-31

    This is the second Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for firing US coals. The focus of our efforts during the last three months have been on: (1) Completion of a long term field test for Rich Reagent Injection (RRI) at the Conectiv BL England Station Unit No.1, a 130 MW Cyclone fired boiler; (2) Extending our Computational Fluid Dynamics (CFD) based NOx model to accommodate the chemistry for RRI in PC fired boilers; (3) Design improvements and calibration tests of the corrosion probe; and (4) Investigations on ammonia adsorption mechanisms and removal processes for Fly Ash.

  7. NOx Control Options and Integration for US Coal Fired Boilers

    SciTech Connect

    Mike Bockelie; Kevin Davis; Connie Senior; Darren Shino; Dave Swenson; Larry Baxter; Calvin Bartholomew; William Hecker; Stan Harding

    2005-03-31

    This is the nineteenth Quarterly Technical Report for DOE Cooperative Agreement No: DEFC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NO{sub x} control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. Refurbished corrosion probes were installed at Plant Gavin and operated for approximately 1,300 hours. This quarterly report includes further results from the BYU catalyst characterization lab and the in-situ lab, and includes the first results from a model suitable for comprehensive simulation codes for describing catalyst performance. The SCR slipstream reactor at Plant Gadsden operated for approximately 100 hours during the quarter because of ash blockage in the inlet probe.

  8. NOx Control Options and Integration for US Coal Fired Boilers

    SciTech Connect

    Mike Bockelie; Kevin Davis; Temi Linjewile; Connie Senior; Eric Eddings; Kevin Whitty; Larry Baxter; Calvin Bartholomew; William Hecker; Stan Harding; Robert Hurt

    2003-12-31

    This is the fourteenth Quarterly Technical Report for DOE Cooperative Agreement No: DEFC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. Using the initial CFD baseline modeling of the Gavin Station and the plant corrosion maps, six boiler locations for the corrosion probes were identified and access ports have been installed. Preliminary corrosion data obtained appear consistent and believable. In situ, spectroscopic experiments at BYU reported in part last quarter were completed. New reactor tubes have been made for BYU's CCR that allow for testing smaller amounts of catalyst and thus increasing space velocity; monolith catalysts have been cut and a small reactor that can accommodate these pieces for testing is in its final stages of construction. A poisoning study on Ca-poisoned catalysts was begun this quarter. A possible site for a biomass co-firing test of the slipstream reactor was visited this quarter. The slipstream reactor at Rockport required repair and refurbishment, and will be re-started in the next quarter. This report describes the final results of an experimental project at Brown University on the fundamentals of ammonia / fly ash interactions with relevance to the operation of advanced NOx control technologies such as selective catalytic reduction. The Brown task focused on the measurement of ammonia adsorption isotherms on commercial fly ash samples subjected to a variety of treatments and on the chemistry of dry and semi-dry ammonia removal processes.

  9. NOx CONTROL OPTIONS AND INTEGRATION FOR US COAL FIRED BOILERS

    SciTech Connect

    Mike Bockelie; Marc Cremer; Kevin Davis; Connie Senior; Bob Hurt; Eric Eddings; Larry Baxter

    2002-10-24

    This is the ninth Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for firing US coals. The Electric Power Research Institute (EPRI) is providing cofunding for this program. This program contains multiple tasks and good progress is being made on all fronts. Various subsystems of BYU's Catalyst Characterization System (CCS) were upgraded this quarter. Work on the CCS hardware and software will continue in the coming quarter. A preliminary test matrix of poisoning experiments in the CCS has been drafted that will explore the effects of at least three poisons: sodium, potassium and calcium. During this quarter, we attempted to resolve discrepancies in previous in situ measurements of catalyst sulfation. Modifications were made to the XPS analysis procedure that allowed analyses of uncrushed samples. Although the XPS and FTIR results are now more consistent in that both indicate that the surface is sulfating (unlike the results reported last quarter), they disagree with respect to which species sulfates. The CEM system for the multi-catalyst slipstream reactor arrived this quarter. Minor modifications to the reactor and control system were completed. The reactor will be shipped to AEP Rockport plant next quarter for shakedown and installation. In a parallel effort, we have proposed to make mercury oxidation measurements across the catalysts at the start of the field test. Pending approval from DOE, we will begin the mercury measurements next quarter.

  10. Efficacy and safety of muscarinic antagonists as add-on therapy for male lower urinary tract symptoms

    PubMed Central

    Li, Jinhong; Shi, Qingquan; Bai, Yunjin; Pu, Chunxiao; Tang, Yin; Yuan, Haichao; Wu, Yunjian; Wei, Qiang; Han, Ping

    2014-01-01

    Alpha-adrenoceptor antagonists (alpha-blockers) are widely prescribed to treat lower urinary tract symptoms (LUTS) in men but fail to ameliorate LUTS sufficiently, especially the storage symptoms related to frequency, urgency and nocturia. We performed a meta-analysis of randomised controlled trials (RCTs) comparing an alpha-blocker plus muscarinic antagonist with an alpha-blocker alone in male LUTS patients who were treated with alpha-blocker prior to randomisation. The review contained six randomised controlled trials (RCTs) that included a total of 2,208 male patients who were randomised to receive alpha-blocker plus muscarinic antagonist or alpha-blocker alone. The add-on group experienced significantly greater improvement in both total IPSS (International Prostate Symptom Score) and storage IPSS. Adverse events (AEs) were commonly experienced by both groups (41.6 vs. 33.3%) though they were not severe. Our meta-analysis indicated that muscarinic antagonists as add-on therapy alleviate LUTS, especially storage symptoms. The add-on therapy demonstrated safety and tolerability comparable with alpha-blocker monotherapy in male with LUTS. PMID:24492830

  11. NOx Control Options and Integration for US Coal Fired Boilers

    SciTech Connect

    Mike Bockelie; Marc Cremer; Kevin Davis; Martin Denison; Adel Sarofim; Connie Senior; Hong-Shig Shim; Dave Swenson; Bob Hurt; Eric Suuberg; Eric Eddings; Kevin Whitty; Larry Baxter; Calvin Bartholomew; William Hecker

    2006-06-30

    This is the Final Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project was to develop cost-effective analysis tools and techniques for demonstrating and evaluating low-NOx control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) provided co-funding for this program. This project included research on: (1) In furnace NOx control; (2) Impacts of combustion modifications on boiler operation; (3) Selective Catalytic Reduction (SCR) catalyst testing and (4) Ammonia adsorption/removal on fly ash. Important accomplishments were achieved in all aspects of the project. Rich Reagent Injection (RRI), an in-furnace NOx reduction strategy based on injecting urea or anhydrous ammonia into fuel rich regions in the lower furnace, was evaluated for cyclone-barrel and PC fired utility boilers. Field tests successfully demonstrated the ability of the RRI process to significantly reduce NOx emissions from a staged cyclone-fired furnace operating with overfire air. The field tests also verified the accuracy of the Computational Fluid Dynamic (CFD) modeling used to develop the RRI design and highlighted the importance of using CFD modeling to properly locate and configure the reagent injectors within the furnace. Low NOx firing conditions can adversely impact boiler operation due to increased waterwall wastage (corrosion) and increased soot production. A corrosion monitoring system that uses electrochemical noise (ECN) corrosion probes to monitor, on a real-time basis, high temperature corrosion events within the boiler was evaluated. Field tests were successfully conducted at two plants. The Ohio Coal Development Office provided financial assistance to perform the field tests. To investigate soot behavior, an advanced model to predict soot production and destruction was implemented into an existing reacting CFD modeling tool. Comparisons between experimental data collected

  12. NOx Control Options and Integration for US Coal Fired Boilers

    SciTech Connect

    Mike Bockelie; Kevin Davis; Temi Linjewile; Connie Senior; Eric Eddings; Kevin Whitty; Larry Baxter; Calvin Bartholomew; William Hecker; Stan Harding

    2003-06-30

    This is the twelfth Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. This program contains multiple tasks and good progress is being made on all fronts. During this quarter, a new effort was begun on the development of a corrosion management system for minimizing the impacts of low NOx combustion systems on waterwalls; a kickoff meeting was held at the host site, AEP's Gavin Plant, and work commenced on fabrication of the probes. FTIR experiments for SCR catalyst sulfation were finished at BYU and indicated no vanadium/vanadyl sulfate formation at reactor conditions. Improvements on the mass-spectrometer system at BYU have been made and work on the steady state reactor system shakedown neared completion. The slipstream reactor continued to operate at AEP's Rockport plant; at the end of the quarter, the catalysts had been exposed to flue gas for about 1000 hours. Some operational problems were addressed that enable the reactor to run without excessive downtime by the end of the quarter.

  13. NOx CONTROL OPTIONS AND INTEGRATION FOR US COAL FIRED BOILERS

    SciTech Connect

    Michael J. Bockelie

    2000-10-31

    This report summarizes the research that has been performed by Reaction Engineering International (REI) during the last three months on demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for firing US coals. The focus of our efforts during the last six months have been on: (1) Field Tests for RRI at the Conectiv BL England Station Unit No.1, a 130 MW cyclone fired boiler; (2) Extending our Computational Fluid Dynamics (CFD) based NOx model to accommodate the chemistry for Rich Reagent Injection (RRI) in cyclone fired boilers; (3) Applying the NOx model to evaluate RRI systems integrated into a boiler with Over Fired Air (OFA) and Selective Non-Catalytic Reduction (SNCR); (4) Field Tests of the REI Corrosion Probe at the Conectiv BL England Station Unit No.1; (5) Commence engineering study of ammonia adsorption mechanisms for Fly Ash; (6) Presentation of current program accomplishments and plans for future work to DoE staff members at NETL-FE (Pittsburgh); and (7) Presentation of preliminary field test results for RRI to EPRI CNCIG.

  14. NOx CONTROL OPTIONS AND INTEGRATION FOR US COAL FIRED BOILERS

    SciTech Connect

    Mike Bockelie; Marc Cremer; Kevin Davis; Connie Senior; Bob Hurt; Eric Eddings; Larry Baxter

    2002-07-28

    This is the eighth Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. This program contains multiple tasks and good progress is being made on all fronts. CFD modeling studies of RRI in a full scale utility boiler have been performed that provide further insight into the NOx reduction process that occurs if the furnace is not adequately staged. In situ reactivity data indicate thus far that titania sulfates under SCR conditions but there is no indication of vanadia sulfation in agreement with some, but not most literature results. Additional analysis and advanced diagnostics are under way to confirm this result and determine its accuracy. Construction of a catalyst characterization reactor system is nearly complete, with a few remaining details discussed in this report. Shakedown testing of the SCR field reactor was completed at the University of Utah pilot-scale coal furnace. The CEM system has been ordered. Talks continued with American Electric Power about hosting a demonstration at their Rockport plant.

  15. NOx Control Options and Integration for US Coal Fired Boilers

    SciTech Connect

    Mike Bockelie; Kevin Davis; Connie Senior Darren Shino; Dave Swenson; Larry Baxter; Calvin Bartholomew; William Hecker; Stan Harding

    2004-09-30

    This is the seventeenth Quarterly Technical Report for DOE Cooperative Agreement No: DEFC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. The SCR slipstream reactor was assembled and installed at Plant Gadsden this quarter. Safety equipment for ammonia had not been installed at the end of the quarter, but will be installed at the beginning of next quarter. The reactor will be started up next quarter. Four ECN corrosion probes were reinstalled at Gavin and collected corrosion data for approximately one month. Two additional probes were installed and removed after about 30 hours for future profilometry analysis. Preliminary analysis of the ECN probes, the KEMA coupons and the CFD modeling results all agree with the ultrasonic tube test measurements gathered by AEP personnel.

  16. Therapeutic Options for Controlling Fluids in the Visual System

    NASA Technical Reports Server (NTRS)

    Curry, Kristina M.; Wotring, Virginia E.

    2014-01-01

    Visual Impairment/Intracranial Pressure (VIIP) is a newly recognized risk at NASA. The VIIP project examines the effect of long-term exposure to microgravity on vision of crewmembers before and after they return to Earth. Diamox (acetazolamide) is a medication which is used to decrease intraocular pressure; however, it carries a 3% risk of kidney stones. Astronauts are at a higher risk of kidney stones during spaceflight and the use Diamox would only increase the risk; therefore alternative therapies were investigated. Histamine 2 (H2) antagonist acid blockers such as cimetidine, ranitidine, famotidine and nizatidine are typically used to relieve the symptoms of gastroesophageal reflux disease (GERD). H2 receptors have been found in the human visual system, which has led to research on the use of H2 antagonist blockers to control fluid production in the human eye. Another potential therapeutic strategy is targeted at aquaporins, which are water channels that help maintain fluid homeostasis. Aquaporin antagonists are also known to affect intracranial pressure which can in turn alter intraocular pressure. Studies on aquaporin antagonists suggest high potential for effective treatment. The primary objective of this investigation is to review existing research on alternate medications or therapy to significantly reduce intracranial and intraocular pressure. A literature review was conducted. Even though we do not have all the answers quite yet, a considerable amount of information was discovered, and findings were narrowed, which should allow for more conclusive answers to be found in the near future.

  17. Internal Control Rod Drive Mechanisms, Design Options for IRIS

    SciTech Connect

    Conway, Lawrence E.; Petrovic, Bojan

    2004-07-01

    IRIS (International Reactor Innovative and Secure) is a medium-power (335 MWe) PWR with an integral, primary circuit configuration, where all the reactor coolant system components are contained within the reactor vessel. This integral configuration is a key reason for the success of IRIS' 'safety-by-design' approach, whereby accident initiators are eliminated or the accident consequences and/or frequency are reduced. The most obvious example of the IRIS safety by design approach is the elimination of large LOCA's, since the integral reactor coolant system has no large loop piping. Another serious accident scenario that is being addressed in IRIS is the postulated ejection of a reactor control cluster assembly (RCCA). This accident initiator can be eliminated by locating the RCCA drive mechanisms (CRDMs) inside the reactor vessel. This eliminates the mechanical drive rod penetration between the RCCA and the external CRDM, eliminating the potential for differential pressure across the pressure boundary, and thus eliminating 'by design' the possibility for rod ejection accident. Moreover, the elimination of the 'large' drive-rod penetrations and the external CRDM pressure housings decreases the likelihood of boric acid leakage and subsequent corrosion of the reactor pressure boundary (like the Davis-Besse incident). This paper will discuss the IRIS top level design requirements and objectives for internal CRDMs, and provide examples candidate designs and their specific performance characteristics. (authors)

  18. NOx Control Options and Integration for US Coal Fired Boilers

    SciTech Connect

    Mike Bockelie; Kevin Davis; Martin Denison; Connie Senior; Hong-Shig Shim; Darren Shino; Dave Swenson; Larry Baxter; Calvin Bartholomew; William Hecker

    2005-06-30

    This is the twentieth Quarterly Technical Report for DOE Cooperative Agreement No: DEFC26-00NT40753. The goal of the project is to develop cost-effective analysis tools and techniques for demonstrating and evaluating low-NO{sub x} control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. At the beginning of this quarter, the corrosion probes were removed from Gavin Station. Data analysis and preparation of the final report continued this quarter. This quarterly report includes further results from the BYU catalyst characterization lab and the in-situ FTIR lab, and includes the first results from tests run on samples cut from the commercial plate catalysts. The SCR slipstream reactor at Plant Gadsden was removed from the plant, where the total exposure time on flue gas was 350 hours. A computational framework for SCR deactivation was added to the SCR model.

  19. NOx CONTROL OPTIONS AND INTEGRATION FOR US COAL FIRED BOILERS

    SciTech Connect

    Mike Bockelie; Marc Cremer; Kevin Davis; Connie Senior; Bob Hurt; Eric Suuberg; Eric Eddings; Larry Baxter

    2002-01-31

    This is the sixth Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. This program contains multiple tasks and good progress is being made on all fronts. Preliminary results from laboratory and field tests of a corrosion probe to predict waterwall wastage indicate good agreement between the electrochemical noise corrosion rates predicted by the probe and corrosion rates measured by a surface profilometer. Four commercial manufacturers agreed to provide catalyst samples to the program. BYU has prepared two V/Ti oxide catalysts (custom, powder form) containing commercially relevant concentrations of V oxide and one containing a W oxide promoter. Two pieces of experimental apparatus being built at BYU to carry out laboratory-scale investigations of SCR catalyst deactivation are nearly completed. A decision was made to carry out the testing at full-scale power plants using a slipstream of gas instead of at the University of Utah pilot-scale coal combustor as originally planned. Design of the multi-catalyst slipstream reactor was completed during this quarter. One utility has expressed interest in hosting a long-term test at one of their plants that co-fire wood with coal. Tests to study ammonia adsorption onto fly ash have clearly established that the only routes that can play a role in binding significant amounts of ammonia to the ash surface, under practical ammonia slip conditions, are those that must involve co-adsorbates.

  20. NOx CONTROL OPTIONS AND INTEGRATION FOR US COAL FIRED BOILERS

    SciTech Connect

    Mike Bockelie; Marc Cremer; Kevin Davis; Connie Senior; Bob Hurt; Eric Eddings; Larry Baxter

    2001-10-10

    This is the fifth Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for firing US coals. The Electric Power Research Institute (EPRI) is providing cofunding for this program. This program contains multiple tasks and good progress is being made on all fronts. Field tests for NOx reduction in a cyclone fired utility boiler due to using Rich Reagent Injection (RRI) have been started. CFD modeling studies have been started to evaluate the use of RRI for NOx reduction in a corner fired utility boiler using pulverized coal. Field tests of a corrosion monitor to measure waterwall wastage in a utility boiler have been completed. Computational studies to evaluate a soot model within a boiler simulation program are continuing. Research to evaluate SCR catalyst performance has started. A literature survey was completed. Experiments have been outlined and two flow reactor systems have been designed and are under construction. Commercial catalyst vendors have been contacted about supplying catalyst samples. Several sets of new experiments have been performed to investigate ammonia removal processes and mechanisms for fly ash. Work has focused on a promising class of processes in which ammonia is destroyed by strong oxidizing agents at ambient temperature during semi-dry processing (the use of moisture amounts less than 5 wt-%). Both ozone and an ozone/peroxide combination have been used to treat both basic and acidic ammonia-laden ashes.

  1. NOx Control Options and Integration for US Coal Fired Boilers

    SciTech Connect

    Mike Bockelie; Kevin Davis; Temi Linjewile; Connie Senior; Eric Eddings; Kevin Whitty; Larry Baxter; Calvin Bartholomew; William Hecker; Stan Harding

    2003-09-30

    This is the thirteenth Quarterly Technical Report for DOE Cooperative Agreement No: DEFC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NO{sub x} control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. This program contains multiple tasks and good progress is being made on all fronts. The corrosion probe task is proceeding: Two plant visits were made to prepare for field testing and shakedown tests for the probes were conducted at the University of Utah''s L1500 furnace. Corrosion probes will be installed at the Gavin Plant site in the next quarter. Laboratory studies of SCR catalyst continued this quarter. FTIR studies of catalyst sulfation and of adsorption of NH3 and NO were continued at BYU. NO activities have been measured for a number of samples of BYU catalyst and insights have been gained from the results. Plans are being detailed to test monolith and plate catalysts exposed in the field. In this quarter, the catalysts in the slipstream reactor at AEP's Rockport plant were exposed to the dusty flue gas for 1695 hours. Thus the cumulative catalyst exposure to flue gas rose from 980 hours last quarter to 2677 hours in this quarter. Loss of catalyst activity was noted between April (when the catalysts were fresh) and August. Further analysis of activity data will be needed.

  2. NOx CONTROL OPTIONS AND INTEGRATION FOR US COAL FIRED BOILERS

    SciTech Connect

    Mike Bockelie; Marc Cremer; Kevin Davis; Connie Senior; Bob Hurt; Eric Eddings; Larry Baxter

    2002-04-30

    This is the seventh Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. This program contains multiple tasks and good progress is being made on all fronts. A series of field tests for RRI at the Ameren Sioux Unit No.1 have demonstrated that RRI can provide up to 30% NOx reduction over the use of over fire air in large scale (480MW) cyclone fired utility boilers. The field tests and modeling results are in good agreement. Final data analysis has been completed for tests performed at Eastlake Power Station of a real-time waterwall corrosion monitoring system. The tests demonstrated that corrosion could be measured accurately in real-time in normal boiler operations, and an assessment of waterwall wastage could be made without impacting boiler availability. Detailed measurements of soot volume fraction have been performed for a coal burner in a pilot scale test furnace. The measured values are in good agreement with the expected trends for soot generation and destruction. Catalysts from four commercial manufacturers have been ordered and one of the samples was received this quarter. Several in situ analyses of vanadium-based SCR catalyst systems were completed at BYU. Results to date indicate that the system produces results that represent improvements compared to literature examples of similar experiments. Construction of the catalyst characterization system (CCS) reactor is nearly complete, with a few remaining details discussed in this report. A literature review originally commissioned from other parties is being updated and will be made available under separate cover as part of this investigation. Fabrication of the multi-catalyst slipstream

  3. NOx Control Options and Integration for US Coal Fired Boilers

    SciTech Connect

    Mike Bockelie; Kevin Davis; Temi Linjewile; Connie Senior; Eric Eddings; Kevin Whitty; Larry Baxter; Calvin Bartholomew; William Hecker; Stan Harding

    2004-03-31

    This is the fifteenth Quarterly Technical Report for DOE Cooperative Agreement No: DE-FC26-00NT40753. The goal of the project is to develop cost effective analysis tools and techniques for demonstrating and evaluating low NOx control strategies and their possible impact on boiler performance for boilers firing US coals. The Electric Power Research Institute (EPRI) is providing co-funding for this program. At AEP's Gavin Plant, data from the corrosion probes showed that corrosion rate increased as boiler load was increased. During an outage at the plant, the drop in boiler load, sensor temperature and corrosion rate could all be seen clearly. Restarting the boiler saw a resumption of corrosion activity. This behavior is consistent with previous observations made at a 600MWe utility boiler. More data are currently being examined for magnitudes of corrosion rates and changes in boiler operating conditions. Considerable progress was made this quarter in BYU's laboratory study of catalyst deactivation. Surface sulfation appears to partially suppress NO adsorption when the catalyst is not exposed to NH3; NH3 displaces surface-adsorbed NO on SCR catalysts and surface sulfation increases the amount of adsorbed NH3, as confirmed by both spectroscopy and TPD experiments. However, there is no indication of changes in catalyst activity despite changes in the amount of adsorbed NH3. A monolith test reactor (MTR), completed this quarter, provided the first comparative data for one of the fresh and field-exposed monolith SCR catalysts yet developed in this project. Measurements of activity on one of the field-exposed commercial monolith catalysts do not show significant changes in catalyst activity (within experimental error) as compared to the fresh catalyst. The exposed surface of the sample contains large amounts of Ca and Na, neither of which is present in the fresh sample, even after removal of visibly obvious fouling deposits. However, these fouling compounds do not

  4. PRELIMINARY PERFORMANCE AND COST ESTIMATES OF MERCURY EMISSION CONTROL OPTIONS FOR ELECTRIC UTILITY BOILERS

    EPA Science Inventory


    The paper discusses preliminary performance and cost estimates of mercury emission control options for electric utility boilers. Under the Clean Air Act Amendments of 1990, EPA had to determine whether mercury emissions from coal-fired power plants should be regulated. To a...

  5. MENU OF NOX EMISSION CONTROL OPTIONS FOR COAL-FIRED ELECTRIC UTILITY BOILERS

    EPA Science Inventory

    The paper reviews NOx control options for coal-fired electric utility boilers. (NOTE: Acid Rain NOx regulations, the Ozone Transport Commission's NOx Budget Program, revision of the New Source Performance Standards (NSPS) for NOx emissions from utility sources, and Ozone Transpor...

  6. NOX EMISSION CONTROL OPTIONS FOR COAL-FIRED ELECTRIC UTILITY BOILERS

    EPA Science Inventory

    The paper reviews NOx control options for coal-fired electric utility boilers. (NOTE: Acid Rain NOx regulations, the Ozone Transport Commission's NOx Budget Program, revision of the New Source Performance Standards (NSPS) for NOx emissions from utility sources, and Ozone Transpor...

  7. A PC add-on card for Mössbauer data acquisition system

    NASA Astrophysics Data System (ADS)

    Chittaranjan, C. M.; Jayapandian, J.; Gopinathan, K. P.

    1993-02-01

    A user friendly Mössbauer data acquisition add-on card for IBM compatible PC has been designed and fabricated. It is a firmware which acquires data and shares the CPU of the host PC to transfer the data into the PC memory. The card generates the wave form for the drive unit, generates dwell time marker pulses and counts the energy selected single channel analyzer (SCA) pulses. The significant feature of the system is that the counting of the SCA pulses is done with two counters, resulting in zero dead time. Two temporary dual port RAMs (DP RAM) on board enable real time data acquisition. The software which controls the hardware is menu driven and user friendly and works under DOS environment. An on line display of the spectrum is provided with a cursor which enables the inspection of counts in any channel during the acquisition. The current version of the spectrometer has a capacity of 2048 channels and this can be extended easily up to 8192 channels.

  8. A guidance and control assessment of three vertical landing options for RLV

    NASA Astrophysics Data System (ADS)

    Gallaher, M.; Coughlin, D.; Krupp, D.

    1995-09-01

    The National Aeronautics and Space Administration is considering a vertical lander as a candidate concept for a single-stage-to-orbit reusable launch vehicle (RLV). Three strategies for guiding and controlling the inversion of a reentering RLV from a nose-first attitude to a vertical landing attitude are suggested. Each option is simulated from a common reentry state to touchdown, using a common guidance algorithm and different controllers. Results demonstrate the characteristics that typify and distinguish each concept and help to identify peculiar problems, level of guidance and control sophistication required, feasibility concerns, and areas in which stringent subsystem requirements will be imposed by guidance and control.

  9. A guidance and control assessment of three vertical landing options for RLV

    NASA Technical Reports Server (NTRS)

    Gallaher, M.; Coughlin, D.; Krupp, D

    1995-01-01

    The National Aeronautics and Space Administration is considering a vertical lander as a candidate concept for a single-stage-to-orbit reusable launch vehicle (RLV). Three strategies for guiding and controlling the inversion of a reentering RLV from a nose-first attitude to a vertical landing attitude are suggested. Each option is simulated from a common reentry state to touchdown, using a common guidance algorithm and different controllers. Results demonstrate the characteristics that typify and distinguish each concept and help to identify peculiar problems, level of guidance and control sophistication required, feasibility concerns, and areas in which stringent subsystem requirements will be imposed by guidance and control.

  10. ACCIDENT ANALYSES & CONTROL OPTIONS IN SUPPORT OF THE SLUDGE WATER SYSTEM SAFETY ANALYSIS

    SciTech Connect

    WILLIAMS, J.C.

    2003-11-15

    This report documents the accident analyses and nuclear safety control options for use in Revision 7 of HNF-SD-WM-SAR-062, ''K Basins Safety Analysis Report'' and Revision 4 of HNF-SD-SNF-TSR-001, ''Technical Safety Requirements - 100 KE and 100 KW Fuel Storage Basins''. These documents will define the authorization basis for Sludge Water System (SWS) operations. This report follows the guidance of DOE-STD-3009-94, ''Preparation Guide for US. Department of Energy Nonreactor Nuclear Facility Safety Analysis Reports'', for calculating onsite and offsite consequences. The accident analysis summary is shown in Table ES-1 below. While this document describes and discusses potential control options to either mitigate or prevent the accidents discussed herein, it should be made clear that the final control selection for any accident is determined and presented in HNF-SD-WM-SAR-062.

  11. A review of modafinil and armodafinil as add-on therapy in antipsychotic-treated patients with schizophrenia

    PubMed Central

    Arends, Johannes; Timmerman, Leo; Lancel, Marike

    2012-01-01

    Schizophrenia is characterized by reality distortion, psychomotor poverty and cognitive disturbances. These characteristics contribute to a lesser social functioning and lower quality of life in patients with schizophrenia. It has been suggested that modafinil and its isomer armodafinil as an add-on strategy to antipsychotic treatment in patients with schizophrenia may improve cognitive functioning, attenuate fatigue, inactiveness and other negative functions as well as weight gain. In this paper we review the literature relevant to the question of whether modafinil and armodafinil are beneficial as add-on therapy in antipsychotic-treated patients with schizophrenia. A total of 15 articles were included in this review; of the 15 articles, 10 were randomized controlled trials (RCTs). Evidence for the use of modafinil or armodafinil as add-on therapy to antipsychotic drugs to alleviate fatigue, sleepiness and inactivity is inconclusive. One cohort study and one out of two single-dose crossover RCTs in which modafinil addition was studied could demonstrate a positive effect. All five RCTs of modafinil (three RCTs) and armodafinil (two RCTs) addition with a longer study duration could not demonstrate a positive effect. With respect to cognitive disturbances, animal models of cognitive deficits show clear improvements with modafinil. In RCTs with a treatment duration of 4 weeks or more, however, no positive effect could be demonstrated on cognitive functioning with modafinil and armodafinil addition. Yet, four single-dose crossover RCTs of modafinil addition show significant positive effects on executive functioning, verbal memory span, visual memory, working memory, spatial planning, slowing in latency, impulse control and recognition of faces expressing sadness and sadness misattribution in the context of disgust recognition. The addition of modafinil or armodafinil to an antipsychotic regime, despite theoretical and preclinical considerations, has not been proved to

  12. A review of modafinil and armodafinil as add-on therapy in antipsychotic-treated patients with schizophrenia.

    PubMed

    Wittkampf, Laura Christina; Arends, Johannes; Timmerman, Leo; Lancel, Marike

    2012-06-01

    Schizophrenia is characterized by reality distortion, psychomotor poverty and cognitive disturbances. These characteristics contribute to a lesser social functioning and lower quality of life in patients with schizophrenia. It has been suggested that modafinil and its isomer armodafinil as an add-on strategy to antipsychotic treatment in patients with schizophrenia may improve cognitive functioning, attenuate fatigue, inactiveness and other negative functions as well as weight gain. In this paper we review the literature relevant to the question of whether modafinil and armodafinil are beneficial as add-on therapy in antipsychotic-treated patients with schizophrenia. A total of 15 articles were included in this review; of the 15 articles, 10 were randomized controlled trials (RCTs). Evidence for the use of modafinil or armodafinil as add-on therapy to antipsychotic drugs to alleviate fatigue, sleepiness and inactivity is inconclusive. One cohort study and one out of two single-dose crossover RCTs in which modafinil addition was studied could demonstrate a positive effect. All five RCTs of modafinil (three RCTs) and armodafinil (two RCTs) addition with a longer study duration could not demonstrate a positive effect. With respect to cognitive disturbances, animal models of cognitive deficits show clear improvements with modafinil. In RCTs with a treatment duration of 4 weeks or more, however, no positive effect could be demonstrated on cognitive functioning with modafinil and armodafinil addition. Yet, four single-dose crossover RCTs of modafinil addition show significant positive effects on executive functioning, verbal memory span, visual memory, working memory, spatial planning, slowing in latency, impulse control and recognition of faces expressing sadness and sadness misattribution in the context of disgust recognition. The addition of modafinil or armodafinil to an antipsychotic regime, despite theoretical and preclinical considerations, has not been proved to

  13. Sensitivity analysis of add-on price estimate for select silicon wafering technologies

    NASA Technical Reports Server (NTRS)

    Mokashi, A. R.

    1982-01-01

    The cost of producing wafers from silicon ingots is a major component of the add-on price of silicon sheet. Economic analyses of the add-on price estimates and their sensitivity internal-diameter (ID) sawing, multiblade slurry (MBS) sawing and fixed-abrasive slicing technique (FAST) are presented. Interim price estimation guidelines (IPEG) are used for estimating a process add-on price. Sensitivity analysis of price is performed with respect to cost parameters such as equipment, space, direct labor, materials (blade life) and utilities, and the production parameters such as slicing rate, slices per centimeter and process yield, using a computer program specifically developed to do sensitivity analysis with IPEG. The results aid in identifying the important cost parameters and assist in deciding the direction of technology development efforts.

  14. Civic Engagement and Global Citizenship in a University Context: Core Business or Desirable Add-On?

    ERIC Educational Resources Information Center

    Munck, Ronaldo

    2010-01-01

    Can civic engagement become a "core business" of the contemporary university, or is it an attractive "add-on" that is not affordable in the current economic climate? Contemporary universities often play an important role in local community development and, as such, have the opportunity to develop civic engagement strategies to sit alongside…

  15. 24 CFR 990.190 - Other formula expenses (add-ons).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Other formula expenses (add-ons). 990.190 Section 990.190 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT THE PUBLIC...

  16. Proposed helmet PET geometries with add-on detectors for high sensitivity brain imaging

    NASA Astrophysics Data System (ADS)

    Tashima, Hideaki; Yamaya, Taiga

    2016-10-01

    For dedicated brain PET, we can significantly improve sensitivity for the cerebrum region by arranging detectors in a compact hemisphere. The geometrical sensitivity for the top region of the hemisphere is increased compared with conventional cylindrical PET consisting of the same number of detectors. However, the geometrical sensitivity at the center region of the hemisphere is still low because the bottom edge of the field-of-view is open, the same as for the cylindrical PET. In this paper, we proposed a helmet PET with add-on detectors for high sensitivity brain PET imaging for both center and top regions. The key point is the add-on detectors covering some portion of the spherical surface in addition to the hemisphere. As the location of the add-on detectors, we proposed three choices: a chin detector, ear detectors, and a neck detector. For example, the geometrical sensitivity for the region-of-interest at the center was increased by 200% by adding the chin detector which increased the size by 12% of the size of the hemisphere detector. The other add-on detectors gave almost the same increased sensitivity effect as the chin detector did. Compared with standard whole-body-cylindrical PET, the proposed geometries can achieve 2.6 times higher sensitivity for brain region even with less than 1/4 detectors. In addition, we conducted imaging simulations for geometries with a diameter of 250 mm and with high resolution depth-of-interaction detectors. The simulation results showed that the proposed geometries increased image quality, and all of the add-on detectors were equivalently effective. In conclusion, the proposed geometries have high potential for widespread applications in high-sensitivity, high-resolution, and low-cost brain PET imaging.

  17. Life-cycle assessment of selected management options for air pollution control residues from waste incineration.

    PubMed

    Fruergaard, Thilde; Hyks, Jiri; Astrup, Thomas

    2010-09-15

    Based on available technology and emission data seven selected management options for air-pollution-control (APC) residues from waste incineration were evaluated by life-cycle assessment (LCA) using the EASEWASTE model. Scenarios were evaluated with respect to both non-toxicity impact categories (e.g. global warming) and toxicity related impact categories (e.g. ecotoxicity and human toxicity). The assessment addressed treatment and final placement of 1 tonne of APC residue in seven scenarios: 1) direct landfilling without treatment (baseline), 2) backfilling in salt mines, 3) neutralization of waste acid, 4) filler material in asphalt, 5) Ferrox stabilization, 6) vitrification, and 7) melting with automobile shredder residues (ASR). The management scenarios were selected as examples of the wide range of different technologies available worldwide while at the same time using realistic technology data. Results from the LCA were discussed with respect to importance of: energy consumption/substitution, material substitution, leaching, air emissions, time horizon aspects for the assessment, and transportation distances. The LCA modeling showed that thermal processes were associated with the highest loads in the non-toxicity categories (energy consumption), while differences between the remaining alternatives were small and generally considered insignificant. In the toxicity categories, all treatment/utilization options were significantly better than direct landfilling without treatment (lower leaching), although the thermal processes had somewhat higher impacts than the others options (air emissions). Transportation distances did not affect the overall ranking of the management alternatives.

  18. Add on testosterone therapy in negative symptoms of schizophrenia with gonadal trauma: Hitting the bull's eye.

    PubMed

    Jha, Shailesh; Garg, Amit

    2016-06-30

    The coincidence or causal incidence of hormonal dysregulation leading to psychotic manifestation had been a point of debate. The interplay of these hormones in pathogenesis of psychotic symptom domains is still inconclusive along with some symptom domains which worsen with antipsychotics. Early detection and treatment with liaison approach is of great help to such patients. We report a case of schizophrenia with primary hypogonadism that responded dramatically to add on testosterone supplement. PMID:27138816

  19. THERIAK_D: An add-on to implement equilibrium computations in geodynamic models

    NASA Astrophysics Data System (ADS)

    Duesterhoeft, Erik; Capitani, Christian

    2013-11-01

    This study presents the theory, applicability, and merits of the new THERIAK_D add-on for the open source Theriak/Domino software package. The add-on works as an interface between Theriak and user-generated scripts, providing the opportunity to process phase equilibrium computation parameters in a programming environment (e.g., C or MATLAB®). THERIAK_D supports a wide range of features such as calculating the solid rock density or testing the stability of mineral phases along any pressure-temperature (P-T) path and P-T grid. To demonstrate applicability, an example is given in which the solid rock density of a 2-D-temperature-pressure field is calculated, portraying a simplified subduction zone. Consequently, the add-on effectively combines thermodynamics and geodynamic modeling. The carefully documented examples could be easily adapted for a broad range of applications. THERIAK_D is free, and the program, user manual, and source codes may be downloaded from http://www.min.uni-kiel.de/˜ed/theriakd/.

  20. Nitrogen oxides emission control options for coal-fired electric utility boilers

    SciTech Connect

    Ravi K. Srivastava; Robert E. Hall; Sikander Khan; Kevin Culligan; Bruce W. Lani

    2005-09-01

    Recent regulations have required reductions in emissions of nitrogen oxides (NOx) from electric utility boilers. To comply with these regulatory requirements, it is increasingly important to implement state-of-the-art NOx control technologies on coal-fired utility boilers. This paper reviews NOx control options for these boilers. It discusses the established commercial primary and secondary control technologies and examines what is being done to use them more effectively. Furthermore, the paper discusses recent developments in NOx controls. The popular primary control technologies in use in the United States are low-NOx burners and overfire air. Data reflect that average NOx reductions for specific primary controls have ranged from 35% to 63% from 1995 emissions levels. The secondary NOx control technologies applied on U.S. coal-fired utility boilers include reburning, selective noncatalytic reduction (SNCR), and selective catalytic reduction (SCR). Thirty-six U.S. coal-fired utility boilers have installed SNCR, and reported NOx reductions achieved at these applications ranged from 15% to 66%. Recently, SCR has been installed at 150 U.S. coal-fired utility boilers. Data on the performance of 20 SCR systems operating in the United States with low-NOx emissions reflect that in 2003, these units achieved NOx emission rates between 0.04 and 0.07 lb/106 Btu. 106 refs., 6 figs., 6 tabs.

