Science.gov

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, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true Add-on Control Systems Compliance.... 63, Subpt. DDDD, Table 1B Table 1B to Subpart DDDD of Part 63—Add-on Control Systems Compliance... compliance options by using an emissions control system . . . Fiberboard mat dryer heated zones (at...

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

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true Add-on Control Systems Compliance Options 1B Table 1B to Subpart DDDD of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Products Pt. 63, Subpt. DDDD, Table 1B Table 1B to Subpart DDDD of Part 63—Add-on Control...

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false Add-on Control Systems Compliance Options 1B Table 1B to Subpart DDDD of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Products Pt. 63, Subpt. DDDD, Table 1B Table 1B to Subpart DDDD of Part 63—Add-on Control...

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

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false Add-on Control Systems Compliance Options 1B Table 1B to Subpart DDDD of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Products Pt. 63, Subpt. DDDD, Table 1B Table 1B to Subpart DDDD of Part 63—Add-on Control...

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Add-on Control Systems Compliance Options 1B Table 1B to Subpart DDDD of Part 63 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... CATEGORIES National Emission Standards for Hazardous Air Pollutants: Plywood and Composite Wood Products...

  6. 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

    ... Rate With Add-on Controls Option or the Control Efficiency/Outlet Concentration Compliance Option 4... Emission Rate With Add-on Controls Option or the Control Efficiency/Outlet Concentration Compliance Option... fan operation in each 3-hour block period must not fall outside of the range established according...

  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, 2013 CFR

    2013-07-01

    ... Rate With Add-on Controls Option or the Control Efficiency/Outlet Concentration Compliance Option 4... Emission Rate With Add-on Controls Option or the Control Efficiency/Outlet Concentration Compliance Option... fan operation in each 3-hour block period must not fall outside of the range established according...

  8. 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

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the add-on control... Emission Rate with Add-on Controls Option § 63.3966 How do I determine the add-on control device emission... the add-on control device emission destruction or removal efficiency as part of the performance...

  9. 40 CFR 63.4566 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the add-on control... with Add-on Controls Option § 63.4566 How do I determine the add-on control device emission destruction... add-on control device emission destruction or removal efficiency as part of the performance...

  10. 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the add-on control... Emission Rate with Add-on Controls Option § 63.3966 How do I determine the add-on control device emission... the add-on control device emission destruction or removal efficiency as part of the performance...

  11. 40 CFR 63.4566 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false How do I determine the add-on control... with Add-on Controls Option § 63.4566 How do I determine the add-on control device emission destruction... add-on control device emission destruction or removal efficiency as part of the performance...

  12. 40 CFR 63.4566 - How do I determine the add-on control device emission destruction or removal efficiency?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the add-on control... with Add-on Controls Option § 63.4566 How do I determine the add-on control device emission destruction... add-on control device emission destruction or removal efficiency as part of the performance...

  13. 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

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false How do I determine the add-on control... Emission Rate with Add-on Controls Option § 63.3966 How do I determine the add-on control device emission... the add-on control device emission destruction or removal efficiency as part of the performance...

  14. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the add-on control... with Add-on Controls Option § 63.3966 How do I determine the add-on control device emission destruction... add-on control device emission destruction or removal efficiency as part of the performance...

  15. 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

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the add-on control... Pollutants: Surface Coating of Wood Building Products Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4766 How do I determine the add-on control device emission destruction...

  16. 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

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false How do I determine the add-on control... Pollutants: Surface Coating of Large Appliances Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4166 How do I determine the add-on control device emission destruction or...

  17. 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

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the add-on control... Pollutants: Surface Coating of Metal Cans Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.3545 How do I determine the add-on control device emission destruction or removal...

  18. 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the add-on control... Pollutants: Surface Coating of Wood Building Products Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4766 How do I determine the add-on control device emission destruction...

  19. 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the add-on control... Pollutants: Surface Coating of Metal Cans Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.3545 How do I determine the add-on control device emission destruction or removal...

  20. 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

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false How do I determine the add-on control... Pollutants: Surface Coating of Metal Furniture Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4965 How do I determine the add-on control device emission destruction or...

  1. 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the add-on control... Pollutants: Surface Coating of Large Appliances Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4166 How do I determine the add-on control device emission destruction or...

  2. 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

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false How do I determine the add-on control... Pollutants: Surface Coating of Metal Cans Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.3545 How do I determine the add-on control device emission destruction or removal...

  3. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the add-on control... Surface Coating of Plastic Parts and Products Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4566 How do I determine the add-on control device emission destruction or...

  4. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the add-on control... Coating of Metal Cans Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.3545 How do I determine the add-on control device emission destruction or removal efficiency? You must...

  5. 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

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the add-on control... Pollutants: Surface Coating of Metal Furniture Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4965 How do I determine the add-on control device emission destruction or...

  6. 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

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the add-on control... Pollutants: Surface Coating of Large Appliances Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4166 How do I determine the add-on control device emission destruction or...

  7. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the add-on control... Coating of Wood Building Products Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4766 How do I determine the add-on control device emission destruction or removal...

  8. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the add-on control... Coating of Large Appliances Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4166 How do I determine the add-on control device emission destruction or removal efficiency? (a)...

  9. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the add-on control... Coating of Metal Furniture Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4965 How do I determine the add-on control device emission destruction or removal efficiency? You...

  10. 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the add-on control... Pollutants: Surface Coating of Metal Furniture Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4965 How do I determine the add-on control device emission destruction or...

  11. 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

    ... device emission destruction or removal efficiency? 63.4766 Section 63.4766 Protection of Environment... Coating of Wood Building Products Compliance Requirements for the Emission Rate with Add-on Controls Option § 63.4766 How do I determine the add-on control device emission destruction or removal...

  12. 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

  13. 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...

  14. 40 CFR 75.34 - Units with add-on emission controls.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 17 2014-07-01 2014-07-01 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...

  15. 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... 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...

  16. 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... 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...

  17. 40 CFR 75.34 - Units with add-on emission controls.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 16 2011-07-01 2011-07-01 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...

  18. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the outlet THC.../outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and add-on control... section to determine either the outlet THC emissions or add-on control device emission destruction...

  19. Glucagon-like peptide-1 receptor agonists as insulin add-on therapy in patients with inadequate glycemic control in type 2 diabetes mellitus: lixisenatide as a new therapeutic option.

    PubMed

    Gómez-Huelgas, Ricardo; Azriel, Sharona; Puig-Domingo, Manel; Vidal, Josep; de Pablos-Velasco, Pedro

    2015-03-01

    Despite the variety of therapeutic options for the management of type 2 diabetes mellitus, many patients fail to meet glycated hemoglobin (HbA1c) targets. The relative contribution of postprandial plasma glucose (PPG) to overall HbA1c is estimated at 40-60%, with the effect of PPG on HbA1c being prominent in patients on basal insulin. The development of glucagon-like peptide-1 receptor agonists (GLP-1RAs) has been an important achievement in diabetes management and has become an established treatment. Of available GLP-1RAs, lixisenatide is a once-daily prandial GLP-1RA that has been shown to produce a reduction in HbA1c with a pronounced postprandial effect, suggesting a complementary effect between lixisenatide and basal insulin on PPG and fasting plasma glucose, resulting in a beneficial effect on body weight in all populations. Therefore, lixisenatide will make an important addition to current options for treating diabetes, especially for patients not achieving glycemic targets with basal insulin therapy.

  20. 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

    ... 40 Protection of Environment 15 2014-07-01 2014-07-01 false How do I determine the add-on control... determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control device emission destruction...

  1. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the add-on control... Limitations § 63.3166 How do I determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control...

  2. 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

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the add-on control... Requirements § 63.4362 How do I determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control...

  3. 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

    ... 40 Protection of Environment 12 2011-07-01 2009-07-01 true How do I determine the add-on control... § 63.4362 How do I determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control...

  4. 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

    ... 40 Protection of Environment 14 2011-07-01 2011-07-01 false How do I determine the add-on control... determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control device emission destruction...

  5. 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

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false How do I determine the add-on control... Requirements § 63.4362 How do I determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control...