  1. Nitrogen oxides emission control options for coal-fired electric utility boilers.

    PubMed

    Srivastava, Ravi K; Hall, Robert E; Khan, Sikander; Culligan, Kevin; Lani, Bruce W

    2005-09-01

    Recent regulations have required reductions in emissions of nitrogen oxides (NOx) from electric utility boilers. To comply with these regulatory requirements, it is increasingly important to implement state-of-the-art NOx control technologies on coal-fired utility boilers. This paper reviews NOx control options for these boilers. It discusses the established commercial primary and secondary control technologies and examines what is being done to use them more effectively. Furthermore, the paper discusses recent developments in NOx controls. The popular primary control technologies in use in the United States are low-NOx burners and overfire air. Data reflect that average NOx reductions for specific primary controls have ranged from 35% to 63% from 1995 emissions levels. The secondary NOx control technologies applied on U.S. coal-fired utility boilers include reburning, selective noncatalytic reduction (SNCR), and selective catalytic reduction (SCR). Thirty-six U.S. coal-fired utility boilers have installed SNCR, and reported NOx reductions achieved at these applications ranged from 15% to 66%. Recently, SCR has been installed at >150 U.S. coal-fired utility boilers. Data on the performance of 20 SCR systems operating in the United States with low-NOx emissions reflect that in 2003, these units achieved NOx emission rates between 0.04 and 0.07 lb/10(6) Btu.

  2. Field Testing of Activated Carbon Injection Options for Mercury Control at TXU's Big Brown Station

    SciTech Connect

    John Pavlish; Jeffrey Thompson; Christopher Martin; Mark Musich; Lucinda Hamre

    2009-01-07

    The primary objective of the project was to evaluate the long-term feasibility of using activated carbon injection (ACI) options to effectively reduce mercury emissions from Texas electric generation plants in which a blend of lignite and subbituminous coal is fired. Field testing of ACI options was performed on one-quarter of Unit 2 at TXU's Big Brown Steam Electric Station. Unit 2 has a design output of 600 MW and burns a blend of 70% Texas Gulf Coast lignite and 30% subbituminous Powder River Basin coal. Big Brown employs a COHPAC configuration, i.e., high air-to-cloth baghouses following cold-side electrostatic precipitators (ESPs), for particulate control. When sorbent injection is added between the ESP and the baghouse, the combined technology is referred to as TOXECON{trademark} and is patented by the Electric Power Research Institute in the United States. Key benefits of the TOXECON configuration include better mass transfer characteristics of a fabric filter compared to an ESP for mercury capture and contamination of only a small percentage of the fly ash with AC. The field testing consisted of a baseline sampling period, a parametric screening of three sorbent injection options, and a month long test with a single mercury control technology. During the baseline sampling, native mercury removal was observed to be less than 10%. Parametric testing was conducted for three sorbent injection options: injection of standard AC alone; injection of an EERC sorbent enhancement additive, SEA4, with ACI; and injection of an EERC enhanced AC. Injection rates were determined for all of the options to achieve the minimum target of 55% mercury removal as well as for higher removals approaching 90%. Some of the higher injection rates were not sustainable because of increased differential pressure across the test baghouse module. After completion of the parametric testing, a month long test was conducted using the enhanced AC at a nominal rate of 1.5 lb/Macf. During the

  3. Perceptions of Control and Use of Control Options in Computer-Assisted Video Instruction.

    ERIC Educational Resources Information Center

    Gay, Geri; And Others

    1988-01-01

    Discussion of the effectiveness of learner control in computer assisted instruction focuses on a study of undergraduates at Cornell University using an interactive videodisc lesson on waterfowl identification. Opportunities for students to modify the delivery of the program are described, and the effects of student expectations of control on…

  4. Effects of minocycline add-on treatment on brain morphometry and cerebral perfusion in recent-onset schizophrenia.

    PubMed

    Chaves, Cristiano; Marque, Cristiane R; Maia-de-Oliveira, João P; Wichert-Ana, Lauro; Ferrari, Thiago B; Santos, Antonio C; Araújo, David; Machado-de-Sousa, João P; Bressan, Rodrigo A; Elkis, Helio; Crippa, José A; Guimarães, Francisco S; Zuardi, Antônio W; Baker, Glen B; Dursun, Serdar M; Hallak, Jaime E C

    2015-02-01

    Increasing evidence suggests that the tetracycline antibiotic minocycline has neuroprotective effects and is a potential treatment for schizophrenia. However, the mechanisms of action of minocycline in the CNS remain elusive. The aim of this study was to investigate the effects of minocycline on brain morphology and cerebral perfusion in patients with recent-onset schizophrenia after 12months of a randomized double-blind, placebo-controlled clinical trial of minocycline add-on treatment. This study included 24 outpatients with recent-onset schizophrenia randomized for 12months of adjuvant treatment with minocycline (200mg/d) or placebo. MRI (1.5T) and [(99m)Tc]-ECD SPECT brain scans were performed at the end of the 12-month of trial. Between-condition comparisons of SPECT and MRI brain images were performed using statistical parametric mapping and analyzed by voxel-based morphometry (VBM). Minocycline adjuvant treatment significantly reduced positive and negative symptoms when compared with placebo. The VBM analysis of MRI scans showed that the patients in the placebo group had significant lower gray matter volumes in the midposterior cingulate cortex and in the precentral gyrus in comparison with the patients in the minocycline group. In addition, a decreased ECD uptake in the minocycline condition was observed in fronto-temporal areas. These results suggest that minocycline may protect against gray matter loss and modulate fronto-temporal areas involved in the pathophysiology of schizophrenia. Furthermore, minocycline add-on treatment may be a potential treatment in the early stages of schizophrenia and may ameliorate clinical deterioration and brain alterations observed in this period.

  5. Diagnostic options for radiative divertor feedback control on NSTX-Ua)

    NASA Astrophysics Data System (ADS)

    Soukhanovskii, V. A.; Gerhardt, S. P.; Kaita, R.; McLean, A. G.; Raman, R.

    2012-10-01

    A radiative divertor technique is used in present tokamak experiments and planned for ITER to mitigate high heat loads on divertor plasma-facing components (PFCs) to prevent excessive material erosion and thermal damage. In NSTX, a large spherical tokamak with lithium-coated graphite PFCs and high divertor heat flux (qpeak ⩽ 15 MW/m2), radiative divertor experiments have demonstrated a significant reduction of divertor peak heat flux simultaneously with good core H-mode confinement using pre-programmed D2 or CD4 gas injections. In this work diagnostic options for a new real-time feedback control system for active radiative divertor detachment control in NSTX-U, where steady-state peak divertor heat fluxes are projected to reach 20-30 MW/m2, are discussed. Based on the NSTX divertor detachment measurements and analysis, the control diagnostic signals available for NSTX-U include divertor radiated power, neutral pressure, spectroscopic deuterium recombination signatures, infrared thermography of PFC surfaces, and thermoelectric scrape-off layer current. In addition, spectroscopic "security" monitoring of possible confinement or pedestal degradation is recommended. These signals would be implemented in a digital plasma control system to manage the divertor detachment process via an actuator (impurity gas seeding rate).

  6. Environmental problems in the People`s Republic of China: Current magnitude and possible control options

    SciTech Connect

    Bhadtti, N.; Biang, C.A.; Poch, L.A.; Tompkins, M.M.

    1995-09-01

    The People`s Republic of China has been undergoing rapid economic development over the past several decades. This development has taken place with little or no attention being paid to its environmental consequences. This situation has resulted in severe contamination of the air, water, and soil resources of China, with attendant damage to human and natural populations. This report determines the major causes of air, water, and soil pollution in China and assesses their extent and magnitude. It then examines the impacts of the pollutants on various components of the human and natural environment. It identifies possible regulatory and ameliorative options available to China to deal with these pollution problems and provides information on specific strategies and the costs associated with their implementation. The objective is to shed light on China`s pollution control and remediation requirements in the near future.

  7. Traditional versus rule-based programming techniques - Application to the control of optional flight information

    NASA Technical Reports Server (NTRS)

    Ricks, Wendell R.; Abbott, Kathy H.

    1987-01-01

    A traditional programming technique for controlling the display of optional flight information in a civil transport cockpit is compared to a rule-based technique for the same function. This application required complex decision logic and a frequently modified rule base. The techniques are evaluated for execution efficiency and implementation ease; the criterion used to calculate the execution efficiency is the total number of steps required to isolate hypotheses that were true and the criteria used to evaluate the implementability are ease of modification and verification and explanation capability. It is observed that the traditional program is more efficient than the rule-based program; however, the rule-based programming technique is more applicable for improving programmer productivity.

  8. 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.

  9. Gantry and isocenter displacements of a linear accelerator caused by an add-on micromultileaf collimator

    SciTech Connect

    Riis, Hans L.; Zimmermann, Sune J.; Hjelm-Hansen, Mogens

    2013-03-15

    Purpose: The delivery of high quality stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) treatments to the patient requires knowledge of the position of the isocenter to submillimeter accuracy. To meet the requirements the deviation between the radiation and mechanical isocenters must be less than 1 mm. The use of add-on micromultileaf collimators ({mu}MLCs) in SRS and SRT is an additional challenge to the anticipated high-level geometric and dosimetric accuracy of the treatment. The aim of this work was to quantify the gantry excursions during rotation with and without an add-on {mu}MLC attached to the gantry head. In addition, the shift in the position of the isocenter and its correlation to the kV beam center of the cone-beam CT system was included in the study. Methods: The quantification of the gantry rotational performance was done using a pointer supported by an in-house made rigid holder attached to the gantry head of the accelerator. The pointer positions were measured using a digital theodolite. To quantify the effect of an {mu}MLC of 50 kg, the measurements were repeated with the {mu}MLC attached to the gantry head. The displacement of the isocenter due to an add-on {mu}MLC of 50 kg was also investigated. In case of the pointer measurement the {mu}MLC was simulated by weights attached to the gantry head. A method of least squares was applied to determine the position and displacement of the mechanical isocenter. Additionally, the displacement of the radiation isocenter was measured using a ball-bearing phantom and the electronic portal image device system. These measurements were based on 8 MV photon beams irradiated onto the ball from the four cardinal angles and two opposed collimator angles. The measurements and analysis of the data were carried out automatically using software delivered by the manufacturer. Results: The displacement of the mechanical isocenter caused by a 50 kg heavy {mu}MLC was found to be (-0.01 {+-} 0.05, -0

  10. Uranium-233 waste definition: Disposal options, safeguards, criticality control, and arms control

    SciTech Connect

    Forsberg, C.W.; Storch, S.N.; Lewis, L.C.

    1998-07-07

    The US investigated the use of {sup 233}U for weapons, reactors, and other purposes from the 1950s into the 1970s. Based on the results of these investigations, it was decided not to use {sup 233}U on a large scale. Most of the {sup 233}U-containing materials were placed in long-term storage. At the end of the cold war, the US initiated, as part of its arms control policies, a disposition program for excess fissile materials. Other programs were accelerated for disposal of radioactive wastes placed in storage during the cold war. Last, potential safety issues were identified related to the storage of some {sup 233}U-containing materials. Because of these changes, significant activities associated with {sup 233}U-containing materials are expected. This report is one of a series of reports to provide the technical bases for future decisions on how to manage this material. A basis for defining when {sup 233}U-containing materials can be managed as waste and when they must be managed as concentrated fissile materials has been developed. The requirements for storage, transport, and disposal of radioactive wastes are significantly different than those for fissile materials. Because of these differences, it is important to classify material in its appropriate category. The establishment of a definition of what is waste and what is fissile material will provide the guidance for appropriate management of these materials. Wastes are defined in this report as materials containing sufficiently small masses or low concentrations of fissile materials such that they can be managed as typical radioactive waste. Concentrated fissile materials are defined herein as materials containing sufficient fissile content such as to warrant special handling to address nuclear criticality, safeguards, and arms control concerns.

  11. Village Alcohol Control and the Local Option Law. A Report to the Alaska State Legislature.

    ERIC Educational Resources Information Center

    Lonner, Thomas D.; Duff, J. Kenneth

    This is a report on Alaska's "local option law" which allows villages to choose one of the following four options on alcohol availability in their communities: (1) the sale of alcoholic beverages is prohibited unless sold under a community liquor license; (2) the sale of alcoholic beverages is limited to one of several types of retail licenses…

  12. Benefits and risks of add-on therapies for Alzheimer's disease.

    PubMed

    Magierski, Radoslaw; Sobow, Tomasz

    2015-10-01

    Despite three decades of intensive research, the efforts of scientific society and industry and the expenditures, numerous attempts to develop effective treatments for Alzheimer's disease have failed. Currently, approved and widely used medications to treat cognitive deficits in Alzheimer's disease are symptomatic only and show at best modest efficacy. In this context, the need to develop a successful, disease-modifying treatment is loudly expressed. One way to achieve this goal is the use of add-on therapies or various combinations of existing 'conventional' drugs. Results of several clinical studies and post hoc analyses of combination therapy with all cholinesterase inhibitors and memantine are published. Moreover, there is a need for studies on long-term efficacy of combination therapy in Alzheimer's.

  13. Addiction surplus: the add-on margin that makes addictive consumptions difficult to contain.

    PubMed

    Adams, Peter J; Livingstone, Charles

    2015-01-01

    Addictive consumptions generate financial surpluses over-and-above non-addictive consumptions because of the excessive consumption of addicted consumers. This add-on margin or 'addiction surplus' provides a powerful incentive for beneficiaries to protect their income by ensuring addicted consumers keep consuming. Not only that, addiction surplus provides the financial base that enables producers to sponsor activities which aim to prevent public health initiatives from reducing consumption. This paper examines the potency of addiction surplus to engage industry, governments and communities in an on-going reliance on addiction surplus. It then explores how neo-liberal constructions of a rational consumer disguise the ethical and exploitative dynamics of addiction surplus by examining ways in which addictive consumptions fail to conform to notions of autonomy and rationality. Four measures are identified to contain the distorting effects of addiction surplus.

  14. The CONVEX Liner Add-On to the DIAMOND-FORTUNE event

    SciTech Connect

    Heuze, F.E.; Swift, R.P.; Hill, L.R.; Barrett, W.H.

    1993-11-15

    This report describes the execution of the CONVEX Liner Add-On to the DIAMOND FORTUNE low-yield cavity test of the Defense Nuclear Agency. CONVEX stands for COntained Nuclear Vessel EXperiment. It concerns the design of underground chambers where repeated low-yield nuclear explosions could be conducted. The approach proposed by the first author in the early 1980`s was to engineer a steel-lined rock cavern where the steel liner would be prestressed against the rock by tendons and/or bolts. These would daylight in tunnels surrounding the main cavity. From there, they could be initially tensioned and retensioned, if needed, after each test. The CONVEX Liner Add-On to DIAMOND FORTUNE consisted of anchoring a 1.4-m square, 2.5-cm thick steel plate to the wall of the cavity, using a 5-cm diameter center bolt, and four 2.5-cm diameter comer bolts. The bolts daylighted in a drift surrounding the gallery, and separated from it by a 9-m thick rock pillar. The liner plate, the bolts, and the rock pillar were equipped with 23 gages to describe the thermal and mechanical response of the system during pretensioning, during the dynamic loading phase, and post-test. Particular emphasis was given to obtaining the response both upon loading and during the rebound of the system, in order to determine whether the plate ever separated from the rock. So, the main operational objectives of this project were to acquire response data of the system under nuclear loading and to ascertain the status of contact between the steel plate and the rock, as shown by toadstool data and bolt tension data. The instrumentation and data acquisition system performed extremely well. Data were recorded during the dynamic phase; plate temperature was monitored for several hours after the test; and the remaining tension was obtained for several bolts more than three months after the test, upon re-entry in the runaround drift.

  15. The FAST module: an add-on unit for driving commercial scanning probe microscopes at video rate and beyond.

    PubMed

    Esch, Friedrich; Dri, Carlo; Spessot, Alessio; Africh, Cristina; Cautero, Giuseppe; Giuressi, Dario; Sergo, Rudi; Tommasini, Riccardo; Comelli, Giovanni

    2011-05-01

    We present the design and the performance of the FAST (Fast Acquisition of SPM Timeseries) module, an add-on instrument that can drive commercial scanning probe microscopes (SPM) at and beyond video rate image frequencies. In the design of this module, we adopted and integrated several technical solutions previously proposed by different groups in order to overcome the problems encountered when driving SPMs at high scanning frequencies. The fast probe motion control and signal acquisition are implemented in a way that is totally transparent to the existing control electronics, allowing the user to switch immediately and seamlessly to the fast scanning mode when imaging in the conventional slow mode. The unit provides a completely non-invasive, fast scanning upgrade to common SPM instruments that are not specifically designed for high speed scanning. To test its performance, we used this module to drive a commercial scanning tunneling microscope (STM) system in a quasi-constant height mode to frame rates of 100 Hz and above, demonstrating extremely stable and high resolution imaging capabilities. The module is extremely versatile and its application is not limited to STM setups but can, in principle, be generalized to any scanning probe instrument.

  16. The use of vaccination as an option for the control of avian influenza.

    PubMed

    Capua, Ilaria; Marangon, Stefano

    2003-08-01

    countries enforcing a vaccination policy. This review considers the possible strategies for the control of avian influenza infections, bearing in mind the new proposed definition of AI, including the advantages and disadvantages of using conventional inactivated (homologous and heterologous) vaccines and recombinant vaccines. Reference is made to the different control strategies, including the restriction measures to be applied in case of the enforcement of a vaccination policy. In addition, the implications of a vaccination policy on trade are discussed. It is concluded that if vaccination is accepted as an option for the control of AI, vaccine banks, including companion diagnostic tests, must be established and made available for immediate use.

  17. Evaluation of Humidity Control Options in Hot-Humid Climate Homes (Fact Sheet)

    SciTech Connect

    Not Available

    2011-12-01

    dehumidification is needed to maintain space relative humidity (RH) below 60% in a hot-humid climate home. Researchers also concluded that while all the active dehumidification options included in the study successfully controlled space relative humidity excursions, the increase in whole-house energy consumption was much more sensitive to the humidity set point than the chosen technology option. In the high-performance home, supplemental dehumidification equipment results in a significant source energy consumption penalty at 50% RH set point (12.6%-22.4%) compared to the consumption at 60% RH set point (1.5%-2.7%). At 50% and 55% RH set points, A/C with desiccant wheel dehumidifier and A/C with ERV and high-efficiency DX dehumidifier stand out as the two cases resulting in the smallest increase of source energy consumption. At an RH set point of 60%, all explicit dehumidification technologies result in similar insignificant increases in source energy consumption and thus are equally competitive.

  18. Prospective open-label study of add-on and monotherapy topiramate in civilians with chronic nonhallucinatory posttraumatic stress disorder

    PubMed Central

    Berlant, Jeffrey L

    2004-01-01

    Background In order to confirm therapeutic effects of topiramate on posttraumatic stress disorder (PTSD) observed in a prior study, a new prospective, open-label study was conducted to examine acute responses in chronic, nonhallucinatory PTSD. Methods Thirty-three consecutive newly recruited civilian adult outpatients (mean age 46 years, 85% female) with DSM-IV-diagnosed chronic PTSD, excluding those with concurrent auditory or visual hallucinations, received topiramate either as monotherapy (n = 5) or augmentation (n = 28). The primary measure was a change in the PTSD Checklist-Civilian Version (PCL-C) score from baseline to 4 weeks, with response defined as a ≥ 30% reduction of PTSD symptoms. Results For those taking the PCL-C at both baseline and week 4 (n = 30), total symptoms declined by 49% at week 4 (paired t-test, P < 0.001) with similar subscale reductions for reexperiencing, avoidance/numbing, and hyperarousal symptoms. The response rate at week 4 was 77%. Age, sex, bipolar comorbidity, age at onset of PTSD, duration of symptoms, severity of baseline PCL-C score, and monotherapy versus add-on medication administration did not predict reduction in PTSD symptoms. Median time to full response was 9 days and median dosage was 50 mg/day. Conclusions Promising open-label findings in a new sample converge with findings of a previous study. The use of topiramate for treatment of chronic PTSD, at least in civilians, warrants controlled clinical trials. PMID:15315714

  19. 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

  20. Smokers and non‐smokers talk about regulatory options in tobacco control

    PubMed Central

    Carter, Stacy M; Chapman, Simon

    2006-01-01

    Objective Community members are occasionally polled about tobacco control policies, but are rarely given opportunities to elaborate on their views. We examined laypeople's conversations to understand how 11 regulatory options were supported or opposed in interactions. Design Qualitative design; purposive quota sampling; data collection via focus groups. Setting Three locations in Sydney, Australia. Participants 63 smokers and 75 non‐smokers, men and women, from three age groups (18–24, 35–44, 55–64 years), recruited primarily via telephone. Measurements Semi‐structured question route; data managed in NVivo; responses compared between groups. Results Laypeople rejected some regulatory proposals and certain arguments about taxation and the cost of cessation treatments. Protecting children and hypothecating tobacco excise for health education and care were highly acceptable. Plain packaging, banning retail displays and youth smoking prevention received qualified support. Bans on political donations from tobacco corporations were popular in principle but considered logistically fraught. Smokers asked for better cessation assistance and were curious about cigarette ingredients. Justice was an important evaluative principle. Support was often conditional and unresolved arguments frequent. We present both sides of these conflicts and the ways in which policies were legitimised or de‐legitimised in conversation. Conclusions Simple measures of agreement used in polls may obscure the complexity of community responses to tobacco policy. Support was frequently present but contested; some arguments that seem self‐evident to advocates were not so to participants. The detailed understanding of laypeople's responses provided through qualitative methods may help frame proposals and arguments to meet concerns about justice, effectiveness and feasibility. PMID:16998175

  1. [Topiramate in clinical practice (part 1). Multicentric retrospective analysis of the efficacy of topiramate as add-on therapy according to the topographic form of focal epilepsy].

    PubMed

    Biraben, A; Genton, P

    2000-11-01

    Randomized, controlled studies of new antiepileptic drugs do not always highlight their best utilization in clinical practice. The authors gathered 361 cases of focal epilepsies treated with topiramate (TPM) as an add-on to other anti epileptic drugs prior to marketing. Among these, only 237 were treated for at least 3 months and analyzed here. These patients were treated by neurologists in a clinical setting, with free choice of associated drugs, titration and final daily doses. Compared with controlled studies, TPM was titrated slowly (mean rate: 43 mg/week, vs 100 to 200), and was given at a lower final dose (346 mg/d, vs 200 to 1000). This analysis confirmed the efficacy of TPM as add-on therapy in focal epilepsies (9.3p.100 totally controlled, 19 p.100 with reduction of seizures=90 p. 100, 52.7 p.100 responders at=50 p.100). It showed that there was a striking response in epilepsies originating from the central areas, which are often drug-resistant (19 p.100 totally controlled, 33.33 p. 100 with reduction of seizures=90 p.100). There were responders in all topographic groups. There was however no specific response according to etiology. PMID:11119051

  2. Effects of gliclazide add on metformin on serum omentin-1 levels in patients with type 2 diabetes mellitus

    PubMed Central

    Al-Gareeb, Ali I.; Alrubai, Haidar F.; Suliaman, Sammar M.

    2016-01-01

    Background: Omentin is a newly identified adipokine that has beneficial influence against cardiovascular disorders. Hence, considering the impact of anti-diabetic drug on omentin levels may provide an adjuvant strategy to protect diabetic patients against valuable clinical hazards. Aim of the Study: To investigate the influence of metformin alone or in combination with gliclazide on the level of serum omentin among patients with type 2 diabetes mellitus (T2DM). Patients and Methods: A total of 70 newly diagnosed patients with T2DM were enrolled in this randomized, double-blind prospective study, and divided into two equal groups based on treatment regimen in which Group 1 treated with metformin (1000 mg) and Group 2 treated with metformin (1000 mg) plus gliclazide (80 mg). Blood glucose levels, HbA1C, insulin levels, and serum omentin-1 were measured at baseline and after 12 weeks of treatment. Result: Use of gliclazide as an add-on therapy to metformin in patients with T2DM result in better glycemic control evidenced by significant reductions in the levels of blood glucose levels and HbA1C and much more improvement in insulin sensitivity evidenced by significant decreased in insulin resistance index, whereas it has adverse impact on serum omentin-1 levels evidenced by significant decrement in omentin-1 level in comparison to their pretreatment levels among Group 2 patients. Conclusions: Adding of gliclazide to metformin in treatment of patients with T2DM might extend the therapeutic action of metformin in regarding much better controlling of glycemic indices, but, at the same time, it might attenuate the cardioprotective effects of metformin by its adverse influence on serum omentin-1 levels. PMID:27042415

  3. A cost-effective add-on-value card-assisted firewall over Taiwan's NHI VPN framework.

    PubMed

    Huang, Jyh-Win; Hou, Ting-Wei

    2007-06-01

    Besides the overall budget for building the infrastructure of a healthcare-service-based virtual private network (VPN) in Taiwan, two issues were considered critical for its acceptance by the country's 17,000 plus medical institutions. One was who was to pay for the network (ADSL or modem) connection fee; the other was who was to pay for the firewall/anti-virus software. This paper addresses the second issue by proposing an efficient freeware firewall, named card-assisted firewall (CAF), for NHI VPN edge-hosts, which is also an add-on-value application of the National Healthcare IC card that every insurant and medical professional has. The innovative concept is that any NHI VPN site (edge-host) can establish diversified secure-authenticated connections with other sites only by an authentication mechanism, which requires a NHI Java card state machine and the Access Control List of the host. It is different from two-factor authentication cards in four ways: (1) a PIN code is not a must; (2) it requires authentication with the remote IC card Data Centre; (3) the NHI cards are already available, no modification is needed, and there is no further cost for the deployment of the cards; (4) although the cards are in the reader, the communication cannot start unless the cards are in the corresponding states; i.e. the states allow communication. An implementation, on a Microsoft Windows XP platform, demonstrated the system's feasibility over an emulation of the NHI VPN framework. It maintained a high line speed, the driver took up 39 KB of disk space, installation was simple, not requiring any extra hardware or software, and the average packet processing time of the CAF driver measured was 0.3084 ms. The average overhead in comparing the Access Control List predefined routing in card, in an FTP testing experiment, was 5.7 micros (receiving) and 8 micros (sending).

  4. A cost-effective add-on-value card-assisted firewall over Taiwan's NHI VPN framework.

    PubMed

    Huang, Jyh-Win; Hou, Ting-Wei

    2007-06-01

    Besides the overall budget for building the infrastructure of a healthcare-service-based virtual private network (VPN) in Taiwan, two issues were considered critical for its acceptance by the country's 17,000 plus medical institutions. One was who was to pay for the network (ADSL or modem) connection fee; the other was who was to pay for the firewall/anti-virus software. This paper addresses the second issue by proposing an efficient freeware firewall, named card-assisted firewall (CAF), for NHI VPN edge-hosts, which is also an add-on-value application of the National Healthcare IC card that every insurant and medical professional has. The innovative concept is that any NHI VPN site (edge-host) can establish diversified secure-authenticated connections with other sites only by an authentication mechanism, which requires a NHI Java card state machine and the Access Control List of the host. It is different from two-factor authentication cards in four ways: (1) a PIN code is not a must; (2) it requires authentication with the remote IC card Data Centre; (3) the NHI cards are already available, no modification is needed, and there is no further cost for the deployment of the cards; (4) although the cards are in the reader, the communication cannot start unless the cards are in the corresponding states; i.e. the states allow communication. An implementation, on a Microsoft Windows XP platform, demonstrated the system's feasibility over an emulation of the NHI VPN framework. It maintained a high line speed, the driver took up 39 KB of disk space, installation was simple, not requiring any extra hardware or software, and the average packet processing time of the CAF driver measured was 0.3084 ms. The average overhead in comparing the Access Control List predefined routing in card, in an FTP testing experiment, was 5.7 micros (receiving) and 8 micros (sending). PMID:17541860

  5. Aerodynamic drag reduction tests on a full-scale tractor-trailer combination with several add-on devices

    NASA Technical Reports Server (NTRS)

    Montoya, L. C.; Steers, L. L.

    1974-01-01

    Aerodynamic drag tests were performed on a conventional cab-over-engine tractor with a 45-foot trailer and five commercially available or potentially available add-on devices using the coast-down method. The tests ranged in velocity from approximately 30 miles per hour to 65 miles per hour and included some flow visualization. A smooth, level runway at Edwards Air Force Base was used for the tests, and deceleration measurements were taken with both accelerometers and stopwatches. An evaluation of the drag reduction results obtained with each of the five add-on devices is presented.

  6. Add-on prednisolone in the management of cervical lymph node tuberculosis.

    PubMed

    Bunkar, Moti Lal; Agnihotri, Shashi Prakash; Gupta, Prahlad Ral; Arya, Savita

    2016-04-01

    Studies defining role of systemic steroids in routine management of cervical lymph node tuberculosis (CLNTB) are too few and inconclusive. The present study was carried out to define the role of add-on prednisolone in the management of CLNTB. Patients of CLNTB were randomized into two groups. Group I patients received DOTS Category I treatment along with prednisolone 1mg/kg for first 4 weeks and then tapered down. Group II patients received DOTS Category I treatment along with placebo. Patients were kept under close follow up for 6 months. Response to therapy and adverse drug reactions, if any, were recorded. A total of 120 patients completed the study protocol. The two groups were similar with respect to age, sex, smoking, alcoholism, and clinical profile (p>0.5). At 2 months, 54 out of 60 patients in Group I showed symptom relief when compared with 44 out of 60 patients in Group II (p<0.001). Abscess, sinus, and/or appearance of new lymph node/s were noted in 3 and 13 patients in Group I and Group II, respectively (p<0.001). Complete resolution was seen in 57 patients in Group I when compared with only 40 patients of Group II and sequel in form of residual LN was noted in three patients of Group I when compared with 20 in Group II (p<0.001). Gastrointestinal side effects were reported by higher number of patients in Group I but skin rashes and joint pain were fewer when compared with Group II (p>0.05). All the adverse reactions were transient and amenable to symptomatic treatment. PMID:27451818

  7. Establishing a Near Term Lunar Farside Gravity Model via Inexpensive Add-on Navigation Payload

    NASA Technical Reports Server (NTRS)

    Folta, David; Mesarch, Michael; Miller, Ronald; Bell, David; Jedrey, Tom; Butman, Stanley; Asmar, Sami

    2007-01-01

    The Space Communications and Navigation, Constellation Integration Project (SCIP) is tasked with defining, developing, deploying and operating an evolving multi-decade communications and navigation (C/N) infrastructure including services and subsystems that will support both robotic and human exploration activities at the Moon. This paper discusses an early far side gravitational mapping service and related telecom subsystem that uses an existing spacecraft (WIND) and the Lunar Reconnaissance Orbiter (LRO) to collect data that would address several needs of the SCIP. An important aspect of such an endeavor is to vastly improve the current lunar gravity model while demonstrating the navigation and stationkeeping of a relay spacecraft. We describe a gravity data acquisition activity and the trajectory design of the relay orbit in an Earth-Moon L2 co-linear libration orbit. Several phases of the transfer from an Earth-Sun to the Earth-Moon region are discussed along with transfers within the Earth-Moon system. We describe a proposed, but not integrated, add-on to LRO scheduled to be launched in October of 2008. LRO provided a real host spacecraft against which we designed the science payload and mission activities. From a strategic standpoint, LRO was a very exciting first flight opportunity for gravity science data collection. Gravity Science data collection requires the use of one or more low altitude lunar polar orbiters. Variations in the lunar gravity field will cause measurable variations in the orbit of a low altitude lunar orbiter. The primary means to capture these induced motions is to monitor the Doppler shift of a radio signal to or from the low altitude spacecraft, given that the signal is referenced to a stable frequency reference. For the lunar far side, a secondary orbiting radio signal platform is required. We provide an in-depth look at link margins, trajectory design, and hardware implications. Our approach posed minimum risk to a host mission while

  8. Mozart K.448 acts as a potential add-on therapy in children with refractory epilepsy.

    PubMed

    Lin, Lung-Chang; Lee, Wei-Te; Wang, Chien-Hua; Chen, Hsiu-Lin; Wu, Hui-Chuan; Tsai, Chin-Lin; Wei, Ruey-Chang; Mok, Hin-Kiu; Weng, Chia-Fen; Lee, Mei-Wen; Yang, Rei-Cheng

    2011-03-01

    Mozart's Sonata for two pianos in D major, K.448 (Mozart K.448), has been shown to improve mental function, leading to what is known as the Mozart effect. Our previous work revealed that epileptiform discharges in children with epilepsy decreased during and immediately after listening to Mozart K.448. In this study, we evaluated the long-term effects of Mozart K.448 on children with refractory epilepsy. Eleven children with refractory epilepsy were enrolled. All of the patients were diagnosed as having had refractory epilepsy for more than 1 year (range =1 year to 6 years 4 months, mean =3 years 11 months) and had been receiving at least two antiepileptic drugs (AED). During the study period, they listened to Mozart K.448 once a day before bedtime for 6 months. Seizure frequencies were recorded 6 months before they started listening to this music and monthly during the study period. All of the patients remained on the same AEDs during the 6-month study period. Frequencies of seizures were compared before and after listening to Mozart K.448. Eight of eleven patients were seizure free (N=2) or had very good responses (N=6) after 6 months of listening to Mozart K.448. The remaining three (27.3%) showed minimal or no effect (effectiveness <50%; unmodified or worsened seizure frequency). The average seizure reduction was 53.6 ± 62.0%. There were no significant differences in seizure reduction with IQ, etiology, or gender. We conclude that Mozart K.448 should be further studied as a potential add-on therapy in the treatment of children with refractory epilepsy.

  9. JV Task 122 - Assessment of Mercury Control Options for the San Miguel Electric Cooperative Power Plant

    SciTech Connect

    Nicholas Lentz; Brandon Pavlish; John Kay; Michael Jones

    2009-02-01

    In the United States, testing has been under way at electric coal-fired power plants to find viable and economical mercury control strategies to meet pending regulations. San Miguel Electric Cooperative (SMEC) engaged the Energy & Environmental Research Center (EERC) through a request for proposal (RFP) to perform research tests to evaluate sorbent-based technologies at its coal-fired San Miguel Generating Station to identify possible technology options that could be used by SMEC to meet the mercury reduction requirements of future U.S. federal standards. The goal of the testing was to target a mercury removal of {ge}90%. The EERC has successfully field-tested several sorbent-based technologies in previous projects that offer promise and potential to achieve a target removal of {ge}90%. Based on these field test results, yet recognizing that fuel type and plant operating conditions affect mercury capture significantly, the EERC proposed research tests to evaluate potential sorbent-based technologies provided by Norit Americas and the EERC that could potentially meet SMEC's mercury control objectives. Over the period of May through mid-June 2008, the EERC tested injection of both treated and nontreated activated carbon (AC) provided by Norit Americas and sorbent enhancement additives (SEAs) provided by the EERC. Tests were performed at San Miguel Unit 1 (450 MW) and included injection at the inlet of the air heater (AH) (temperature of 720 F). The test coal was a Texas lignite fuel with an average moisture content of 31.19%, an ash content of 26.6%, a heating value of 5,094 Btu/lb, a sulfur content of 2.7%, and a mercury concentration of 0.182 ppm, all reported on an as-received basis. Pilot-scale testing results identified DARCO{reg_sign} Hg-LH, SEA2 + DARCO{reg_sign} Hg, and the ChemMod sorbents as technologies with the potential to achieve the target mercury removal of {ge}90% at the full-scale test. Mercury concentrations were tracked with continuous mercury

  10. Technical and economic evaluation of controlled disposal options for very low level radioactive wastes

    SciTech Connect

    Robinson, P.J. , Brisbane, CA ); Vance, J.N. )

    1990-08-01

    Over the past several years, there has been considerable interest by the nuclear industry in the Nuclear Regulatory Commission (NRC) explicitly defined an activity level in plant waste materials at which the radiological impacts would be so low as to be considered Below Regulatory Concern (BRC). In January 1989, Electric Power Research Institute (EPRI) completed an extensive industry research effort to develop the technical bases for establishing criteria for the disposal of very low activity wastes in ordinary disposal facilities. The Nuclear Management and Resources Council (NUMARC), with assistance from the Edison Electric Institute (EEI) and the Electric Power Research Institute (EPRI), drafted a petition titled: Petition for Rulemaking Regarding Disposal of Below Regulatory Concern Radioactive Wastes from Commercial Nuclear Power Plants.'' Subsequent to the industry making a final decision for submittal of the drafted BRC petition, EPRI was requested to evaluate the technical and economic impact of six BRC options. These options are: take no action in pursuing a BRC waste exemption, petition the NRC for authorization to disposal of any BRC waste in any ordinary disposal facility, limit disposal of BRC waste to the nuclear power plant site, limit disposal of BRC waste to the nuclear power plant site and other utility owned property, petition for a mixed waste exemption, and petition for single waste stream exemptions in sequence (i.e. soil, followed by sewage sludge, etc.). The petition and technical bases were written to support the disposal of any BRC waste type in any ordinary disposal facility. These documents do not provide all of the technical and economic information needed to completely assessment the BRC options. This report provides the technical and economic basis for a range of options concerning disposal of very low activity wastes. 3 figs., 20 tabs.

  11. Loxapine Add-on for Adolescents and Adults with Autism Spectrum Disorders and Irritability

    PubMed Central

    Reed, Gregory; Cain, Sharon E.; Zhou, Xinghua; Barth, Francis X.; Aman, Michael G.; Palaguachi, Gladys I.; Mikhnev, Dmytro; Teng, Rujia; Andridge, Rebecca; Logan, Marilyn; Butler, Merlin G.; Han, Joan C.