  6. 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

    ... 40 Protection of Environment 15 2012-07-01 2012-07-01 false How do I determine the add-on control... determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control device emission destruction...

  7. 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the add-on control... Requirements § 63.4362 How do I determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on control...

  8. 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

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the add-on control... Emission Limitations § 63.3166 How do I determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on...

  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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the add-on control... Emission Limitations § 63.3166 How do I determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on...

  10. 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

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false How do I determine the add-on control... Emission Limitations § 63.3166 How do I determine the add-on control device emission destruction or removal efficiency? You must use the procedures and test methods in this section to determine the add-on...

  11. Revisiting clonidine: an innovative add-on option for attention-deficit/hyperactivity disorder.

    PubMed

    Childress, A C; Sallee, F R

    2012-03-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder characterized by developmentally inappropriate levels of inattention, hyperactivity and impulsivity. Although much evidence supports the use of psychostimulants as a first-line treatment in children and adolescents, up to 30% of patients may have an inadequate response to these medications. For these patients, addition of an α₂-adrenoceptor agonist can further improve ADHD symptoms. The α₂-adrenoceptor agonists may work in a synergistic fashion with stimulants through regulation of prefrontal cortex function. Early studies were completed with immediate-release clonidine (CLON-IR), which requires multiple daily doses and achieves a higher maximum concentration more rapidly than the more recently developed extended-release clonidine (CLON-XR). Pharmacokinetic properties of CLON-XR may be responsible for differences in efficacy and tolerability between the CLON-IR and CLON-XR formulations. Recent double-blind, placebo-controlled trials have shown that extended-release α₂-adrenoceptor agonists are safe and effective, both as monotherapy and as adjunctive treatment with stimulants. This review will focus on clonidine used in conjunction with stimulants to optimize treatment of ADHD.

  12. 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

    ... 40 Protection of Environment 13 2013-07-01 2012-07-01 true How do I determine the outlet THC... Control Efficiency/outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and... methods in this section to determine either the outlet THC emissions or add-on control device...

  13. 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

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false How do I determine the outlet THC... Control Efficiency/outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and... methods in this section to determine either the outlet THC emissions or add-on control device...

  14. 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

    ... 40 Protection of Environment 13 2014-07-01 2014-07-01 false How do I determine the outlet THC... Control Efficiency/outlet Concentration Option § 63.3555 How do I determine the outlet THC emissions and... methods in this section to determine either the outlet THC emissions or add-on control device...

  15. Add-on fluvoxamine treatment for schizophrenia: an updated meta-analysis of randomized controlled trials.

    PubMed

    Kishi, Taro; Hirota, Tomoya; Iwata, Nakao

    2013-12-01

    We performed an updated meta-analysis of fluvoxamine add-on therapy in patients with schizophrenia treated with antipsychotics based on two previous meta-analyses (Sepehry et al., in J Clin Psychiatry 68:604-610, 2007 and Singh et al., in Br J Psychiatry J Mental Sci 197:174-179, 2010). We searched PubMed, the Cochrane Library database, and PsycINFO up to January 2013. We conducted a systematic review and meta-analysis of individual patient data from randomized controlled trials comparing fluvoxamine add-on therapy with placebo. The risk ratio (RR), 95 % confidence intervals (CI), and standardized mean difference (SMD) were calculated. Seven studies (total n = 272) were identified. These included two clozapine studies, one olanzapine study, one second-generation antipsychotic (SGA) monotherapy study, and three first-generation antipsychotics (FGAs) monotherapy studies. There were significant effect of fluvoxamine add-on therapy on overall (SMD = -0.46, CI = -0.75 to -0.16, p = 0.003, I (2) = 0 %, 5 studies, n = 180) and negative symptoms (SMD = -0.44, CI = -0.74 to -0.14, p = 0.004, I (2) = 0 %, 5 studies, n = 180). However, fluvoxamine add-on therapy showed no significant effects on positive symptoms, depressive symptoms, and discontinuations from any cause or adverse events. Fluvoxamine add-on therapy in patients primarily treated with SGAs improved overall (p = 0.02) but not negative symptoms (p = 0.31). On the other hand, fluvoxamine add-on therapy in patients primarily treated with FGAs improved both overall (p = 0.04) and negative symptoms (p = 0.004) compared with control groups. Our results suggest that fluvoxamine add-on therapy is more beneficial on the psychopathology (especially negative symptoms) than controls in patients with schizophrenia who are primarily treated with FGAs. Given that a small number of studies were included in this meta-analysis, the results should be treated with caution.

  16. 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

    ... (kg/h). Cc = Concentration of organic compounds as carbon in the vent gas, as determined by Method 25...) and 760 millimeters of mercury (mmHg)). (e) For each test run, determine the add-on control...

  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

    ..., 2F, or 2G, dry standard cubic meters/hour (dscm/h). Cc = Concentration of organic compounds as carbon...) and 760 millimeters of mercury (mmHg)). (e) For each test run, determine the add-on control...

  18. 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

    ... organic compounds as carbon in the vent gas, as determined by Method 25 or Method 25A, parts per million... 760 millimeters of mercury (mmHg)). (e) For each test run, determine the add-on control device...

  19. 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

    ... = concentration of organic compounds as carbon in the vent gas, as determined by Method 25 or Method 25A, parts... Kelvin and 760 millimeters of mercury ). (d) For each test run, determine the add-on control...

  20. 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

  1. 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

    ... system or add-on control device which is not taken into account when demonstrating compliance with the... Limitations § 63.3169 What are the requirements for a capture system or add-on control device which is not... capture systems or add-on control devices which you choose not to take into account when...

  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, 2014 CFR

    2014-07-01

    ... capture system or add-on control device which is not taken into account when demonstrating compliance with... capture system or add-on control device which is not taken into account when demonstrating compliance with the applicable emission limitations? You may have capture systems or add-on control devices which...

  3. 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

    ... capture system or add-on control device which is not taken into account when demonstrating compliance with... Emission Limitations § 63.3169 What are the requirements for a capture system or add-on control device...? You may have capture systems or add-on control devices which you choose not to take into account...

  4. 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, 2012 CFR

    2012-07-01

    ... capture system or add-on control device which is not taken into account when demonstrating compliance with... capture system or add-on control device which is not taken into account when demonstrating compliance with the applicable emission limitations? You may have capture systems or add-on control devices which...

  5. 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

    ... system or add-on control device which is not taken into account when demonstrating compliance with the....3169 What are the requirements for a capture system or add-on control device which is not taken into... systems or add-on control devices which you choose not to take into account when demonstrating...

  6. 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, 2013 CFR

    2013-07-01

    ... system or add-on control device which is not taken into account when demonstrating compliance with the... system or add-on control device which is not taken into account when demonstrating compliance with the applicable emission limitations? You may have capture systems or add-on control devices which you choose...

  7. 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

    ... capture system or add-on control device which is not taken into account when demonstrating compliance with... Emission Limitations § 63.3169 What are the requirements for a capture system or add-on control device...? You may have capture systems or add-on control devices which you choose not to take into account...

  8. 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

    ... system or add-on control device which is not taken into account when demonstrating compliance with the....3169 What are the requirements for a capture system or add-on control device which is not taken into... systems or add-on control devices which you choose not to take into account when demonstrating...

  9. 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...

  10. 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...

  11. 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...

  12. 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

    ... Pollutants for Engine Test Cells/Stands Testing and Initial Compliance Requirements § 63.9323 How do I... and test methods in this section to determine the add-on control device emission destruction or removal efficiency as part of the performance test required by § 63.9310. You must conduct three test...

  13. 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.

  14. 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, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 13 2012-07-01 2012-07-01 false Operating Limits if Using an Add-on... Limits if Using an Add-on Control Device for Open Molding Operations As specified in §§ 63.5715(a) and 63... device and add-on control device inlet in any 3-hour period must not fall below the average...

  15. In a randomized placebo-controlled add-on study orlistat significantly reduced clozapine-induced constipation.

    PubMed

    Chukhin, Evgeny; Takala, Pirjo; Hakko, Helinä; Raidma, Mirjam; Putkonen, Hanna; Räsänen, Pirkko; Terevnikov, Viacheslav; Stenberg, Jan-Henry; Eronen, Markku; Joffe, Grigori

    2013-03-01

    Constipation is a common and potentially fatal side effect of clozapine treatment. Another important side effect of clozapine may also be significant weight gain. Orlistat is a weight-control medication that is known to induce loose stools as a common side effect. This study aimed to explore whether orlistat used to control clozapine-induced weight gain can simultaneously tackle clozapine-related constipation. In this 16-week randomized-controlled study, clozapine-treated patients received add-on orlistat (n=30) or add-on placebo (n=24). Colonic function was measured using the Bristol Stool Form Scale. There was a significant (P=0.039) difference in the prevalence of constipation in favor of orlistat over placebo in completers (n=40) at the endpoint. A decrease in the prevalence of constipation within the orlistat group (P=0.035) was observed (vs. no statistically significant changes in the placebo group). In clozapine-treated patients, orlistat may be beneficial not only for weight control but also as a laxative. As no established treatments for clozapine-induced constipation exist, orlistat can be considered for this population, although more studies are required.

  16. 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...

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

    PubMed

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

    2015-07-01

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

  18. 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

    ... = concentration of organic compounds as carbon in the vent gas, as determined by Method 25 or Method 25A, parts... Kelvin (K) and 760 millimeters of mercury (mm Hg)). (e) For each test run, determine the add-on...

  19. Effectiveness of coenzyme Q10 in prophylactic treatment of migraine headache: an open-label, add-on, controlled trial.

    PubMed

    Shoeibi, Ali; Olfati, Nahid; Soltani Sabi, Mohsen; Salehi, Maryam; Mali, Sara; Akbari Oryani, Mahsa

    2017-03-01

    Despite the huge health and economic burden of migraine headache, few medications have been approved for its prophylactic treatment, most of which can potentially induce serious adverse effects. Coenzyme Q10 (CoQ10) is a supplement and has shown preliminary benefits in migraine prophylaxis. We aimed to assess this effect in an adult population. This is an open-label, parallel, add-on, match-controlled trial. Eighty patients diagnosed with migraine headache based on International Headache Society criteria were allocated to receiving only their current preventive drugs or their current preventive drugs plus 100 mg CoQ10 daily, matching for their baseline characteristics, and were assessed for frequency and severity of attacks, and ≥50 % reduction in attack frequency per month. Thirty-six and 37 patients were analyzed in CoQ10 and control groups, respectively. Number of attacks per month dropped significantly in the CoQ10 group (mean decrease: 1.6 vs. 0.5 among CoQ10 and control groups, respectively, p < 0.001). A significant reduction was also evident in the severity of headaches (mean decrease: 2.3 vs. 0.6 among CoQ10 and control groups, respectively, p < 0.001). For ≥50 % reduction in the frequency of attacks per month, the number needed to treat was calculated as 1.6. No side effects for CoQ10 were observed. This study suggests that CoQ10 might reduce the frequency of headaches, and may also make them shorter in duration, and less severe, with a favorable safety profile.

  20. 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…

  1. A placebo-controlled add-on trial of the Ampakine, CX516, for cognitive deficits in schizophrenia.

    PubMed

    Goff, Donald C; Lamberti, J Steven; Leon, Andrew C; Green, Michael F; Miller, Alexander L; Patel, Jayendra; Manschreck, Theo; Freudenreich, Oliver; Johnson, Steven A

    2008-02-01

    AMPA-receptor-positive modulators (Ampakines) facilitate learning and memory in animal models and in preliminary trials in human subjects. CX516 is the first Ampakine to be studied for cognitive enhancement in schizophrenia. Stable schizophrenia patients treated with clozapine (n=52), olanzapine (n=40), or risperidone (n=13) were randomly assigned to add-on treatment with CX516 900 mg three times daily or placebo for 4 weeks. Subjects were assessed with a cognitive battery at baseline, week 4, and at 4-week follow-up. Clinical scales and safety monitoring were also performed. The primary endpoint was the change from baseline in a composite cognitive score at week 4 for the intent-to-treat sample. Additional analyses examined change in symptom rating scores and examined drug effects on patients treated with clozapine separately from patients treated with either olanzapine or risperidone. A total of 105 patients were randomized and 95 (90%) completed the 4-week trial. Patients treated with CX516 did not differ from placebo in change from baseline on the composite cognitive score, or on any cognitive test at weeks 4 or 8. The between groups effect size at week 4 for the cognitive composite score was -0.19 for clozapine-treated patients and 0.24 for patients treated with olanzapine or risperidone. The placebo group improved more on the PANSS total score than the CX516 group; no other clinical rating differed between treatment groups. CX516 was associated with fatigue, insomnia and epigastric discomfort compared to placebo, but was generally well tolerated. CX516 was not effective for cognition or for symptoms of schizophrenia when added to clozapine, olanzapine, or risperidone.

  2. 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

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

    PubMed Central

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

    2017-01-01

    Background The aim of this study was to investigate the efficacy and safety of vildagliptin as an add-on therapy for patients with type 2 diabetes mellitus inadequately controlled with basal insulin. Methods Twenty-four patients treated with basal insulin and oral anti-diabetes drugs were randomly allocated into two groups: the control group (did not receive any add-on drugs) and vildagliptin group (received vildagliptin 100 mg/day for 6 months). The primary outcome was changes in hemoglobin A1c (HbA1c) from baseline to end of study. Results Treatment with vildagliptin significantly reduced HbA1c from 8.1±0.7% at baseline to 7.1±0.7% (P < 0.01), while there was no significant change of HbA1c in the control group. Vildagliptin group showed significant reduction of HbA1c compared with control group (-1.0±0.3% vs. 0.2±0.8%, P < 0.01). In addition, vildagliptin group showed a significant increase in 1,5-anhydroglucitol compared with the control group (4.5 ± 3.4 vs. 0.5 ± 4.1 μg/mL, P < 0.05). Mild hypoglycemia was reported in one patient of the vildagliptin group and two patients of the control group. Conclusion Vildagliptin improved glycemic control without increasing hypoglycemia in Japanese type 2 diabetes inadequately controlled with basal insulin treatment and other oral anti-diabetes drugs. This study was registered with UMIN (University Hospital Medical Information Network ID#000010849). PMID:28179966

  4. 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

  5. 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

  6. 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

  7. 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...

  8. 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 ...

  9. 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.

  10. Lamotrigine as add-on treatment to lithium and divalproex: lessons learned from a double-blind, placebo-controlled trial in rapid-cycling bipolar disorder

    PubMed Central

    Kemp, David E; Gao, Keming; Fein, Elizabeth B; Chan, Philip K; Conroy, Carla; Obral, Sarah; Ganocy, Stephen J; Calabrese, Joseph R

    2013-01-01

    Objectives A substantial portion of the morbidity associated with rapid-cycling bipolar disorder (RCBD) stems from refractory depression. This study assessed the antidepressant effects of lamotrigine as compared with placebo when used as add-on therapy for rapid-cycling bipolar depression non-responsive to the combination of lithium plus divalproex. Methods During Phase 1 of this trial, hypomanic, manic, mixed, and/or depressed outpatients (n = 133) aged 18–65 with DSM-IV RCBD type I or II were initially treated with the open combination of lithium and divalproex for up to 16 weeks. During Phase 2, subjects who did not meet the criteria for stabilization (n = 49) (i.e., remained or cycled into the depressed phase) were randomly assigned to double-blind, adjunctive lamotrigine (n = 23) or adjunctive placebo (n = 26). The primary endpoint was the mean change in depression symptom severity from the beginning of Phase 2 to the end of Phase 2 (week 12) on the Montgomery-Åsberg Depression Rating Scale (MADRS) total score. Data were analyzed by analysis of covariance with last observation carried forward and a mixed-models analysis. Results During Phase 1, a high rate of study discontinuations occurred due to intolerable side effects (13/133; 10%) and study non-adherence (22/133; 17%). Only 14% (19/133) stabilized on the open combination of lithium and divalproex. Among the 49 (37%) patients randomized to the double-blind adjunctive treatment phase, mean ± standard error change from baseline on the MADRS total score was −8.5 ± 1.7 points for lamotrigine and −9.1 ± 1.5 points for placebo (p = NS; mixed-models analysis). No significant differences were observed in the rates of response, remission, or bimodal response between lamotrigine and placebo. Conclusions The poor tolerability, lack of efficacy, and high rate of early discontinuation with the combination of lithium and divalproex suggests this regimen was ineffective for the majority of patients with RCBD

  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, 2010 CFR

    2010-07-01

    ... difference across the catalyst bed in each 3-hour period does not fall below the temperature difference limit... to the catalyst bed in each 3-hour block period must not fall below the limit established according... average temperature at the inlet to the catalyst bed at or above the temperature limit...