    2015-01-01

    Abstract Objectives: Our clinical experience with low dose loxapine (5–15 mg/day) suggests promising efficacy and safety for irritability in autism spectrum disorders (ASD). We studied low dose loxapine prospectively in adolescents and adults with ASD and irritability. Additionally, we measured loxapine and metabolite concentrations, and brain-derived neurotrophic factor (BDNF) as a biomarker of neuromodulation. Methods: We performed a 12 week open trial of add-on loxapine in subjects, ages 13–65 years, diagnosed with ASD, and Aberrant Behavior Checklist-Irritability (ABC-I) subscale scores >14. Loxapine was dosed flexibly up to 15 mg daily, starting with 5 mg on alternate days. From weeks 1 to 6, other psychoactive medications were tapered if possible; from weeks 6 to 12, all medication doses were held stable. The primary outcome was the Clinical Global Impressions-Improvement subscale (CGI-I), ratings of Much Improved or Very Much Improved. Secondary outcomes were the ABC-I, Repetitive Behavior Scale-Revised, and Schalock Quality of Life scale. Serum BDNF and loxapine and metabolite concentrations were assayed. BDNF rs6265 was genotyped. Results: Sixteen subjects were enrolled; 12 completed all visits. Median age was 18 years (range 13–39). Median final loxapine dose was 7.5 mg/day (2.5–15). All 14 subjects (100%) with data at week 12 were rated as Much Improved on CGI-I at 12 weeks. Mean change on ABC-I at 12 weeks was −31%, p=0.01. Mean body mass index (BMI)-Z decreased between weeks 6 and 12, p=0.03. Side effects were minimal, and prolactin elevation occurred in only one subject. BDNF concentrations measured in 11 subjects increased significantly (p=0.04). Subjects with AG genotype for BDNF rs6265 required a lower dose of loxapine at study end, but had similar behavioral and BDNF concentration changes as the GG genotype. Conclusions: Low dose loxapine shows promise as a repurposed drug for irritability in ASD. Loxapine effects on BDNF warrant

  12. Space station systems technology study (add-on task). Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    1985-01-01

    System concepts were characterized in order to define cost versus benefits for autonomous functional control and for controls and displays for OMV, OTV, and spacecraft servicing and operation. The attitude control topic focused on characterizing the Space Station attitude control problem through simulation of control system responses to structural disturbances. The first two topics, mentioned above, focused on specific technology items that require advancement in order to support an early 1990s initial launch of a Space Station, while the attitude control study was an exploration of the capability of conventional controller techniques.

  13. International Space Station (ISS) External Thermal Control System (ETCS) Loop A Pump Module (PM) Jettison Options Assessment

    NASA Technical Reports Server (NTRS)

    Murri, Daniel G.; Dwyer Cianciolo, Alicia; Shidner, Jeremy D.; Powell, Richard W.

    2014-01-01

    On December 11, 2013, the International Space Station (ISS) experienced a failure of the External Thermal Control System (ETCS) Loop A Pump Module (PM). To minimize the number of extravehicular activities (EVA) required to replace the PM, jettisoning the faulty pump was evaluated. The objective of this study was to independently evaluate the jettison options considered by the ISS Trajectory Operations Officer (TOPO) and to provide recommendations for safe jettison of the ETCS Loop A PM. The simulation selected to evaluate the TOPO options was the NASA Engineering and Safety Center's (NESC) version of Program to Optimize Simulated Trajectories II (POST2) developed to support another NESC assessment. The objective of the jettison analysis was twofold: (1) to independently verify TOPO posigrade and retrograde jettison results, and (2) to determine jettison guidelines based on additional sensitivity, trade study, and Monte Carlo (MC) analysis that would prevent PM recontact. Recontact in this study designates a propagated PM trajectory that comes within 500 m of the ISS propagated trajectory. An additional simulation using Systems Tool Kit (STK) was run for independent verification of the POST2 simulation results. Ultimately, the ISS Program removed the PM jettison option from consideration. However, prior to the Program decision, the retrograde jettison option remained part of the EVA contingency plan. The jettison analysis presented showed that, in addition to separation velocity/direction and the atmosphere conditions, the key variables in determining the time to recontact the ISS is highly dependent on the ballistic number (BN) difference between the object being jettisoned and the ISS.

  14. Estimation and evaluation of management options to control and/or reduce the risk of not complying with commercial sterility.

    PubMed

    Pujol, Laure; Albert, Isabelle; Magras, Catherine; Johnson, Nicholas Brian; Membré, Jeanne-Marie

    2015-11-20

    In a previous study, a modular process risk model, from the raw material reception to the final product storage, was built to estimate the risk of a UHT-aseptic line of not complying with commercial sterility (Pujol et al., 2015). This present study was focused on demonstrating how the model (updated version with uncertainty and variability separated and 2(nd) order Monte Carlo procedure run) could be used to assess quantitatively the influence of management options. This assessment was done in three steps: pinpoint which process step had the highest influence on the risk, identify which management option(s) could be the most effective to control and/or reduce the risk, and finally evaluate quantitatively the influence of changing process setting(s) on the risk. For Bacillus cereus, it was identified that during post-process storage in an aseptic tank, there was potentially an air re-contamination due to filter efficiency loss (efficiency loss due to successive in-place sterilizations after cleaning operations), followed by B. cereus growth. Two options were then evaluated: i) reducing by one fifth of the number of filter sterilizations before renewing the filters, ii) designing new UHT-aseptic lines without an aseptic tank, i.e. without a storage period after the thermal process and before filling. Considering the uncertainty in the model, it was not possible to confirm whether these options had a significant influence on the risk associated with B. cereus. On the other hand, for Geobacillus stearothermophilus, combinations of heat-treatment time and temperature enabling the control or reduction in risk by a factor of ca. 100 were determined; for ease of operational implementation, they were presented graphically in the form of iso-risk curves. For instance, it was established that a heat treatment of 138°C for 31s (instead of 138°C for 25s) enabled a reduction in risk to 18×10(-8) (95% CI=[10; 34]×10(-8)), instead of 578×10(-8) (95% CI=[429; 754]×10

  15. Estimation and evaluation of management options to control and/or reduce the risk of not complying with commercial sterility.

    PubMed

    Pujol, Laure; Albert, Isabelle; Magras, Catherine; Johnson, Nicholas Brian; Membré, Jeanne-Marie

    2015-11-20

    In a previous study, a modular process risk model, from the raw material reception to the final product storage, was built to estimate the risk of a UHT-aseptic line of not complying with commercial sterility (Pujol et al., 2015). This present study was focused on demonstrating how the model (updated version with uncertainty and variability separated and 2(nd) order Monte Carlo procedure run) could be used to assess quantitatively the influence of management options. This assessment was done in three steps: pinpoint which process step had the highest influence on the risk, identify which management option(s) could be the most effective to control and/or reduce the risk, and finally evaluate quantitatively the influence of changing process setting(s) on the risk. For Bacillus cereus, it was identified that during post-process storage in an aseptic tank, there was potentially an air re-contamination due to filter efficiency loss (efficiency loss due to successive in-place sterilizations after cleaning operations), followed by B. cereus growth. Two options were then evaluated: i) reducing by one fifth of the number of filter sterilizations before renewing the filters, ii) designing new UHT-aseptic lines without an aseptic tank, i.e. without a storage period after the thermal process and before filling. Considering the uncertainty in the model, it was not possible to confirm whether these options had a significant influence on the risk associated with B. cereus. On the other hand, for Geobacillus stearothermophilus, combinations of heat-treatment time and temperature enabling the control or reduction in risk by a factor of ca. 100 were determined; for ease of operational implementation, they were presented graphically in the form of iso-risk curves. For instance, it was established that a heat treatment of 138°C for 31s (instead of 138°C for 25s) enabled a reduction in risk to 18×10(-8) (95% CI=[10; 34]×10(-8)), instead of 578×10(-8) (95% CI=[429; 754]×10

  16. Achieving glycemic control in elderly patients with type 2 diabetes: a critical comparison of current options

    PubMed Central

    Du, Ye-Fong; Ou, Horng-Yih; Beverly, Elizabeth A; Chiu, Ching-Ju

    2014-01-01

    The prevalence of type 2 diabetes mellitus (T2DM) is increasing in the elderly. Because of the unique characteristics of elderly people with T2DM, therapeutic strategy and focus should be tailored to suit this population. This article reviews the guidelines and studies related to older people with T2DM worldwide. A few important themes are generalized: 1) the functional and cognitive status is critical for older people with T2DM considering their life expectancy compared to younger counterparts; 2) both severe hypoglycemia and persistent hyperglycemia are deleterious to older adults with T2DM, and both conditions should be avoided when determining therapeutic goals; 3) recently developed guidelines emphasize the avoidance of hypoglycemic episodes in older people, even in the absence of symptoms. In addition, we raise the concern of glycemic variability, and discuss the rationale for the selection of current options in managing this patient population. PMID:25429208

  17. MULTIPOLLUTANT EMISSION CONTROL TECHNOLOGY OPTIONS FOR COAL-FIRED POWER PLANTS

    EPA Science Inventory

    The report presents and analyzes various existing and novel control technologies designed to achieve multipollutant [sulfur dioxide (SO2), nitrogen oxide (NOX), and mercury (Hg)] emission reductions. Summary descriptions are included of 23 multipollutant control technologies that...

  18. ALTERNATE VOC CONTROL TECHNIQUE OPTIONS FOR SMALL ROTOGRAVURE AND FLEXOGRAPHY FACILITIES

    EPA Science Inventory

    The report identifies Available Control Techniques (ACTs) for states to use as a referenec when implementing Reasonable Available Control Technilogy (RACT) for graphic arts facilities that are covered by the Control Technologies Guidelines (CTGs), but emit less than 91 tonnes of ...

  19. Arms Control and nonproliferation technologies: Technology options and associated measures for monitoring a Comprehensive Test Ban, Second quarter

    SciTech Connect

    Casey, Leslie A.

    1994-01-01

    This newsletter contains reprinted papers discussing technology options and associated measures for monitoring a Comprehensive Test Ban Treaty (CTBT). These papers were presented to the Conference on Disarmament (CD) in May and June 1994. An interagency Verification Monitoring Task Force developed the papers. The task force included participants from the Arms Control and Disarmament Agency, the Department of Defense, the Department of Energy, the Intelligence Community, the Department of Interior, and the Department of State. The purpose of this edition of Arms Control and Nonproliferation Technologies is to share these papers with the broad base of stakeholders in a CTBT and to facilitate future technology discussions. The papers in the first group discuss possible technology options for monitoring a CTBT in all environments (underground, underwater, atmosphere, and space). These technologies, along with on-site inspections, would facilitate CTBT monitoring by treaty participants. The papers in the second group present possible associated measures, e.g., information exchanges and transparency measures, that would build confidence among states participating in a CTBT.

  20. Rehabilitation Options

    MedlinePlus

    ... Speech Pathology Occupational Therapy Art Therapy Recreational therapy Neuropsychology Home Care Options Advanced Care Planning Palliative Care ... Speech Pathology Occupational Therapy Art Therapy Recreational therapy Neuropsychology Home Care Options Advanced Care Planning Palliative Care ...

  1. Number of options in a movement sequence affects learners' behavior in a self-controlled practice condition.

    PubMed

    Bastos, Flavio Henrique; Tani, Go; de Araujo, Ulysses Okada; Walter, Cinthya; Freudenheim, Andrea Michele

    2010-10-01

    Self-controlling practice implies a process of decision making, which suggests that the options in a self-controlled practice condition could affect learners. The number of task components with no fixed position in a movement sequence may affect the way learners self-control their practice. A 200-cm coincident timing track with 90 light-emitting diodes (LEDs)--the first and the last LEDs being the warning and the target lights, respectively--was set so that the apparent speed of the light along the track was 1.33 m/sec. Participants were required to touch six sensors sequentially, the last one coincidently with the lighting of the target light (timing task). Group 1 (n = 55) had only one constraint, and were instructed to touch the sensors in any order, except for the last sensor which had to be the one positioned close to the target light. Group 2 (n = 53) had three constraints: the first two and the last sensor to be touched. Both groups practiced the task until timing error was less than 30 msec. on three consecutive trials. There were no statistically significant differences between groups in the number of trials needed to reach the performance criterion, but (a) participants in Group 2 created fewer sequences compared to Group 1, and (b) were more likely to use the same sequence throughout the learning process. The number of options for a movement sequence affected the way learners self-controlled their practice, but had no effect on the amount of practice to reach criterion performance.

  2. Pricing Options.

    ERIC Educational Resources Information Center

    Tenopir, Carol

    1998-01-01

    Presents results of a recent survey of over 100 public and academic libraries about pricing options from online companies. Most options fall into three categories: pay-as-you-go, fixed-rate, and user-based. Results are discussed separately for public and academic libraries and for consortial discounts. Trends in pricing options preferred by…

  3. Metabolic and other effects of pioglitazone as an add-on therapy to metformin in the treatment of polycystic ovary syndrome (PCOS).

    PubMed

    Valsamakis, Georgios; Lois, Kostas; Kumar, Sudhesh; Mastorakos, George

    2013-01-01

    Insulin resistance is a key pathogenic defect of the clustered metabolic disturbances seen in polycystic ovary syndrome (PCOS). Metformin is an insulin sensitizer acting in the liver and the peripheral tissues that ameliorates the metabolic and reproductive defects in PCOS. In addition, pioglitazone is an insulin sensitizer used in diabetes mellitus type 2 (T2DM), improving insulin resistance (IR) in adipose tissue and muscles. In T2DM, these drugs are also used as a combined treatment due to their "add-on effect" on insulin resistance. Although the beneficial role of troglitazone (a member of the thiazolidinediones (TZDs) family) in PCOS has been shown in the past, currently only pioglitazone is available in the market. A few small randomized controlled trials have directly compared the effectiveness of pioglitazone in women with PCOS, while there are a limited number of small studies that support the beneficial metabolic add-on effect of pioglitazone on metformin-treated PCOS women as compared to metformin or pioglitazone monotherapy. These findings suggest a potentially promising role for combined pioglitazone/metformin treatment in the management of PCOS in metformin-resistant patients. In view of recent concerns regarding pioglitazone usage and its associated health risk, we aim to compare the pros and cons of each drug regarding their metabolic and other hormonal effects in women with PCOS and to explore the possible beneficial effect of combined therapy in certain cases, taking into consideration the teratogenic effect of pioglitazone. Finally, we discuss the need for a randomized controlled trial that will evaluate the metabolic and other hormonal effects of combined metformin/pioglitazone treatment in PCOS with selective treatment targets.

  4. Technical Highlight: Evaluation of Humidity Control Options in Hot-Humid Climate Homes

    SciTech Connect

    none,

    2011-12-01

    This technical highlight describes NREL research to analyze the indoor relative humidity in three home types in the hot-humid climate zone, and examine the impacts of various dehumidification equipment and controls.

  5. Optimising and Communicating Options for the Control of Invasive Plant Disease When There Is Epidemiological Uncertainty

    PubMed Central

    Cunniffe, Nik J.; Stutt, Richard O. J. H.; DeSimone, R. Erik; Gottwald, Tim R.; Gilligan, Christopher A.

    2015-01-01

    Although local eradication is routinely attempted following introduction of disease into a new region, failure is commonplace. Epidemiological principles governing the design of successful control are not well-understood. We analyse factors underlying the effectiveness of reactive eradication of localised outbreaks of invading plant disease, using citrus canker in Florida as a case study, although our results are largely generic, and apply to other plant pathogens (as we show via our second case study, citrus greening). We demonstrate how to optimise control via removal of hosts surrounding detected infection (i.e. localised culling) using a spatially-explicit, stochastic epidemiological model. We show how to define optimal culling strategies that take account of stochasticity in disease spread, and how the effectiveness of disease control depends on epidemiological parameters determining pathogen infectivity, symptom emergence and spread, the initial level of infection, and the logistics and implementation of detection and control. We also consider how optimal culling strategies are conditioned on the levels of risk acceptance/aversion of decision makers, and show how to extend the analyses to account for potential larger-scale impacts of a small-scale outbreak. Control of local outbreaks by culling can be very effective, particularly when started quickly, but the optimum strategy and its performance are strongly dependent on epidemiological parameters (particularly those controlling dispersal and the extent of any cryptic infection, i.e. infectious hosts prior to symptoms), the logistics of detection and control, and the level of local and global risk that is deemed to be acceptable. A version of the model we developed to illustrate our methodology and results to an audience of stakeholders, including policy makers, regulators and growers, is available online as an interactive, user-friendly interface at http://www.webidemics.com/. This version of our model

  6. Options for control of foot-and-mouth disease: knowledge, capability and policy

    PubMed Central

    Paton, David J.; Sumption, Keith J.; Charleston, Bryan

    2009-01-01

    Foot-and-mouth disease can be controlled by zoo-sanitary measures and vaccination but this is difficult owing to the existence of multiple serotypes of the causative virus, multiple host species including wildlife and extreme contagiousness. Although intolerable to modern high-production livestock systems, the disease is not usually fatal and often not a priority for control in many developing countries, which remain reservoirs for viral dissemination. Phylogenetic analysis of the viruses circulating worldwide reveals seven principal reservoirs, each requiring a tailored regional control strategy. Considerable trade benefits accrue to countries that eradicate the disease but as well as requiring regional cooperation, achieving and maintaining this status using current tools takes a great deal of time, money and effort. Therefore, a progressive approach is needed that can provide interim benefits along the pathway to final eradication. Research is needed to understand and predict the patterns of viral persistence and emergence and to improve vaccine selection. Better diagnostic methods and especially better vaccines could significantly improve control in both the free and the affected parts of the world. In particular, vaccines with improved thermostability and a longer duration of immunity would facilitate control and make it less reliant on advanced veterinary infrastructures. PMID:19687036

  7. Fluid Power Multi-actuator Circuit Board with Microcomputer Control Option.

    ERIC Educational Resources Information Center

    McKechnie, R. E.; Vickers, G. W.

    1981-01-01

    Describes a portable fluid power engineering laboratory and class demonstration apparatus designed to enable students to design, build, and test multi-actuator circuits. Features a variety of standard pneumatic values and actuators fitted with quick disconnect couplings. Discusses sequencing circuit boards, microcomputer control, cost, and…

  8. Evaluating the Collaborative Strategic Reading Intervention: An Overview of Randomized Controlled Trial Options

    ERIC Educational Resources Information Center

    Hitchcock, John H.; Kurki, Anja; Wilkins, Chuck; Dimino, Joseph; Gersten, Russell

    2009-01-01

    When attempting to determine if an intervention has a causal impact, the "gold standard" of program evaluation is the randomized controlled trial (RCT). In education studies random assignment is rarely feasible at the student level, making RCTs harder to conduct. School-level assignment is more common but this often requires considerable resources…

  9. Baseline Serum Aldosterone-to-Renin Ratio is Associated with the Add-on Effect of Thiazide Diuretics in Non-Diabetic Essential Hypertensives

    PubMed Central

    Huang, Chin-Chou; Leu, Hsin-Bang; Huang, Po-Hsun; Wu, Tao-Cheng; Lin, Shing-Jong; Chen, Jaw-Wen

    2013-01-01

    Background The baseline status of renin-angiotensin-aldosterone system (RAAS) might modify the blood pressure (BP) lowering effects of thiazide diuretics. This study aimed to determine if baseline RAAS indicated by serum aldosterone-to-renin ratio (ARR) could be associated with the add-on effects of thiazide on BP lowering in patients with other concomitant antihypertensive medication. Methods Non-diabetic hypertensive patients, either untreated or unsatisfactorily treated, were enrolled if their office systolic BP was ≥ 140 or diastolic BP ≥ 90 mmHg. After 2 weeks of diet control and lifestyle modification, patients with persistently elevated BP were prospectively given hydrochlorothiazide 50 mg daily for 2 weeks. Serum aldosterone-to-renin ratio (ARR) was determined before thiazide treatment. Patients with a significant (≥ 10%) reduction of office mean artery pressure (MAP) by thiazide treatment were defined as responders. Results Among the 66 patients studied, 27 were defined as responders after a 2-week hydrochlorothiazide treatment. Baseline serum renin level was reduced and ARR increased (p = 0.009) in the responders as compared with the non-responders. A similar pattern was also apparent in patients with or without concomitant medications. Furthermore, baseline renin level was inversely and ARR positively correlated to the MAP reduction both in the whole patient group and in patients with concomitant medications. By stepwise multiple linear regression analysis, ARR was the only independent predictor for the response to thiazide treatment (β = 0.051, p = 0.007). Conclusions Baseline ARR could be associated with the add-on effects of hydrochlorothiazide on BP reduction in patients with other concomitant antihypertensive treatment. PMID:27122683

  10. Epidemiology and detection as options for control of viral and parasitic foodborne disease.

    PubMed Central

    Jaykus, L. A.

    1997-01-01

    Human enteric viruses and protozoal parasites are important causes of emerging food and waterborne disease. Epidemiologic investigation and detection of the agents in clinical, food, and water specimens, which are traditionally used to establish the cause of disease outbreaks, are either cumbersome, expensive, and frequently unavailable or unattempted for the important food and waterborne enteric viruses and protozoa. However, the recent introduction of regulatory testing mandates, alternative testing strategies, and increased epidemiologic surveillance for food and waterborne disease should significantly improve the ability to detect and control these agents. We discuss new methods of investigating foodborne viral and parasitic disease and the future of these methods in recognizing, identifying, and controlling disease agents. PMID:9366607

  11. Estimating the costs of tsetse control options: an example for Uganda.

    PubMed

    Shaw, A P M; Torr, S J; Waiswa, C; Cecchi, G; Wint, G R W; Mattioli, R C; Robinson, T P

    2013-07-01

    Decision-making and financial planning for tsetse control is complex, with a particularly wide range of choices to be made on location, timing, strategy and methods. This paper presents full cost estimates for eliminating or continuously controlling tsetse in a hypothetical area of 10,000km(2) located in south-eastern Uganda. Four tsetse control techniques were analysed: (i) artificial baits (insecticide-treated traps/targets), (ii) insecticide-treated cattle (ITC), (iii) aerial spraying using the sequential aerosol technique (SAT) and (iv) the addition of the sterile insect technique (SIT) to the insecticide-based methods (i-iii). For the creation of fly-free zones and using a 10% discount rate, the field costs per km(2) came to US$283 for traps (4 traps per km(2)), US$30 for ITC (5 treated cattle per km(2) using restricted application), US$380 for SAT and US$758 for adding SIT. The inclusion of entomological and other preliminary studies plus administrative overheads adds substantially to the overall cost, so that the total costs become US$482 for traps, US$220 for ITC, US$552 for SAT and US$993 - 1365 if SIT is added following suppression using another method. These basic costs would apply to trouble-free operations dealing with isolated tsetse populations. Estimates were also made for non-isolated populations, allowing for a barrier covering 10% of the intervention area, maintained for 3 years. Where traps were used as a barrier, the total cost of elimination increased by between 29% and 57% and for ITC barriers the increase was between 12% and 30%. In the case of continuous tsetse control operations, costs were estimated over a 20-year period and discounted at 10%. Total costs per km(2) came to US$368 for ITC, US$2114 for traps, all deployed continuously, and US$2442 for SAT applied at 3-year intervals. The lower costs compared favourably with the regular treatment of cattle with prophylactic trypanocides (US$3862 per km(2) assuming four doses per annum at 45

  12. So many options, so little control: abstract representations can reduce selection demands to increase children's self-directed flexibility.

    PubMed

    Snyder, Hannah R; Munakata, Yuko

    2013-11-01

    Children often struggle to behave flexibly when they must use self-directed goals (e.g., doing homework without prompting) rather than externally driven goals (e.g., cleaning up when told). Such struggles may reflect the demands of selecting among many potential options, as required for self-directed control. The current study tested whether (a) 6-year-old children show difficulty in selecting among competing semantic representations, (b) providing category labels designed to reduce selection demands improves performance, and (c) such benefits transfer to self-directed flexibility. Selection was measured using the blocked cyclic naming task for the first time with children. Pictures were named repeatedly in either homogeneous blocks from the same category (e.g., all animals), which create high selection demands due to spreading semantic activation and engage effortful cognitive control, or mixed blocks with each picture from a different category. Children showed robust difficulty in selecting among options, as indexed by response time (RT) differences between homogeneous and mixed blocks. Providing subcategory labels designed to reduce selection demands by distinguishing among same-category items (e.g., "A cow is a farm animal. A cat is a pet.") improved selection. Providing superordinate categories (e.g., "A cow is an animal. A cat is an animal.") also improved selection, but these benefits were less robust, and subcategory labels led to greater benefits than superordinate category labels on a subsequent verbal fluency task. These results support a role for subcategory representations in reducing selection demands to aid self-directed flexibility while suggesting that some children may use superordinate category labels to activate subcategory representations on their own. PMID:23998951

  13. Effect of add-on valproate on craving in methamphetamine depended patients: A randomized trial

    PubMed Central

    Kheirabadi, Gholam Reza; Ghavami, Masoud; Maracy, Mohammad Reza; Salehi, Mehrdad; Sharbafchi, Mohammad Reza

    2016-01-01

    Background: Methamphetamine dependence lead to the compulsive use, loss of control, and social and occupational dysfunctions. This study aimed to compare the effect of valproate in reducing the craving in methamphetamine dependents. Materials and Methods: This is a randomized, double-blind, controlled clinical trial on 40 men of 18–40 years old referred to Noor Hospital during December 2012–September 2013 in Isfahan, Iran. The subjects participated in matrix program and randomly were divided into two groups of valproate and placebo. A 4-months program of intervention with valproate or placebo was arranged for each group. The rate of craving to methamphetamine and positive methamphetamine urine tests were evaluated in both groups every 2 weeks using cocaine craving questionnaire-brief (CCQ-Brief) and urine test. After the 4 months (active treatment with valproate and placebo), the drug was tapered and discontinued within 10 days, and patients were introduced to self-help groups and monitored regularly on a weekly basis over another 3 months. Collected data were analyzed with SPSS 20 using analysis of covariance repeated measure, Chi-square, and t-test. Results: CCQ score of the intervention group was significantly less than the placebo group (P < 0.001), except on weeks 1, 3, and 28. The ratio of a positive urine test for methamphetamine in the intervention group was significantly lower than the control group in all screenings except weeks 3 and 28. Conclusion: Adding valproate to matrix program in the treatment of methamphetamine dependence showed significant effect on the reduction of the craving to methamphetamine.

  14. Effect of add-on valproate on craving in methamphetamine depended patients: A randomized trial

    PubMed Central

    Kheirabadi, Gholam Reza; Ghavami, Masoud; Maracy, Mohammad Reza; Salehi, Mehrdad; Sharbafchi, Mohammad Reza

    2016-01-01

    Background: Methamphetamine dependence lead to the compulsive use, loss of control, and social and occupational dysfunctions. This study aimed to compare the effect of valproate in reducing the craving in methamphetamine dependents. Materials and Methods: This is a randomized, double-blind, controlled clinical trial on 40 men of 18–40 years old referred to Noor Hospital during December 2012–September 2013 in Isfahan, Iran. The subjects participated in matrix program and randomly were divided into two groups of valproate and placebo. A 4-months program of intervention with valproate or placebo was arranged for each group. The rate of craving to methamphetamine and positive methamphetamine urine tests were evaluated in both groups every 2 weeks using cocaine craving questionnaire-brief (CCQ-Brief) and urine test. After the 4 months (active treatment with valproate and placebo), the drug was tapered and discontinued within 10 days, and patients were introduced to self-help groups and monitored regularly on a weekly basis over another 3 months. Collected data were analyzed with SPSS 20 using analysis of covariance repeated measure, Chi-square, and t-test. Results: CCQ score of the intervention group was significantly less than the placebo group (P < 0.001), except on weeks 1, 3, and 28. The ratio of a positive urine test for methamphetamine in the intervention group was significantly lower than the control group in all screenings except weeks 3 and 28. Conclusion: Adding valproate to matrix program in the treatment of methamphetamine dependence showed significant effect on the reduction of the craving to methamphetamine. PMID:27656618

  15. A Mathematical Model that Simulates Control Options for African Swine Fever Virus (ASFV)

    PubMed Central

    Barongo, Mike B.; Bishop, Richard P; Fèvre, Eric M; Knobel, Darryn L; Ssematimba, Amos

    2016-01-01

    A stochastic model designed to simulate transmission dynamics of African swine fever virus (ASFV) in a free-ranging pig population under various intervention scenarios is presented. The model was used to assess the relative impact of the timing of the implementation of different control strategies on disease-related mortality. The implementation of biosecurity measures was simulated through incorporation of a decay function on the transmission rate. The model predicts that biosecurity measures implemented within 14 days of the onset of an epidemic can avert up to 74% of pig deaths due to ASF while hypothetical vaccines that confer 70% immunity when deployed prior to day 14 of the epidemic could avert 65% of pig deaths. When the two control measures are combined, the model predicts that 91% of the pigs that would have otherwise succumbed to the disease if no intervention was implemented would be saved. However, if the combined interventions are delayed (defined as implementation from > 60 days) only 30% of ASF-related deaths would be averted. In the absence of vaccines against ASF, we recommend early implementation of enhanced biosecurity measures. Active surveillance and use of pen-side diagnostic assays, preferably linked to rapid dissemination of this data to veterinary authorities through mobile phone technology platforms are essential for rapid detection and confirmation of ASF outbreaks. This prediction, although it may seem intuitive, rationally confirms the importance of early intervention in managing ASF epidemics. The modelling approach is particularly valuable in that it determines an optimal timing for implementation of interventions in controlling ASF outbreaks. PMID:27391689

  16. A Mathematical Model that Simulates Control Options for African Swine Fever Virus (ASFV).

    PubMed

    Barongo, Mike B; Bishop, Richard P; Fèvre, Eric M; Knobel, Darryn L; Ssematimba, Amos

    2016-01-01

    A stochastic model designed to simulate transmission dynamics of African swine fever virus (ASFV) in a free-ranging pig population under various intervention scenarios is presented. The model was used to assess the relative impact of the timing of the implementation of different control strategies on disease-related mortality. The implementation of biosecurity measures was simulated through incorporation of a decay function on the transmission rate. The model predicts that biosecurity measures implemented within 14 days of the onset of an epidemic can avert up to 74% of pig deaths due to ASF while hypothetical vaccines that confer 70% immunity when deployed prior to day 14 of the epidemic could avert 65% of pig deaths. When the two control measures are combined, the model predicts that 91% of the pigs that would have otherwise succumbed to the disease if no intervention was implemented would be saved. However, if the combined interventions are delayed (defined as implementation from > 60 days) only 30% of ASF-related deaths would be averted. In the absence of vaccines against ASF, we recommend early implementation of enhanced biosecurity measures. Active surveillance and use of pen-side diagnostic assays, preferably linked to rapid dissemination of this data to veterinary authorities through mobile phone technology platforms are essential for rapid detection and confirmation of ASF outbreaks. This prediction, although it may seem intuitive, rationally confirms the importance of early intervention in managing ASF epidemics. The modelling approach is particularly valuable in that it determines an optimal timing for implementation of interventions in controlling ASF outbreaks. PMID:27391689

  17. Evaluation of containment and control options for methyl bromide in commodity treatment. Final report

    SciTech Connect

    DeWolf, G.B.; Harrison, M.R.

    1994-07-01

    Methyl bromide (MeBr), with the chemical formula CH3Br, also called bromomethane, is listed by the 1991 Montreal Protocol as an ozone depleting chemical similar to the other halogenated hydrocarbons such as the chloro-fluorocarbons (CFCs). The U.S. Environmental Protection Agency's (EPA's) regulations authorized by the Clean Air Act (CAA) call for a phaseout of MeBr by the year 2001. MeBr is widely used in United States agriculture as a fumigant. This study has gathered preliminary data that can be used to determine if some of the essential agricultural commodity fumigation applications for MeBr could be continued by the use of some emission control methods on those commodity fumigation applications.

  18. [Extracorporeal shockwave therapy (ESWT) as therapeutic option in supraspinatus tendon syndrome? One year results of a placebo controlled study].

    PubMed

    Schmitt, J; Tosch, A; Hünerkopf, M; Haake, M

    2002-07-01

    Extracorporeal shock wave therapy (ESWT) is seen as a therapeutic option in the treatment of chronic supraspinatus tendinitis by some authors. To test whether ESWT comprising 3 x 2000 pulses with the positive energy flux density ED+ of 0.33 mJ/mm2 is clinically superior to a sham ESWT treatment, a prospective, randomized, single-blinded, placebo-controlled study with an independent observer was performed. Forty patients were treated either by verum ESWT or sham ESWT under local anesthesia. Target criteria were the age-corrected Constant score, pain at rest and during activity on a visual analogue scale, and subjective improvement. Patients who reported no subjective improvement after 12 weeks were deblinded and received verum ESWT if they had belonged to the placebo group (partial crossover). The results of the verum group lie within the range of results for ESWT published by other authors. Patients in the placebo group with local anesthetic showed equally good results. At 12 weeks, and 1 year after intervention, no difference could be found between the verum and placebo groups regarding Constant score, pain, shoulder function, or subjective improvement. The nonresponders to the placebo ESWT continued to show no improvement after receiving verum ESWT. This contradicts a specific ESWT effect. Based on the results of this placebo-controlled study, ESWT appears to have no clinically relevant effect on supraspinatus tendinitis. The study underlines the importance of a control group in evaluating new treatment methods for diseases with unknown natural history.

  19. Antidiabetic Effects of Add-On Gynostemma pentaphyllum Extract Therapy with Sulfonylureas in Type 2 Diabetic Patients

    PubMed Central

    Huyen, V. T. T.; Phan, D. V.; Thang, P.; Ky, P. T.; Hoa, N. K.; Ostenson, C. G.

    2012-01-01

    Aims. To investigate the antidiabetic effect of the traditional Vietnamese herb Gynostemma pentaphyllum (GP) together with sulfonylurea (SU) in 25 drug-naïve type 2 diabetic patients. Methods. After 4-week treatment with gliclazide (SU), 30 mg daily, all patients were randomly assigned into 2 groups to add on GP extract or placebo extract, 6 g daily, during eight weeks. Results. After 4-week SU treatment, fasting plasma glucose (FPG) and HbA1C decreased significantly (P < 0.001). FPG was further reduced after add-on therapy with 2.9 ± 1.7 and 0.9 ± 0.6 mmol/L in the GP and placebo groups, respectively (P < 0.001). Therapy with GP extract also reduced 30- and 120-minute oral glucose tolerance test postload values. HbA1C levels decreased approximately 2% units in the GP group compared to 0.7% unit in the placebo group (P < 0.001). Conclusion. GP extract in addition to SU offers an alternative to addition of other oral medication to treat type 2 diabetic patients. PMID:23125867

  20. Analysis of the add-on effect of α-glucosidase inhibitor, acarbose in insulin therapy: A pilot study

    PubMed Central

    Li, Feng-Fei; Fu, Li-Yuan; Xu, Xiao-Hua; Su, Xiao-Fei; Wu, Jin-Dan; Ye, Lei; Ma, Jian-Hua

    2016-01-01

    The aim of the present study was to evaluate the add-on effect of acarbose therapy in oxidative stress, and the lipid and inflammatory profiles of patients with type 2 diabetes mellitus (T2DM) treated with insulin. This was an open and unblended study. Patients (n=134) with T2DM (haemoglobin A1c range, 9.0–12.0%) were recruited. After continuous subcutaneous insulin infusion for 7 days for initial rapid correction of hyperglycaemia, a premixed insulin titration period (duration, 4–6 days) subsequently followed. Patients were then randomized (1:1) into two groups as follows: An acarbose plus pre-mixed 30/70 insulin group or a pre-mixed 30/70 insulin only group; each group received treatment for 2 weeks. Plasma high-sensitivity C-reactive protein (Hs-CRP), 8-iso-prostaglandin F2α (8-iso PGF2α), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6 levels were measured before and after therapy. Patients that received acarbose plus insulin demonstrated greater reduction in 8-iso PGF2α, Hs-CRP, TNF-α, IL-1β and IL-6 levels when compared with the insulin only patients. Thus, acarbose add-on insulin therapy was identified to be associated with greater improvements in oxidative stress and inflammation in patients with T2DM when compared with those that received insulin only therapy.

  1. Cost-effective particulate control options at Potomac Electric Power Company's Dickerson Station: An integrated approach to current and future particulate limits

    SciTech Connect

    Christoffersen, S.W.; Rouse, G.T.; Krasnopoler, M.J.; Chapowski, J.A.

    1998-07-01

    The Dickerson Generating Station evaluated several particulate control options to identify the most cost-effective option. The study's goals were to: eliminate the particulate scrubber and its high maintenance costs, and incorporate flexibility for low-sulfur coal and possible stricter emission limits. Each of the three Dickerson 190 MW units has a small 37-year-old electrostatic precipitator and a wet particulate scrubber. The study evaluated alternatives to replace the scrubber and enhance ESP performance: Existing ESP alternatives--Extend height of existing ESP; Flue gas conditioning. Scrubber stream alternatives--Partial-flow ESP or pulse jet baghouse. Full-flow alternatives--Supplemental ESP; COHPAC baghouse; replacement ESP or baghouse. A technical and economic prescreening eliminated some of the options. Capital, operating, and life cycle costs were estimated for the remaining options to determine the most cost-effective alternative. This paper will present the technical and economic evaluations done for this study, including performance and costs.

  2. A Review of the Invasive Mosquitoes in Europe: Ecology, Public Health Risks, and Control Options

    PubMed Central

    Hansford, Kayleigh M.; Schaffner, Francis; Versteirt, Veerle; Hendrickx, Guy; Zeller, Herve; Bortel, Wim Van

    2012-01-01

    Abstract There has been growing interest in Europe in recent years in the establishment and spread of invasive mosquitoes, notably the incursion of Aedes albopictus through the international trade in used tires and lucky bamboo, with onward spread within Europe through ground transport. More recently, five other non-European aedine mosquito species have been found in Europe, and in some cases populations have established locally and are spreading. Concerns have been raised about the involvement of these mosquito species in transmission cycles of pathogens of public health importance, and these concerns were borne out following the outbreak of chikungunya fever in Italy in 2007, and subsequent autochthonous cases of dengue fever in France and Croatia in 2010. This article reviews current understanding of all exotic (five introduced invasive and one intercepted) aedine species in Europe, highlighting the known import pathways, biotic and abiotic constraints for establishment, control strategies, and public health significance, and encourages Europe-wide surveillance for invasive mosquitoes. PMID:22448724

  3. Dissolved Oxygen Dynamics in Coastal Pacific Northwest Rivers: Biological Controls and Management Options

    NASA Astrophysics Data System (ADS)

    Sobota, D. J.; Foster, E.; Michie, R.; Waltz, D.

    2014-12-01

    In Oregon's Central Coast Range (OCR), dissolved O2 concentrations in at least 10% of stream length frequently dip below state standards set to ensure survival and reproduction of native salmonids. We examined O2 dynamics on 12 OCR rivers during times of the year when standards had been violated. Continuous dissolved O2 data were collected 15 minutes apart over a 24-hour period during spring (May - June) or fall (September - November) 2008 on each river. We modeled O2 dynamics for each river with parameters describing O2 exchange with the atmosphere, production of O2 from gross primary production (GPP), and consumption of O2 by ecosystem respiration (ER) fit to observed data. Average nighttime atmospheric O2 exchange and ER were estimated by regressing interval changes in dissolved O2 concentrations between measurements with corresponding O2 saturation deficits. GPP for each daytime sampling interval was calculated as the difference between O2 saturation deficit and the sum of temperature-corrected reaeration and ecosystem respiration. All regression models developed for estimating night-time reaeration and ER were highly significant (p<0.03; adjusted r2=0.17 - 0.77). GPP ranged from 0.62 to 14.95 mg O2 L-1 d-1, ER ranged from -1.21 mg O2 L-1 d-1, and net daily metabolism (NDM; net O2 flux controlled by biological processes) ranged from -11.64 to 3.75 mg O2 L-1 d-1 across all rivers and seasons. Increased aquatic productivity resulting from adjacent and upstream human activities likely altered dissolved O2 dynamics in these rivers. Through scenario analysis, we found that at one river (Alsea), GPP and ER would need to be reduced by 85 and 73%, respectively, to meet the state standard (95% saturation). Our modeling approach can be connected with management actions across a variety of spatial and temporal scales, ranging from local, riparian-scale manipulations of shading and organic matter input to watershed and regional nutrient and temperature management.

  4. Globes from global data: Charting international research networks with the GRASS GIS r.out.polycones add-on module.

    NASA Astrophysics Data System (ADS)

    Löwe, Peter

    2015-04-01

    Many Free and Open Source Software (FOSS) tools have been created for the various application fields within geoscience. While FOSS allows re-implementation of functionalities in new environments by access to the original codebase, the easiest approach to build new software solutions for new problems is the combination or merging of existing software tools. Such mash-ups are implemented by embedding and encapsulating FOSS tools within each another, effectively focusing the use of the embedded software to the specific role it needs to perform in the given scenario, while ignoring all its other capabilities. GRASS GIS is a powerful and established FOSS GIS for raster, vector and volume data processing while the Generic Mapping Tools (GMT) are a suite of powerful Open Source mapping tools, which exceed the mapping capabilities of GRASS GIS. This poster reports on the new GRASS GIS add-on module r.out.polycones. It enables users to utilize non-continuous projections for map production within the GRASS production environment. This is implemented on the software level by encapsulating a subset of GMT mapping capabilities into a GRASS GIS (Version 6.x) add-on module. The module was developed at the German National Library of Science and Technology (TIB) to provide custom global maps of scientific collaboration networks, such as the DataCite consortium, the registration agency for Digital Object Identifiers (DOI) for research data. The GRASS GIS add-on module can be used for global mapping of raster data into a variety of non continuous sinosoidal projections, allowing the creation of printable biangles (gores) to be used for globe making. Due to the well structured modular nature of GRASS modules, technical follow-up work will focus on API-level Python-based integration in GRASS 7 [1]. Based on this, GMT based mapping capabilities in GRASS will be extended beyond non-continuous sinosoidal maps and advanced from raster-layers to content GRASS display monitors. References

  5. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below.... Measuring the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle according to § 63.3168(d); andii. Maintaining the total regeneration desorbing gas mass flow at...

  6. 40 CFR 63.3166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) through (5) of this section. (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to... to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part 60, as appropriate, for gas analysis to determine dry molecular...

  7. 40 CFR 63.3166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) of this section. (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to select... CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part 60, as appropriate, for gas analysis to determine dry molecular weight. The...

  8. 40 CFR 63.3166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) through (5) of this section. (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to... to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part 60, as appropriate, for gas analysis to determine dry molecular...

  9. 40 CFR 63.3166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) through (5) of this section. (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to... to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part 60, as appropriate, for gas analysis to determine dry molecular...

  10. 40 CFR 63.3166 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) of this section. (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to select... CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part 60, as appropriate, for gas analysis to determine dry molecular weight. The...

  11. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... the catalyst bed in any 3-hour block period must not fall below the limit established according to... data to 3-hour block averages; and iii. maintaining the 3-hour block average catalyst bed inlet... catalyst bed in any 3-hour block period does not fall below the temperature difference limit...

  12. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the catalyst bed in any 3-hour block period must not fall below the limit established according to... data to 3-hour block averages; and iii. maintaining the 3-hour block average catalyst bed inlet... catalyst bed in any 3-hour block period does not fall below the temperature difference limit...

  13. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... catalyst bed in any 3-hour period must not fall below the combustion temperature limit established according to § 63.3360(e)(3)(ii) i. Collecting the catalyst bed inlet temperature data according to § 63... catalyst bed inlet temperature at or above the temperature limit. b. The temperature rise across...

  14. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... before the catalyst bed in any 3-hour period must not fall below the limit established according to § 63... catalyst bed at or above the temperature limit. b. ensure that the average temperature difference across the catalyst bed in any 3-hour period does not fall below the temperature difference limit...

  15. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... catalyst bed in any 3-hour period must not fall below the combustion temperature limit established according to § 63.3360(e)(3)(ii) i. Collecting the catalyst bed inlet temperature data according to § 63... catalyst bed inlet temperature at or above the temperature limit. b. The temperature rise across...

  16. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... before the catalyst bed in any 3-hour period must not fall below the limit established according to § 63... catalyst bed at or above the temperature limit. b. ensure that the average temperature difference across the catalyst bed in any 3-hour period does not fall below the temperature difference limit...

  17. 40 CFR Table 1 to Subpart Ssss of... - Operating Limits if Using Add-on Control Devices and Capture System

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... before the catalyst bed in any 3-hour period must not fall below the limit established according to § 63... catalyst bed at or above the temperature limit. b. ensure that the average temperature difference across the catalyst bed in any 3-hour period does not fall below the temperature difference limit...

  18. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below... cycle according to § 63.3168(d); andii. Maintaining the total regeneration desorbing gas mass flow at or... any cooling cycle must not exceed the carbon bed temperature limit established according to §...

  19. 40 CFR Table 1 to Subpart IIIi of... - Operating Limits for Capture Systems and Add-On Control Devices

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... desorbing gas (e.g., steam or nitrogen) mass flow for each carbon bed regeneration cycle must not fall below... cycle according to § 63.3168(d); andii. Maintaining the total regeneration desorbing gas mass flow at or... any cooling cycle must not exceed the carbon bed temperature limit established according to §...

  20. 40 CFR 63.9323 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to select sampling sites and velocity traverse points. (2) Use Method 2, 2A, 2C, 2D, 2F, or 2G of appendix A to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part...

  1. 40 CFR 63.9323 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to select sampling sites and velocity traverse points. (2) Use Method 2, 2A, 2C, 2D, 2F, or 2G of appendix A to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part...

  2. 40 CFR 63.9323 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... (1) Use Method 1 or 1A of appendix A to 40 CFR part 60, as appropriate, to select sampling sites and velocity traverse points. (2) Use Method 2, 2A, 2C, 2D, 2F, or 2G of appendix A to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part...

  3. 40 CFR Table 2 to Subpart Oooo of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the catalyst bed in any 3-hour block period must not fall below the limit established according to... data to 3-hour block averages; and iii. maintaining the 3-hour block average catalyst bed inlet... catalyst bed in any 3-hour block period does not fall below the temperature difference limit...

  4. 40 CFR Table 1 to Subpart Jjjj of... - Operating Limits if Using Add-On Control Devices and Capture System

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... Catalytic oxidizer a. The average temperature at the inlet to the catalyst bed in any 3-hour period must not... the catalyst bed inlet temperature data according to § 63.3350(e)(9);ii. Reducing the data to 3-hour block averages; and iii. Maintain the 3-hour average catalyst bed inlet temperature at or above...

  5. 40 CFR 63.3966 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 1A of appendix A to 40 CFR part 60, as appropriate, to select sampling sites and velocity traverse points. (2) Use Method 2, 2A, 2C, 2D, 2F, or 2G of appendix A to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part 60,...

  6. 40 CFR 63.3966 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 1A of appendix A to 40 CFR part 60, as appropriate, to select sampling sites and velocity traverse points. (2) Use Method 2, 2A, 2C, 2D, 2F, or 2G of appendix A to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part 60,...

  7. 40 CFR 63.3966 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 1A of appendix A to 40 CFR part 60, as appropriate, to select sampling sites and velocity traverse points. (2) Use Method 2, 2A, 2C, 2D, 2F, or 2G of appendix A to 40 CFR part 60, as appropriate, to measure gas volumetric flow rate. (3) Use Method 3, 3A, or 3B of appendix A to 40 CFR part 60,...

  8. 40 CFR 63.4766 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME PTC 19.10-1981, “Flue and Exhaust... device emission destruction or removal efficiency? 63.4766 Section 63.4766 Protection of Environment... removal efficiency? You must use the procedures and test methods in this section to determine the...

  9. 40 CFR 63.4766 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME PTC 19.10-1981, “Flue and Exhaust... device emission destruction or removal efficiency? 63.4766 Section 63.4766 Protection of Environment... removal efficiency? You must use the procedures and test methods in this section to determine the...

  10. 40 CFR 63.4766 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., carbon dioxide, and carbon monoxide content of exhaust gas in ANSI/ASME PTC 19.10-1981, “Flue and Exhaust... device emission destruction or removal efficiency? 63.4766 Section 63.4766 Protection of Environment... removal efficiency? You must use the procedures and test methods in this section to determine the...

  11. Laboratory tests on an aircraft fuselage to determine the insertion loss of various acoustic add-on treatments

    NASA Technical Reports Server (NTRS)

    Heitman, K. E.; Mixson, J. S.

    1984-01-01

    This paper describes a laboratory study of add-on acoustic treatments for a propeller-driven light aircraft fuselage. The treatments included: no treatment (i.e., baseline fuselage); a production-type double-wall interior; and various amounts of high density fiberglass added to the baseline fuselage. The sound source was a pneumatic-driver with attached exponential horn, supplied with a broadband signal. Data were acquired at the approximate head positions of the six passenger seats. The results were analyzed on space-averaged narrowband, one-third octave band and overall insertion loss basis. In addition, insertion loss results for the different configurations at specific frequencies representing propeller tone spectra are presented. The propeller tone data includes not only the space-averaged insertion loss, but also the variation of insertion loss at these particular frequencies across the six microphone positions.

  12. The Effects of Pycnogenol® as Add-on Drug to Metformin Therapy in Diabetic Rats.

    PubMed

    Jankyova, Stanislava; Rubintova, Dominika; Janosikova, Lenka; Panek, Peter; Foltanova, Tatiana; Kralova, Eva

    2016-08-01

    The progression of diabetes mellitus leads in time to the development of serious cardiovascular complications. Pycnogenol® (PYC) belongs to strong antioxidants that may interfere with different pathways playing an important role in diseases associated with oxidative stress. Metformin (MET), commonly used antidiabetic drug, has cardio-protective effects via activation of AMP kinase (AMPK). In our study, we examined the effects of PYC as add-on drug to metformin therapy in streptozotocin (STZ)-induced diabetic rats. Our results revealed that both used agents, PYC and MET, showed improvement of blood glucose levels, vascular reactivity, left ventricular hypertrophy, expression of AMPK, glucose transporter 4 (GLUT4) and calcium/calmodulin-dependent protein kinase II (CaMKII) in left ventricle of the hearts. However, the combination of these interventions has failed to possess higher efficacy. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27170051

  13. Combining controlled-vocabulary and free-text search options in order to enhance the retrieval of metadata for access to environmental data

    SciTech Connect

    Vogel, R.L.; Northcutt, R.T.

    1997-08-01

    NASA`s Global Change Master Directory (GCMD) is an online service which assists the scientific community in the discovery of and linkage to environmental data. The GCMD consists of a relational database with over 3600 descriptions of data from over 650 data centers worldwide. Over 35% of the data descriptions are related to marine and coastal environments, representing both remotely-sensed and in-situ data. In addition to oceanography, the GCMD features data descriptions in meteorology, ecology, hydrology and geology, thereby facilitating interdisciplinary searches for data. Two search interfaces allow users to retrieve the descriptions: one uses controlled vocabulary, the other permits the input of free-text. The offering of search options presents the opportunity to test user preferences and search successes. For one month in which user accesses were analyzed, users retrieved information more often using the free-text search option than with the controlled search option.

  14. Treatment of infectious waste: development and testing of an add-on set for used gravity displacement autoclaves.

    PubMed

    Stolze, René; Kühling, Jan-Gerd

    2009-06-01

    The safe management of potentially infectious healthcare waste is gaining increasing worldwide importance. In developing countries, simple incinerators are used for the treatment of this type of waste stream. However, as these incinerators produce high emissions and represent the main generators of dioxin and furans in these countries, alternative and cost-effective solutions are needed. As steam treatment systems do not produce persistent organic pollutants, the use of existing (older) medical autoclaves could represent a solution for the treatment of infectious waste. ETLog Health EnviroTech & Logistics, the German-based consulting and engineering company carried out the first research into whether gravity air displacement autoclaves can be used for the safe decontamination of infectious waste. The research showed that it is not possible to decontaminate waste using this type of autoclave. A subsequent research and development phase might, however, make it possible to develop a new process cycle. Tests carried out on the basis of international standards and norms showed that by applying this process cycle and using an add-on set, it is possible to treat healthcare waste using the existing stock of older medical autoclaves. The process cycle and the add-on set developed were tested under existing conditions in Hanoi, Vietnam using the treatment cycle developed for a 13-year-old autoclave. All the parameters for infectious waste decontamination were reached. As modified autoclaves prevent the emission of toxic substances, this approach presents an interim solution, which avoids the impacts on human health and the environment caused by the incineration of healthcare waste.

  15. Long-term safety and tolerability of saxagliptin add-on therapy in older patients (aged ≥65 years) with type 2 diabetes

    PubMed Central

    Iqbal, Nayyar; Allen, Elsie; Öhman, Peter

    2014-01-01

    Background Treatment decisions for older patients with type 2 diabetes mellitus must balance glycemic control and adverse event risk. The objective of this study was to evaluate the long-term safety and tolerability of saxagliptin 5 mg as add-on therapy to common antihyperglycemic drugs in patients aged ≥65 years and <65 years. Methods Pooled adverse event data from three placebo-controlled trials of 76–206 weeks’ duration in older (≥65 years) and younger (<65 years) patients receiving saxagliptin 5 mg or matching placebo added to metformin, glyburide, or a thiazolidinedione were analyzed. Measurements were calculated from day of first dose to specified event or last dose and included time at risk for adverse events, treatment-related adverse events, serious adverse events, adverse events leading to discontinuation, and events of special interest. Weighted incidence rates (number of events/total time) and incidence rate ratios (saxagliptin/placebo) with 95% confidence intervals were calculated (Mantel-Haenszel test). Results A total of 205 older (mean age 69 years; saxagliptin, n=99; placebo, n=106) and 1,055 younger (mean age 52 years; saxagliptin, n=531; placebo, n=524) patients were assessed. Regardless of age category, the adverse event incidence rates were generally similar between treatments, with confidence intervals for incidence rate ratios bridging 1. Treatment-related adverse events occurred in 36 older patients receiving saxagliptin versus 32 receiving placebo (incidence rate 34.1 versus 27.1 per 100 person-years) and in 150 younger patients in both treatment groups (incidence rate 24.0 versus 27.8 per 100 person-years). With saxagliptin versus placebo, serious adverse events occurred in eight versus 14 older (incidence rate 5.7 versus 9.9 per 100 person-years) and 49 versus 44 younger patients (incidence rate 6.5 versus 6.6 per 100 person-years). There were two deaths (one patient ≥65 years) with saxagliptin and six (none aged ≥65 years

  16. Options Week

    ERIC Educational Resources Information Center

    Bornscheuer, Joan H.

    1974-01-01

    Urges the practice of providing optional assignments within the framework of any given course in order to sustain student interest in foreign language learning. Specific lesson plans are provided. (LG)

  17. Should sulfonylureas remain an acceptable first-line add-on to metformin therapy in patients with type 2 diabetes? No, it's time to move on!

    PubMed

    Genuth, Saul

    2015-01-01

    Since their introduction to clinical practice in the 1950s, sulfonylureas have been widely prescribed for use in patients with type 2 diabetes. Of all the other medications currently available for clinical use, only metformin has been used more frequently. However, several new drug classes have emerged that are reported to have equal glucose-lowering efficacy and greater safety when added to treatment of patients in whom metformin monotherapy is no longer sufficient. Moreover, current arguments also suggest that the alternative drugs may be superior to sulfonylureas with regard to the risk of cardiovascular complications. Thus, while there is universal agreement that metformin should remain the first-line pharmacologic therapy for those in whom lifestyle modification is insufficient to control hyperglycemia, there is no consensus as to which drug should be added to metformin. Therefore, given the current controversy, we provide a Point-Counterpoint on this issue. In the preceding point narrative, Dr. Abrahamson provides his argument suggesting that avoiding use of sulfonylureas as a class of medication as an add-on to metformin is not appropriate as there are many patients whose glycemic control would improve with use of these drugs with minimal risk of adverse events. In the counterpoint narrative below, Dr. Genuth suggests there is no longer a need for sulfonylureas to remain a first-line addition to metformin for those patients whose clinical characteristics are appropriate and whose health insurance and/or financial resources make an alternative drug affordable.

  18. GLP1-RA Add-on Therapy in Patients with Type 2 Diabetes Currently on a Bolus Containing Insulin Regimen.

    PubMed

    Davies, Marie L; Pham, David Q; Drab, Scott R

    2016-08-01

    Adding glucagon-like peptide-1 receptor agonists (GLP-1 RAs) to basal insulin regimens has become a guideline-recommended treatment option for uncontrolled type 2 diabetes. However, limited data exist to support the use of GLP-1 RAs with insulin regimens, including bolus insulin in patients with type 2 diabetes. The primary objectives of this review were to identify if the combination of a GLP-1 RA and an insulin regimen containing bolus insulin resulted in improvements in HbA1c , weight loss, reduction in insulin doses, and to evaluate the side effect profile of this combination in terms of nausea and hypoglycemia risk. Eight studies using exenatide twice/day, liraglutide, and dulaglutide were reviewed ranging in average duration of follow-up from 3 to 15 months. Seven studies showed that addition of a GLP-1 RA was associated with significant HbA1c reductions ranging from 0.4% to 1.64% from baseline to follow-up. Patients in all eight studies had significant weight loss in the GLP-1 RA arm from baseline to follow-up ranging from 0.87 to 10.2 kg. In all the studies, total daily bolus insulin doses decreased 25-67% from baseline to follow-up. In some studies, a portion of patients were able to discontinue bolus insulin all together after initiation of a GLP-1 RA. In addition, in two randomized trials included in the review, the GLP-1 RA arm showed significant improvement in HbA1c and weight compared with the control group who received basal/bolus regimens. Nausea was identified in 7-42% of participants using GLP-1 RAs with insulin. Data support the use of GLP-1 RAs added to insulin regimens already containing bolus insulin for glycemic control, weight loss, and reduction or discontinuation of bolus insulin. PMID:27340935

  19. Options in Education, Transcript for November 17, 1975: School Desegregation, School Bus Drivers, and Parental Participation in the Control of Schools.

    ERIC Educational Resources Information Center

    George Washington Univ., Washington, DC. Inst. for Educational Leadership.

    "Options in Education" is a radio news program which focuses on issues and developments in education. This transcript of the show contains discussions of civil rights and school desegregation, learning to drive a school bus, and parental participation in the control of schools. Participants in this part of the program are John Merrow and Wendy…

  20. Effects of Add-On Therapy with NDC-052, an Extract from Magnoliae Flos, in Adult Asthmatic Patients Receiving Inhaled Corticosteroids

    PubMed Central

    Park, Chan Sun; Kim, Tae-Bum; Lee, Jae-Young; Park, Jae Yong; Lee, Yong Chul; Jeong, Seong Su; Lee, Yang Deok; Cho, You Sook

    2012-01-01

    Background/Aims There is a need for new anti-asthmatic medications with fewer side effects. NDC-052, an extract of the medicinal herb Magnoliae flos, which has a long history of clinical use, was recently found to have anti-inflammatory effects. Herein, we evaluated the effects of NDC-052 as an add-on therapy in patients with mild to moderate asthma using inhaled corticosteroids (ICS). Methods In a non-comparative, multi-center trial, 148 patients taking ICS received NDC-052 for eight weeks. We evaluated their forced expiratory volume in one second (FEV1), morning and evening peak expiratory flow rate (AM and PM PEFR), AM/PM asthma symptom scores, visual analogue symptom (VAS) scores, night-time wakening, frequency of short-acting β2-agonist usage, and adverse events. Results After eight weeks, both AM and PM PEFRs were significantly improved. Asthma symptom scores, VAS scores, the frequency of nights without awakening, and the frequency of β2-agonist use were also reduced. Most of the adverse drug reactions were mild and resolved spontaneously. Conclusions The addition of NDC-052 to ICS had a beneficial effect on asthma control in patients with mild to moderate asthma, with good tolerability and fewer side effects. Further studies are necessary to evaluate the effects of NDC-052 in patients with severe and/or refractory asthma. PMID:22403504

  1. Sodium-glucose co-transporter-2 inhibitors as add-on therapy to insulin: rationale and evidences.

    PubMed

    Singh, Awadhesh Kumar; Singh, Ritu

    2016-01-01

    Sodium-glucose co-transporter-2 inhibitors (SGLT-2I) are recently approved class of anti-hyperglycaemic agents for the treatment of type 2 diabetes mellitus (T2DM). SGLT-2I inhibits renal glucose reabsorption, thereby ensuing urinary glucose excretion in a dose-dependent manner. This caloric loss and osmotic diuresis, secondary to increased urinary glucose excretion, has a unique potential to counter insulin induced weight gain and fluid retention, with little potential of hypoglycemic exacerbation. Also, as these agents act independently of insulin secretion or action, they are effective even in long-standing diabetes with depleted β-cell reserve. Improvement in insulin sensitivity, as observed with SGLT-2I can also facilitate insulin action. Furthermore, significant reduction in total daily insulin dosage and reduction of body weight as observed during combination therapy renders SGLT-2I, a near-ideal partner to insulin. This review aims to evaluate the safety and efficacy of currently used SGLT-2I as an add-on to insulin therapy in the treatment of T2DM.

  2. Can intermittent theta burst stimulation as add-on to psychotherapy improve nicotine abstinence? Results from a pilot study.

    PubMed

    Dieler, Alica C; Dresler, Thomas; Joachim, Kathrin; Deckert, Jürgen; Herrmann, Martin J; Fallgatter, Andreas J

    2014-01-01

    Smoking is among the leading causes of mortality worldwide. Discontinuing smoking can increase life expectancy to the presmoking level. Unaided attempts are often ineffective, strengthening the necessity of cognitive-behavioral therapy (CBT), nicotine replacement or pharmacotherapy. Still, relapse rates are high. Recently, a modulation of nicotine craving, which predicts relapse, through transcranial magnetic stimulation to the prefrontal cortex was shown. In a pilot study, we investigated whether 4 sessions of intermittent theta burst stimulation (iTBS) as add-on treatment to CBT reduces nicotine craving and improves long-term abstinence (at 3, 6 and 12 months). Smokers were randomly assigned to a treatment (n = 38) or a sham group (n = 36). Although we did not find reduced craving, we could show higher abstinence rates in the treatment group at 3 months. At 6 and 12 months abstinence rates did not differ significantly. Results at 12 months, however, have to be interpreted cautiously due to significant differences in the dropout rates between the two groups at this time point. We provide first evidence for a beneficial effect of additional iTBS on intermediate nicotine abstinence; however, the low number of iTBS sessions might have prevented longer effects. More lasting effects might be achieved by iTBS maintenance sessions in analogy to the treatment of depression. PMID:24924851

  3. Adolescent depressive disorders and family based interventions in the family options multicenter evaluation: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background There is increasing community and government recognition of the magnitude and impact of adolescent depression. Family based interventions have significant potential to address known risk factors for adolescent depression and could be an effective way of engaging adolescents in treatment. The evidence for family based treatments of adolescent depression is not well developed. The objective of this clinical trial is to determine whether a family based intervention can reduce rates of unipolar depressive disorders in adolescents, improve family functioning and engage adolescents who are reluctant to access mental health services. Methods/Design The Family Options study will determine whether a manualized family based intervention designed to target both individual and family based factors in adolescent depression (BEST MOOD) will be more effective in reducing unipolar depressive disorders than an active (standard practice) control condition consisting of a parenting group using supportive techniques (PAST). The study is a multicenter effectiveness randomized controlled trial. Both interventions are delivered in group format over eight weekly sessions, of two hours per session. We will recruit 160 adolescents (12 to 18 years old) and their families, randomized equally to each treatment condition. Participants will be assessed at baseline, eight weeks and 20 weeks. Assessment of eligibility and primary outcome will be conducted using the KID-SCID structured clinical interview via adolescent and parent self-report. Assessments of family mental health, functioning and therapeutic processes will also be conducted. Data will be analyzed using Multilevel Mixed Modeling accounting for time x treatment effects and random effects for group and family characteristics. This trial is currently recruiting. Challenges in design and implementation to-date are discussed. These include diagnosis and differential diagnosis of mental disorders in the context of adolescent

  4. Expensing options solves nothing.

    PubMed

    Sahlman, William A

    2002-12-01

    The use of stock options for executive compensation has become a lightning rod for public anger, and it's easy to see why. Many top executives grew hugely rich on the back of the gains they made on their options, profits they've been able to keep even as the value they were supposed to create disappeared. The supposed scam works like this: Current accounting regulations let companies ignore the cost of option grants on their income statements, so they can award valuable option packages without affecting reported earnings. Not charging the cost of the grants supposedly leads to overstated earnings, which purportedly translate into unrealistically high share prices, permitting top executives to realize big gains when they exercise their options. If an accounting anomaly is the problem, then the solution seems obvious: Write off executive share options against the current year's revenues. The trouble is, Sahlman writes, expensing option grants won't give us a more accurate view of earnings, won't add any information not already included in the financial statements, and won't even lead to equal treatment of different forms of executive pay. Far worse, expensing evades the real issue, which is whether compensation (options and other-wise) does what it's supposed to do--namely, help a company recruit, retain, and provide the right people with appropriate performance incentives. Any performance-based compensation system has the potential to encourage cheating. Only ethical management, sensible governance, adequate internal control systems, and comprehensive disclosure will save the investor from disaster. If, Sahlman warns, we pass laws that require the expensing of options, thinking that's fixed the fundamental flaws in corporate America's accounting, we will have missed a golden opportunity to focus on the much more extensive defects in the present system. PMID:12510541

  5. Neuroprotective and neurogenesis agent for treating bipolar II disorder: add-on memantine to mood stabilizer works.

    PubMed

    Lu, Ru-Band; Chen, Shiou-Lan; Lee, Sheng-Yu; Chang, Yun-Hsuan; Chen, Shih-Heng; Chu, Chun-Hsieh; Tzeng, Nian-Sheng; Lee, I Hui; Chen, Po See; Yeh, Tzung Lieh; Huang, San-Yuan; Yang, Yen Kuang; Hong, Jau-Shyong

    2012-08-01

    Bipolar disorder, characterized by a dysregulation of mood, impulsivity, risky behavior and interpersonal problems, is a recurrent and often becomes chronic psychiatric illness. However, bipolar subtypes are not often recognized in psychiatric settings, especially bipolar II subtype, until Akiskal and Angst made clear definition to bipolar I (BP-I) and bipolar II (BP-II) disorder in 1999. More and more studies, not only on family inheritance, diagnosis, but also on disease process have been reported that BP-I and BP-II are two different disorders with distinct pathological mechanisms. In general, patients with BP-II express less symptoms and have shorter hypomania stages than BP-I. According to a longitudinal research, patients with BP-II have poor recovery than do BP-I patients. Memantine used to be recognized as a noncompetitive N-methyl-d-aspartate receptor antagonist. However, it was found to have neuroprotective and neurogenesis effect in several neurodegenerative diseases in the past years. We found that memantine could inhibit brain inflammatory response through its action on neuroglial cells and provide neurotrophic effect. The above evidences of benefit on auto-immune system with memantine would support that memantine as add-on therapy to valproate might be more effective than valproate alone on improvement of the neuron degeneration in bipolar disorders. Review articles indicate that not only the mood stabilizers provide with good neuroprotection, but the memantine also have conspicuous anti-autoimmune and neurogenesis effect. Therefore, we propose that drugs with neuroprotective effect and neurotrophic effect may treat neurodegenerative diseases including BP-II. The combination treatment of mood stabilizers memantine may not only augment and improve the remedy for bipolar disorders, but also repair the damaged neurons and neurogenesis through activation of astroglial cell and release of neurotrophic factors.

  6. 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

  7. Correlation between total vitamin D levels and psychotic psychopathology in patients with schizophrenia: therapeutic implications for add-on vitamin D augmentation

    PubMed Central

    Altunsoy, Neslihan; Tikir, Baise; Cingi Külük, Merve; Unal, Kubranur; Goka, Sema; Aydemir, Cigdem; Goka, Erol

    2014-01-01

    episode, significantly different from those in remission. Is vitamin D deficiency the result or the cause of an acute episode? Our results contribute to the idea that vitamin D deficiency and schizophrenia may have interactions with an unknown pathway. Present data points out a possible influence at a genomic level. Future trials may investigate this association with longer follow up. We recommend that, serum vitamin D levels should be measured in patients with schizophrenia especially in long term care. Appropriate further treatment with add-on vitamin D supplements and diets that are rich in vitamin D should be considered. PMID:25489478

  8. Peak load management: Potential options

    SciTech Connect

    Englin, J.E.; De Steese, J.G.; Schultz, R.W.; Kellogg, M.A.

    1989-10-01

    This report reviews options that may be alternatives to transmission construction (ATT) applicable both generally and at specific locations in the service area of the Bonneville Power Administration (BPA). Some of these options have potential as specific alternatives to the Shelton-Fairmount 230-kV Reinforcement Project, which is the focus of this study. A listing of 31 peak load management (PLM) options is included. Estimated costs and normalized hourly load shapes, corresponding to the respective base load and controlled load cases, are considered for 15 of the above options. A summary page is presented for each of these options, grouped with respect to its applicability in the residential, commercial, industrial, and agricultural sectors. The report contains comments on PLM measures for which load shape management characteristics are not yet available. These comments address the potential relevance of the options and the possible difficulty that may be encountered in characterizing their value should be of interest in this investigation. The report also identifies options that could improve the efficiency of the three customer utility distribution systems supplied by the Shelton-Fairmount Reinforcement Project. Potential cogeneration options in the Olympic Peninsula are also discussed. These discussions focus on the options that appear to be most promising on the Olympic Peninsula. Finally, a short list of options is recommended for investigation in the next phase of this study. 9 refs., 24 tabs.

  9. Towards the implementation of the "basket of options" approach to helminth parasite control of livestock: emphasis on the tropics/subtropics.

    PubMed

    Krecek, Rosina C; Waller, Peter J

    2006-07-31

    The virtual reliance on anthelmintic drugs alone to control internal parasites of livestock is inappropriate and ultimately unsustainable. In the tropics and subtropics, widespread and high levels of anthelmintic resistance, particularly in nematode parasites of small ruminants, is rife. But more to the point, many farmers in these regions of the world are resource poor and cannot afford, or are reluctant to purchase drugs that may also be of dubious quality. As it is with any intervention, the benefits must outweigh the costs. This is not only in terms of conventional parameters such as reduced mortality and increasing productivity (meat, milk, fibre and traction power) of livestock, but also within the broad framework of helminths of veterinary/human importance, the aim should be a positive impact on reducing the threat of helminth zoonoses. However, understanding the issues involved and education of the end-users (farmers) is of fundamental importance, before any internal parasite control program should be promoted. Within the above context, we provide examples of how the "basket of options" approach could be adopted for the control of three quite disparate helminth problems in the tropics and subtropics, viz.: strongyle nematode infections of donkeys, the Taenia solium cysticercosis/taeniosis problem of pig and man and Haemonchus contortus infections in small ruminants. The "best practice" approaches can be defined as those "basket of options" that are practical, affordable, available and appropriate, whether to the commercial producer, or to the resource-poor farmer. Constraints that may restrict applying such options are accessibility to, and affordability of, suitable remedies and above all, the availability of information needed to make informed decisions in this regard. PMID:16764993

  10. Low long-term efficacy and tolerability of add-on rufinamide in patients with Dravet syndrome.

    PubMed

    Mueller, A; Boor, R; Coppola, G; Striano, P; Dahlin, M; von Stuelpnagel, C; Lotte, J; Staudt, M; Kluger, G

    2011-07-01

    In this retrospective European multicenter study we evaluated the efficacy and tolerability of rufinamide in patients with Dravet syndrome and refractory seizures. Twenty patients were included; in 16 patients a SCN1A mutation was detected. The responder rate after 6 months was 20%, and after 34 months, 5%. The retention rate was 45% after 6 months and 5% after 34 months. Rufinamide treatment was stopped because of aggravation of seizures (30%), no effect (45%), and side effects (10%). The efficacy and long-term retention rate were low in our patients with Dravet syndrome and refractory seizures, far lower than in patients with Lennox-Gastaut syndrome; one-third of our patients experienced seizure aggravation. Therefore, rufinamide does not seem to be a suitable option for long-term treatment in patients with Dravet syndrome. PMID:21620771

  11. Plasma Renin Activity Predicts Blood Pressure Responses to β-Blocker and Thiazide Diuretic as Monotherapy and Add-On Therapy for Hypertension

    PubMed Central

    Turner, Stephen T.; Schwartz, Gary L.; Chapman, Arlene B.; Beitelshees, Amber L.; Gums, John G.; Cooper-DeHoff, Rhonda M.; Boerwinkle, Eric; Johnson, Julie A.; Bailey, Kent R.

    2010-01-01

    BACKGROUND Age and race categories or renin profiling have been recommended to predict blood pressure responses to monotherapy with a β-blocker or thiazide diuretic. Whether these or other characteristics predict blood pressure responses when the drugs are administered as add-on therapy is uncertain. METHODS We evaluated predictors of blood pressure response in 363 men and women ≤65 years of age with primary hypertension (152 blacks, 211 whites), 86 of whom (24%) were untreated and 277 of whom (76%) were withdrawn from previous antihypertensive drugs before randomization to either atenolol followed by addition of hydrochlorothiazide (N = 180) or hydrochlorothiazide followed by addition of atenolol (N = 183). Responses were determined by home blood pressure averages before and after each drug administration. Race, age, plasma renin activity, and other characteristics including pretreatment blood pressure levels were incorporated into linear regression models to quantify their contributions to prediction of blood pressure responses. RESULTS Plasma renin activity and pretreatment blood pressure level consistently contributed to prediction of systolic and diastolic responses to each drug administered as mono- and as add-on therapy. Higher plasma renin activity was consistently associated with greater blood pressure responses to atenolol and lesser responses to hydrochlorothiazide. The predictive effects of plasma renin activity were statistically independent of race, age, and other characteristics. CONCLUSIONS Plasma renin activity and pretreatment blood pressure level predict blood pressure responses to atenolol and hydrochlorothiazide administered as mono- and as add-on therapy in men and women ≤65 years of age. PMID:20725057

  12. Efficacy of Add-On Deep Transcranial Magnetic Stimulation in Comorbid Alcohol Dependence and Dysthymic Disorder: Three Case Reports

    PubMed Central

    Rapinesi, Chiara; Serata, Daniele; Casale, Antonio Del; Bersani, Francesco S.; Solfanelli, Andrea; Scatena, Paola; Raccah, Ruggero N.; Brugnoli, Roberto; Digiacomantonio, Vittorio; Carbonetti, Paolo; Fensore, Claudio; Tatarelli, Roberto; Angeletti, Gloria; Ferracuti, Stefano; Girardi, Paolo

    2013-01-01

    Background: Craving for alcohol is associated with abnormal activation in the dorsolateral prefrontal cortex. Deep transcranial magnetic stimulation (dTMS) has shown promise in the treatment of depression. There are few treatment options for treatment-resistant dysthymic disorder comorbid with alcohol use disorder. Objective: To investigate the possible anticraving efficacy of bilateral dorsolateral prefrontal cortex high-frequency dTMS in 3 patients with comorbid long-term DSM-IV-TR dysthymic disorder and alcohol use disorder. Method: Three patients with alcohol use disorder with dysthymic disorder in their detoxification phase (abstaining for > 1 month) underwent twenty 20-minute sessions of 20 Hz dTMS over the dorsolateral prefrontal cortex over 28 days between 2011 and 2012. Alcohol craving was rated with the Obsessive Compulsive Drinking Scale and depressive symptoms with the Hamilton Depression Rating Scale. Results: All 3 patients responded unsatisfactorily to initial intravenous antidepressant and antianxiety combinations but responded after 10 dTMS sessions, improving on both anxiety-depressive symptoms and craving. This improvement enabled us to reduce antidepressant dosages after dTMS cycle completion. Discussion: High-frequency bilateral dorsolateral prefrontal cortex dTMS with left prevalence was found to produce significant anticraving effects in alcohol use disorder comorbid with dysthymic disorder. The potential of dTMS for reducing craving in patients with substance use disorder deserves to be further investigated. PMID:23724355

  13. Atmospheric nitrogen deposition loadings to the Chesapeake Bay: An initial analysis of the cost effectiveness of control options

    SciTech Connect

    1996-12-31

    The purpose of this project was to examine whether programs to control regional airborne oxides of nitrogen (NOx) are cost-effective ways to reduce nitrogen loads to the Bay compared with other management scenarios. Regional control programs considered in this analysis include: the Low Emission Vehicle (LEV) program of the Ozone Transport Commission (OTC), and a 0.15 pounds (lbs) per million British thermal unit (MMBtu) NOx emission limit applied to large fuel combustors in the Northeast Ozone Transport Region (OTC) States. The effect of extending the OTR programs to wider areas of the country - whose emissions also influence the Bay - was also examined.

  14. RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME I - INTRODUCTION AND METHODOLOGY

    EPA Science Inventory

    The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

  15. Contribution of deforestation to atmospheric CO/sub 2/ and reforestation as an option to control CO/sub 2/

    SciTech Connect

    Kinsman, J.D.; Marland, G.

    1989-01-01

    In this paper we discuss various aspects of global climate change as related to forests: the rate of deforestation; CO/sub 2/ emissions resulting from deforestation; and reforestation as a means to control atmospheric CO/sub 2/. We also include for perspective a discussion of current policy considerations related to methods for reducing deforestation or promoting reforestation. 68 refs.