  12. 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

    ... 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...

  13. 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...

  14. Lobeglitazone and pioglitazone as add-ons to metformin for patients with type 2 diabetes: a 24-week, multicentre, randomized, double-blind, parallel-group, active-controlled, phase III clinical trial with a 28-week extension.

    PubMed

    Jin, S-M; Park, C-Y; Cho, Y M; Ku, B J; Ahn, C W; Cha, B-S; Min, K W; Sung, Y A; Baik, S H; Lee, K W; Yoon, K-H; Lee, M-K; Park, S W

    2015-06-01

    We aimed to compare the efficacy and safety of lobeglitazone and pioglitazone as add-ons to metformin in patients with type 2 diabetes. Patients who were inadequately controlled by metformin were randomized and treated once daily with either lobeglitazone (0.5 mg, n = 128) or pioglitazone (15 mg, n = 125) for 24 weeks, with a 28-week extension trial of lobeglitazone treatment in patients who consented. The primary endpoint was the change in glycated haemoglobin (HbA1c) concentration from baseline to week 24. At week 24, the mean change from baseline in HbA1c was -0.74% for the lobeglitazone group and -0.74% for the pioglitazone group, with a mean difference of 0.01% [95% confidence interval (CI) of difference, -0.16 to 0.18]. The effects of lobeglitazone on lipid variables and the adverse events associated with lobeglitazone were similar to those observed with pioglitazone. Lobeglitazone was not inferior to pioglitazone as an add-on to metformin in terms of their efficacy and safety.

  15. A single-blind, placebo-controlled, dose-ranging trial of oral hepatic-directed vesicle insulin add-on to oral antidiabetic treatment in patients with type 2 diabetes mellitus.

    PubMed

    Geho, W Blair; Rosenberg, Len N; Schwartz, Sherwyn L; Lau, John R; Gana, Theophilus J

    2014-05-01

    The dose response of postprandial plasma glucose (PPG) to add-on, premeal oral hepatic-directed vesicle-insulin (HDV-I), an investigational lipid bio-nanoparticle hepatocyte-targeted insulin delivery system, was evaluated in a 3-test-meal/day model in type 2 diabetes patients. The single-blind, placebo-controlled, dose-escalating trial enrolled 6 patients with HbA(1c) 8.6 ± 2.0% (70.0 ± 21.9 mmol/mol) and on stable metformin therapy. Patients received oral HDV-I capsules daily 30 minutes before breakfast, lunch, and dinner as follows: placebo capsules, 0.05, 0.1, 0.2, and 0.4 U/kg on days 1, 2, 3, 4, and 5, respectively. Outcome measures were PPG and incremental PPG area under the concentration-time curve (AUC). All 4 doses of oral HDV-I statistically significantly lowered mean PPG (P ≤ .0110 each) and incremental PPG (P ≤ .0352 each) AUC compared to placebo. A linear dose response was not observed. The 0.05 U/kg dose was the minimum effective dose in the dosage range studied. Three adverse events unrelated to treatment were observed. Add-on oral HDV-I 0.05-0.4 U/kg significantly lowered PPG excursions and the dose response curve was flat. These results are consistent with the lack of a linear dose response between portal and systemic plasma insulin concentrations in previous animal and human studies. Oral HDV-I was safe and well tolerated.

  16. 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

    ... the limit established according to § 63.3967(b) (for magnet wire coating machines, temperature can be... temperature before (or for magnet wire coating machines after) the catalyst bed at or above the temperature... magnet wire coating machines according to section 3.0 of appendix A to this subpart i. Maintaining and...

  17. 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...

  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, 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...

  19. 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

    ... 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 not... at or above the mass flow limit. b. The temperature of the carbon bed, after completing...

  20. 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

    ... 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 fall below... above the mass flow limit. b. the temperature of the carbon bed after completing each regeneration...

  1. 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

    ... measured just before the catalyst bed in any 3-hour period must not fall below the limit established... the catalyst bed); and either i. Collecting the temperature data according to § 63.3968(c);ii... for magnet wire coating machines after) the catalyst bed at or above the temperature limit. b....

  2. 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

    ... before the catalyst bed in any 3-hour period must not fall below the limit established according to § 63... to 3-hour block averages; and iii. Maintaining the 3-hour average temperature before the catalyst bed... catalyst bed in any 3-hour period does not fall below the temperature difference limit...

  3. 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

    ... before the catalyst bed in any 3-hour period must not fall below the limit established according to § 63... to 3-hour block averages; and iii. maintaining the 3-hour average temperature before the catalyst bed... catalyst bed in any 3-hour period does not fall below the temperature difference limit...

  4. 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

    ... 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 average temperature difference across the catalyst bed in any 3-hour period does not fall below the temperature difference limit...

  5. 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

    ... before the catalyst bed in any 3-hour period must not fall below the limit established according to § 63... to 3-hour block averages; and iii. maintaining the 3-hour average temperature before the catalyst bed... catalyst bed in any 3-hour period does not fall below the temperature difference limit...

  6. 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

    .... The average temperature measured just before the catalyst bed in any 3-hour period must not fall below... monitored before or after the catalyst bed); and either i. Collecting the temperature data according to § 63... temperature before (or for magnet wire coating machines after) the catalyst bed at or above the...

  7. 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

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

  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, 2014 CFR

    2014-07-01

    ... measured just before the catalyst bed in any 3-hour period must not fall below the limit established... 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...

  9. 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...

  10. 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...

  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

    ... 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...

  12. 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...

  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

    ... 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...

  14. 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...

  15. 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...

  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, 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...

  17. 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...

  18. 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

    ... 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...

  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, 2011 CFR

    2011-07-01

    ... 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...

  20. 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

    ... 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...

  1. Efficacy and safety comparison of add-on therapy with liraglutide, saxagliptin and vildagliptin, all in combination with current conventional oral hypoglycemic agents therapy in poorly controlled Chinese type 2 diabetes.

    PubMed

    Li, C-J; Yu, Q; Yu, P; Zhang, Q-M; Ding, M; Liu, X-J; Yu, D-M

    2014-09-01

    To compare the efficacy and safety of adding liraglutide, saxagliptin and vildagliptin to current therapy in Chinese type 2 diabetes subjects with poor glycemic control.A 24-week, randomized, open-label, parallel clinical trial was performed. A total 178 patients completed the trial who had been randomly assigned to add-on once daily liraglutide (1.2 mg/day injected subcutaneously), to saxagliptin (5 mg once daily) or to vildagliptin (50 mg twice daily). Glycosylated hemoglobin (HbA1c) values, fasting and postprandial blood glucose (FBG and P2BG), body weight, body mass index (BMI), episodes of hypoglycemia and adverse events were evaluated.Over the 24-week treatment period, greater lowering of mean of HbA1c was achieved with 1.2 mg liraglutide (-1.50%, 95% CI [-1.67, -1.34]) than with saxagliptin (-1.23%, 95% CI [-1.36, -1.11]) and vildagliptin (-1.25%, 95% CI [-1.37, -1.13]). There was no significant between-group difference of percentages of subjects who reached a target HbA1c<7.0%, but significantly more subjects with liraglutide achieved HbA1c≤6.5% compared with saxagliptin and vildagliptin. The mean reduction of FBG value from baseline was 2.23 mmol/L with liraglutide, much greater than 1.83 mmol/L with saxagliptin (p=0.013), but similar to 2.03 mmol/L with -vildaglitpin group. As to the P2BG value, greater reductions was found with liraglutide (-4.80 mmol/L) than -3.56 mmol/L with saxagliptin (p=0.000) and -3.57 mmol/L with vildagliptin (p=0.000). Moreover, greater mean reductions of body weight and BMI with liraglutide (-6.0 kg and -2.1 kg/m(2)) were achieved than with saxagliptin and vildagliptin (both p<0.001), whereas no significant difference was found between saxagliptin and vildagliptin group. The incidence of hypoglycemia was recorded low and similar in each treatment group. Nausea was more common with liraglutide (27%) than with saxagliptin (3.2%) and vildagliptin (5.2%), but no significant between-group difference was reported

  2. Effects of Passion Flower Extract, as an Add-On Treatment to Sertraline, on Reaction Time in Patients ‎with Generalized Anxiety Disorder: A Double-Blind Placebo-Controlled Study.

    PubMed

    Nojoumi, Mandana; Ghaeli, Padideh; Salimi, Samrand; Sharifi, Ali; Raisi, Firoozeh

    2016-07-01

    Objective: Because of functional impairment caused by generalized anxiety disorder and due to cognitive side ‎effects of many anti-anxiety agents, in this study we aimed to evaluate the influence of Passion ‎flower standardized extract on reaction time in patients with generalized anxiety disorder.‎ Method: Thirty patients aged 18 to 50 years of age, who were diagnosed with generalized anxiety disorder and ‎fulfilled the study criteria, entered this double-blind placebo-controlled study. Reaction time was ‎measured at baseline and after one month of treatment using computerized software. Correct ‎responses, omission and substitution errors and the mean time of correct responses (reaction time) in ‎both visual and auditory tests were collected. The analysis was performed between the two groups ‎and within each group utilizing SPSS PASW- statics, Version 18. P-value less than 0.05 was ‎considered statistically significant.‎ Results: All the participants were initiated on Sertraline 50 mg/day, and the dosage was increased to 100 ‎mg / day after two weeks. Fourteen patients received Pasipy (Passion Flower) 15 drops three times ‎daily and 16 received placebo concurrently. Inter-group comparison proved no significant difference ‎in any of the test items between assortments while a significant decline was observed in auditory ‎omission errors in passion flower group after on month of treatment using intra-group analysis.‎‎ Conclusion: This study noted that passion flower might be suitable as an add-on in the treatment of generalized ‎anxiety disorder with low side effects. Further studies with longer duration are recommended to ‎confirm the results of this study.‎.

  3. Effects of Passion Flower Extract, as an Add-On Treatment to Sertraline, on Reaction Time in Patients ‎with Generalized Anxiety Disorder: A Double-Blind Placebo-Controlled Study

    PubMed Central

    Nojoumi, Mandana; Ghaeli, Padideh; Salimi, Samrand; Sharifi, Ali; Raisi, Firoozeh

    2016-01-01

    Objective: Because of functional impairment caused by generalized anxiety disorder and due to cognitive side ‎effects of many anti-anxiety agents, in this study we aimed to evaluate the influence of Passion ‎flower standardized extract on reaction time in patients with generalized anxiety disorder.‎ Method: Thirty patients aged 18 to 50 years of age, who were diagnosed with generalized anxiety disorder and ‎fulfilled the study criteria, entered this double-blind placebo-controlled study. Reaction time was ‎measured at baseline and after one month of treatment using computerized software. Correct ‎responses, omission and substitution errors and the mean time of correct responses (reaction time) in ‎both visual and auditory tests were collected. The analysis was performed between the two groups ‎and within each group utilizing SPSS PASW- statics, Version 18. P-value less than 0.05 was ‎considered statistically significant.‎ Results: All the participants were initiated on Sertraline 50 mg/day, and the dosage was increased to 100 ‎mg / day after two weeks. Fourteen patients received Pasipy (Passion Flower) 15 drops three times ‎daily and 16 received placebo concurrently. Inter-group comparison proved no significant difference ‎in any of the test items between assortments while a significant decline was observed in auditory ‎omission errors in passion flower group after on month of treatment using intra-group analysis.‎‎ Conclusion: This study noted that passion flower might be suitable as an add-on in the treatment of generalized ‎anxiety disorder with low side effects. Further studies with longer duration are recommended to ‎confirm the results of this study.‎ PMID:27928252

  4. 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

  5. Add-on unidirectional elastic metamaterial plate cloak.

    PubMed

    Lee, Min Kyung; Kim, Yoon Young

    2016-02-10

    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.

  6. 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

  7. Efficacy and safety of nebulized formoterol as add-on therapy in COPD patients receiving maintenance tiotropium bromide: Results from a 6-week, randomized, placebo-controlled, clinical trial.

    PubMed

    Hanania, Nicola A; Boota, Ahmad; Kerwin, Edward; Tomlinson, LaTanya; Denis-Mize, Kimberly

    2009-06-18

    Current guidelines for the treatment of chronic obstructive pulmonary disease (COPD) recommend the use of long-acting bronchodilators in the maintenance management of COPD. Combining bronchodilators that work through different mechanisms is recommended in patients with continuous symptoms. We conducted this study to confirm and further investigate the efficacy and safety of nebulized formoterol as an add-on therapy to maintenance tiotropium in patients with COPD. This randomized, double-blind, placebo-controlled, parallel-group study (NCT00507234) was conducted at 24 US sites from March to October 2007 in 155 patients aged > or =40 years with post-bronchodilator forced expiratory volume in 1 second (FEV(1)) > or =25% to <65% predicted normal. COPD patients receiving open-label tiotropium bromide 18 microg once daily during a 1- to 2-week run-in period were randomized to receive either formoterol fumarate inhalation solution 20 microg or placebo by nebulization twice daily for 6 weeks while continuing treatment with tiotropium. Outcomes included serial spirometry, inspiratory capacity (IC), baseline dyspnoea index/transition dyspnoea index (BDI/TDI), daily symptom scores, salbutamol (albuterol) use and health status measured by the St George's Respiratory Questionnaire (SGRQ). The primary efficacy endpoint was standardized absolute FEV(1) area under the curve over 3 hours (AUC(0-3)) at week 6. Treatment groups (formoterol plus tiotropium, n = 78; placebo plus tiotropium, n = 77) were comparable at baseline. At 6 weeks, FEV(1) AUC(0-3) was significantly greater in the formoterol group compared with the placebo group (1.57 vs 1.38 L [p < 0.0001]). Similarly, formoterol plus tiotropium improved other lung function measures, including FEV(1), forced vital capacity and post-dose IC at day 1, and maintained efficacy through week 6. Formoterol plus tiotropium decreased rescue albuterol use throughout the study (p < 0.05). Mean TDI, SGRQ and most symptom scores did not

  8. 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

  9. Bed bugs: clinical relevance and control options.

    PubMed

    Doggett, Stephen L; Dwyer, Dominic E; Peñas, Pablo F; Russell, Richard C

    2012-01-01

    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.

  10. 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

  11. Dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin: rationale and evidences.

    PubMed

    Singh, Awadhesh Kumar; Singh, Ritu

    2016-01-08

    Type 2 diabetes mellitus being a progressive disease will eventually require insulin therapy. While insulin therapy is the ultimate option, many patients still fall short of target glycemic goals. This could, perhaps be due to the fear, unwillingness and practical barriers to insulin intensification. Hypoglycemia, oedema and weight gain is another limitation. Newer therapies with dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose co-transporter-2 (SGLT-2) inhibitors are exciting options as both classes do not cause hypoglycemia and are either weight neutral or cause weight loss. DPP-4 inhibitors are an appealing option as an add-on therapy to insulin especially in elderly and patients with renal impairment. Moreover, glucose-dependent insulinotropic polypeptide (GIP) mediated augmentation of glucagon by DPP-4 inhibitors could also protect against hypoglycemia. These collective properties make these class a potential add-on candidate to insulin therapy. This article will review the efficacy and safety of DPP-4 inhibitors as an add-on to insulin therapy.