  16. Add-on effects of a low-dose aripiprazole in resolving hyperprolactinemia induced by risperidone or paliperidone.

    PubMed

    Qiao, Ying; Yang, Fuzhong; Li, Chunbo; Guo, Qian; Wen, Hui; Zhu, Suoyu; Ouyang, Qiong; Shen, Weidi; Sheng, Jianhua

    2016-03-30

    This study investigated the effects of a low-dose aripiprazole adjunctive treatment for risperidone- or paliperidone-induced hyperprolactinemia in Han Chinese women with schizophrenia. After 4 weeks of risperidone or paliperidone treatment, 60 out of 66 patients improved significantly and experienced hyperprolactinemia. They were randomly assigned to the treatment group (aripiprazole adjunctive treatment) (n=30) or control group (non-adjunctive treatment) (n=30). The dosage of risperidone and paliperidone were maintained; and aripiprazole was maintained at 5mg/day during the 8-week study period. The prolactin levels at the end of the 8th week were significantly lower in the treatment group than in the control group. The estradiol level correlated negatively with serum prolactin level both in the treatment group and the control group at the end of the 8th week and the 4th week respectively. The Positive and Negative Syndrome Scale score improved significantly during the 8-week study period in both groups. The incidence of treatment-emergent adverse event was similar in two groups. Low-dose aripiprazole adjunctive treatment is effective in relieving risperidone- and paliperidone-induced hyperprolactinemia in female schizophrenic patients without increasing adverse event.

  17. POWDERED ACTIVATED CARBON FROM NORTH DAKOTA LIGNITE: AN OPTION FOR DISINFECTION BY-PRODUCT CONTROL IN WATER TREATMENT PLANTS

    SciTech Connect

    Daniel J. Stepan; Thomas A. Moe; Melanie D. Hetland; Margaret L. Laumb

    2001-06-01

    New federal drinking water regulations have been promulgated to restrict the levels of disinfection by-products (DBPs) in finished public water supplies. DBPs are suspected carcinogens and are formed when organic material is partially oxidized by disinfectants commonly used in the water treatment industry. Additional federal mandates are expected in the near future that will further affect public water suppliers with respect to DBPs. Powdered activated carbon (PAC) has traditionally been used by the water treatment industry for the removal of compounds contributing to taste and odor problems. PAC also has the potential to remove naturally occurring organic matter (NOM) from raw waters prior to disinfection, thus controlling the formation of regulated DBPs. Many small water systems are currently using PAC for taste and odor control and have the potential to use PAC for controlling DBPs. This project, a cooperative effort between the Energy & Environmental Research Center (EERC), the Grand Forks Water Treatment Plant, and the University of North Dakota Department of Civil Engineering, consists of several interrelated tasks. The objective of the research was to evaluate a cost-effective PAC produced from North Dakota lignite for removing NOM from water and reducing trihalomethane formation potential. The research approach was to develop a statistically valid testing protocol that can be used to compare dose-response relationships between North Dakota lignite-derived PAC and commercially available PAC products. A statistical analysis was performed to determine whether significant correlations exist between operating conditions, water properties, PAC properties, and dose-response behavior. Pertinent physical and chemical properties were also measured for each of the waters and each of the PACs.

  18. Psycho-Biological Changes with Add on Yoga Nidra in Patients with Menstrual Disorders: a Randomized Clinical Trial

    PubMed Central

    Rani, Khushbu; Tiwari, S.C.; Kumar, Santosh; Singh, Uma; Prakash, Jai; Srivastava, Neena

    2016-01-01

    Introduction: Menstrual disorders are common problems among women in the reproductive age group. Yuga interventions may decrease the physical and psychological problems related to menstrual disorders. The present study was aimed to assess the effect of Yoga Nidra on psychological problems in patients with menstrual disorders. Methods: A total number of 100 women recruited from the department of obstetrics and gynecology and were then randomly allocated into two groups: a) intervention received yogic intervention and medication for 6 month, and b) control group received no yogic intervention and they only received prescribed medication). Psychological General Well-Being Index (PGWBI) and hormonal profile were assessed at the time of before and after six months on both groups. Results: The mean score of anxiety, depression, positive well-being, general health, and vitality scores, as well as hormonal levels, in posttest were significantly different in intervention group as compared with pretest. But there was no significant difference in control group. Conclusion: Yoga Nidra can be a successful therapy to overcome the psychiatric morbidity associated with menstrual irregularities. Therefore, Yogic relaxation training (Yoga Nidra) could be prescribed as an adjunct to conventional drug therapy for menstrual dysfunction. PMID:26989661

  19. Volar locking distal radius plates show better short-term results than other treatment options: A prospective randomised controlled trial

    PubMed Central

    Drobetz, Herwig; Koval, Lidia; Weninger, Patrick; Luscombe, Ruth; Jeffries, Paula; Ehrendorfer, Stefan; Heal, Clare

    2016-01-01

    AIM To compare the outcomes of displaced distal radius fractures treated with volar locking plates and with immediate postoperative mobilisation with the outcomes of these fractures treated with modalities that necessitate 6 wk wrist immobilisation. METHODS A prospective, randomised controlled single-centre trial was conducted with 56 patients who had a displaced radius fracture were randomised to treatment either with a volar locking plate (n = 29), or another treatment modality (n = 27; cast immobilisation with or without wires or external fixator). Outcomes were measured at 12 wk. Functional outcome scores measured were the Patient-Rated Wrist Evaluation (PRWE) Score; Disabilities of the Arm, Shoulder and Hand and activities of daily living (ADLs). Clinical outcomes were wrist range of motion and grip strength. Radiographic parameters were volar inclination and ulnar variance. RESULTS Patients in the volar locking plate group had significantly better PRWE scores, ADL scores, grip strength and range of extension at three months compared with the control group. All radiological parameters were significantly better in the volar locking plate group at 3 mo. CONCLUSION The present study suggests that volar locking plates produced significantly better functional and clinical outcomes at 3 mo compared with other treatment modalities. Anatomical reduction was significantly more likely to be preserved in the plating group. Level of evidence: II. PMID:27795951

  20. Tramadol/acetaminophen combination as add-on therapy in the treatment of patients with ankylosing spondylitis.

    PubMed

    Chang, Jhi-Kai; Yu, Chen-Tung; Lee, Ming-Yung; Yeo, Kj; Chang, I-Chang; Tsou, Hsi-Kai; Wei, James Cheng-Chung

    2013-03-01

    This study aimed to determine the safety and efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (Ultracet®) in patients with ankylosing spondylitis (AS). This was a 12-week, randomized, double-blind, placebo-controlled study. Sixty patients with active AS according to the Modified New York Criteria were enrolled. Active disease was defined by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for more than 3 at randomization. Subjects were randomized equally into two groups: the treatment group received aceclofenac plus Ultracet® one tablet twice a day, and the control group received aceclofenac plus placebo for 12 weeks. The primary endpoint was a difference of Assessment in Ankylosing Spondylitis (ASAS20) response criteria between two groups at week 12. At week 12, ASAS20 was achieved by 53.3 % of the aceclofenac plus Ultracet group and 31 % of the aceclofenac alone group (p = 0.047). For the pain visual analogue scale at week 12, there was a reduction of 45.6 % in aceclofenac plus Ultracet group and 25.7 % in the aceclofenac alone group (p = 0.087). There was no statistically significant difference between two groups in BASDAI, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Global Index, Physician Global Assessment, spinal mobility, ESR, hs-CRP, and Ankylosing Spondylitis Quality of Life Questionnaire. A slight increase in total adverse events was noted with dizziness (7.5 vs 1.5 %), vertigo (4.5 vs 1.5 %), and nausea/vomiting (6 vs 0 %) in the Ultracet arm compared to placebo. The tramadol 37.5 mg/acetaminophen 325 mg combination tablet (Ultracet®) might has additional effect to nonsteroidal anti-inflammatory drugs in the treatment of patients with ankylosing spondylitis. It showed marginal benefit in pain and disease activity. However, a slight increase in minor adverse events was noted.

  1. Add-on clinical effects of simvastatin and ondansetron in patients with schizophrenia stabilized on antipsychotic treatment: pilot study

    PubMed Central

    Chaudhry, Imran B.; Husain, Nusrat; Drake, Richard; Dunn, Graham; Kazmi, Ajmal; Hamirani, Munir M.; Rahman, Raza; Stirling, John; Deakin, William

    2014-01-01

    Objectives: There is some evidence that anti-inflammatory treatment may have beneficial effects in schizophrenia and major depression. Statins are cholesterol-lowering agents but have been found to be anti-inflammatory and also decrease C-reactive protein (CRP). Ondansetron is a serotonin (5-HT3) receptor antagonist widely used to prevent nausea and vomiting in patients receiving chemotherapy for cancer. Small studies have suggested that adjunctive ondansetron is efficacious against schizophrenia symptoms. We carried out a feasibility study in schizophrenia patients (within 5 years of first diagnosis) to explore the adjunctive use of simvastatin and ondansetron on positive, negative and general psychopathology. Methods: This was a 12-week rater-blind placebo-controlled study. A total of 36 patients with DSM-IV diagnosis of schizophrenia were recruited, 12 in each arm. Patients were assessed at baseline and at 12 weeks using Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression (CGI) scale, Global Assessment of Functioning (GAF) and Abnormal Involuntary Movement Scale (AIMS). Results: Both simvastatin and ondansetron provide some evidence of a reduction in symptoms compared with treatment as usual (TAU) on PANSS total score, although this was not statistically significant. In the secondary analyses, no significant differences were seen on CGI, GAF and AIMS. Conclusions: Anti-inflammatory treatments have been shown to have some beneficial effects in schizophrenia. Both simvastatin and ondansetron provide some evidence of a reduction in symptoms compared with TAU. This study has led to a larger Stanley Medical Research Institute (SMRI)-funded, double-blind, randomized control trial. PMID:25057343

  2. Novel operative treatment options.

    PubMed

    Ricketts, D N J; Pitts, N B

    2009-01-01

    There are an increasing number of more novel options available for operative intervention. This chapter outlines a series of operative treatment options which are available to the modern clinician to select from once a decision has been made to treat a carious lesion operatively. A series of novel methods of caries removal have been described; including chemomechanical caries removal, air abrasion, sono-abrasion, polymer rotary burs and lasers. There are also novel approaches to ensure complete caries removal and novel approaches for the management of deep caries. A novel question increasingly asked by clinicians is: does all the caries need to be removed? Operative management options here include: therapeutic fissure sealants, ultraconservative caries removal, stepwise excavation and the Hall technique. In conclusion, there is now a growing wealth of evidence that questions the traditional methods of caries removal and restoring the tooth. In parallel, there is a growing movement exploring the merits of therapeutically sealing caries into the tooth. This philosophy is alien to many of today's dentists and, until further randomized controlled trials are carried out in primary care, prudent caution must be exercised with this promising approach. Research is required into techniques which will allow monitoring of sealed caries to detect any rare, but insidious, failures. These novel techniques are an alternative way of managing the later stages of the caries process from a sounder biological basis and have marked potential benefits to patients from treatment, pain and outcome perspectives.

  3. The safeguards options study

    SciTech Connect

    Hakkila, E.A.; Mullen, M.F.; Olinger, C.T.; Stanbro, W.D.; Olsen, A.P.; Roche, C.T.; Rudolph, R.R.; Bieber, A.M.; Lemley, J.; Filby, E.

    1995-04-01

    The Safeguards Options Study was initiated to aid the International Safeguards Division (ISD) of the DOE Office of Arms Control and Nonproliferation in developing its programs in enhanced international safeguards. The goal was to provide a technical basis for the ISD program in this area. The Safeguards Options Study has been a cooperative effort among ten organizations. These are Argonne National Laboratory, Brookhaven National Laboratory, Idaho National Engineering Laboratory, Lawrence Livermore National Laboratory, Los Alamos National Laboratory, Mound Laboratory, Oak Ridge National Laboratory, Pacific Northwest Laboratories, Sandia National Laboratories, and Special Technologies Laboratory. Much of the Motivation for the Safeguards Options Study is the recognition after the Iraq experience that there are deficiencies in the present approach to international safeguards. While under International Atomic Energy Agency (IAEA) safeguards at their declared facilities, Iraq was able to develop a significant weapons program without being noticed. This is because negotiated safeguards only applied at declared sites. Even so, their nuclear weapons program clearly conflicted with Iraq`s obligations under the Nuclear Nonproliferation Treaty (NPT) as a nonnuclear weapon state.

  4. Bait-delivered pimozide causes precocious embryo implantation in mink: a fertility control option for the exotic stoat?

    PubMed

    Marks, Clive A; Lindeberg, Heli; Van Cleeff, Judy

    2006-01-01

    Stoats (Mustela erminea), an exotic pest in New Zealand, threaten the conservation of several ground-nesting bird species and broad-scale methods for their control are sought. Females are seasonally monestrous, show a 9-month period of obligatory diapause and usually do not breed more than once in their lives. A bait-delivered agent that terminates diapause and results in a non-viable embryo may have a significant impact on their reproductive success. Prolactin (PRL) is hypothesised to be the only gonadotrophin required for renewal of luteal activity and blastocyst implantation in some mustelids. We investigated the effects of bait-delivered dopamine (DA) antagonists (which stimulate the release of PRL) using a mink model (Mustela vison), a species that maintains a short period of diapause. A bait dose of 0.8 mg kg(-1) of pimozide was more effective in elevating PRL levels than equivalent doses of fluphenazine, sulpiride (P < 0.01) or haloperidol (P < 0.05). Bait doses of 1.6 mg kg(-1) pimozide given at Days 0, 3, 9 and 11 after mating caused a significant reduction in the length of pregnancy compared with a positive control and placebo (46 days v. 51 days), indicating early termination of diapause (P < 0.01). Pimozide doses caused higher elevations in PRL concentration relative to the oral placebo by Day 12, but mean PRL levels fell below all other groups by Day 18. A borderline significant increase in progesterone (P4) secretion compared with the oral placebo was detected at Day 18. These results suggest that bait-delivered pimozide can elevate PRL outside of the normal breeding season and doses of 1.6 mg kg(-1) are effective in terminating embryonic diapause in mink. The implications and limitations of these data are discussed with reference to the use of bait-delivered DA antagonists as a possible means to affect the reproductive success of wild stoats. PMID:16930517

  5. Effects and Safety of Linagliptin as an Add-on Therapy in Advanced-Stage Diabetic Nephropathy Patients Taking Renin–Angiotensin–Aldosterone System Blockers

    PubMed Central

    Ueda, Yuichiro; Ishii, Hiroki; Kitano, Taisuke; Shindo, Mitsutoshi; Miyazawa, Haruhisa; Ito, Kiyonori; Hirai, Keiji; Kaku, Yoshio; Mori, Honami; Hoshino, Taro; Ookawara, Susumu; Kakei, Masafumi; Tabei, Kaoru; Morishita, Yoshiyuki

    2016-01-01

    BACKGROUND We investigated the effects and safety of linagliptin as an add-on therapy in patients with advanced-stage diabetic nephropathy (DMN) taking renin–angiotensin–aldosterone system (RAAS) blockers. METHOD Twenty advanced-stage DMN patients (estimated glomerular filtration rate (eGFR): 24.5 ± 13.4 mL/min/1.73 m2) taking RAAS blockers were administered 5 mg/day linagliptin for 52 weeks. Changes in glucose and lipid metabolism and renal function were evaluated. RESULTS Linagliptin decreased glycosylated hemoglobin levels (from 7.32 ± 0.77% to 6.85 ± 0.87%, P < 0.05) without changing fasting blood glucose levels, and significantly decreased total cholesterol levels (from 189.6 ± 49.0 to 170.2 ± 39.2 mg/dL, P < 0.05) and low-density lipoprotein cholesterol levels (from 107.1 ± 32.4 to 90.2 ± 31.0 mg/dL, P < 0.05) without changing high-density lipoprotein cholesterol and triglyceride levels. Urine protein/creatinine ratio and annual change in eGFR remained unchanged. No adverse effects were observed. CONCLUSION Linagliptin as an add-on therapy had beneficial effects on glucose and lipid metabolism without impairment of renal function, and did not have any adverse effects in this population of patients with advanced-stage DMN taking RAAS blockers.

  6. Effects and Safety of Linagliptin as an Add-on Therapy in Advanced-Stage Diabetic Nephropathy Patients Taking Renin–Angiotensin–Aldosterone System Blockers

    PubMed Central

    Ueda, Yuichiro; Ishii, Hiroki; Kitano, Taisuke; Shindo, Mitsutoshi; Miyazawa, Haruhisa; Ito, Kiyonori; Hirai, Keiji; Kaku, Yoshio; Mori, Honami; Hoshino, Taro; Ookawara, Susumu; Kakei, Masafumi; Tabei, Kaoru; Morishita, Yoshiyuki

    2016-01-01

    BACKGROUND We investigated the effects and safety of linagliptin as an add-on therapy in patients with advanced-stage diabetic nephropathy (DMN) taking renin–angiotensin–aldosterone system (RAAS) blockers. METHOD Twenty advanced-stage DMN patients (estimated glomerular filtration rate (eGFR): 24.5 ± 13.4 mL/min/1.73 m2) taking RAAS blockers were administered 5 mg/day linagliptin for 52 weeks. Changes in glucose and lipid metabolism and renal function were evaluated. RESULTS Linagliptin decreased glycosylated hemoglobin levels (from 7.32 ± 0.77% to 6.85 ± 0.87%, P < 0.05) without changing fasting blood glucose levels, and significantly decreased total cholesterol levels (from 189.6 ± 49.0 to 170.2 ± 39.2 mg/dL, P < 0.05) and low-density lipoprotein cholesterol levels (from 107.1 ± 32.4 to 90.2 ± 31.0 mg/dL, P < 0.05) without changing high-density lipoprotein cholesterol and triglyceride levels. Urine protein/creatinine ratio and annual change in eGFR remained unchanged. No adverse effects were observed. CONCLUSION Linagliptin as an add-on therapy had beneficial effects on glucose and lipid metabolism without impairment of renal function, and did not have any adverse effects in this population of patients with advanced-stage DMN taking RAAS blockers. PMID:27660406

  7. Soccer practice as an add-on treatment in the management of individuals with a diagnosis of schizophrenia

    PubMed Central

    Battaglia, Giuseppe; Alesi, Marianna; Inguglia, Michele; Roccella, Michele; Caramazza, Giovanni; Bellafiore, Marianna; Palma, Antonio

    2013-01-01

    Physical activity is an important aspect of good health for everyone; it is even more important for psychiatric patients who usually live an unhealthy lifestyle. In recent years, there has been growing focus on the use of soccer as a vehicle to improve the health of subjects with severe mental illness. The aim of this study was to investigate the effects of soccer practice on the self-reported health quality of life (SRHQL) and sports performance (SP) in psychotic subjects. Eighteen male patients with diagnosis of schizophrenia were randomized into either a trained (TG) or a control group (CG). The TG was trained for 12 weeks using two soccer training sessions per week. The CG did not perform any regular sports activity during the experimental period. Anthropometric measurements, SRHQL, personal time records in a 30 meter sprint test and slalom test running with a ball were evaluated before and after the experimental period. SRHQL was assessed using Short Form-12 questionnaire measuring physical and mental component summary scores. After the training period, the TG showed a relevant decrease by 4.6% in bodyweight (BW) and body mass index compared to baseline. Conversely, the CG showed an increased BW and body mass index by 1.8% from baseline to posttest. Moreover, after 12 weeks we found that control patients increased their BW significantly when compared to trained patients (Δ = 5.4%; P < 0.05). After the training period, comparing the baseline TG’s Short Form-12-scores to posttest results, we found an improvement of 10.5% and 10.8% in physical component summary and mental component summary, respectively. In addition, performances on the 30 meter sprint test and slalom test running with a ball in the TG improved significantly (P < 0.01) from baseline to posttest when compared to CG. Soccer practice appears able to improve psychophysical health in individuals with diagnosis of schizophrenia. Indeed, our study demonstrated that programmed soccer physical activity

  8. Soccer practice as an add-on treatment in the management of individuals with a diagnosis of schizophrenia.

    PubMed

    Battaglia, Giuseppe; Alesi, Marianna; Inguglia, Michele; Roccella, Michele; Caramazza, Giovanni; Bellafiore, Marianna; Palma, Antonio

    2013-01-01

    Physical activity is an important aspect of good health for everyone; it is even more important for psychiatric patients who usually live an unhealthy lifestyle. In recent years, there has been growing focus on the use of soccer as a vehicle to improve the health of subjects with severe mental illness. The aim of this study was to investigate the effects of soccer practice on the self-reported health quality of life (SRHQL) and sports performance (SP) in psychotic subjects. Eighteen male patients with diagnosis of schizophrenia were randomized into either a trained (TG) or a control group (CG). The TG was trained for 12 weeks using two soccer training sessions per week. The CG did not perform any regular sports activity during the experimental period. Anthropometric measurements, SRHQL, personal time records in a 30 meter sprint test and slalom test running with a ball were evaluated before and after the experimental period. SRHQL was assessed using Short Form-12 questionnaire measuring physical and mental component summary scores. After the training period, the TG showed a relevant decrease by 4.6% in bodyweight (BW) and body mass index compared to baseline. Conversely, the CG showed an increased BW and body mass index by 1.8% from baseline to posttest. Moreover, after 12 weeks we found that control patients increased their BW significantly when compared to trained patients (Δ = 5.4%; P < 0.05). After the training period, comparing the baseline TG's Short Form-12-scores to posttest results, we found an improvement of 10.5% and 10.8% in physical component summary and mental component summary, respectively. In addition, performances on the 30 meter sprint test and slalom test running with a ball in the TG improved significantly (P < 0.01) from baseline to posttest when compared to CG. Soccer practice appears able to improve psychophysical health in individuals with diagnosis of schizophrenia. Indeed, our study demonstrated that programmed soccer physical activity

  9. Echinococcus granulosus Infection and Options for Control of Cystic Echinococcosis in Tibetan Communities of Western Sichuan Province, China

    PubMed Central

    Yang, Yu Rong; McManus, Donald P.; Huang, Yan; Heath, David D.

    2009-01-01

    Background Human cystic echinococcosis (CE) is highly endemic in the Tibetan regions of Sichuan where most families keep guard dogs and where there are considerable numbers of ownerless/stray dogs. Strong Buddhist beliefs do not allow for elimination of stray dogs, and many strays are actually fed and adopted by households or monasteries. On account of the high altitude (3900–5000 m), pasturage is the major agricultural activity in this area. The harsh mountainous climate often leads to many grazing animals dying on the pasture at the end of a hard winter. The skin and some meat are taken, and the rest of the animal is left for scavenging birds and animals. The poor sanitation and hygiene, the Buddhist doctrine of allowing old livestock to die naturally, plus the unrestricted disposal of animal viscera post-slaughter may be responsible for the high prevalence of human CE in this setting. Methods and Findings As part of a large collaborative control program for CE in Ganzi County, situated in the west of Sichuan Province, surveillance for Echinococcus infection in domestic dogs using a coproantigen method and necropsy of unwanted dogs was carried out prior to (in 2000) and after (in 2005) dog anthelminthic treatment (5 mg/kg oral praziquantal at 6 month intervals) to determine the efficacy of the treatment for control. The prevalence of E. granulosus only in dogs by necropsy was 27% and 22%, and prevalence of both Echinococcus spp. by necropsy was 63% and 38%; prevalence of both Echinococcus spp. by coproantigen analysis was 50% and 17%. Necropsy of sheep/goats (age <1 to 12 years) (prevalence of E. granulosus in 1–6-year-old animals was 38% and in 10–12-year-old animals was 70%) and yaks (age 4 years) (prevalence of E. granulosus was 38%) was undertaken to determine the baseline transmission pressure. Protoscoleces were only found in very old sheep/goats and yaks. Necropsy of dogs in the Datangma district indicated that there was no apparent significant

  10. Add-On Effect of Chinese Herbal Medicine Bath to Phototherapy for Psoriasis Vulgaris: A Systematic Review

    PubMed Central

    Yu, Jason Jingjie; Zhang, Claire Shuiqing; Xue, Charlie Changli; Lu, Chuanjian

    2013-01-01

    Psoriasis vulgaris is the most common form of psoriasis. Phototherapy has been proven effective for psoriasis, but side effects have become a concern. Chinese herbal medicine (CHM) bath combined with phototherapy has been used in clinical settings, but the additional benefit requires evaluation. This review aims to evaluate the additional benefit and safety of adding CHM bath to phototherapy for psoriasis vulgaris. Cochrane library, PubMed, Embase, CNKI, and CQVIP were searched from their inceptions to 6 August 2012. Randomized controlled trials (RCTs) comparing CHM bath plus phototherapy to phototherapy alone for psoriasis vulgaris were included. Data was analyzed using Review Manager 5.1.0. Thirteen RCTs were included in the review, and eight were included in the meta-analysis. Meta-analysis showed higher efficacy of CHM bath plus phototherapy when compared with phototherapy alone in terms of PASI 60 (RR 1.25; 95% CI: 1.18–1.32). Mild adverse events were reported in ten studies, but these could be alleviated by reducing UV dosage or applying emollient. In conclusion, CHM bath appears to be a beneficial and safe adjunctive therapy to phototherapy for psoriasis vulgaris. However, these results should be interpreted with caution due to the low methodological quality of the included studies. PMID:23983796

  11. Effect of dehydroepiandrosterone add-on therapy on mood, decision making and subsequent relapse of polydrug users.

    PubMed

    Ohana, David; Maayan, Rachel; Delayahu, Yael; Roska, Paola; Ponizovsky, Alexander M; Weizman, Abraham; Yadid, Gal; Yechiam, Eldad

    2016-07-01

    A major problem in the treatment of addiction is predicting and preventing relapse following a rehabilitation program. Recently, in preclinical rodent studies dehydroepiandrosterone (DHEA) was found to markedly improve the resistance to drug reuse. In a double-blind, placebo-controlled study, we examined the effect of DHEA on relapse rates in adult polydrug users taking part in a detoxification program enriched with intensive psychosocial interventions and aftercare. During treatment, participants (79 percent males, mean age 28) consumed DHEA (100 mg/day) or placebo daily for at least 30 days. Of the 121 initial volunteers, 64 participated for at least 1 month. While in treatment, DHEA reduced negative affect on the Positive and Negative Affect Scale (F = 4.25, P = 0.04). Furthermore, in a 16-month follow-up, we found that reuse rates in the DHEA condition were about a third compared with placebo (12 versus 38 percent; χ(2)  = 5.03, P = 0.02). DHEA treatment also resulted in an increase in DHEA sulfate (DHEA-S) 1 month following treatment, and the level of DHEA-S predicted relapse in the follow-up assessment. PMID:25818161

  12. Effect of dehydroepiandrosterone add-on therapy on mood, decision making and subsequent relapse of polydrug users.

    PubMed

    Ohana, David; Maayan, Rachel; Delayahu, Yael; Roska, Paola; Ponizovsky, Alexander M; Weizman, Abraham; Yadid, Gal; Yechiam, Eldad

    2016-07-01

    A major problem in the treatment of addiction is predicting and preventing relapse following a rehabilitation program. Recently, in preclinical rodent studies dehydroepiandrosterone (DHEA) was found to markedly improve the resistance to drug reuse. In a double-blind, placebo-controlled study, we examined the effect of DHEA on relapse rates in adult polydrug users taking part in a detoxification program enriched with intensive psychosocial interventions and aftercare. During treatment, participants (79 percent males, mean age 28) consumed DHEA (100 mg/day) or placebo daily for at least 30 days. Of the 121 initial volunteers, 64 participated for at least 1 month. While in treatment, DHEA reduced negative affect on the Positive and Negative Affect Scale (F = 4.25, P = 0.04). Furthermore, in a 16-month follow-up, we found that reuse rates in the DHEA condition were about a third compared with placebo (12 versus 38 percent; χ(2)  = 5.03, P = 0.02). DHEA treatment also resulted in an increase in DHEA sulfate (DHEA-S) 1 month following treatment, and the level of DHEA-S predicted relapse in the follow-up assessment.

  13. Acidosis and Formaldehyde Secretion as a Possible Pathway of Cancer Pain and Options for Improved Cancer Pain Control.

    PubMed

    Hoang, Ba X; Shaw, D Graeme; Han, Bo; Fang, Josephine Y; Nimni, Marcel

    2015-09-01

    The prevalence of cancer pain in patients with cancer is high. The majority of efforts are spent on research in cancer treatment, but only a small fraction focuses on cancer pain. Pain in cancer patients, viewed predominantly as a secondary issue, is considered to be due to the destruction of tissues, compression of the nerves, inflammation, and secretion of biological mediators from the necrotic tumor mass. As a result, opioid drugs have remained as the primary pharmacological therapy for cancer pain for the past hundred years. This report reviews evidence that cancer pain may be produced by the metabolic effects of two byproducts of cancer-high acidity in the cancer microenvironment and the secretion of formaldehyde and its metabolites. We propose the research and development of therapeutic approaches for preemptive, short- and long-term management of cancer pain using available drugs or nutraceutical agents that can suppress or neutralize lactic acid production in combination with formaldehyde scavengers. We believe this approach may not only improve cancer pain control but may also enhance the quality of life for patients.

  14. Acidosis and Formaldehyde Secretion as a Possible Pathway of Cancer Pain and Options for Improved Cancer Pain Control.

    PubMed

    Hoang, Ba X; Shaw, D Graeme; Han, Bo; Fang, Josephine Y; Nimni, Marcel

    2015-09-01

    The prevalence of cancer pain in patients with cancer is high. The majority of efforts are spent on research in cancer treatment, but only a small fraction focuses on cancer pain. Pain in cancer patients, viewed predominantly as a secondary issue, is considered to be due to the destruction of tissues, compression of the nerves, inflammation, and secretion of biological mediators from the necrotic tumor mass. As a result, opioid drugs have remained as the primary pharmacological therapy for cancer pain for the past hundred years. This report reviews evidence that cancer pain may be produced by the metabolic effects of two byproducts of cancer-high acidity in the cancer microenvironment and the secretion of formaldehyde and its metabolites. We propose the research and development of therapeutic approaches for preemptive, short- and long-term management of cancer pain using available drugs or nutraceutical agents that can suppress or neutralize lactic acid production in combination with formaldehyde scavengers. We believe this approach may not only improve cancer pain control but may also enhance the quality of life for patients. PMID:26368037

  15. Fludarabine add-on therapy in interferon-beta-treated patients with multiple sclerosis experiencing breakthrough disease

    PubMed Central

    Greenberg, Steven J.; Zivadinov, Robert; Lee-Kwen, Peterkin; Sharma, Jitendra; Planter, Margaret; Umhauer, Margaret; Glenister, Norman; Bakshi, Rohit

    2016-01-01

    Background: Patients with relapsing–remitting multiple sclerosis (RRMS) may experience breakthrough disease despite effective interferon beta (IFNβ) therapy. Fludarabine (FLU) is a chemotherapeutic agent used in lymphoproliferative disorders that may be synergistic when combined with immunomodulatory therapy to control active multiple sclerosis (MS). Objective: The objective of this study was to explore the safety and tolerability of FLU versus monthly methylprednisolone (MP) in IFNβ-treated RRMS patients with breakthrough disease. Clinical and MRI effects of IFNβ-1a plus FLU were evaluated. Methods: Eighteen patients with breakthrough disease [⩾2 relapses over the prior year and ⩾1.0-point increase in Expanded Disability Status Scale (EDSS) score sustained for ⩾3 months] after >1 year of IFNβ therapy were enrolled in this prospective, open-label, randomized, proof-of-concept, pilot study. Patients received intravenous (IV) MP 1 g daily for 3 days and then were randomized to receive 3 monthly IV infusions of FLU 25 mg/m2 daily for 5 consecutive days (n = 10) or MP 1 g (n = 8). All patients maintained their intramuscular IFNβ-1a treatment throughout the study. Analyses explored safety signals and directional trends; this preliminary study was not powered to detect clinically meaningful differences. Results: Both combination treatments were safe and well tolerated, with all adverse events mild. Patients treated with IFNβ-1a plus FLU had similar relapse rates, EDSS scores, and MS Functional Composite scores, but significantly less acute corticosteroid use for on-study relapses and better responses on some MRI outcomes, versus patients treated with IFNβ-1a plus MP. Conclusions: Further study of FLU for breakthrough disease in patients with RRMS is warranted. PMID:27006698

  16. Antiproteinuric effect of add-on paricalcitol in CKD patients under maximal tolerated inhibition of renin-angiotensin system: a prospective observational study

    PubMed Central

    2012-01-01

    Background Whether paricalcitol (PCT) reduces proteinuria in the presence of intensified inhibition of Renin-Angiotensin-System (RAS) is poorly studied. We evaluated the antiproteinuric effect of PCT in non-dialysis chronic kidney disease (CKD) patients with proteinuria greater than 0.5 g/24 h persisting despite anti-RAS therapy titrated to minimize proteinuria in the absence of adverse effects. Methods Forty-eight CKD patients were studied in the first six months of add-on oral PCT (1 mcg/day) and three months after drug withdrawal. Results Males were 87.5%, age 63 ± 14 yrs, systolic/diastolic blood pressure (BP) 143 ± 22/78 ± 11 mmHg, eGFR 29.7 ± 14.5 mL/min/1.73 m2, diabetes 40%, and cardiovascular disease 38%. At referral in the center (28 months prior to study baseline), proteinuria was 2.44 (95% CI 1.80-3.04) g/24 h with 6 patients not receiving any anti-RAS and 42 treated with a single agent, at low dosage in most cases. At study baseline, twenty patients were under 2–3 anti-RAS drugs while twenty-eight received 1 agent at full dose and proteinuria resulted to be reduced versus referral to 1.23 g/24 h (95%CI 1.00-1.51). Six months of add-on PCT significantly decreased proteinuria to 0.61 g/24 h (95%CI 0.40-0.93), with levels less than 0.5 g/24 h achieved in 37.5% patients, in the absence of changes of BP and GFR. Proteinuria recovered to basal value after drug withdrawal. The extent of antiproteinuric response to PCT was positively associated with diabetes, eGFR and daily Na excretion (R2 = 0.459, P < 0.0001). PTH decreased from 201 (IQR 92–273) to 83 (IQR 50–189) pg/mL. Conclusions In CKD patients, add-on PCT induces a significant reduction of proteinuria that is evident despite intensified anti-RAS therapy and larger in the presence of diabetes, higher GFR and unrestricted salt intake. PMID:23167771

  17. Novel preventive treatment options.

    PubMed

    Longbottom, C; Ekstrand, K; Zero, D; Kambara, M

    2009-01-01

    A number of novel preventive treatment options which, as with traditional methods, can be differentiated into 3 categories of prevention (primary, secondary and tertiary), have been and are being currently investigated. Those reviewed are either commercially available or appear relatively close to that point. These include: approximal sealants; fluoride applications, including slow-release devices; measures to help remineralize demineralized tissue, including 3 different methods of delivering amorphous calcium phosphate; measures to help modify the biofilm to reduce the cariogenic challenge, including ozone therapy and probiotics; measures to increase enamel resistance to demineralization, including laser treatment of enamel, and a novel 'hybrid' technique for the treatment of primary molar caries which involves 'overlapping' of secondary and tertiary prevention--the Hall technique. Although many of these techniques show considerable promise and dentists should be aware of these developments and follow their progress, the evidence for each of these novel preventive treatment options is currently insufficient to make widespread recommendations. Changes in dental practice should be explored to see how oral health can be best supported through novel preventive systems. Further research is also required involving double-blind randomized controlled trials in order to bring further benefits of more effective caries control to patients. Implementation in practice should follow promptly as new techniques are shown to be clinically valuable for individual patients.

  18. [Third Wave Therapies of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder: A Reasonable Add-on Therapy for CBT? State of the Art].

    PubMed

    Külz, AnneKatrin; Barton, Barbara; Voderholzer, Ulrich

    2016-03-01

    Cognitive behavioral therapy (CBT) with exposure is the state of the art and most efficient treatment for obsessive compulsive disorder and recommended as treatment of 1st choice according to guidelines. Therapies of the third wave, such as mindfulness based approaches (ACT, MBCT), metacognitive therapy, CBASP or schema therapy, have become more popular over past few years. A small number of studies that investigated some of these therapies show promising results. However, due to the small number of available studies, small sample sizes and methodologic limitations (only a few available RCTs) the evidence of these therapies is insufficient. Above all no study compared these alternative therapies with the well-proven CBT and exposure. Therefore, therapies of the third wave should only be used as add-on therapies to CBT and exposure if individually needed in the treatment of OCD. Future research is absolutely needed.

  19. A heuristic model linking yoga philosophy and self-reflection to examine underlying mechanisms of add-on yoga treatment in schizophrenia.

    PubMed

    Rao, Naren; Menon, Sangeetha

    2016-06-01

    Preliminary evidence suggests efficacy of yoga as add-on treatment for schizophrenia, but the underlying mechanism by which yoga improves the symptoms of schizophrenia is not completely understood. Yoga improves self-reflection in healthy individuals, and self-reflection abnormalities are typically seen in schizophrenia. However, whether yoga treatment improves impairments in self-reflection typically seen in patients with schizophrenia is not examined. This paper discusses the potential mechanism of yoga in the treatment of schizophrenia and proposes a testable hypothesis for further empirical studies. It is proposed that self-reflection abnormalities in schizophrenia improve with yoga and the neurobiological changes associated with this can be examined using empirical behavioural measures and neuroimaging measures such as magnetic resonance imaging. PMID:27310309

  20. A heuristic model linking yoga philosophy and self-reflection to examine underlying mechanisms of add-on yoga treatment in schizophrenia.

    PubMed

    Rao, Naren; Menon, Sangeetha

    2016-06-01

    Preliminary evidence suggests efficacy of yoga as add-on treatment for schizophrenia, but the underlying mechanism by which yoga improves the symptoms of schizophrenia is not completely understood. Yoga improves self-reflection in healthy individuals, and self-reflection abnormalities are typically seen in schizophrenia. However, whether yoga treatment improves impairments in self-reflection typically seen in patients with schizophrenia is not examined. This paper discusses the potential mechanism of yoga in the treatment of schizophrenia and proposes a testable hypothesis for further empirical studies. It is proposed that self-reflection abnormalities in schizophrenia improve with yoga and the neurobiological changes associated with this can be examined using empirical behavioural measures and neuroimaging measures such as magnetic resonance imaging.

  1. Use of Bacillus thuringiensis var israelensis as a viable option in an Integrated Malaria Vector Control Programme in the Kumasi Metropolis, Ghana

    PubMed Central

    2013-01-01

    Background Integrated Vector Control (IVC) remains the approach for managing the malaria-causing vector. The study investigated the contribution of Bacillus thuringiensis israelensis (Bti) in the control of malaria by targeting the larvae and also mapped and documented major breeding sites in the Kumasi metropolis, Ghana. Methods Using a hand held GPS receiver unit, major breeding sites within the metropolis were mapped out during the larval survey. Mosquito larvae were then collected from the breeding sites and reared in an insectary to obtain an F1 generation for laboratory bioassays. The minimum effective dosage of Bti Water Dispersible Granular (WDG) formulation was determined by a series of bioassays. Based on the results obtained in the laboratory, the optimum effective dosage of Bti formulations against naturally occurring larvae of the indigenous mosquito species was determined through open field trials. Results A total of 33 breeding sites were identified and geo-referenced during the larval surveys with the majority of the breeding sites located in the Asokwa sub-metropolis, Kumasi, Ghana. A Bti (3,000 International Toxic Unit (ITU)/mg) concentration of 0.026 mg/l resulted in 50% mortality whilst a concentration of 0.136 mg/l resulted in 95% mortality. Results from the open field trials with Bti showed that a dosage of 0.2 kg/ha is as effective as 0.4 kg/ha in suppressing late instars and resulting pupae. Conclusion This study reveals that Bti at a very low dosage of 0.2 kg/ha is highly effective against Anopheles larvae and therefore offers viable options for the management of vector mosquitoes. Further research is needed to extend this to the field in order to determine its ability to reduce malaria incidence. PMID:23607376

  2. Breast Cancer: Treatment Options

    MedlinePlus

    ... Cancer - Treatment Options Request Permissions Print to PDF Breast Cancer - Treatment Options Approved by the Cancer.Net Editorial ... recommendations for ovarian ablation . Hormonal therapy for metastatic breast cancer Hormonal therapies are also commonly used to treat ...

  3. Traditional preventive treatment options.

    PubMed

    Longbottom, C; Ekstrand, K; Zero, D

    2009-01-01

    Preventive treatment options can be divided into primary, secondary and tertiary prevention techniques, which can involve patient- or professionally applied methods. These include: oral hygiene (instruction), pit and fissure sealants ('temporary' or 'permanent'), fluoride applications (patient- or professionally applied), dietary assessment and advice (modification), other measures to help remineralize demineralized tissue and other measures to help modify the biofilm to reduce the cariogenic challenge. There is a considerable body of strong evidence supporting the use of specific techniques for primary prevention of caries in children, e.g. pit and fissure sealants and topically applied fluorides (including patient-applied fluoride toothpastes and professionally applied fluoride varnishes), but limited strong evidence for these techniques for secondary prevention--i.e. where early to established lesions with ICDAS codes 1-4 (and also the severer lesions coded 5 or 6) are involved--and in relation to adults. This lack of evidence reflects a shortage of high-quality trials in the area, as opposed to a series of good studies showing no effect. Since there is also limited longitudinal evidence supporting conventional operative care, and since controlling the caries process prior to first restoration is the key to breaking the repair cycle and improving care for patients, future research should address the shortcomings in the current level of supporting evidence for the various traditional preventive treatment options.

  4. Add-on effect of bedtime dosing of the alpha(1)-adrenergic receptor antagonist doxazosin on morning hypertension and left ventricular hypertrophy in patients undergoing long-term amlodipine monotherapy.

    PubMed

    Ikeda, Toshio; Gomi, Tomoko; Shibuya, Yuko; Shinozaki, Shingo; Suzuki, Yoshifumi; Matsuda, Nami

    2007-11-01

    High morning blood pressure is related to target organ damage and future cardiovascular events. Chronobiologic therapies focusing on the early morning period may be an important strategy for antihypertensive therapy. The aim of this study was to clarify the add-on effects of bedtime dosing of the alpha(1)-adrenergic receptor antagonist doxazosin on morning blood pressure in patients with essential hypertension who were under long-acting calcium channel blocker amlodipine monotherapy. The add-on effects of doxazosin at the maximum dose of 6 mg at bedtime on home blood pressure and left ventricular geometry for 1 year were investigated in 49 subjects (37 men and 12 women, aged 57.5+/-9.1 years) with morning hypertension who had been treated with amlodipine alone for more than 1 year. Doxazosin induced a significant decrease in morning blood pressure (145.6+/-5.6/91.5+/-5.4 to 132.4+/-3.7/83.6+/-5.6 mmHg, pcontrol of morning blood pressure and regression of left ventricular hypertrophy.

  5. Demineralized Bone Matrix Add-On for Acceleration of Bone Healing in Atypical Subtrochanteric Femoral Fracture: A Consecutive Case-Control Study

    PubMed Central

    Kulachote, Noratep; Sirisreetreerux, Norachart; Chanplakorn, Pongsthorn; Fuangfa, Praman; Suphachatwong, Chanyut; Wajanavisit, Wiwat

    2016-01-01

    Background. Delayed union and nonunion are common complications in atypical femoral fractures (AFFs) despite having good fracture fixation. Demineralized bone matrix (DBM) is a successfully proven method for enhancing fracture healing of the long bone fracture and nonunion and should be used in AFFs. This study aimed to compare the outcome after subtrochanteric AFFs (ST-AFFs) fixation with and without DBM. Materials and Methods. A prospective study was conducted on 9 ST-AFFs patients using DBM (DBM group) during 2013-2014 and compared with a retrospective consecutive case series of ST-AFFs patients treated without DBM (2010–2012) (NDBM group, 9 patients). All patients were treated with the same standard guideline and followed up until fractures completely united. Postoperative outcomes were then compared. Results. DBM group showed a significant shorter healing time than NDBM group (28.1 ± 14.4 versus 57.9 ± 36.8 weeks, p = 0.04). Delayed union was found in 4 patients (44%) in DBM group compared with 7 patients (78%) in NDBM group (p > 0.05). No statistical difference of nonunion was demonstrated between both groups (DBM = 1 and NDBM = 2, p > 0.05). Neither postoperative infection nor severe local tissue reaction was found. Conclusions. DBM is safe and effective for accelerating the fracture healing in ST-AFFx and possibly reduces nonunion after fracture fixation. Trial registration number is TCTR20151021001. PMID:27022610

  6. 40 CFR 63.3556 - 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

    ... must monitor and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following the...

  7. 40 CFR 63.3546 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... must monitor and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following the...

  8. 40 CFR 63.4966 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle, for the regeneration cycle either immediately preceding or immediately following the performance test. (2) The...

  9. 40 CFR 63.3967 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... (1) You must monitor and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following...

  10. 40 CFR 63.4567 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or... the minimum total desorbing gas mass flow recorded during the regeneration cycle and the...

  11. 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

    ... nitrogen) mass flow for each regeneration cycle and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following... desorbing gas mass flow recorded during the regeneration cycle and the maximum carbon bed...

  12. 40 CFR 63.4567 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or... the minimum total desorbing gas mass flow recorded during the regeneration cycle and the...

  13. 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

    ... total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle, for the regeneration cycle either immediately preceding or immediately following the performance test. (2) The...

  14. 40 CFR 63.3967 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... (1) You must monitor and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following...

  15. 40 CFR 63.3167 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle and the carbon bed... 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion temperature for... oxidizers in 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion...

  16. 40 CFR 63.4767 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following the performance test. (2)...

  17. 40 CFR 63.4567 - 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

    ...., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or... the minimum total desorbing gas mass flow recorded during the regeneration cycle and the...

  18. 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

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately... are the minimum total desorbing gas mass flow recorded during the regeneration cycle, and the...

  19. 40 CFR 63.3556 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... must monitor and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following the...

  20. 40 CFR 63.4966 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle, for the regeneration cycle either immediately preceding or immediately following the performance test. (2) The...

  1. 40 CFR 63.3967 - 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

    .... (1) You must monitor and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following...

  2. 40 CFR 63.3167 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle and the carbon bed... 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion temperature for... oxidizers in 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion...

  3. 40 CFR 63.4167 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... gas (e.g., steam or nitrogen) mass flow for each regeneration cycle and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately... are the minimum total desorbing gas mass flow recorded during the regeneration cycle and the...

  4. 40 CFR 63.3556 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... must monitor and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following the...

  5. 40 CFR 63.4167 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... gas (e.g., steam or nitrogen) mass flow for each regeneration cycle and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately... are the minimum total desorbing gas mass flow recorded during the regeneration cycle and the...

  6. 40 CFR 63.3546 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... must monitor and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following the...

  7. 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

    ... gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately... are the minimum total desorbing gas mass flow recorded during the regeneration cycle, and the...

  8. 40 CFR 63.4767 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and record the total regeneration desorbing gas (e.g., steam or nitrogen) mass flow for each regeneration cycle, and the carbon bed temperature after each carbon bed regeneration and cooling cycle for the regeneration cycle either immediately preceding or immediately following the performance test. (2)...

  9. 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, 2014 CFR

    2014-07-01

    ... Electrodeposition Primer, Primer-Surfacer, Topcoat, Final Repair, Glass Bonding Primer, and Glass Bonding Adhesive... Primer, and Glass Bonding Adhesive Emission Limitations and the Separate Electrodeposition...

  10. 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

    ...-Surfacer, Topcoat, Final Repair, Glass Bonding Primer, and Glass Bonding Adhesive Emission Limitations § 63... Primer, and Glass Bonding Adhesive Emission Limitations and the Separate Electrodeposition...

  11. 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, 2013 CFR

    2013-07-01

    ... Primer, Primer-Surfacer, Topcoat, Final Repair, Glass Bonding Primer, and Glass Bonding Adhesive Emission... Primer, and Glass Bonding Adhesive Emission Limitations and the Separate Electrodeposition...

  12. 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, 2012 CFR

    2012-07-01

    ... Electrodeposition Primer, Primer-Surfacer, Topcoat, Final Repair, Glass Bonding Primer, and Glass Bonding Adhesive... Primer, and Glass Bonding Adhesive Emission Limitations and the Separate Electrodeposition...

  13. 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, 2011 CFR

    2011-07-01

    ...-Surfacer, Topcoat, Final Repair, Glass Bonding Primer, and Glass Bonding Adhesive Emission Limitations § 63... Primer, and Glass Bonding Adhesive Emission Limitations and the Separate Electrodeposition...

  14. 40 CFR 63.9324 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... performance test, you must monitor and record the temperature just before the catalyst bed and the temperature difference across the catalyst bed at least once every 15 minutes during each of the three test runs. (2) Use... before the catalyst bed and the average temperature difference across the catalyst bed maintained...

  15. 40 CFR 63.9324 - 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

    ... performance test, you must monitor and record the temperature just before the catalyst bed and the temperature difference across the catalyst bed at least once every 15 minutes during each of the three test runs. (2) Use... before the catalyst bed and the average temperature difference across the catalyst bed maintained...

  16. 40 CFR 63.9324 - How do I establish the emission capture system and add-on control device operating limits during...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... performance test, you must monitor and record the temperature just before the catalyst bed and the temperature difference across the catalyst bed at least once every 15 minutes during each of the three test runs. (2) Use... before the catalyst bed and the average temperature difference across the catalyst bed maintained...

  17. 40 CFR 63.4363 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... performance test, you must monitor and record the temperature at the inlet to the catalyst bed and the temperature difference across the catalyst bed at least once every 15 minutes during each of the three test... temperature at the inlet to the catalyst bed and the average temperature difference across the catalyst...

  18. 40 CFR 63.4363 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... performance test, you must monitor and record the temperature at the inlet to the catalyst bed and the temperature difference across the catalyst bed at least once every 15 minutes during each of the three test... temperature at the inlet to the catalyst bed and the average temperature difference across the catalyst...

  19. 40 CFR 63.3167 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... immediately downstream of the firebox before any substantial heat exchange occurs. (2) Use all valid data... 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion temperature for... oxidizers in 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion...

  20. 40 CFR 63.3967 - 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

    ... of the firebox before any substantial heat exchange occurs. (2) Use the data collected during the... manufacturer's recommendations. If the catalyst bed is replaced and is not of like or better kind and quality as the old catalyst then you must conduct a new performance test to determine destruction...

  1. 40 CFR 63.3167 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... downstream of the firebox before any substantial heat exchange occurs. (2) Use all valid data collected... 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion temperature for... oxidizers in 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion...

  2. 40 CFR 63.4567 - 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

    ... not of like or better kind and quality as the old catalyst then you must conduct a new performance... of the firebox before any substantial heat exchange occurs. (2) Use the data collected during the... replacement catalyst is of like or better kind and quality as the old catalyst, then a new performance test...

  3. 40 CFR 63.4567 - 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

    ... not of like or better kind and quality as the old catalyst then you must conduct a new performance... substantial heat exchange occurs. (2) Use the data collected during the performance test to calculate and... replacement catalyst is of like or better kind and quality as the old catalyst, then a new performance test...

  4. 40 CFR 63.3167 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... immediately downstream of the firebox before any substantial heat exchange occurs. (2) Use all valid data... 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion temperature for... oxidizers in 40 CFR 60.395(c), then you may set the minimum operating limit for the combustion...

  5. 40 CFR 63.3967 - 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

    ... of the firebox before any substantial heat exchange occurs. (2) Use the data collected during the... manufacturer's recommendations. If the catalyst bed is replaced and is not of like or better kind and quality as the old catalyst then you must conduct a new performance test to determine destruction...

  6. 40 CFR 63.9324 - 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

    ... (b)(4)(i) through (iii) of this section. (i) Annual sampling and analysis of the catalyst activity (i... or duct static pressure, as specified in paragraphs (c)(1) and (2) of this section. The operating... required by § 63.9310, you must monitor and record either the gas volumetric flow rate or the duct...

  7. 40 CFR Table 4 to Subpart Vvvv of... - Operating Limits if Using an Add-on Control Device for Open Molding Operations

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....007 inch H2O, as established in Method 204 of appendix M to 40 CFR part 51 i. Collecting the direction of air flow, and either the facial velocity of air through all natural draft openings according to... period, either the average facial velocity of air through all natural draft openings in the...

  8. 40 CFR Table 4 to Subpart Vvvv of... - Operating Limits if Using an Add-on Control Device for Open Molding Operations

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... be at least 0.007 inch H2O, as established in Method 204 of appendix M to 40 CFR part 51 i. Collecting the direction of air flow, and either the facial velocity of air through all natural draft.... in any 3-hour period, either the average facial velocity of air through all natural draft openings...

  9. 40 CFR Table 4 to Subpart Vvvv of... - Operating Limits if Using an Add-on Control Device for Open Molding Operations

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ....007 inch H2O, as established in Method 204 of appendix M to 40 CFR part 51 i. Collecting the direction of air flow, and either the facial velocity of air through all natural draft openings according to... period, either the average facial velocity of air through all natural draft openings in the...

  10. 40 CFR Table 4 to Subpart Vvvv of... - Operating Limits if Using an Add-on Control Device for Open Molding Operations

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... be at least 0.007 inch H2O, as established in Method 204 of appendix M to 40 CFR part 51 i. Collecting the direction of air flow, and either the facial velocity of air through all natural draft.... in any 3-hour period, either the average facial velocity of air through all natural draft openings...

  11. 40 CFR 63.4363 - How do I establish the add-on control device operating limits during the performance test?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air... section, unless you have received approval for alternative monitoring and operating limits under § 63.8(f.... (3) As an alternative to monitoring the temperature difference across the catalyst bed, you...

  12. 40 CFR 63.3556 - 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

    ... of key parameters of the valve operating system (e.g., solenoid valve operation, air pressure... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS FOR SOURCE CATEGORIES (CONTINUED) National...

  13. TANK SPACE OPTIONS REPORT

    SciTech Connect

    WILLIS WL; AHRENDT MR

    2009-08-11

    Since this report was originally issued in 2001, several options proposed for increasing double-shell tank (DST) storage space were implemented or are in the process of implementation. Changes to the single-shell tank (SST) waste retrieval schedule, completion of DST space saving options, and the DST space saving options in progress have delayed the projected shortfall of DST storage space from the 2007-2011 to the 2018-2025 timeframe (ORP-11242, River Protection Project System Plan). This report reevaluates options from Rev. 0 and includes evaluations of new options for alleviating projected restrictions on SST waste retrieval beginning in 2018 because of the lack of DST storage space.

  14. Safety and efficacy of an add-on therapy with curcumin phytosome and piperine and/or lipoic acid in subjects with a diagnosis of peripheral neuropathy treated with dexibuprofen

    PubMed Central

    Di Pierro, Francesco; Settembre, Roberto

    2013-01-01

    We conducted an 8-week, open, randomized controlled clinical trial on 141 subjects affected by neuropathic pain to investigate the role of an adjunctive therapy added to the administration of dexibuprofen (400 mg twice a day) and based on a multi-ingredient formula (Lipicur), consisting of lipoic acid plus curcumin phytosome and piperine, in patients with a diagnosis of lumbar sciatica, lumbar disk herniation, and/or lumbar canal stenosis (96 subjects), or with carpal tunnel syndrome (45 subjects). A total of 135 participants completed the study. Treatment with the multi-ingredient formula (Lipicur) reduced neuropathic pain by more than 66% in both conditions (subjects with lumbar sciatica and with carpal tunnel syndrome), and these reductions were statistically significant. Moreover, the treatment reduced dexibuprofen use by about 40%. An add-on therapy with only lipoic acid has not shown any significant results. On the basis of its safety and efficacy, Lipicur could be considered an effective complementary therapy to be added to conventional treatments to achieve better efficacy in reducing neuropathic pain. PMID:23861596

  15. Newer Management Options in Leprosy

    PubMed Central

    Rao, P Narasimha; Jain, Suman

    2013-01-01

    Newer management options are needed for leprosy control even at present, as it is predicted that new cases of leprosy will continue to appear for many more years in future. This article detail newer methods of clinical grading of peripheral nerve involvement (thickening, tenderness and nerve pain which are subjective in nature) and the advances made in the use of Ultrasonography and Colour Doppler as an objective imaging tool for nerves in leprosy. It also briefly discusses the newer drugs and alternative regimens as therapeutic management options which hold promise for leprosy in future. PMID:23372204

  16. Add-On Aliskiren Elicits Stronger Renoprotection Than High-Dose Valsartan in Type 2 Diabetic KKAy Mice That Do Not Respond to Low-Dose Valsartan

    PubMed Central

    Lei, Bai; Nakano, Daisuke; Fan, Yu-Yan; Kitada, Kento; Hitomi, Hirofumi; Kobori, Hiroyuki; Mori, Hirohito; Masaki, Tsutomu; Nishiyama, Akira

    2012-01-01

    We hypothesized that aliskiren provides renoprotection in diabetic animals that did not receive sufficient renoprotection by AT1-receptor antagonist treatment. Type 2 diabetic KKAy mice were treated with group 1: vehicle or group 2: valsartan (15 mg/kg per day) from 12 to 16 weeks of age. The mice were subsequently divided into 4 groups and treated with the following combinations of drugs for another 6 weeks: 1: group 1 kept receiving vehicle, 2: group 2 continuously received 15 mg/kg per day of valsartan (Val-Val15), 3: group 2 received 50 mg/kg per day of valsartan (Val-Val50), 4: group 2 continuously received 15 mg/kg per day of valsartan with 25 mg/kg per day of aliskiren (Val-Val+Ali). Aliskiren exerted significant anti-albuminuric effects, whereas valsartan failed to ameliorate the albuminuria in the first four weeks. Surprisingly, the increasing dosage of valsartan in the Val-Val50 group showed non-significant tendencies to attenuate the albuminuria compared with vehicle infusion. Val-Val+Ali significantly suppressed the development of albuminuria and podocyte injury. Val-Val50 and Val-Val+Ali showed similar suppression of angiotensin II contents in the kidney of KKAy mice. In conclusion, the anti-albuminuric effect that was observed in the type 2 diabetic mice showing no anti-albuminuric effect by valsartan can be attributed to the add-on aliskiren. PMID:22673148

  17. Comparison of the Effects of Continuous Subcutaneous Insulin Infusion and Add-On Therapy with Sitagliptin in Patients with Newly Diagnosed Type 2 Diabetes Mellitus.

    PubMed

    Wan, Heng; Zhao, Defu; Shen, Jie; Lu, Lu; Zhang, Tong; Chen, Zhi

    2016-01-01

    To identify a new regimen to optimize treatment for patients with newly diagnosed type 2 diabetes (T2DM) by short-term continuous subcutaneous insulin infusion (CSII) alone. Methods. 60 patients with newly diagnosed T2DM were randomized into two groups (n = 30 each) and treated for 2 weeks with CSII alone (CSII group) or with CSII plus sitagliptin (CSII + Sig group). The glycemic variability of the patients was measured using a continuous glucose monitoring system (CGMS) for the last 72 hours. A standard meal test was performed before and after the interventions, and the levels of glycated albumin, fasting glucose, fasting C-peptide, postprandial 2 h blood glucose, and postprandial 2 h C-peptide were examined. Results. Compared with the CSII group, the indicators of glycemic variability, such as the mean amplitude of glycemic excursion (MAGE) and the standard deviation of blood glucose (SDBG), were decreased significantly in the CSII + Sig group. The changes before and after treatment in the C-peptide reactivity index (ΔCPI) and the secretory unit of islet in transplantation index (ΔSUIT) indicated a significant improvement in the CSII + Sig group. Conclusions. Add-on therapy with sitagliptin may be an optimized treatment for patients with newly diagnosed T2DM compared with short-term CSII alone. PMID:26798658

  18. Comparison of the Effects of Continuous Subcutaneous Insulin Infusion and Add-On Therapy with Sitagliptin in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

    PubMed Central

    Wan, Heng; Zhao, Defu; Shen, Jie; Lu, Lu; Zhang, Tong; Chen, Zhi

    2016-01-01

    To identify a new regimen to optimize treatment for patients with newly diagnosed type 2 diabetes (T2DM) by short-term continuous subcutaneous insulin infusion (CSII) alone. Methods. 60 patients with newly diagnosed T2DM were randomized into two groups (n = 30 each) and treated for 2 weeks with CSII alone (CSII group) or with CSII plus sitagliptin (CSII + Sig group). The glycemic variability of the patients was measured using a continuous glucose monitoring system (CGMS) for the last 72 hours. A standard meal test was performed before and after the interventions, and the levels of glycated albumin, fasting glucose, fasting C-peptide, postprandial 2 h blood glucose, and postprandial 2 h C-peptide were examined. Results. Compared with the CSII group, the indicators of glycemic variability, such as the mean amplitude of glycemic excursion (MAGE) and the standard deviation of blood glucose (SDBG), were decreased significantly in the CSII + Sig group. The changes before and after treatment in the C-peptide reactivity index (ΔCPI) and the secretory unit of islet in transplantation index (ΔSUIT) indicated a significant improvement in the CSII + Sig group. Conclusions. Add-on therapy with sitagliptin may be an optimized treatment for patients with newly diagnosed T2DM compared with short-term CSII alone. PMID:26798658

  19. Assessment of VOC emissions and their control from baker's yeast manufacturing facilities. Final report

    SciTech Connect

    Barker, R.; Williamson, M.

    1992-01-01

    The Environmental Protection Agency's (EPA's) Control Technology Center (CTC) conducted a study to obtain information on the baker's yeast manufacturing industry. Baker's yeast is produced by a fermentation process that generates large quantities of ethanol and acetaldehyde. Currently, 13 facilities produce baker's yeast in the United States. The volatile organic compound (VOC) emission rate from a typical facility is estimated at 82 megagrams per year (90 tons per year). The majority of these emissions occurs in the final trade fermentations. The VOC emission alternatives that were evaluated during the study were process control measures to reduce the formation of VOC emissions as well as wet scrubbers, carbon adsorbers, incinerators, condensers, and biological filters to control VOC emissions. Of these approaches, it appears that process control measures, catalytic incinerators, or a combination of add-on control techniques (e.g., wet scrubbers followed by an incinerator or a biological filter) are the most feasible approaches for controlling yeast process emissions. Based on the results of the study, the control efficiency associated with the add-on control systems is estimated to be 95 to 98 percent. The report contains information on the baker's yeast fermentation process, the number and locations of yeast plants, the potential emissions from the process, and an evaluation of potential emission control options.

  20. Indirect comparison of lixisenatide versus neutral protamine Hagedorn insulin as add-on to metformin and sulphonylurea in patients with type 2 diabetes mellitus

    PubMed Central

    Fournier, Marie; Germe, Maeva; Theobald, Karlheinz; Scholz, Gerhard H.; Lehmacher, Walter

    2014-01-01

    -insulin, there was a significant reduction in body weight with lixisenatide (MD = –3.62 kg; 95% CI = [–5.86 kg, –1.38 kg]) at study completion. The number of discontinuations due to AEs numerically favoured NPH-insulin over lixisenatide (OR = 2.64; 95% CI = [0.25, 27.96]), with a broad confidence interval. Conclusions: Lixisenatide treatment was associated with a lower risk of hypoglycaemia and a greater weight loss compared with NPH-insulin. Glycaemic control with lixisenatide treatment was comparable with NPH-insulin. These data suggest that lixisenatide is a beneficial treatment option for T2DM patients with inadequate glycaemic control on OADs, and is associated with reduced risk of hypoglycaemia and weight gain. PMID:25332702

  1. Effects of Add-on Fluvastatin Therapy in Patients with Chronic Proteinuric Nephropathy on Dual Renin-Angiotensin System Blockade: The ESPLANADE Trial

    PubMed Central

    Ruggenenti, Piero; Perna, Annalisa; Tonelli, Marcello; Loriga, Giacomina; Motterlini, Nicola; Rubis, Nadia; Ledda, Franca; Rota, Stefano; Satta, Andrea; Granata, Antonio; Battaglia, Giovanni; Cambareri, Francesco; David, Salvatore; Gaspari, Flavio; Stucchi, Nadia; Carminati, Sergio; Ene-Iordache, Bogdan; Cravedi, Paolo

    2010-01-01

    Background and objectives: This open, prospective, randomized trial aimed to assess the effects of statins in chronic kidney disease patients on optimized antiproteinuric treatment with combined angiotensin-converting enzyme inhibition and angiotensin receptor blockade. Design, setting, participants, & measurements: After 1-month benazepril therapy followed by 1-month benazepril-valsartan combined therapy (run-in), 186 consenting patients with residual proteinuria >0.5 g/24 h were randomized to 6-month benazepril-valsartan therapy alone or combined with fluvastatin. Between-groups changes in proteinuria (primary outcome), serum lipids, and GFR were compared by ANCOVA. Analyses were blinded and by intention to treat. Results: During the run-in, proteinuria decreased more on benazepril-valsartan than on benazepril alone. Proteinuria reduction correlated with concomitant reduction in total, LDL, and HDL cholesterol, and apolipoprotein B and apolipoprotein A levels. After randomization, median proteinuria similarly decreased from 1.2 (0.6 to 2.2) to 1.1 (0.5 to 1.7) g/24 h on fluvastatin and from 1.5 (0.8 to 2.7) to 1.0 (0.5 to 2.4) g/24 h on benazapril-valsartan therapy alone. Fluvastatin further reduced total and LDL cholesterol and apolipoprotein B versus benazepril-valsartan alone, but did not affect serum triglycerides and GFR. Treatment was well tolerated. Conclusions: In chronic kidney disease patients with residual proteinuria despite combined angiotensin-converting enzyme inhibitor and angiotensin receptor blockade therapy, add-on fluvastatin does not affect urinary proteins, but further reduces serum lipids and is safe. Whether combined angiotensin-converting enzyme inhibitor, angiotensin receptor blockade, and statin therapy may improve cardiovascular outcomes in this high-risk population is worth investigating. PMID:20671225

  2. Compact fixed wavelength femtosecond oscillators as an add-on for tunable Ti:sapphire lasers extend the range of applications towards multimodal imaging and optogenetics

    NASA Astrophysics Data System (ADS)

    Hakulinen, T.; Klein, J.

    2016-03-01

    Two-photon (2P) microscopy based on tunable Ti:sapphire lasers has become a widespread tool for 3D imaging with sub-cellular resolution in living tissues. In recent years multi-photon microscopy with simpler fixed-wavelength femtosecond oscillators using Yb-doped tungstenates as gain material has raised increasing interest in life-sciences, because these lasers offer one order of magnitude more average power than Ti:sapphire lasers in the wavelength range around 1040 nm: Two-photon (2P) excitation of mainly red or yellow fluorescent dyes and proteins (e.g. YFP, mFruit series) simultaneously has been proven with a single IR laser wavelength. A new approach is to extend the usability of existing tunable Titanium sapphire lasers by adding a fixed IR wavelength with an Yb femtosecond oscillator. By that means a multitude of applications for multimodal imaging and optogenetics can be supported. Furthermore fs Yb-lasers are available with a repetition rate of typically 10 MHz and an average power of typically 5 W resulting in pulse energy of typically 500 nJ, which is comparably high for fs-oscillators. This makes them an ideal tool for two-photon spinning disk laser scanning microscopy and holographic patterning for simultaneous photoactivation of large cell populations. With this work we demonstrate that economical, small-footprint Yb fixed-wavelength lasers can present an interesting add-on to tunable lasers that are commonly used in multiphoton microscopy. The Yb fs-lasers hereby offer higher power for imaging of red fluorescent dyes and proteins, are ideally enhancing existing Ti:sapphire lasers with more power in the IR, and are supporting pulse energy and power hungry applications such as spinning disk microscopy and holographic patterning.

  3. Approximate option pricing

    SciTech Connect

    Chalasani, P.; Saias, I.; Jha, S.

    1996-04-08

    As increasingly large volumes of sophisticated options (called derivative securities) are traded in world financial markets, determining a fair price for these options has become an important and difficult computational problem. Many valuation codes use the binomial pricing model, in which the stock price is driven by a random walk. In this model, the value of an n-period option on a stock is the expected time-discounted value of the future cash flow on an n-period stock price path. Path-dependent options are particularly difficult to value since the future cash flow depends on the entire stock price path rather than on just the final stock price. Currently such options are approximately priced by Monte carlo methods with error bounds that hold only with high probability and which are reduced by increasing the number of simulation runs. In this paper the authors show that pricing an arbitrary path-dependent option is {number_sign}-P hard. They show that certain types f path-dependent options can be valued exactly in polynomial time. Asian options are path-dependent options that are particularly hard to price, and for these they design deterministic polynomial-time approximate algorithms. They show that the value of a perpetual American put option (which can be computed in constant time) is in many cases a good approximation to the value of an otherwise identical n-period American put option. In contrast to Monte Carlo methods, the algorithms have guaranteed error bounds that are polynormally small (and in some cases exponentially small) in the maturity n. For the error analysis they derive large-deviation results for random walks that may be of independent interest.

  4. Exploration Architecture Options - ECLSS, EVA, TCS Implications

    NASA Technical Reports Server (NTRS)

    Chambliss, Joe; Henninger, Don; Lawrence, Carl

    2010-01-01

    Many options for exploration of space have been identified and evaluated since the Vision for Space Exploration (VSE) was announced in 2004. Lunar architectures have been identified and addressed in the Lunar Surface Systems team to establish options for how to get to and then inhabit and explore the moon. The Augustine Commission evaluated human space flight for the Obama administration and identified many options for how to conduct human spaceflight in the future. This paper will evaluate the options for exploration of space for the implications of architectures on the Environmental Control and Life Support (ECLSS), ExtraVehicular Activity (EVA) and Thermal Control System (TCS) Systems. The advantages and disadvantages of each architecture and options are presented.

  5. Exploration Architecture Options - ECLSS, EVA, TCS Implications

    NASA Technical Reports Server (NTRS)

    Chambliss, Joe; Henninger, Don; Lawrence, Carl

    2009-01-01

    Many options for exploration of the Moon and Mars have been identified and evaluated since the Vision for Space Exploration VSE was announced in 2004. Lunar architectures have been identified and addressed in the Lunar Surface Systems team to establish options for how to get to and then inhabit and explore the moon. The Augustine Commission evaluated human space flight for the Obama administration and identified many options for how to conduct human spaceflight in the future. This paper will evaluate the options for exploration of the moon and Mars and those of the Augustine human spaceflight commission for the implications of each architecture on the Environmental Control and Life Support, ExtraVehicular Activity and Thermal Control systems. The advantages and disadvantages of each architecture and options are presented.

  6. The Origins of Options

    PubMed Central

    Smaldino, Paul E.; Richerson, Peter J.

    2012-01-01

    Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one’s current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options. PMID:22514515

  7. Inhaled and systemic corticosteroid response in severe asthma assessed by alveolar nitric oxide: a randomized crossover pilot study of add-on therapy

    PubMed Central

    Williamson, Peter A; Short, Philip M; Vaidyanathan, Sriram; Lipworth, Brian J

    2013-01-01

    AIMS Alveolar nitric oxide (CANO) is a potential biomarker of small airway inflammation. We investigated effects on CANO of the addition of coarse and fine particle inhaled corticosteroids to standard therapy in severe asthma. METHODS Severe asthmatics taking ≥1600 µg day−1 budesonide or equivalent performed a randomized open-label crossover study. Subjects with FEV1 < 80%, gas trapping and CANO≥2 ppb entered a 6 week dose-ramp run-in of fluticasone/salmeterol(FPSM) 250/50 µg twice daily for 3 weeks, then 500/50 µg twice daily for 3 weeks. Patients then received additional HFA-beclomethasone diproprionate (BDP) 200 µg twice daily or FP 250 µg twice daily for 3 weeks in a crossover. Participants then received prednisolone(PRED) 25 mg day−1 for 1 week. Nitric oxide, lung function, mannitol challenge, systemic inflammatory markers and urinary cortisol were measured. RESULTS Fifteen completed per protocol: mean (SD) age 51 (12) years, FEV1 58 (13)% predicted, residual volume 193 (100)% predicted and mannitolPD10 177 (2.8) µg. There was no significant difference between FPSM and add-on therapy for CANO. FPSM/BDP and FPSM/PRED suppressed broncial flux (JawNO) and FENO compared with FPSM alone, but there was no significant difference between FPSM/BDP and FPSM/FP. ECP, e-selectin and ICAM-1 were suppressed by FPSM/PRED compared with FPSM and FPSM/FP but not FPSM/BDP. Plasma cortisol was significantly suppressed by FPSM/PRED. CONCLUSION In severe asthma, CANO is insensitive to changes in dose and delivery of inhaled corticosteroids and is not suppressed by systemic corticosteroids. Additional inhaled HFA-BDP reduced FENO and JawNO without adrenal suppression. There was a trend to reduction in FENO and JawNO with additional FP but this did not reach statistical significance. PRED reduced FENO and JawNO with suppression of systemic inflammatory markers and urinary cortisol. PMID:22568828

  8. SEATSAT programs option analysis

    NASA Technical Reports Server (NTRS)

    Luckl, L.

    1976-01-01

    A preliminary analysis of the costs of SEASAT follow-on options is presented. All the options assume the existence of SEASAT-A as currently defined in the SEASAT Economic Assessment. It is assumed that each option will continue through the year 2000 and approach operational system status in the 1983-1986 period, depending upon the sensor package selected. The launch vehicle assumed through 1983 is the Atlas Agena. After 1983, it is assumed SEASAT-A will switch to the use of the Space Shuttle. All cost estimates are 1976 dollars for fiscal year cost accounting, with no inflation rate included.

  9. Porphyria Treatment Options

    MedlinePlus

    ... only. For treatment options for Porphyria Cutanea Tarda (PCT) , Congenital Erythropoietic Protoporphyria (CEP) and Hepatoerythropoietic Porphyria (HEP) ... Contact Us About Porphyria AIP VP HCP ADP PCT EPP CEP HEP Diet and Nutrition History of ...

  10. Nevada Transportatoion Options Study

    SciTech Connect

    P. GEHNER; E.M. WEAVER; L. FOSSUM

    2006-05-25

    This study performs a cost and schedule analysis of three Nevada Transportation options that support waste receipt at the repository. Based on the U.S. Department of Energy preference for rail transportation in Nevada (given in the Final Environmental Impact Statement), it has been assumed that a branch rail line would be constructed to support waste receipt at the repository. However, due to potential funding constraints, it is uncertain when rail will be available. The three Nevada Transportation options have been developed to meet a varying degree of requirements for transportation and to provide cost variations used in meeting the funding constraints given in the Technical Direction Letter guidelines for this study. The options include combinations of legal-weight truck, heavy-haul truck, and rail. Option 1 uses a branch rail line that would support initial waste receipt at the repository in 2010. Rail transportation would be the primary mode, supplemented by legal weight trucks. This option provides the highest level of confidence in cost and schedule, lowest public visibility, greatest public acceptability, lowest public dose, and is the recommended option for support of waste receipt. The completion of rail by 2010 will require spending approximately $800 million prior to 2010. Option 2 uses a phased rail approach to address a constrained funding scenario. To meet funding constraints, Option 2 uses a phased approach to delay high cost activities (final design and construction) until after initial waste receipt in 2010. By doing this, approximately 95 percent of the cost associated with completion of a branch rail line is deferred until after 2010. To support waste receipt until a branch rail line is constructed in Nevada, additional legal-weight truck shipments and heavy-haul truck shipments (on a limited basis for naval spent nuclear fuel) would be used to meet the same initial waste receipt rates as in Option 1. Use of heavy-haul shipments in the absence

  11. Options Study - Phase II

    SciTech Connect

    R. Wigeland; T. Taiwo; M. Todosow; W. Halsey; J. Gehin

    2010-09-01

    The Options Study has been conducted for the purpose of evaluating the potential of alternative integrated nuclear fuel cycle options to favorably address the issues associated with a continuing or expanding use of nuclear power in the United States. The study produced information that can be used to inform decisions identifying potential directions for research and development on such fuel cycle options. An integrated nuclear fuel cycle option is defined in this study as including all aspects of the entire nuclear fuel cycle, from obtaining natural resources for fuel to the ultimate disposal of used nuclear fuel (UNF) or radioactive wastes. Issues such as nuclear waste management, especially the increasing inventory of used nuclear fuel, the current uncertainty about used fuel disposal, and the risk of nuclear weapons proliferation have contributed to the reluctance to expand the use of nuclear power, even though it is recognized that nuclear power is a safe and reliable method of producing electricity. In this Options Study, current, evolutionary, and revolutionary nuclear energy options were all considered, including the use of uranium and thorium, and both once-through and recycle approaches. Available information has been collected and reviewed in order to evaluate the ability of an option to clearly address the challenges associated with the current implementation and potential expansion of commercial nuclear power in the United States. This Options Study is a comprehensive consideration and review of fuel cycle and technology options, including those for disposal, and is not constrained by any limitations that may be imposed by economics, technical maturity, past policy, or speculated future conditions. This Phase II report is intended to be used in conjunction with the Phase I report, and much information in that report is not repeated here, although some information has been updated to reflect recent developments. The focus in this Options Study was to

  12. The hydrogen hybrid option

    SciTech Connect

    Smith, J.R.

    1993-10-15

    The energy efficiency of various piston engine options for series hybrid automobiles are compared with conventional, battery powered electric, and proton exchange membrane (PEM) fuel cell hybrid automobiles. Gasoline, compressed natural gas (CNG), and hydrogen are considered for these hybrids. The engine and fuel comparisons are done on a basis of equal vehicle weight, drag, and rolling resistance. The relative emissions of these various fueled vehicle options are also presented. It is concluded that a highly optimized, hydrogen fueled, piston engine, series electric hybrid automobile will have efficiency comparable to a similar fuel cell hybrid automobile and will have fewer total emissions than the battery powered vehicle, even without a catalyst.