  12. Control of cervical cancer: women's options and rights.

    PubMed

    Cain, Joanna M; Ngan, Hextan; Garland, Suzanne; Wright, Thomas

    2009-08-01

    Cervical cancer takes the lives of more than 250,000 women each year globally, particularly in under-resourced areas of low-, middle-, and high-income countries. Options for cancer control and treatment have reached a point that there are interventions for control that could be adopted for virtually every resource and demographic situation. Women die despite the availability of attractive control options, which means that educating policy makers, women's health professionals, as well as women themselves, must become a major focus for ongoing control of this disease. The human right to life, to prevention of suffering, and to education are all key rights linked to improving the control of cervical cancer and saving the lives of women, particularly in resource-poor parts of the world.

  13. 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.

  14. Face equipment lighting: integrated vs. add-on

    SciTech Connect

    Scott, F.E.

    1982-10-01

    The problems of providing lighting on face equipment are examined. In the US, some equipment manufacturers are building-in lighting systems to their machinery; others will install lighting systems as add-on or retrofitted items. The pros and cons of each method are examined and the views of manufacturers are quoted.

  15. Linagliptin as add-on therapy to insulin for patients with type 2 diabetes.

    PubMed

    von Websky, Karoline; Reichetzeder, Christoph; Hocher, Berthold

    2013-01-01

    Type 2 diabetes mellitus (T2DM) is a highly prevalent, progressive disease that often is poorly controlled. The combination of an incretin-based therapy and insulin is a promising approach to optimize the management of glycemic control without hypoglycemia and weight gain. Linagliptin, a recently approved oral dipeptidyl peptidase-4 inhibitor, has a unique pharmacological profile. The convenient, once-daily dosing does not need adjustment in patients with hepatic and/or renal impairment. In clinical studies linagliptin shows an important reduction of blood glucose with an overall safety profile similar to that of placebo. So far, the combination of linagliptin and insulin has been tested in three major clinical studies in different populations. It has been shown that linagliptin is an effective and safe add-on therapy to insulin in patients with T2DM. The efficacy and safety of this combination was also shown in vulnerable, elderly T2DM patients and in patients with T2DM and renal impairment. Favorable effects regarding the counteraction of hypoglycemia make linagliptin especially interesting as an add-on therapy to insulin. This review aims to present the existing clinical studies on the efficacy and safety of linagliptin as add-on therapy to insulin in patients with T2DM in the context of current literature. Additionally, the possible advantages of linagliptin as an add-on therapy to insulin in relation to cardiovascular safety, patient-centered therapy and the prevention of hypoglycemia, are discussed.

  16. Significant treatment effect of add-on ketamine anesthesia in electroconvulsive therapy in depressive patients: A meta-analysis.

    PubMed

    Li, Dian-Jeng; Wang, Fu-Chiang; Chu, Che-Sheng; Chen, Tien-Yu; Tang, Chia-Hung; Yang, Wei-Cheng; Chow, Philip Chik-Keung; Wu, Ching-Kuan; Tseng, Ping-Tao; Lin, Pao-Yen

    2017-01-01

    Add-on ketamine anesthesia in electroconvulsive therapy (ECT) has been studied in depressive patients in several clinical trials with inconclusive findings. Two most recent meta-analyses reported insignificant findings with regards to the treatment effect of add-on ketamine anesthesia in ECT in depressive patients. The aim of this study is to update the current evidence and investigate the role of add-on ketamine anesthesia in ECT in depressive patients via a systematic review and meta-analysis. We performed a thorough literature search of the PubMed and ScienceDirect databases, and extracted all relevant clinical variables to compare the antidepressive outcomes between add-on ketamine anesthesia and other anesthetics in ECT. Total 16 articles with 346 patients receiving add-on ketamine anesthesia in ECT and 329 controls were recruited. We found that the antidepressive treatment effect of add-on ketamine anesthesia in ECT in depressive patients was significantly higher than that of other anesthetics (p<0.001). This significance persisted in both short-term (1-2 weeks) and moderate-term (3-4 weeks) treatment courses (all p<0.05). However, the side effect profiles and recovery time profiles were significantly worse in add-on ketamine anesthesia group than in control group. Our meta-analysis highlights the significantly higher antidepressive treatment effect of add-on ketamine in depressive patients receiving ECT compared to other anesthetics. However, clinicians need to take undesirable side effects into consideration when using add-on ketamine anesthesia in ECT in depressive patients.

  17. 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.

  18. Induction and add-on therapy with mitoxantrone and interferon beta in multiple sclerosis.

    PubMed

    Zaffaroni, Mauro; Rizzo, Annalisa; Baldini, Silvana Maria; Ghezzi, Angelo; Comi, Giancarlo

    2008-09-01

    We retrospectively analyzed data from 70 multiple sclerosis (MS) patients treated with mitoxantrone (MX) before Interferon-beta (IFN-beta) because of clinically and MRI very active isolated syndrome (CIS) or relapsing-remitting MS (induction therapy) or due to breakthrough/persistently active disease in spite of IFN-beta (add-on/combination therapy), or for increased disability suggesting a secondary progression (rescue therapy). After almost 2-year follow-up, relapse rate and disability decreased very significantly in the two former groups while MX was essentially ineffective as rescue therapy. Induction therapy is a valid option for very aggressive/active CIS and MS at onset.

  19. A double blind, placebo-controlled, phase II, add-on study of cyclophosphamide (CTX) for 24 months in patients affected by multiple sclerosis on a background therapy with interferon-beta study denomination: CYCLIN.

    PubMed

    Patti, F; Amato, M P; Filippi, M; Gallo, P; Trojano, M; Comi, G C

    2004-08-15

    The authors present and discuss a new protocol for active multiple sclerosis (MS) patients. A double blind randomized controlled multicenter study was planned to study the effects of a combination regimen therapy: cyclophosphamide plus beta interferon versus beta interferon alone on both relapsing-remitting and secondary MS patients with active disease. The primary endpoint of this study is the number of new gadolinium enhancing lesions at MRI evaluation. Secondary endpoints are new T2 lesions, new T1 lesions, T2 lesion load, T1 lesion load, cerebral atrophy, number of patients who were relapse-free, number of patients who improved, yearly relapses, quality of life, disability and cognitive impairment, frequency of neutralizing antibodies, safety of the combination therapy (cyclophosphamide + beta interferon). The study will enroll 225 patients in 25 Italian MS centers. Eligible for the study are patients with either relapsing-remitting or secondary MS according McDonald criteria on 6-24 months beta interferon treatment with active disease (new gadolinium enhancing lesion or who experienced a new relapse on beta interferon treatment). Clinical evaluation will be performed every 4 months, MRI yearly. Vital signs and eventual adverse events will be collected monthly. The study will last 36 months, 12 for the enrollment phase and 24 for the treatment phase. The study will start on April 2004.

  20. 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.

  1. 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.

  2. Sand control completion options for horizontal wells in soft formations

    SciTech Connect

    Penberthy, W.

    1999-02-01

    Sand control is required in most soft formations. So far, stand-alone screens have been the primary method. From completion, productivity and longevity perspectives, a high percentage of horizontal oil wells have not achieved the desired result: a sand-free, high sustained-productivity producer. Gas wells seem to have fared better. Disappointments have prompted some companies to reassess procedures and strategies involved with horizontal wells in these reservoirs. Gravel packing offers another option for completing horizontal wells, with the advantage of enhancing productivity. Gravel packing provides a means of filling and stabilizing the wellbore with high-permeability gravel, thereby avoiding the plugging and erosion noted with stand-alone screens. Recently, several operators have performed horizontal gravel packs after experiencing unacceptable performance with stand-alone screens. While each completion option has advantages and disadvantages, all have applications. Some are best suited to particular reservoirs, and as a consequence, the applicability of each completion technique must be assessed in light of particular reservoir conditions and reserves. This discussion will review various applications of soft rock completion technology in horizontal service, along with benefits and shortfalls.

  3. 24 CFR 990.190 - Other formula expenses (add-ons).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Other formula expenses (add-ons... formula expenses (add-ons). In addition to calculating operating subsidy based on the PEL and UEL, a PHA's eligible formula expenses shall be increased by add-ons. The allowed add-ons are: (a) Self-sufficiency....