  13. Fluorosis varied treatment options

    PubMed Central

    Sherwood, I Anand

    2010-01-01

    Fluorosis has been reported way back in 1901. The treatment options for fluorosis are varied depending upon individual cases. This article comes from Madurai in India where its surrounding towns are fluorosis-prone zones. The purpose of this article is to report various treatment options available for dental fluorosis; this is the first time that complete full mouth rehabilitation for dental fluorosis is being reported. This article also dwells on the need for the dentists to be aware of their local indigenous pathologies to treat it in a better manner. PMID:20582220

  14. Thermal test options

    SciTech Connect

    Koski, J.A.; Keltner, N.R.; Sobolik, K.B.

    1993-02-01

    Shipping containers for radioactive materials must be qualified to meet a thermal accident environment specified in regulations, such at Title 10, Code of Federal Regulations, Part 71. Aimed primarily at the shipping container design, this report discusses the thermal testing options available for meeting the regulatory requirements, and states the advantages and disadvantages of each approach. The principal options considered are testing with radiant heat, furnaces, and open pool fires. The report also identifies some of the facilities available and current contacts. Finally, the report makes some recommendations on the appropriate use of these different testing methods.

  15. Lighting Options for Homes.

    SciTech Connect

    Baker, W.S.

    1991-04-01

    This report covers many aspects of various lighting options for homes. Types of light sources described include natural light, artificial light, incandescent lamps, fluorescent lamps, and high intensity discharge lamps. A light source selection guide gives the physical characteristics of these, design considerations, and common applications. Color, strategies for efficient lighting, and types of lighting are discussed. There is one section giving tips for various situations in specific rooms. Rooms and types of fixtures are shown on a matrix with watts saved by using the recommended type lighting for that room and room location. A major emphasis of this report is saving energy by utilizing the most suitable, recommended lighting option. (BN)

  16. Management options for recycling radioactive scrap metals

    SciTech Connect

    Dehmel, J.C.; MacKinney, J.; Bartlett, J.

    1997-02-01

    The feasibility and advantages of recycling radioactive scrap metals (RSM) have yet to be assessed, given the unique technical, regulatory, safety, and cost-benefit issues that have already been raised by a concerned recycling industry. As is known, this industry has been repeatedly involved with the accidental recycling of radioactive sources and, in some cases, with costly consequences. If recycling were deemed to be a viable option, it might have to be implemented with regulatory monitoring and controls. Its implementation may have to consider various and complex issues and address the requirements and concerns of distinctly different industries. There are three basic options for the recycling of such scraps. They are: (1) recycling through the existing network of metal-scrap dealers and brokers, (2) recycling directly and only with specific steelmills, or (3) recycling through regional processing centers. Under the first option, scrap dealers and brokers would receive material from RSM generators and determine at which steelmills such scraps would be recycled. For the second option, RSM generators would deal directly with selected steelmills under specific agreements. For the third option, generators would ship scraps only to regional centers for processing and shipment to participating steelmills. This paper addresses the potential advantages of each option, identifies the types of arrangements that would need to be secured among all parties, and attempts to assess the receptivity of the recycling industry to each option.

  17. Hepatitis B core-related antigen levels are associated with response to entecavir and peginterferon add-on therapy in hepatitis B e antigen-positive chronic hepatitis B patients.

    PubMed

    van Campenhout, M J H; Brouwer, W P; van Oord, G W; Xie, Q; Zhang, Q; Zhang, N; Guo, S; Tabak, F; Streinu-Cercel, A; Wang, J; Pas, S D; Sonneveld, M J; de Knegt, R J; Boonstra, A; Hansen, B E; Janssen, H L A

    2016-06-01

    Hepatitis B core-related antigen (HBcrAg), a new serum marker, may be useful in monitoring chronic hepatitis B infection. HBcrAg was measured in 175 hepatitis B e antigen-positive patients treated with entecavir (ETV) with or without peginterferon (PEG-IFN) add-on therapy. Decline in HBcrAg was stronger in patients with vs. without combined response (ETV: -3.22 vs. -1.71 log U/mL, p <0.001; PEG-IFN add-on: -3.16 vs. -1.83 IU/mL, p <0.001) and in patients with vs. without hepatitis B surface antigen (HBsAg) response (ETV: -2.60 vs. -1.74 log U/mL, p <0.001; PEG-IFN add-on: -2.38 vs. -2.15 log U/mL, p = 0.31). HBcrAg was associated with combined response (adjusted odds ratio 0.3, 95% confidence interval 0.2-0.5, p <0.001), but was not superior to quantitative HBsAg (qHBsAg).

  18. [Treatment options for patellar tendinopathy].

    PubMed

    Duthon, V B; Borloz, S; Ziltener, J-L

    2012-07-25

    Patellar tendinopathy is also called jumper's knee because of its high incidence in athletes with jumping or cutting activities as soccer, basketball, volleyball. Many different treatment methods have been described. However, no consensus exists regarding the optimal treatment for this condition. According to the literature, eccentric exercise-based physical therapy should be proposed first because of its strong scientific evidence. Shockwave therapy and injections may be useful but their real efficacy still has to be proven by randomized controlled study. For patients recalcitrant to more conservative options, operative management may be indicated.

  19. Are newer, more expensive pharmacotherapy options associated with superior symptom control compared to less costly agents used in a collaborative practice setting?

    PubMed

    Weschules, Douglas J; Maxwell, Terri; Reifsnyder, JoAnne; Knowlton, Calvin H

    2006-01-01

    Innovative approaches to care may be necessary to provide the most effective symptom management to hospice patients. One approach is prescribing newer pharmacotherapy options with the potential to improve symptom management in hospice. Such therapies are sometimes prescribed outside of Food and Drug Administration indications and are typically more costly than older agents used for the same symptoms. Another approach is the collaborative practice (CP) care model, whereby clinical pharmacists are given prescriptive authority according to evidence-based protocols and algorithms within boundaries approved by a physician. The agents typically included in CP protocols are those with wide therapeutic indices and with substantial evidence to support their use. The purpose of this study was to examine both approaches to management of pain, insomnia, and nausea, comparing symptom scores for those patients who received noncollaborative drug therapies (transdermal fentanyl, zolpidem, and ondansetron) to those who received agents under CP (oral sustained-release opioids, temazepam, and prochlorperazine). The object of the study was to investigate outcomes associated with newer drug therapy options as compared to older agents for the management of pain, insomnia, and nausea. A secondary goal is to compare symptom outcomes for patients receiving pharmaceutical care under CP and non-CP models. The study design was retrospective with a cohort. A total of 50 patients were randomly selected for each cohort of the pain and insomnia study arms. Only 45 patients prescribed oral ondansetron met inclusion criteria for the nausea group; 45 patients prescribed prochlorperazine were randomly selected as the comparator group. Patients were compared on their degree of response to the prescribed therapy. Response was classified as complete, partial, no improvement from baseline, worsened, or unknown. A complete response was defined as the symptom score improving to a 0 of 10, regardless of the

  20. Our Energy Options.

    ERIC Educational Resources Information Center

    Meyers, Paul A.; Witt, Frank C.

    Presented is an analysis of alternatives available to the United States in dealing with energy problems. Options explained and evaluated include coal, solar, hydroelectric, nuclear, geothermal, wind, biomass, and energy conservation. The booklet is part of Project APEC (America's Possible Energy Choices), a nationally validated Title IVc project…

  1. Idaho's Energy Options

    SciTech Connect

    Robert M. Neilson

    2006-03-01

    This report, developed by the Idaho National Laboratory, is provided as an introduction to and an update of the status of technologies for the generation and use of energy. Its purpose is to provide information useful for identifying and evaluating Idaho’s energy options, and for developing and implementing Idaho’s energy direction and policies.

  2. Alternative Education Options.

    ERIC Educational Resources Information Center

    Little (Arthur D.), Inc., Washington, DC.

    This guide deals with various areas of alternative education programs, including current practices and different options available to school and community personnel. Steps are outlined to assess present educational settings, design new programs, select the participants, and implement and evaluate the new program. The first appendix contains…

  3. Career Options in Chemistry.

    ERIC Educational Resources Information Center

    Belloli, Robert C.

    1985-01-01

    Describes a credit/no credit course which focuses on career options in chemistry. The course (consisting of 15 one-hour seminar-type sessions) includes guest speakers for several sessions and an emphasis (in introductory sessions) on graduate school in chemistry, the chemical industry, resumes, and interviews. Also briefly describes an internship…

  4. Yellow laser acupuncture — A new option for prevention and early intervention of lifestyle-related diseases: A randomized, placebo-controlled trial in volunteers

    PubMed Central

    Wang, Guangjun; Gaischek, Ingrid; Wang, Lu; Wallner-Liebmann, Sandra; Petek, Erwin

    2015-01-01

    Background and aims: The yellow laser constitutes a totally new option in the field of laser acupuncture, in addition to the already existing red, near infrared, green and violet lasers. Especially for so called lifestyle-related diseases, this could open up new methods of integrative therapy. The goal of the present study was to investigate among other parameters blood pressure (BP), heart rate (HR), heart rate variability (HRV), and temperature effects before, during, and after stimulation of different acupoints with yellow laser. Subjects and methods: We recruited 26 healthy volunteers (13 female, 13 male; mean age ± SD 24.1 ± 3.3 years) at the Medical University of Graz. The acupoints Baihui, Neiguan, Taichong and a placebo point were stimulated with a 589 nm (50 mW, 500 µm; 5 min) yellow laser. Blood pressure was measured noninvasively at the wrist; for the registration of the electrocardiogram a medilog AR12 HRV system was used. Effects on temperature were measured with a Flir i7 infrared camera. Results: There were significant decreases after yellow laser acupuncture in the systolic BP, diastolic BP also decreased (n.s.). HRV in both (men and women) increased. The temperature during the yellow laser stimulation decreased significantly in all measured points. After the stimulation it increased again significantly. Based on a questionnaire volunteers reported a significantly decreased level of stress after yellow laser stimulation. Conclusion: Significant positive effects on BP and well-being were found after yellow laser stimulation. The results are very promising and can be very important especially for the treatment of lifestyle related diseases. PMID:25941426

  5. RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME IV - SITE SPECIFIC STUDIES FOR MO, MS, NC, NH, NJ, NY, OH

    EPA Science Inventory

    The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

  6. RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME III - SITE SPECIFIC STUDIES FOR IN, KY, MA, MD, MI, MN

    EPA Science Inventory

    The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

  7. RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME V - SITE SPECIFIC STUDIES FOR PA, SC, TN, VA, WI, WV

    EPA Science Inventory

    The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

  8. RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME II - SITE SPECIFIC STUDIES FOR AL, DE. FL, GA, IL

    EPA Science Inventory

    The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

  9. Exploration Architecture Options - ECLSS, TCS, EVA Implications

    NASA Technical Reports Server (NTRS)

    Chambliss, Joe; Henninger, Don

    2011-01-01

    Many options for exploration of space have been identified and evaluated since the Vision for Space Exploration (VSE) was announced in 2004. The Augustine Commission evaluated human space flight for the Obama administration then the Human Exploration Framework Teams (HEFT and HEFT2) evaluated potential exploration missions and the infrastructure and technology needs for those missions. Lunar architectures have been identified and addressed by the Lunar Surface Systems team to establish options for how to get to, and then inhabit and explore, the moon. This paper will evaluate the options for exploration of space for the implications of architectures on the Environmental Control and Life Support (ECLSS), Thermal Control (TCS), and Extravehicular Activity (EVA) Systems.

  10. [Gastroparesis and its treatment options].

    PubMed

    Igaz, Péter; Tulassay, Zsolt

    2008-03-01

    Gastroparesis is a disorder of gastric emptying that occurs in the absence of mechanical obstruction. Its cardinal features include nausea, vomiting, bloating, early satiety and discomfort. Weight loss, dehydration, electrolyte disturbances and malnutrition may develop in severe cases. The majority of cases is idiopathic, long standing diabetes mellitus is responsible for about 25-30% of cases. Diabetic gastroparesis may render glucose control extremely difficult, its treatment represents a major challenge. Besides frequent, small meals and psychological support, several drug options are available, however, their efficacy is limited and only a few randomized studies have been performed to date. Prokinetic agents (erythromycin, domperidone, metoclopramide) and antiemetics (phenothiazines, serotonin antagonists, butyrophenones) are the most wide-spread medicaments. Among the novel, recently developed agents, 5-HT4 serotonin receptor agonists and dopamine D2 receptor antagonists are the most promising. Injection of botulinum toxin into the pyloric sphincter resulted in faster gastric emptying and symptom alleviation in some studies. Gastric electric stimulation appears to be one of the most effective options, both low and high-frequency stimulation may alleviate symptoms. Gastrostomy/jejunostomy and other surgical interventions are considered as "last resort". PMID:18292033

  11. Treatment options for threatened miscarriage.

    PubMed

    Qureshi, N S

    2009-12-01

    Threatened miscarriage, as demonstrated by vaginal bleeding with or without abdominal cramps, is a common complication of pregnancy. It occurs in about 20% of recognised pregnancies. Risk of miscarriage is increased in older women and those with a history of miscarriage. Low serum levels of progesterone or human chorionic gonadotrophin (hCG) are a risk factor for miscarriage. Other risk factors include heavy bleeding, early gestational age and an empty gestational sac of >15-17 mm diameter. Clinical history and examination, maternal serum biochemistry and ultrasound findings provide valuable information about the prognosis and are important to establish in order to determine potential treatment options. Although bed rest is the most common choice of treatment, there is little evidence of its value. Other options include luteal support with progesterone, dydrogesterone or hCG. There is some evidence from clinical studies indicating that progesterone or dydrogesterone may reduce the rate of miscarriage, although further data from double-blind, randomised-controlled trials are necessary to confirm efficacy. PMID:19945236

  12. Moving granular-bed filter development program, Option III: Development of moving granular-bed filter technology for multi-contaminant control. Task 14: Test plan; Topical report

    SciTech Connect

    Haas, J.C.; Olivo, C.A.; Wilson, K.B.

    1994-04-01

    An experimental test plan has been prepared for DOE/METC review and approval to develop a filter media suitable for multi-contaminant control in granular-bed filter (GBF) applications. The plan includes identification, development, and demonstration of methods for enhanced media morphology, chemical reactivity, and mechanical strength. The test plan includes media preparation methods, physical and chemical characterization methods for fresh and reacted media, media evaluation criteria, details of test and analytical equipment, and test matrix of the proposed media testing. A filter media composed of agglomerated limestone and clay was determined to be the best candidate for multi-contaminate control in GBF operation. The combined limestone/clay agglomerate has the potential to remove sulfur and alkali species, in addition to particulate, and possibly halogens and trace heavy metals from coal process streams.

  13. Achilles Tendinosis: Treatment Options

    PubMed Central

    Lopez, Roberto Gabriel L.

    2015-01-01

    Athletes usually complain of an ongoing or chronic pain over the Achilles tendon, but recently even non-athletes are experiencing the same kind of pain which affects their daily activities. Achilles tendinosis refers to a degenerative process of the tendon without histologic or clinical signs of intratendinous inflammation. Treatment is based on whether to stimulate or prevent neovascularization. Thus, until now, there is no consensus as to the best treatment for this condition. This paper aims to review the common ways of treating this condition from the conservative to the surgical options. PMID:25729512

  14. Adolescent pregnancy options.

    PubMed

    Resnick, M D

    1992-09-01

    The range of pregnancy options available to adolescents each have significant ramifications for future educational and economic achievement. The changing societal context of adolescent pregnancy decision-making are described, and the characteristics of adolescents who choose to terminate their pregnancy, parent their child, or place for adoption are examined. The role of significant others in decision-making and the implications of mandatory parental involvement in pregnancy decision-making is discussed, as well as the roles of schools in promoting the well-being and potential of adolescents considering pregnancy decisions. PMID:1434557

  15. Antiviral options for biodefense.

    PubMed

    Byrd, Chelsea M; Grosenbach, Douglas W; Hruby, Dennis E

    2013-10-01

    A key to biodefense strategies is an assessment of current therapies available as well as the expedited development of new antiviral therapeutic options. Viruses make up the majority of the National Institute of Allergy and Infectious Diseases (NIAID) Category A Priority Pathogens, agents that are considered to pose the greatest risk to public health and national security, and yet there are currently no approved treatments for most of these viral biodefense threats. A review of the Category A viral biothreat agents and strategies for the development of new therapeutics are presented here. PMID:23773331

  16. Treatment options for hyperhidrosis.

    PubMed

    Walling, Hobart W; Swick, Brian L

    2011-10-01

    Hyperhidrosis is a disorder of excessive sweating beyond what is expected for thermoregulatory needs and environmental conditions. Primary hyperhidrosis has an estimated prevalence of nearly 3% and is associated with significant medical and psychosocial consequences. Most cases of hyperhidrosis involve areas of high eccrine density, particularly the axillae, palms, and soles, and less often the craniofacial area. Multiple therapies are available for the treatment of hyperhidrosis. Options include topical medications (most commonly aluminum chloride), iontophoresis, botulinum toxin injections, systemic medications (including glycopyrrolate and clonidine), and surgery (most commonly endoscopic thoracic sympathectomy [ETS]). The purpose of this article is to comprehensively review the literature on the subject, with a focus on new and emerging treatment options. Updated therapeutic algorithms are proposed for each commonly affected anatomic site, with practical procedural guidelines. For axillary and palmoplantar hyperhidrosis, topical treatment is recommended as first-line treatment. For axillary hyperhidrosis, botulinum toxin injections are recommended as second-line treatment, oral medications as third-line treatment, local surgery as fourth-line treatment, and ETS as fifth-line treatment. For palmar and plantar hyperhidrosis, we consider a trial of oral medications (glycopyrrolate 1-2 mg once or twice daily preferred to clonidine 0.1 mg twice daily) as second-line therapy due to the low cost, convenience, and emerging literature supporting their excellent safety and reasonable efficacy. Iontophoresis is considered third-line therapy for palmoplantar hyperhidrosis; efficacy is high although so are the initial levels of cost and inconvenience. Botulinum toxin injections are considered fourth-line treatment for palmoplantar hyperhidrosis; efficacy is high though the treatment remains expensive, must be repeated every 3-6 months, and is associated with pain and

  17. Adolescent pregnancy options.

    PubMed

    Resnick, M D

    1992-09-01

    The range of pregnancy options available to adolescents each have significant ramifications for future educational and economic achievement. The changing societal context of adolescent pregnancy decision-making are described, and the characteristics of adolescents who choose to terminate their pregnancy, parent their child, or place for adoption are examined. The role of significant others in decision-making and the implications of mandatory parental involvement in pregnancy decision-making is discussed, as well as the roles of schools in promoting the well-being and potential of adolescents considering pregnancy decisions.

  18. Evaluation of the Add-On Effect of Chinese Patent Medicine for Patients with Stable or Unstable Angina: A Systematic Review and Meta-Analysis

    PubMed Central

    Mao, Chen; Chung, Vincent C. H.; Yuan, Jin-Qiu; Yu, Yuan-Yuan; Yang, Zu-Yao; Wu, Xin-Yin; Tang, Jin-Ling

    2013-01-01

    Chinese herbal medicine (CHM) has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR) = 0.50, 95% confidence interval (CI) 0.33–0.78), myocardial infarction (RR = 0.32, 95% CI 0.14–0.72), heart failure (RR = 0.37, 95% CI 0.15–0.91), and angina (RR = 0.46, 95% CI 0.30–0.71) than that of control group. For trials that included unstable angina patients, CHM led to significantly lower occurrence of total heart events (RR = 0.46, 95% CI 0.32–0.66), myocardial infarction (RR = 0.37, 95% CI 0.26–0.54), and angina (RR = 0.36, 95%CI 0.26–0.51). Likewise, for trials that included stable or unstable angina patients, the rates of myocardial infarction (RR = 0.34, 95% CI 0.17–0.68) and angina (RR = 0.46, 95% CI 0.30–0.70) in CHM group were significantly lower than that in control group. In conclusion, CHM is very likely to be able to improve the survival of angina patients who are already receiving western medicine. PMID:24416066

  19. Add-on histamine receptor-3 antagonist for allergic rhinitis: a double blind randomized crossover trial using the environmental exposure unit

    PubMed Central

    2014-01-01

    Background Oral antihistamines that target the histamine receptor–1, such as fexofenadine, offer suboptimal relief of allergic rhinitis-associated nasal congestion. Combinations with oral sympathomimetics, such as pseudoephedrine, relieve congestion but produce side effects. Previous animal and human studies with histamine receptor-3 antagonists, such as PF-03654764, demonstrate promise. Methods Herein we employ the Environmental Exposure Unit (EEU) to conduct the first randomized controlled trial of PF-03654764 in allergic rhinitis. 64 participants were randomized in a double-blind, placebo-controlled 4-period crossover study. Participants were exposed to ragweed pollen for 6 hours post-dose in the EEU. The primary objective was to compare the effect of PF-03654764 + fexofenadine to pseudoephedrine + fexofenadine on the subjective measures of congestion and Total Nasal Symptom Score (TNSS). The objectives of our post-hoc analyses were to compare all treatments to placebo and determine the onset of action (OA). This trial was registered at ClinicalTrials.gov (NCT01033396). Results PF-03654764 + fexofenadine was not superior to pseudoephedrine + fexofenadine. In post-hoc analyses, PF-03654764 + fexofenadine significantly reduced TNSS, relative to placebo, and OA was 60 minutes. Pseudoephedrine + fexofenadine significantly reduced congestion and TNSS, relative to placebo, with OA of 60 and 30 minutes, respectively. Although this study was not powered for a statistical analysis of safety, it was noted that all PF-03654764-treated groups experienced an elevated incidence of adverse events. Conclusions PF-03654764 + fexofenadine failed to provide superior relief of allergic rhinitis-associated nasal symptoms upon exposure to ragweed pollen compared to fexofenadine + pseudoephedrine. However, in post-hoc analyses, PF-03654764 + fexofenadine improved TNSS compared to placebo. Side effects in the PF-03654764-treated groups were

  20. Characterization of a high-pressure diesel fuel injection system as a control technology option to improve engine performance and reduce exhaust emissions

    NASA Technical Reports Server (NTRS)

    Mcfadden, J. J.; Dezelick, R. A.; Barrows, R. R.

    1983-01-01

    Test results from a high pressure electronically controlled fuel injection system are compared with a commercial mechanical injection system on a single cylinder, diesel test engine using an inlet boost pressure of 2.6:1. The electronic fuel injection system achieved high pressure by means of a fluid intensifier with peak injection pressures of 47 to 69 MPa. Reduced exhaust emissions were demonstrated with an increasing rate of injection followed by a fast cutoff of injection. The reduction in emissions is more responsive to the rate of injection and injection timing than to high peak injection pressure.

  1. Survey report: Potential options for the control of border agents` exposure to vehicle emissions at United States port of entry, San Ysidro, California

    SciTech Connect

    Dunn, K.; Mead, K.R.; Heitbrink, W.A.

    1999-05-14

    The National Institute for Occupational Safety and Health (NIOSH) conducted a site visit in response to a Health Hazard Evaluation (HHE) request received from the United State Immigration and Naturalization Service (INS). Personal air samples were collected for carbon monoxide (CO), hydrocarbons, and lead particulate matter. Personal and area air samples for lead, carbon dioxide and hydrocarbons were all within acceptable occupational health criteria for full shift exposures, however, peak exposures exceeded the NIOSH recommended ceiling concentration of 200 parts per million. Based on these results, the NIOSH HHE team made several recommendations that included modifying the local exhaust ventilation systems, incorporating administrative controls, and elimination of some tasks.

  2. [Controlled release oxycodone--a new option in the treatment of severe and very severe pain. Review of studies on neuropathic, physical activity-related and postoperative pain].

    PubMed

    Stiehl, M

    2004-08-01

    Opioids are used not only in the treatment of cancer pain, but also pain of non-malignant genesis. In recent years, the efficacy of controlled release (CR) oxycodone in the treatment of the above-mentioned types of pain has been investigated in a number of clinical studies. The present article reviews the clinical studies that have been already published. Thanks to its outstanding pharmacological and pharmacodynamic properties, CR oxycodone is fast acting and brings about long lasting pain relief, coupled with benefits for physical and mental activities. This results in a significant quality-of-life improvement. Oral therapy with CR oxycodone is safe and can be precisely controlled. Since there are no clinical relevant metabolites, there is no danger of accumulation in patients with renal infarction due to these metabolites. Side effects are those typical for opioids, and are readily manageable. CR oxycodone is a good alternative in the treatment of non-cancer pain and can be recommended as first-line treatment for the above-mentioned indications. PMID:16739361

  3. Mixed waste management options

    SciTech Connect

    Owens, C.B.; Kirner, N.P.

    1991-12-31

    Disposal fees for mixed waste at proposed commercial disposal sites have been estimated to be $15,000 to $40,000 per cubit foot. If such high disposal fees are imposed, generators may be willing to apply extraordinary treatment or regulatory approaches to properly dispose of their mixed waste. This paper explores the feasibility of several waste management scenarios and attempts to answer the question: Can mixed waste be managed out of existence? Existing data on commercially generated mixed waste streams are used to identify the realm of mixed waste known to be generated. Each waste stream is evaluated from both a regulatory and technical perspective in order to convert the waste into a strictly low-level radioactive or a hazardous waste. Alternative regulatory approaches evaluated in this paper include a delisting petition, no migration petition, and a treatability variance. For each waste stream, potentially available treatment options are identified that could lead to these variances. Waste minimization methodology and storage for decay are also considered. Economic feasibility of each option is discussed broadly.

  4. Retrieval options study

    SciTech Connect

    Not Available

    1980-03-01

    This Retrieval Options Study is part of the systems analysis activities of the Office of Nuclear Waste Isolation to develop the scientific and technological bases for radioactive waste repositories in various geologic media. The study considers two waste forms, high level waste and spent fuel, and defines various classes of waste retrieval and recovery. A methodology and data base are developed which allow the relative evaluation of retrieval and recovery costs and the following technical criteria: safety; technical feasibility; ease of retrieval; probable intact retrieval time; safeguards; monitoring; criticality; and licensability. A total of 505 repository options are defined and the cost and technical criteria evaluated utilizing a combination of facts and engineering judgments. The repositories evaluated are selected combinations of the following parameters: Geologic Media (salt, granite, basalt, shale); Retrieval Time after Emplacement (5 and 25 years); Emplacement Design (nominal hole, large hole, carbon steel canister, corrosion resistant canister, backfill in hole, nominal sleeves, thick wall sleeves); Emplacement Configuration (single vertical, multiple vertical, single horizontal, multiple horizontal, vaults; Thermal Considerations; (normal design, reduced density, once-through ventilation, recirculated ventilation); Room Backfill; (none, run-of-mine, early, 5 year delay, 25 year delay, decommissioned); and Rate of Retrieval; (same as emplacement, variably slower depending on repository/canister condition).

  5. DEVELOPMENT OF AN ANTIFOAM TRACKING SYSTEM AS AN OPTION TO SUPPORT THE MELTER OFF-GAS FLAMMABILITY CONTROL STRATEGY AT THE DWPF

    SciTech Connect

    Edwards, T.; Lambert, D.

    2014-08-27

    The Savannah River National Laboratory (SRNL) has been working with the Savannah River Remediation (SRR) Defense Waste Processing Facility (DWPF) in the development and implementation of an additional strategy for confidently satisfying the flammability controls for DWPF’s melter operation. An initial strategy for implementing the operational constraints associated with flammability control in DWPF was based upon an analytically determined carbon concentration from antifoam. Due to the conservative error structure associated with the analytical approach, its implementation has significantly reduced the operating window for processing and has led to recurrent Slurry Mix Evaporator (SME) and Melter Feed Tank (MFT) remediation. To address the adverse operating impact of the current implementation strategy, SRR issued a Technical Task Request (TTR) to SRNL requesting the development and documentation of an alternate strategy for evaluating the carbon contribution from antifoam. The proposed strategy presented in this report was developed under the guidance of a Task Technical and Quality Assurance Plan (TTQAP) and involves calculating the carbon concentration from antifoam based upon the actual mass of antifoam added to the process assuming 100% retention. The mass of antifoam in the Additive Mix Feed Tank (AMFT), in the Sludge Receipt and Adjustment Tank (SRAT), and in the SME is tracked by mass balance as part of this strategy. As these quantities are monitored, the random and bias uncertainties affecting their values are also maintained and accounted for. This report documents: 1) the development of an alternate implementation strategy and associated equations describing the carbon concentration from antifoam in each SME batch derived from the actual amount of antifoam introduced into the AMFT, SRAT, and SME during the processing of the batch. 2) the equations and error structure for incorporating the proposed strategy into melter off-gas flammability assessments

  6. Use of the venture wire-control catheter for accessing side branches during provisional stenting: an option for bifurcations with an unfavorable anatomy.

    PubMed

    Ojeda, Soledad; Pan, Manuel; Mazuelos, Francisco; Romero, Miguel; Segura, José; Pavlovic, Djordje; Crespín, Manuel; Suárez de Lezo, José

    2010-12-01

    We report our experience with the Venture wire-control catheter in 20 patients with bifurcation lesions in which it was impossible to access the side branch using conventional techniques. This device was always used as a last resort and was employed during different stages in the treatment of the bifurcation lesions (i.e. initially, after stenting of the main vessel or both). In 17 patients (85%), use of the Venture catheter resulted in the success of the procedure. Only one complication associated with a monorail catheter was recorded. It was resolved successfully. One patient died from heart failure 10 days after the procedure and two patients, in whom it was impossible to access the side branch, had non-Q-wave myocardial infarctions. In conclusion, the Venture catheter was effective and safe, and enabled the side branches of complex bifurcation lesions to be accessed. PMID:21144413

  7. FW2.2 and cell cycle control in developing tomato fruit: a possible example of gene co-option in the evolution of a novel organ.

    PubMed

    Cong, Bin; Tanksley, Steven D

    2006-12-01

    fw2.2 is one of the few QTLs thus far isolated from plants and the first one known to control fruit size. While it has been established that FW2.2 is a regulator (either directly or indirectly) of cell division, FW2.2 does not share sequence homology to any protein of known function (Frary et al. Science 289:85-88, 2000; Cong et al. Proc Natl Acad Sci USA 99:13606-13611, 2002; Liu et al. Plant Physiol 132:292-299, 2003). Thus, the mechanism by which FW2.2 mediates cell division in developing fruit is currently unknown. In an effort to remedy this situation, a combination of yeast two-hybrid screens, in vitro binding assays and cell bombardment studies were performed. The results provide strong evidence that FW2.2 physically interacts at or near the plasma membrane with the regulatory (beta) subunit of a CKII kinase. CKII kinases are well-studied in both yeast and animals where they form part of cell cycle related signaling pathway. Thus while FW2.2 is a plant-specific protein and regulates cell division in a specialized plant organ (fruit), it appears to participate in a cell-cycle control signal transduction pathway that predates the divergence of single- and multi-cellular organisms. These results thus provide a glimpse into how ancient and conserved regulatory processes can be co-opted in the evolution of novel organs such as fruit. PMID:16941207

  8. Option generation in decision making: ideation beyond memory retrieval

    PubMed Central

    Del Missier, Fabio; Visentini, Mimì; Mäntylä, Timo

    2015-01-01

    According to prescriptive decision theories, the generation of options for choice is a central aspect of decision making. A too narrow representation of the problem may indeed limit the opportunity to evaluate promising options. However, despite the theoretical and applied significance of this topic, the cognitive processes underlying option generation are still unclear. In particular, while a cued recall account of option generation emphasizes the role of memory and executive control, other theoretical proposals stress the importance of ideation processes based on various search and thinking processes. Unfortunately, relevant behavioral evidence on the cognitive processes underlying option generation is scattered and inconclusive. In order to reach a better understanding, we carried out an individual-differences study employing a wide array of cognitive predictors, including measures of episodic memory, semantic memory, cognitive control, and ideation fluency. The criterion tasks consisted of three different poorly-structured decision-making scenarios, and the participants were asked to generate options to solve these problems. The main criterion variable of the study was the number of valid options generated, but also the diversity and the quality of generated options were examined. The results showed that option generation fluency and diversity in the context of ill-structured decision making are supported by ideation ability even after taking into account the effects of individual differences in several other aspects of cognitive functioning. Thus, ideation processes, possibly supported by search and thinking processes, seem to contribute to option generation beyond basic associative memory retrieval. The findings of the study also indicate that generating more options may have multifaceted consequences for choice, increasing the quality of the best option generated but decreasing the mean quality of the options in the generated set. PMID:25657628

  9. Low-dose add-on memantine treatment may improve cognitive performance and self-reported health conditions in opioid-dependent patients undergoing methadone-maintenance-therapy.

    PubMed

    Chang, Yun-Hsuan; Chen, Shiou-Lan; Lee, Sheng-Yu; Chen, Po See; Wang, Tzu-Yun; Lee, I Hui; Chen, Kao Chin; Yang, Yen Kuang; Hong, Jau-Shyong; Lu, Ru-Band

    2015-01-01

    An important interaction between opioid and dopamine systems has been indicated, and using opioids may negatively affect cognitive functioning. Memantine, a medication for Alzheimer's disease, increasingly is being used for several disorders and maybe important for cognitive improvement. Opioid-dependent patients undergoing methadone-maintenance-therapy (MMT) and healthy controls (HCs) were recruited. Patients randomly assigned to the experimental (5 mg/day memantine (MMT+M) or placebo (MMT+P) group: 57 in MMT+M, 77 in MMT+P. Those completed the cognitive tasks at the baseline and after the 12-week treatment were analyzed. Thirty-seven age- and gender-matched HCs, and 42 MMT+P and 39 MMT+M patients were compared. The dropout rates were 49.4% in the MMT+P and 26.3% in the MMT+M. Both patient groups' cognitive performances were significantly worse than that of the HCs. After the treatment, both patient groups showed improved cognitive performance. We also found an interaction between the patient groups and time which indicated that the MMT+M group's post-treatment improvement was better than that of the MMT+P group. Memantine, previously reported as neuroprotective may attenuate chronic opioid-dependence-induced cognitive decline. Using such low dose of memantine as adjuvant treatment for improving cognitive performance in opioid dependents; the dose of memantine might be a worthy topic in future studies. PMID:25989606

  10. Low-dose add-on memantine treatment may improve cognitive performance and self-reported health conditions in opioid-dependent patients undergoing methadone-maintenance-therapy.

    PubMed

    Chang, Yun-Hsuan; Chen, Shiou-Lan; Lee, Sheng-Yu; Chen, Po See; Wang, Tzu-Yun; Lee, I Hui; Chen, Kao Chin; Yang, Yen Kuang; Hong, Jau-Shyong; Lu, Ru-Band

    2015-05-19

    An important interaction between opioid and dopamine systems has been indicated, and using opioids may negatively affect cognitive functioning. Memantine, a medication for Alzheimer's disease, increasingly is being used for several disorders and maybe important for cognitive improvement. Opioid-dependent patients undergoing methadone-maintenance-therapy (MMT) and healthy controls (HCs) were recruited. Patients randomly assigned to the experimental (5 mg/day memantine (MMT+M) or placebo (MMT+P) group: 57 in MMT+M, 77 in MMT+P. Those completed the cognitive tasks at the baseline and after the 12-week treatment were analyzed. Thirty-seven age- and gender-matched HCs, and 42 MMT+P and 39 MMT+M patients were compared. The dropout rates were 49.4% in the MMT+P and 26.3% in the MMT+M. Both patient groups' cognitive performances were significantly worse than that of the HCs. After the treatment, both patient groups showed improved cognitive performance. We also found an interaction between the patient groups and time which indicated that the MMT+M group's post-treatment improvement was better than that of the MMT+P group. Memantine, previously reported as neuroprotective may attenuate chronic opioid-dependence-induced cognitive decline. Using such low dose of memantine as adjuvant treatment for improving cognitive performance in opioid dependents; the dose of memantine might be a worthy topic in future studies.

  11. Cataloguing and displaying Web feeds from French language health sites: a Web 2.0 add-on to a health gateway.

    PubMed

    Kerdelhué, G; Thirion, B; Dahamna, B; Darmoni, S J

    2008-01-01

    Among the numerous new functionalities of the Internet, commonly called Web 2.0, Web syndication illustrates the trend for better and faster information sharing. Web feeds (a.k.a RSS feeds), which were used mostly on weblogs at first, are now also widely used in academic, scientific and institutional websites such as PubMed. As very few French language feeds were listed or catalogued in the Health field by the year of 2007, it was decided to implement them in the quality-controlled health gateway CISMeF ([French] acronym for Catalogue and Index of French Language Health Resources on the Internet). Furthermore, making full use of the nature of Web syndication, a Web feed aggregator was put online in to provide a dynamic news gateway called "CISMeF actualités" (http://www.chu-rouen.fr/actualites/). This article describes the process to retrieve and implement the Web feeds in the catalogue and how its terminology was adjusted to describe this new content. It also describes how the aggregator was put online and the features of this news gateway. CISMeF actualités was built accordingly to the editorial policy of CISMeF. Only a part of the Web feeds of the catalogue were included to display the most authoritative sources. Web feeds were also grouped by medical specialties and by countries using the prior indexing of websites with MeSH terms and the so-called metaterms. CISMeF actualités now displays 131 Web feeds across 40 different medical specialities, coming from 5 different countries. It is one example, among many, that static hypertext links can now easily and beneficially be completed, or replaced, by dynamic display of Web content using syndication feeds. PMID:18487704

  12. Tolerance and effect of an add-on treatment with a cough medicine containing ivy leaves dry extract on lung function in children with bronchial asthma.

    PubMed

    Zeil, S; Schwanebeck, U; Vogelberg, C

    2014-09-15

    Ivy leaves dry extract is registered as an expectorant in patients with respiratory diseases associated with productive cough. Next to its secretolytical properties, bronchospasmolytical effects are described. However only limited data exist about a possible therapeutical effect in asthmatic patients. In this double blind, placebo-controlled, randomized cross-over study, 30 children (median age 9.07 years (min-max: 6-11)) suffering from partial or uncontrolled mild persistent allergic asthma despite long-term treatment with 400 μg budesonide equivalent were investigated. After a four week run-in period, patients either received ivy leaves dry extract for four weeks in addition to their inhaled corticosteroid therapy or placebo, followed by a wash-out phase before switching to the other treatment arm. Lung function, FeNO, exhaled breath condensate pH and life quality was analyzed after each treatment period. There was a significant improvement of MEF(75-25), MEF25 and VC after treatment with ivy leaves dry extract (MEF(75-25) change in the mean 0.115 l/s, p=0.044; MEF25 change in the mean 0.086 l/s, p=0.041; VC change in the mean 0.052 l, p=0.044), but not after treatment with placebo. For the primary outcome parameters (relative change of FEV1 and MEF(75-25) before bronchodilation) no treatment effect could be detected in the cross-over analysis (FEV1 p=0.6763 and MEF(75-25) p=0.6953). This proof-of-concept study indicates that children with mild uncontrolled asthma despite regular inhaled corticosteroid therapy might benefit from an additional therapy with ivy leaves dry extract. However, further studies are needed. PMID:24916707

  13. Horizon 2020 in Diabetic Kidney Disease: The Clinical Trial Pipeline for Add-On Therapies on Top of Renin Angiotensin System Blockade

    PubMed Central

    Perez-Gomez, Maria Vanessa; Sanchez-Niño, Maria Dolores; Sanz, Ana Belen; Martín-Cleary, Catalina; Ruiz-Ortega, Marta; Egido, Jesus; Navarro-González, Juan F.; Ortiz, Alberto; Fernandez-Fernandez, Beatriz

    2015-01-01

    Diabetic kidney disease is the most frequent cause of end-stage renal disease. This implies failure of current therapeutic approaches based on renin-angiotensin system (RAS) blockade. Recent phase 3 clinical trials of paricalcitol in early diabetic kidney disease and bardoxolone methyl in advanced diabetic kidney disease failed to meet the primary endpoint or terminated on safety concerns, respectively. However, various novel strategies are undergoing phase 2 and 3 randomized controlled trials targeting inflammation, fibrosis and signaling pathways. Among agents currently undergoing trials that may modify the clinical practice on top of RAS blockade in a 5-year horizon, anti-inflammatory agents currently hold the most promise while anti-fibrotic agents have so far disappointed. Pentoxifylline, an anti-inflammatory agent already in clinical use, was recently reported to delay estimated glomerular filtration rate (eGFR) loss in chronic kidney disease (CKD) stage 3–4 diabetic kidney disease when associated with RAS blockade and promising phase 2 data are available for the pentoxifylline derivative CTP-499. Among agents targeting chemokines or chemokine receptors, the oral small molecule C-C chemokine receptor type 2 (CCR2) inhibitor CCX140 decreased albuminuria and eGFR loss in phase 2 trials. A dose-finding trial of the anti-IL-1β antibody gevokizumab in diabetic kidney disease will start in 2015. However, clinical development is most advanced for the endothelin receptor A blocker atrasentan, which is undergoing a phase 3 trial with a primary outcome of preserving eGFR. The potential for success of these approaches and other pipeline agents is discussed in detail. PMID:26239562

  14. Achalasia: current treatment options.

    PubMed

    Familiari, Pietro; Greco, Santi; Volkanovska, Ance; Gigante, Giovanni; Cali, Anna; Boškoski, Ivo; Costamagna, Guido

    2015-01-01

    Achalasia is a rare esophageal motility disorder, characterized by impaired swallow-induced, lower esophageal sphincter (LES) relaxation and defective esophageal peristalsis. Unfortunately, there are no etiological therapies for achalasia. Patients present with dysphagia, chest pain and regurgitation of undigested food, often leading to weight loss. The currently available treatments have the common aim of relieving symptoms by decreasing the pressure of the LES. This can be achieved with some medications, by inhibiting the cholinergic innervation (botulinum toxin), by stretching (endoscopic dilation) or cutting (surgery) the LES. Recently, other therapeutic options, including per-oral endoscopic myotomy have been developed and are gaining international consensus. The authors report on the benefits and weaknesses of the different therapies and provide an updated approach to the management of achalasia. PMID:26186641

  15. [Treatment options for brachymetatarsia].

    PubMed

    Wingenfeld, C; Arbab, D; Abbara-Czardybon, M

    2013-01-01

    Brachymetatarsia can be congenital, idiopathic or secondary and describes an abnormal shortening of a metatarsal bone. The indications for treatment are not only due to cosmesis. The shortening of a ray changes the biomechanics of the foot and can lead to metatarsalgia. A frequent clinical feature is dorsal dislocation of a toe causing painful shoe conflict and disturbed proprioception. There are three main options for operative correction: lengthening osteotomy, interposition of a tricortical bone and gradual lengthening by callus distraction. While one stage lengthening procedures such as osteotomy and interposition are more appropriate for correction of moderate length deficiencies, the callus distraction method is more suitable for larger elongation. Common to all procedures is a long-term treatment with a high risk of different complications whereby patient compliance can be problematical. PMID:23238881

  16. Mars Surface Habitability Options

    NASA Technical Reports Server (NTRS)

    Howe, A. Scott; Simon, Matthew; Smitherman, David; Howard, Robert; Toups, Larry; Hoffman, Stephen J.

    2015-01-01

    This paper reports on current habitability concepts for an Evolvable Mars Campaign (EMC) prepared by the NASA Human Spaceflight Architecture Team (HAT). For many years NASA has investigated alternative human Mars missions, examining different mission objectives, trajectories, vehicles, and technologies; the combinations of which have been referred to as reference missions or architectures. At the highest levels, decisions regarding the timing and objectives for a human mission to Mars continue to evolve while at the lowest levels, applicable technologies continue to advance. This results in an on-going need for assessments of alternative system designs such as the habitat, a significant element in any human Mars mission scenario, to provide meaningful design sensitivity characterizations to assist decision-makers regarding timing, objectives, and technologies. As a subset of the Evolvable Mars Campaign activities, the habitability team builds upon results from past studies and recommends options for Mars surface habitability compatible with updated technologies.

  17. Safinamide as Add-On Therapy to Levodopa in Mid- to Late-Stage Parkinson’s Disease Fluctuating Patients: Post hoc Analysesof Studies 016 and SETTLE

    PubMed Central

    Cattaneo, Carlo; Sardina, Marco; Bonizzoni, Ermino

    2016-01-01

    Background: Studies 016 and SETTLE showed that safinamide was safe and effective as adjunct therapy in patients with advanced Parkinson’s disease (PD) and motor fluctuations. The addition of safinamide to a stable dose of levodopa alone or with other antiparkinsonian medications significantly increased ON time with no/non-troublesome dyskinesia, decreased OFF time and improved Parkinson’s symptoms. Objective: To evaluate the clinical effects of safinamide 100 mg/day on motor fluctuations and cardinal Parkinson’s symptoms in specific patient subgroups using pooled data from Studies 016 and SETTLE. Methods: Both studies were double blind, placebo-controlled, randomized, phase 3 trials which enrolled patients with mid- to late-stage PD experiencing motor fluctuations while receiving optimized and stable doses of levodopa, alone or with other dopaminergic treatments. The present post-hoc analyses assessed the change from baseline in ON time (with no or non-troublesome dyskinesia) and OFF time in subgroups of patients who were receiving only levodopa at baseline, who were classified as “mild fluctuators” (daily OFF time ≤4 h), and who were receiving concomitant dopaminergic therapy, with or without amantadine, and the effects of safinamide versus placebo on individual cardinal PD symptoms during ON time. Results: Safinamide significantly increased mean ON time (with no or non-troublesome dyskinesia) and reduced mean OFF time when used as first adjunct therapy in levodopa-treated patients and patients with mild motor fluctuations. Mean daily ON time (with no or non-troublesome dyskinesia) and OFF time were favorably changed, compared with placebo, to similar extents regardless of whether patients were receiving concomitant dopamine agonists, catechol-O-methyltransferase inhibitors and amantadine. Additionally, safinamide improved bradykinesia, rigidity, tremor and gait. Conclusions: Safinamide was a safe and effective first adjunct therapy in levodopa

  18. Regulation of Memory Accuracy with Multiple Answers: The Plurality Option

    ERIC Educational Resources Information Center

    Luna, Karlos; Higham, Philip A.; Martin-Luengo, Beatriz

    2011-01-01

    We report two experiments that investigated the regulation of memory accuracy with a new regulatory mechanism: the plurality option. This mechanism is closely related to the grain-size option but involves control over the number of alternatives contained in an answer rather than the quantitative boundaries of a single answer. Participants were…

  19. 42 CFR 480.121 - Optional disclosure of nonconfidential information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Optional disclosure of nonconfidential information... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) Disclosure of Nonconfidential Information § 480.121 Optional disclosure...

  20. The Impact of Alternative Schooling Options on School Finance.

    ERIC Educational Resources Information Center

    Christy, W. Keith

    In these times of reforming public education, considerable debate is being given to alternative schooling options. Many policymakers view school choice as a means of increasing parental influence of educational services and of reducing the control of government, professional administrators, and educators. These alternative schooling options have…

  1. 48 CFR 570.401 - Renewal options.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Requirements 570.401 Renewal options. (a) Exercise of options. Before exercising an option to renew, follow the... information review. Before exercising an option to renew a lease, review current market information...

  2. 48 CFR 570.401 - Renewal options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Requirements 570.401 Renewal options. (a) Exercise of options. Before exercising an option to renew, follow the... survey. Before exercising an option to renew a lease, review current market information to ensure...

  3. Selected Energy Conservation Options for Homeowners: Options, Expenses and Payoffs.

    ERIC Educational Resources Information Center

    Lengyel, Dorothy L.; And Others

    This publication is a check list for homeowners and renters to help them reduce energy costs. The list consists of 126 energy conservation options. These options range from "change clothes instead of adjusting thermostat" and "air conditioners turned off when not home" to "use sink stopper" and "weatherstripping and caulking applied." For each…

  4. Traditional operative treatment options.

    PubMed

    Ricketts, D N J; Pitts, N B

    2009-01-01

    Operative intervention should be avoided, whenever possible, by adopting a preventive approach. Timely management of early caries can lead to arrest and possibly remineralization of the lesion rendering operative intervention unnecessary. The dentist must judge when the tooth tissue has become sufficiently demineralized to allow bacterial ingress leading to irreversible changes in the tissue. Once a decision has been made to restore a tooth, the clinician must decide, from a series of traditional operative treatment options, what materials should be used in the restoration and what preparation will achieve good retention and best preservation of tooth structure. With the development of new adhesive materials and a more conservative approach, a new era of minimally invasive dentistry has dawned. Improvements in the properties of composite materials have made them the choice for coronal aesthetic restorations: for posterior restorations involving load-bearing occlusal surfaces, amalgam is still the most commonly used material in UK dental practice; glass ionomer materials also have a place in minimally invasive dentistry--patterns of use differing in different counties. The numbers of studies investigating minimal caries removal are relatively limited; there are still scope and need for research in this field.

  5. AFCI Options Study

    SciTech Connect

    R. Wigeland; T. Taiwo; M. Todosow; W. Halsey; J. Gehin

    2009-09-01

    This report describes the background and framework for both organizing the discussion and providing information on the potential for nuclear energy R&D to develop alternative nuclear fuel cycles that would address the issues with the current implementations of nuclear power, including nuclear waste disposal, proliferation risk, safety, security, economics, and sustainability. The disposition of used fuel is the cause of many of the concerns, and the possible approaches to used fuel management identify a number of basic technology areas that need to be considered. The basic science in each of the technology areas is discussed, emphasizing what science is currently available, where scientific knowledge may be insufficient, and especially to identify specific areas where transformational discoveries may allow achievement of performance goals not currently attainable. These discussions lead to the wide range of technical options that have been the basis for past and current research and development on advanced nuclear fuel cycles in the United States. The results of this work are then briefly reviewed to show the extent to which such approaches are capable of addressing the issues with nuclear power, the potential for moving further, and the inherent limitations.

  6. Treatment Options for Narcolepsy.

    PubMed

    Barateau, Lucie; Lopez, Régis; Dauvilliers, Yves

    2016-05-01

    Narcolepsy type 1 and narcolepsy type 2 are central disorders of hypersomnolence. Narcolepsy type 1 is characterized by excessive daytime sleepiness and cataplexy and is associated with hypocretin-1 deficiency. On the other hand, in narcolepsy type 2, cerebrospinal fluid hypocretin-1 levels are normal and cataplexy absent. Despite major advances in our understanding of narcolepsy mechanisms, its current management is only symptomatic. Treatment options may vary from a single drug that targets several symptoms, or multiple medications that each treats a specific symptom. In recent years, narcolepsy treatment has changed with the widespread use of modafinil/armodafinil for daytime sleepiness, antidepressants (selective serotonin and dual serotonin and noradrenalin reuptake inhibitors) for cataplexy, and sodium oxybate for both symptoms. Other psychostimulants can also be used, such as methylphenidate, pitolisant and rarely amphetamines, as third-line therapy. Importantly, clinically relevant subjective and objective measures of daytime sleepiness are required to monitor the treatment efficacy and to provide guidance on whether the treatment goals are met. Associated symptoms and comorbid conditions, such as hypnagogic/hypnopompic hallucinations, sleep paralysis, disturbed nighttime sleep, unpleasant dreams, REM- and non REM-related parasomnias, depressive symptoms, overweight/obesity, and obstructive sleep apnea, should also be taken into account and managed, if required. In the near future, the efficacy of new wake-promoting drugs, anticataplectic agents, hypocretin replacement therapy and immunotherapy at the early stages of the disease should also be evaluated. PMID:27155860

  7. Synroc processing options

    SciTech Connect

    Rozsa, R.B.; Hoenig, C.L.

    1981-09-01

    Synroc is a titanate-based ceramic material currently being developed for immobilizing high-level nuclear reactor wastes in solid form. Synroc D is a unique variation of Synroc. It can contain the high-level defense wastes, particularly those in storage at the Savannah River Plant. In this report, we review the early development of the initial Synroc process, discuss modification and other options that simplify it overall, and recommend the future direction of research and development in the processing area. A reference Synroc process is described briefly and contrasted with the Savannah River Laboratory glass-based reference case. Preliminary engineering layouts show Synroc to be a more complex processing operation and, thus, more expensive than the glass-based process. However, we believe that simplifications, which will significantly reduce the cost difference, are possible. Further research and development will continue in the areas of slurry processing, fluidized bed calcination, and mineralization. This last will use sintering, hot uniaxial pressing, or hot isostatic pressing.

  8. Maintenance and supply options

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The object of the Maintenance and Supply Option was to develop a high level operational philosophy related to maintenance and supply operations and incorporate these concepts into the Lunar Base Study. Specific products to be generated during this task were three trade studies and a conceptual design of the Logistic Supply Module. The crew size study was performed to evaluate crew sizes from the baseline size of four to a crew size of eight and determine the preferred crew size. The second trade study was to determine the impact of extending surface stay times and recommend a preferred duration of stay time as a function of crew, consumables, and equipment support capabilities. The third trade study was an evaluation of packaging and storage methods to determine the preferred logistics approach to support the lunar base. A modified scenario was developed and served as the basis of the individual trade studies. Assumptions and guidelines were also developed from experience with Apollo programs, Space Shuttle operations, and Space Station studies. With this information, the trade studies were performed and a conceptual design for the Logistic Supply Module was developed.

  9. Spotted knapweed, Centaurea stoebe, control options

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Spotted knapweed is a non native perennial forb that is spreading rapidly in the Western United States. This plant species produces a compound that retards the growth of many native plants, giving it a competitive advantage. Spotted knapweed has been identified in several areas of Alaska. A descript...

  10. Global FMD control - Is it an option?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The outbreaks of foot-and-mouth disease (FMD) in Europe in 2001 identified the vulnerability of the intensive agricultural industries in Europe and North America to the economic consequences of the introduction of a highly infectious animal disease. The very large illegal international trade in ani...

  11. SUSTAINABILITY, OPTION, THEORY, AND QUALITY CONTROL

    EPA Science Inventory

    Recently, Cabezas and Fath (2000) hypothesized that constant Fisher Information is a necessary condition for the persistence, i.e., sustainability of a dynamic regime of a system. A sustainable dynamic regime is one that persists and an unsustainable regime is one that does not ...

  12. Mine Drainage Control and Treatment Options

    EPA Science Inventory

    This presentation is the third in a series of webinars for Region 10's Hardrock Mine Geochemistry and Hydrology Webinar Workshops. It will discuss briefly how mine drainage forms, some suggested mitigation methods, how ions in the drainage change if drainage does get to the envi...

  13. Identity Options in Russian Textbooks

    ERIC Educational Resources Information Center

    Shardakova, Marya; Pavlenko, Aneta

    2004-01-01

    This article introduces a new analytical approach to the study of identity options offered in foreign and second language textbooks. This approach, grounded in poststructuralist theory and critical discourse analysis, is applied to 2 popular beginning Russian textbooks. Two sets of identity options are examined in the study: imagined learners…

  14. A Smorgasbord of Assessment Options

    ERIC Educational Resources Information Center

    Bacon, Kathy A.

    2010-01-01

    The wealth of assessment options that exists offers teachers and students a "menu" of selections. Just as matching appetite needs with appropriate food selection is fundamental to a successful dining experience, matching assessment options to targeted achievement needs is crucial to an effective assessment experience. The author uses a geometry…

  15. 40 CFR 63.4341 - How do I demonstrate initial compliance?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Printing, Coating, and Dyeing of Fabrics and Other Textiles Compliance Requirements for the Emission Rate with Add-on Controls Option § 63... control option. (b) You may use the emission rate with add-on controls option for any individual...

  16. 40 CFR 63.4341 - How do I demonstrate initial compliance?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Printing, Coating, and Dyeing of Fabrics and Other Textiles Compliance Requirements for the Emission Rate with Add-on Controls Option § 63... control option. (b) You may use the emission rate with add-on controls option for any individual...

  17. 40 CFR 63.4341 - How do I demonstrate initial compliance?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (CONTINUED) National Emission Standards for Hazardous Air Pollutants: Printing, Coating, and Dyeing of Fabrics and Other Textiles Compliance Requirements for the Emission Rate with Add-on Controls Option § 63... control option. (b) You may use the emission rate with add-on controls option for any individual...

  18. Network interface unit design options performance analysis

    NASA Technical Reports Server (NTRS)

    Miller, Frank W.

    1991-01-01

    An analysis is presented of three design options for the Space Station Freedom (SSF) onboard Data Management System (DMS) Network Interface Unit (NIU). The NIU provides the interface from the Fiber Distributed Data Interface (FDDI) local area network (LAN) to the DMS processing elements. The FDDI LAN provides the primary means for command and control and low and medium rate telemetry data transfers on board the SSF. The results of this analysis provide the basis for the implementation of the NIU.

  19. 24-h Efficacy of Glaucoma Treatment Options.

    PubMed

    Konstas, Anastasios G P; Quaranta, Luciano; Bozkurt, Banu; Katsanos, Andreas; Garcia-Feijoo, Julian; Rossetti, Luca; Shaarawy, Tarek; Pfeiffer, Norbert; Miglior, Stefano

    2016-04-01

    Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle. Since glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous, it is logical that we should aim to understand the efficacy of all treatment options throughout the 24-h period. This article first reviews the concept and value of diurnal and 24-h IOP monitoring. It then critically evaluates selected available evidence on the 24-h efficacy of medical, laser and surgical therapy options. During the past decade several controlled trials have significantly enhanced our understanding on the 24-h efficacy of all glaucoma therapy options. Nevertheless, more long-term evidence is needed to better evaluate the 24-h efficacy of glaucoma therapy and the precise impact of IOP characteristics on glaucomatous progression and visual prognosis.

  20. Assessing Ammonia Treatment Options

    EPA Science Inventory

    This is the second of three articles to help water system operators understand ammonia and how to monitor and control its effects at the plant and in the distribution system. The first article (Opflow, April 2012) provided an overview of ammonia's chemistry, origins, and water sy...

  1. Advanced Nuclear Fuel Cycle Options

    SciTech Connect

    Roald Wigeland; Temitope Taiwo; Michael Todosow; William Halsey; Jess Gehin

    2010-06-01

    A systematic evaluation has been conducted of the potential for advanced nuclear fuel cycle strategies and options to address the issues ascribed to the use of nuclear power. Issues included nuclear waste management, proliferation risk, safety, security, economics and affordability, and sustainability. The two basic strategies, once-through and recycle, and the range of possibilities within each strategy, are considered for all aspects of the fuel cycle including options for nuclear material irradiation, separations if needed, and disposal. Options range from incremental changes to today’s implementation to revolutionary concepts that would require the development of advanced nuclear technologies.

  2. FS65 Disposition Option Report

    SciTech Connect

    Wenz, Tracy R.

    2015-09-25

    This report outlines the options for dispositioning the MOX fuel stored in FS65 containers at LANL. Additional discussion regarding the support equipment for loading and unloading the FS65 transport containers is included at the end of the report.

  3. Hemorrhoidectomy - making sense of the surgical options.

    PubMed

    Yeo, Danson; Tan, Kok-Yang

    2014-12-01

    While debate continues as to which is the best surgical method for the treatment of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that is effective while being safe and painless. In reality, the less painful the procedure, the more likely it is to be associated with recurrence post-op. Where hemorrhoids surgery is concerned, there isn't a "one size fits all" option. Most of the randomized controlled trials performed to date include hemorrhoids of various grades and with a focus on only comparing surgical methods while failing to stratify the outcomes according to the grade of hemorrhoid. We believe that surgery needs to be tailored not only to the grade of the hemorrhoids, but also to the size, circumferential nature of the disease, and prevailing symptomatology.

  4. Hemorrhoidectomy - making sense of the surgical options

    PubMed Central

    Yeo, Danson; Tan, Kok-Yang

    2014-01-01

    While debate continues as to which is the best surgical method for the treatment of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that is effective while being safe and painless. In reality, the less painful the procedure, the more likely it is to be associated with recurrence post-op. Where hemorrhoids surgery is concerned, there isn’t a “one size fits all” option. Most of the randomized controlled trials performed to date include hemorrhoids of various grades and with a focus on only comparing surgical methods while failing to stratify the outcomes according to the grade of hemorrhoid. We believe that surgery needs to be tailored not only to the grade of the hemorrhoids, but also to the size, circumferential nature of the disease, and prevailing symptomatology. PMID:25493010

  5. A systematic review and mixed-treatment comparison of dapagliflozin with existing anti-diabetes treatments for those with type 2 diabetes mellitus inadequately controlled by sulfonylurea monotherapy

    PubMed Central

    2014-01-01

    Background To compare the first-in-class sodium glucose co-transporter 2 (SGLT2) inhibitor, dapagliflozin, with existing type 2 diabetes mellitus (T2DM) treatment options available within the European Union (EU) for add-on therapy to sulfonylureas (SUs). Methods A systematic review was conducted to identify randomised controlled trials (RCTs) in T2DM patients inadequately controlled by SU monotherapy. Direct meta-analysis, Bucher indirect comparisons and Bayesian network meta-analysis (NMA) were conducted on studies meeting predefined inclusion criteria. Sufficient data were available to assess three clinical endpoints at 24 (+/- 6) weeks follow-up: mean change in HbA1c from baseline, mean change in weight from baseline, and the proportion of patients experiencing at least one episode of hypoglycaemia. The effect of confounding baseline factors was explored through covariate analyses. Results The search identified 1,901 unique citations, with 1,870 excluded based on title/abstract. From reviewing full-texts of the remaining 31 articles, 5 studies were considered eligible for analysis. All studies were comparable in terms of baseline characteristics, including: HbA1c, age and body mass index (BMI). In addition to dapagliflozin, sufficient data for meta-analysis was available for three dipeptidyl peptidase-4 (DPP-4) inhibitors and one glucagon-like peptide-1 (GLP-1) analogue. Based on fixed-effect NMA, all treatment classes resulted in statistically significant decreases in HbA1c at follow-up compared to placebo. Dapagliflozin treatment resulted in significantly decreased weight at follow-up compared to placebo (-1.54 kg; 95% CrI -2.16, -0.92), in contrast to treatment with GLP-1 analogues (-0.65 kg; 95% CrI -1.37, 0.07) and DPP-4 inhibitors (0.57 kg; 95% CrI 0.09, 1.06). The odds of hypoglycaemia were similar to placebo for dapagliflozin and DPP-4 inhibitor add-on treatment, but significantly greater than placebo for GLP-1 analogue add-on treatment (10.89; 95% Cr

  6. Optimizing treatment options.

    PubMed

    Naclerio, R M

    1998-12-01

    Full and accurate diagnosis of allergic rhinitis is important as a basis for treatment decisions, as many nasal disorders have similar signs and symptoms. Optimal allergen avoidance is the starting point of treatment, so causative allergens need to be identified. Oral antihistamines are effective in relieving the majority of symptoms of allergic rhinitis and allergic conjunctivitis, but provide only partial relief from nasal congestion. Topical alpha-adrenergic decongestants help to relieve congestion, but prolonged use leads to rhinitis medicamentosa. Systemic decongestants are less effective than topical agents and their use is limited by systemic and central side-effects. The value of leukotriene antagonists has yet to be fully evaluated. Intranasal ipratropium bromide helps to control watery secretions, and an aerosol may be more effective than an aqueous solution. Topical glucocorticosteroids, such as triamcinolone, are the most potent and effective agents available for treating allergic rhinitis. The available evidence indicates that there is very little systemic absorption. Sodium cromoglycate is effective in allergic rhinitis, though less so than topical steroids, and has the least adverse effects among the antiallergic agents. Immunotherapy can be effective and may be indicated in individuals who cannot avoid the causative allergen. Special considerations apply to the treatment of allergic rhinitis in elderly or pregnant patients. Finally, patients with long-standing allergic conditions should be re-assessed regularly.

  7. Contraceptive options for adolescents.

    PubMed

    Moriarty, A L

    1997-01-01

    Data on national trends of sex behavior indicate that adolescents in the US are initiating sexual activity at younger ages than in the past several decades. The 1996 Centers for Disease Control Youth Behavior Survey found that 36.9% of 9th graders and 66.4% of 12th graders had been sexually active. Of those, 37.9% were sexually active within the 3 months preceding the survey. 12.7% of the sexually active boys and 4.9% of the sexually active girls reported beginning sexual activity before age 13 years. 72% of individuals aged 15-17 years and 84% of those aged 18-19 report using some form of contraception. However, many use contraception inconsistently. The most popular and effective methods of contraception chosen by adolescents are condoms, oral contraception, and depot medroxyprogesterone acetate (DMPA). These methods are discussed. Before either oral contraceptive pill or DMPA use is initiated, a detailed health history should be taken and a complete physical examination conducted which includes a pelvic examination.

  8. Postmission disposal options for upper stages

    NASA Astrophysics Data System (ADS)

    Eichler, Peter; Reynolds, Robert C.; Zhang, Jingchang; Bade, Anette; Jackson, A. A.; Johnson, Nicholas L.; McNamara, Roger

    1997-10-01

    NASA Management Instruction (NMI) 1700.8 directs each project office to limit orbital debris generation if this action is cost-effective and consistent with achieving mission objectives. To implement this policy, the NASA Office of Safety and Mission Assurance, the sponsor of NMI 1700.8, tasked NASA Johnson Space Center (JSC) to develop the NASA Safety Standard 1740.14: Guidelines and Assessment Procedures for Limiting Orbital Debris, August 1995. To mitigate the accumulation of mass in Earth orbit, NSS 1740.14 addresses the issues of postmission disposal of spacecraft and upper stages. According to the guidelines, these systems in general should be left in an orbit in which, using conservative projections for solar activity, atmospheric drag and gravitational perturbations will limit the lifetime in low Earth orbit (LEO) to no longer than 25 years after completion of mission. Consequently, JSC undertook a series of studies to investigate the most efficient and cost effective options for reducing orbit lifetime. In this paper we present an overview of the various options and give hints for the choice of the option best suited for specific mission types, e.g., depending on initial orbit, existing propulsion systems, existing electrical power level, electrical power and attitude control lifetime, and acceptable maneuver time and mass penalties.

  9. Autonomy, constraining options, and organ sales.

    PubMed

    Taylor, James Stacey

    2002-01-01

    Although there continues to be a chronic shortage of transplant organs the suggestion that we should try to alleviate it through allowing a current market in them continues to be morally condemned, usually on the grounds that such a market would undermine the autonomy of those who would participate in it as vendors. Against this objection Gerald Dworkin has argued that such markets would enhance the autonomy of the vendors through providing them with more options, thus enabling them to exercise a greater degree of control over their bodies. Paul Hughes and T.L. Zutlevics have recently criticized Dworkin's argument, arguing that the option to sell an organ is unusual in that it is an autonomy-undermining "constraining option" whose presence in a person's choice set is likely to undermine her autonomy rather than enhance it. I argue that although Hughes' and Zutlevics' arguments are both innovative and persuasive they are seriously flawed--and that allowing a market in human organs is more likely to enhance vendor autonomy than diminish it. Thus, given that autonomy is the preeminent value in contemporary medical ethics this provides a strong prima facie case for recognizing the moral legitimacy of such markets. PMID:12747360

  10. Weighing the options for limiting surplus animals.

    PubMed

    Asa, Cheryl

    2016-05-01

    The unsustainability of many animal programs managed by zoos and aquariums has brought renewed attention to unresolved questions about various management strategies. Solving the "sustainability crisis" for many species will require housing more adults and producing more offspring than there are existing spaces in accredited zoos and aquariums. Careful reproductive management is central to addressing this challenge, but opinions differ about which management strategies are best for an individual, for a species, for an institution, or for a country or region. The primary options for limiting the number of animals that would be surplus to the population are to prevent reproduction or to euthanize. However, there is much misunderstanding about methods for controlling reproduction, in particular about contraceptives and species differences in their effects. Careful weighing of all the options is called for. Lifetime Reproductive Planning may help increase breeding success through careful reproductive management but cannot eliminate production of surplus animals. Limiting reproduction does not address the problem of animals already in the population. Despite best efforts and planning, consistently hitting target numbers for a population may never be achieved. Increasing capacity provides a temporary patch when targets are exceeded, but is not a long-term solution, since each generation potentially produces even more individuals needing even more space. Welfare considerations should be included in discussions of management euthanasia and its alternatives. Such discussions will be most productive if based on full awareness of the advantages and disadvantages of all the options. Zoo Biol. 35:183-186, 2016. © 2016 Wiley Periodicals, Inc.

  11. Comparison between three option, four option and five option multiple choice question tests for quality parameters: A randomized study

    PubMed Central

    Vegada, Bhavisha; Shukla, Apexa; Khilnani, Ajeetkumar; Charan, Jaykaran; Desai, Chetna

    2016-01-01

    Background: Most of the academic teachers use four or five options per item of multiple choice question (MCQ) test as formative and summative assessment. Optimal number of options in MCQ item is a matter of considerable debate among academic teachers of various educational fields. There is a scarcity of the published literature regarding the optimum number of option in each item of MCQ in the field of medical education. Objectives: To compare three options, four options, and five options MCQs test for the quality parameters – reliability, validity, item analysis, distracter analysis, and time analysis. Materials and Methods: Participants were 3rd semester M.B.B.S. students. Students were divided randomly into three groups. Each group was given one set of MCQ test out of three options, four options, and five option randomly. Following the marking of the multiple choice tests, the participants’ option selections were analyzed and comparisons were conducted of the mean marks, mean time, validity, reliability and facility value, discrimination index, point biserial value, distracter analysis of three different option formats. Results: Students score more (P = 0.000) and took less time (P = 0.009) for the completion of three options as compared to four options and five options groups. Facility value was more (P = 0.004) in three options group as compared to four and five options groups. There was no significant difference between three groups for the validity, reliability, and item discrimination. Nonfunctioning distracters were more in the four and five options group as compared to three option group. Conclusion: Assessment based on three option MCQs is can be preferred over four option and five option MCQs. PMID:27721545

  12. Lunar Cube Transfer Trajectory Options

    NASA Technical Reports Server (NTRS)

    Folta, David; Dichmann, Donald J.; Clark, Pamela; Haapala, Amanda; Howell, Kathleen

    2015-01-01

    Numerous Earth-Moon trajectory and lunar orbit options are available for Cubesat missions. Given the limited Cubesat injection infrastructure, transfer trajectories are contingent upon the modification of an initial condition of the injected or deployed orbit. Additionally, these transfers can be restricted by the selection or designs of Cubesat subsystems such as propulsion or communication. Nonetheless, many trajectory options can be considered which have a wide range of transfer durations, fuel requirements, and final destinations. Our investigation of potential trajectories highlights several options including deployment from low Earth orbit (LEO), geostationary transfer orbits (GTO), and higher energy direct lunar transfers and the use of longer duration Earth-Moon dynamical systems. For missions with an intended lunar orbit, much of the design process is spent optimizing a ballistic capture while other science locations such as Sun-Earth libration or heliocentric orbits may simply require a reduced Delta-V imparted at a convenient location along the trajectory.

  13. Lunar Cube Transfer Trajectory Options

    NASA Technical Reports Server (NTRS)

    Folta, David; Dichmann, Donald James; Clark, Pamela E.; Haapala, Amanda; Howell, Kathleen

    2015-01-01

    Numerous Earth-Moon trajectory and lunar orbit options are available for Cubesat missions. Given the limited Cubesat injection infrastructure, transfer trajectories are contingent upon the modification of an initial condition of the injected or deployed orbit. Additionally, these transfers can be restricted by the selection or designs of Cubesat subsystems such as propulsion or communication. Nonetheless, many trajectory options can b e considered which have a wide range of transfer duration, fuel requirements, and final destinations. Our investigation of potential trajectories highlights several options including deployment from low Earth orbit (LEO) geostationary transfer orbits (GTO) and higher energy direct lunar transfer and the use of longer duration Earth-Moon dynamical systems. For missions with an intended lunar orbit, much of the design process is spent optimizing a ballistic capture while other science locations such as Sun-Earth libration or heliocentric orbits may simply require a reduced Delta-V imparted at a convenient location along the trajectory.

  14. Steam generator waste disposal options

    SciTech Connect

    Fisher, H.O.M.

    1994-12-31

    The steam generator waste stream has been examined, and disposal options associated with the decommissioning of the reference pressurized water reactor (PWR) power station have been investigated as described in NUREG/CR-0130. Specifically, the removal and disposal of the steam generators and those activities and associated occupational doses inherent in the activities have been examined. The results of this effort are compared in this paper to more recent data for the reference PWR contained in NUREG/CR-5884, and a determination of the appropriate volumes and activities is made. These data are used to complete projections of steam generator waste volumes and activities generated from light water reactor decommissioning using the DECON decommissioning alternative. Several disposal options for the steam generators are considered and the segmentation, one-piece waste package, and smelting options are detailed.

  15. Design Evolution Study - Aging Options

    SciTech Connect

    P. McDaniel

    2002-04-05

    The purpose of this study is to identify options and issues for aging commercial spent nuclear fuel received for disposal at the Yucca Mountain Mined Geologic Repository. Some early shipments of commercial spent nuclear fuel to the repository may be received with high-heat-output (younger) fuel assemblies that will need to be managed to meet thermal goals for emplacement. The capability to age as much as 40,000 metric tons of heavy metal of commercial spent nuclear he1 would provide more flexibility in the design to manage this younger fuel and to decouple waste receipt and waste emplacement. The following potential aging location options are evaluated: (1) Surface aging at four locations near the North Portal; (2) Subsurface aging in the permanent emplacement drifts; and (3) Subsurface aging in a new subsurface area. The following aging container options are evaluated: (1) Complete Waste Package; (2) Stainless Steel inner liner of the waste package; (3) Dual Purpose Canisters; (4) Multi-Purpose Canisters; and (5) New disposable canister for uncanistered commercial spent nuclear fuel. Each option is compared to a ''Base Case,'' which is the expected normal waste packaging process without aging. A Value Engineering approach is used to score each option against nine technical criteria and rank the options. Open issues with each of the options and suggested future actions are also presented. Costs for aging containers and aging locations are evaluated separately. Capital costs are developed for direct costs and distributable field costs. To the extent practical, unit costs are presented. Indirect costs, operating costs, and total system life cycle costs will be evaluated outside of this study. Three recommendations for aging commercial spent nuclear fuel--subsurface, surface, and combined surface and subsurface are presented for further review in the overall design re-evaluation effort. Options that were evaluated but not recommended are: subsurface aging in a new

  16. TALEN/CRISPR-mediated eGFP knock-in add-on at the OCT4 locus does not impact differentiation of human embryonic stem cells towards endoderm.

    PubMed

    Krentz, Nicole A J; Nian, Cuilan; Lynn, Francis C

    2014-01-01

    Human embryonic stem cells (hESCs) have great promise as a source of unlimited transplantable cells for regenerative medicine. However, current progress on producing the desired cell type for disease treatment has been limited due to an insufficient understanding of the developmental processes that govern their differentiation, as well as a paucity of tools to systematically study differentiation in the lab. In order to overcome these limitations, cell-type reporter hESC lines will be required. Here we outline two strategies using Transcription Activator Like Effector Nucleases (TALENs) and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-CRISPR-Associated protein (Cas) to create OCT4-eGFP knock-in add-on hESC lines. Thirty-one and forty-seven percent of clones were correctly modified using the TALEN and CRISPR-Cas9 systems, respectively. Further analysis of three correctly targeted clones demonstrated that the insertion of eGFP in-frame with OCT4 neither significantly impacted expression from the wild type allele nor did the fusion protein have a dramatically different biological stability. Importantly, the OCT4-eGFP fusion was easily detected using microscopy, flow cytometry and western blotting. The OCT4 reporter lines remained equally competent at producing CXCR4+ definitive endoderm that expressed a panel of endodermal genes. Moreover, the genomic modification did not impact the formation of NKX6.1+/SOX9+ pancreatic progenitor cells following directed differentiation. In conclusion, these findings demonstrate for the first time that CRISPR-Cas9 can be used to modify OCT4 and highlight the feasibility of creating cell-type specific reporter hESC lines utilizing genome-editing tools that facilitate homologous recombination.

  17. 48 CFR 2917.207 - Exercising options.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Exercising options. 2917... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 2917.207 Exercising options. The contracting officer must use a standardized determination and finding before exercising an option in accordance...

  18. 48 CFR 2917.207 - Exercising options.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Exercising options. 2917... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 2917.207 Exercising options. The contracting officer must use a standardized determination and finding before exercising an option in accordance...

  19. 48 CFR 2917.207 - Exercising options.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 7 2011-10-01 2011-10-01 false Exercising options. 2917... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 2917.207 Exercising options. The contracting officer must use a standardized determination and finding before exercising an option in accordance...

  20. 48 CFR 2917.207 - Exercising options.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Exercising options. 2917... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 2917.207 Exercising options. The contracting officer must use a standardized determination and finding before exercising an option in accordance...