  4. 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... formula expenses (add-ons). In addition to calculating operating subsidy based on the PEL and UEL, a PHA's eligible formula expenses shall be increased by add-ons. The allowed add-ons are: (a) Self-sufficiency....

  5. 24 CFR 990.190 - Other formula expenses (add-ons).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Other formula expenses (add-ons... formula expenses (add-ons). In addition to calculating operating subsidy based on the PEL and UEL, a PHA's eligible formula expenses shall be increased by add-ons. The allowed add-ons are: (a) Self-sufficiency....

  6. 24 CFR 990.190 - Other formula expenses (add-ons).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Other formula expenses (add-ons... formula expenses (add-ons). In addition to calculating operating subsidy based on the PEL and UEL, a PHA's eligible formula expenses shall be increased by add-ons. The allowed add-ons are: (a) Self-sufficiency....

  7. Dipeptidyl peptidase-4 inhibitors or sodium glucose co-transporter-2 inhibitors as an add-on to insulin therapy: A comparative review.

    PubMed

    Singh, Awadhesh Kumar; Singh, Ritu

    2016-01-01

    The gradual decline in β-cell function is inevitable in type 2 diabetes mellitus and therefore, substantial proportions of patients require insulin subsequently, in order to achieve optimal glucose control. While weight gain, hypoglycemia, and fluid retention especially during dose intensification is a known limitation to insulin therapy, these adverse effects also reduce patient satisfaction and treatment adherence. It is also possible that the benefits of intensive control achieved by insulin therapy, perhaps get nullified by the weight gain and hypoglycemia. In addition, improvement in plasma glucose or glycated hemoglobin (HbA1c) itself is associated with weight gain. Notably, studies have already suggested that reduction in body weight by ~3-5%, may allow a significantly better glycemic control. Thus, a class of drugs, which can reduce HbA1c effectively, yet are weight neutral or preferably reduce body weight, could be the most sought out strategy as an add-on therapy to insulin. While sulfonylureas (SUs) are associated with weight gain and hypoglycemia, pioglitazone increases body weight and fluid retention. Moreover, SUs are not recommended once premix or prandial insulin is commenced. The addition of newer agents, such as glucagon-like peptide-1 receptor agonist to insulin certainly appears to be an effective tool in reducing both HbA1c and body weight as is evident across the studies; however, this approach incurs an additional injection as well as cost. Dipeptidyl peptidase-4 inhibitors (DPP-4I) and sodium-glucose co-transporter-2 inhibitors (SGLT-2I) are other exciting options, as an add-on to insulin therapy primarily because these are oral drugs and do not possess any intrinsic potential of hypoglycemia. Furthermore, these are either weight neutral or induce significant weight loss. This review article aims to comparatively analyze the safety and efficacy of DPP-4I and SGLT-2I, as an add-on therapy to insulin.

  8. Add-on therapy of pitavastatin and eicosapentaenoic acid improves outcome of peginterferon plus ribavirin treatment for chronic hepatitis C.

    PubMed

    Kohjima, Motoyuki; Enjoji, Munechika; Yoshimoto, Tsuyoshi; Yada, Ryoko; Fujino, Tatsuya; Aoyagi, Yoko; Fukushima, Nobuyoshi; Fukuizumi, Kunitaka; Harada, Naohiko; Yada, Masayoshi; Kato, Masaki; Kotoh, Kazuhiro; Nakashima, Manabu; Sakamoto, Naoya; Tanaka, Yasuhito; Nakamuta, Makoto

    2013-02-01

    Despite the use of pegylated-interferon (peg-IFN) plus ribavirin combination therapy, many patients infected with hepatitis C virus (HCV)-1b remain HCV-positive. To determine whether addition of pitavastatin and eicosapentaenoic acid (EPA) is beneficial, the "add-on" therapy option (add-on group) was compared retrospectively with unmodified peg-IFN/ribavirin therapy (standard group). Association of host- or virus-related factors with sustained virological response was assessed. In HCV replicon cells, the effects of pitavastatin and/or EPA on HCV replication and expression of innate-immunity- and lipid-metabolism-associated genes were investigated. In patients infected with HCV-1b, sustained virological response rates were significantly higher in the add-on than standard group. In both groups, sustained virological response rates were significantly higher in patients with genotype TT of IL-28B (rs8099917) than in those with non-TT genotype. Among the patients with non-TT genotype, sustained virological response rates were markedly higher in the add-on than standard group. By multivariate analysis, genome variation of IL28B but not add-on therapy remained as a predictive factor of sustained virological response. In replicon cells, pitavastatin and EPA suppressed HCV replication. Activation of innate immunity was obvious in pitavastatin-treated cells and EPA suppressed the expression of sterol regulatory element binding protein-1c and low-density lipoprotein receptor. Addition of pitavastatin and EPA to peg-IFN/ribavirin treatment improved sustained virological response in patients infected with HCV-1b. Genotype variation of IL-28B is a strong predictive factor in add-on therapy.

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

    PubMed Central

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

    2016-01-01

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

  10. 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

  11. 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.

  12. 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.

  13. Add-on gabapentin in the treatment of opiate withdrawal.

    PubMed

    Martínez-Raga, José; Sabater, Ana; Perez-Galvez, Bartolome; Castellano, Miguel; Cervera, Gaspar

    2004-05-01

    Gabapentin is an antiepileptic drug shown to be effective in the treatment of pain disorders and appears to be useful as well for several psychiatric disorders, including bipolar disorder, anxiety disorders, alcohol withdrawal and cocaine dependence. Gabapentin, at a dose of 600 mg three times a day, was evaluated as an add-on medication to a standard detoxification regime in seven heroin dependent individuals undergoing outpatient opiate withdrawal treatment. All seven patients successfully completed opiate detoxification and commenced opiate antagonist treatment with naltrexone on day five of withdrawal treatment, as scheduled. No adverse event was noted. Gabapentin appeared to lead a reduction in symptomatic medication and an overall beneficial effect on symptoms of heroin withdrawal.

  14. Evaluation of automatic exposure control options in digital mammography.

    PubMed

    Zhou, Yifang; Scott, Alexander; Allahverdian, Janet; Frankel, Steve

    2014-01-01

    To quantify the trade-offs of dose and image quality among pre-loaded automatic exposure control (AEC) options in digital mammography, two AEC tables from the Hologic Selenia digital mammography system were compared: the default AEC "table 0" and AEC "table 1". Realistically-shaped phantoms consisting of tissue-equivalent material of various thicknesses (4.5 cm-7 cm) were imaged to obtain a figure of merit (FOM), the squared contrast-to-noise ratio per mean glandular dose. To relate the results to pathological findings and to evaluate the overall performance, the measured contrast-to-noise ratios were applied to simulated lesions on the anthropomorphic breast phantom images, producing various lesion configurations which were blindly scored. It was found that the AEC table 1 improves the low contrast FOM by 11% to 20% for the breast thicknesses of 4.5-6 cm. However, for the 7 cm thick breast, the AEC table 1 decreases the low contrast FOM by 17%. For microcalcifications, the AEC table 1 improves the FOM slightly for the breast thicknesses of 4.5--6 cm and decreases it by 18% at a thickness of 7 cm. The lesion simulation showed enhanced contrast due to the AEC table 1 for the breast thicknesses of 5 cm, 6 cm, and 7 cm, but the enhancement gradually reduces as the thickness increases. The lesion reading showed that the microcalcification detection was scored significantly higher from the AEC table 1 for the thicknesses 5 cm, 6 cm, and 7 cm. The corresponding improvement of mass detection scores was also observed but not consistently significant over the thickness range.

  15. 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.

  16. Controlling VOC emissions: Plants may choose from several recovery, destruction options

    SciTech Connect

    Cloud, R.

    1996-01-01

    In complying with the 1990 Clean Air Act Amendments (CAAA), chemical manufacturing plants may choose among several volatile organic compounds (VOC) emissions control options. These include recuperative and regenerative thermal oxidation, catalytic oxidation, carbon adsorption, hybrid systems and biofiltration. This article discusses the pros and cons of each of these options, and the applications in which each option may provide the most benefits. Other factors in selecting a VOC control system are also listed.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. Electrostatic precipitators create new options for particulate control

    SciTech Connect

    Toher, J.; D`Agostino, M.

    1997-07-01

    Black Hills Power and Light Co. (BHP and L) of Rapid City, S.D., decided it was vital to complete a critical evaluation of total plant costs when selecting emissions control technology for a new 80 MW generating unit in 1992. The evaluation resulted in selection of circulating dry scrubber (CDS) technology from Environmental Elements Corp. in Baltimore. The technology is available under license from Lurgi GmbH of Frankfurt, Germany. The BHP and L application is the second such selection of CDS technology in the United States but represents the first time an electrostatic precipitator (ESP) has been used for particulate control.

  3. Clobazam: An effective add-on therapy in refractory status epilepticus.

    PubMed

    Sivakumar, Sanjeev; Ibrahim, Mohammad; Parker, Dennis; Norris, Gregory; Shah, Aashit; Mohamed, Wazim

    2015-06-01

    Refractory status epilepticus (RSE) is a medical emergency, with significant morbidity and mortality. The use and effectiveness of clobazam, a unique 1,5-benzodiazepine, in the management of RSE has not been reported before. Over the last 24 months, we identified 17 patients with RSE who were treated with clobazam in our hospital. Eleven of the 17 patients had prior epilepsy. Fifteen patients had focal status epilepticus. Use of clobazam was prompted by a favorable pharmacokinetic profile devoid of drug interactions. Clobazam was introduced after a median duration of 4 days and after a median of three failed antiepileptic drugs. A successful response, defined as termination of RSE within 24 h of administration, without addition or modification of concurrent AED and with successful wean of anesthetic infusions, was seen in 13 patients. Indeterminate response was seen in three patients, whereas clobazam was unsuccessful in one patient. Clobazam averted the need for anesthetic infusions in five patients. Clobazam was well tolerated, and appears to be an effective and promising option as add-on therapy in RSE. Its efficacy, particularly early in the course of SE, should be further investigated in prospective, randomized trials.

  4. 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 ...

  5. 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

  6. 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.

  7. 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.

  8. Efficacy of prophylactic treatment with montelukast and montelukast plus add-on loratadine for seasonal allergic rhinitis.

    PubMed

    Yamamoto, Hideyuki; Yamada, Takechiyo; Sakashita, Masafumi; Kubo, Seita; Susuki, Dai; Tokunaga, Takahiro; Ogi, Kazuhiro; Terasawa, Yoko; Yamashita, Shinji; Kayano, Yuichiro; Masada, Mikio; Kimura, Yuichi; Fujieda, Shigeharu

    2012-01-01

    Cysteinyl leukotriene and leukotriene receptor occupancy have been linked to several processes in seasonal allergic rhinitis (SAR), including nasal congestion, rhinorrhea, and recruitment of inflammatory cells. We investigated whether add-on loratadine, an antihistamine, might be effective for SAR patients showing unsatisfactory control of symptoms with the leukotriene receptor antagonist (LTRA) montelukast alone. Patients with SAR caused by Japanese cedar pollen (SAR-JCP; mean age, 29.4 years) were given prophylactic montelukast for 1 month before peak JCP dispersal. Patients recorded the severity of the symptoms (sneezing, rhinorrhea, nasal congestion, and ocular symptoms) daily on visual analog scale (VAS). We selected patients with VAS scores of >50 for any of the symptoms just before the peak pollen season (March 2 to March 8) and designated them as "poorly controlled" patients. Then, in the peak JCP season (from March 9), we conducted a randomized, double-blind, placebo-controlled study to determine whether add-on loratadine might be effective for these "poorly controlled" patients. Montelukast alone was effective, as evaluated by improvement of the VAS scores, in 95 of the 137 patients (69.3%). Add-on loratadine significantly decreased the total scores for nasal symptoms (p < 0.05), sneezing (p < 0.05), and rhinorrhea (p < 0.05) when compared with placebo. The symptoms of SAR in two of three SAR-JP patients could be controlled (VAS score[s] under 50) by prophylactic treatment with montelukast alone under the condition of mild JCP dispersal. Furthermore, the effect of add-on antihistamine on sneezing and rhinorrhea was found in selected SAR-JCP patients.

  9. 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

  10. Add-on memantine to valproate treatment increased HDL-C in bipolar II disorder

    PubMed Central

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

    2016-01-01

    Memantine is a noncompetitive NMDA receptor antagonist. As an augmenting agent, it has an antidepressant-like and mood-stabilizing effect. Memantine also reduces binge eating episodes and weight. We investigated whether memantine added on to valproate (VPA) is more effective than VPA alone for treating BP-II depression and improving the patient’s metabolic profile. This was a randomized, double-blind, controlled study. BP-II patients undergoing regular VPA treatments were randomly assigned to one of two groups: VPA plus either add-on [1] memantine (5 mg/day) (n = 62) or [2] placebo (n = 73) for 12 weeks. The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) were used to evaluate clinical response. Height, weight, fasting serum glucose, fasting total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides were followed regularly. Multiple linear regressions with generalized estimating equation methods were used to analyze the effects of memantine on clinical performance. There were no significant differences in pre- and post-treatment YMRS and HDRS scores between the VPA + memantine and VPA + placebo groups. Although there were no significant differences in the pre- and post-treatment values of most metabolic indices between the two groups, there was a significant increase of HDL-C (p = 0.009) in the VPA + memantine group compared with the VPA + placebo group. This increase remained significant even after controlling for body mass index (BMI) (p = 0.020). We conclude that add-on memantine plus VPA treatment of BP-II depression increases the blood level of HDL-C even in the absence of change in affective symptoms. PMID:23870798

  11. 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.

  12. 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

  13. Investigation of lunar base thermal control system options

    NASA Technical Reports Server (NTRS)

    Ewart, Michael K.

    1993-01-01

    Long duration human exploration missions to the Moon will require active thermal control systems which have not previously been used in space. The two technologies which are most promising for long term lunar base thermal control are heat pumps and radiator shades. Recent trade-off studies at the Johnson Space Center have focused development efforts on the most promising heat pump and radiator shade technologies. Since these technologies are in the early stages of development and many parameters used in the study are not well defined, a parametric study was done to test the sensitivity to each assumption. The primary comparison factor in these studies was the total mass system, with power requirements included in the form of a mass penalty for power. Heat pump technologies considered were thermally driven heat pumps such as metal hydride, complex compound, absorption and zeolite. Also considered were electrically driven Stirling and vapor compression heat pumps. Radiator shade concepts considered included step shaped, V-shaped and parabolic (or catenary) shades and ground covers. A further trade study compared the masses of heat pump and radiator shade systems.

  14. 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.

  15. 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.

  16. Changing options for the control of deciduous fruit tree diseases.

    PubMed

    Sutton, T B

    1996-01-01

    The evolution of disease management programs for deciduous fruit trees in the United States over the past 50 years has been influenced by factors that include public concern over pesticide residues on fruit and in the environment, the development of resistance of many important tree pathogens to fungicides and bactericides, the loss of fungicide registrations and restrictions on their use due to concern for human health and the environment and/or marketing decisions by the manufacturers, and changes in cultural practices and marketing objectives. These factors have led to wider use of forecasting models and cultural controls, the development of resistance management strategies, and the introduction of new equipment and methods for pesticide application. These same factors will most likely continue to drive the fruit industry to adopt disease management programs that rely less on pesticides in the future.

  17. 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.

  18. 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

  19. 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.

  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

    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.

  1. 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)

  2. 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.

  3. 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.

  4. 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

  5. The Obama administration's options for health care cost control: hope versus reality.

    PubMed

    Marmor, Theodore; Oberlander, Jonathan; White, Joseph

    2009-04-07

    Controlling the costs of medical care has long been an elusive goal in U.S. health policy. This article examines the options for health care cost control under the Obama administration. The authors argue that the administration's approach to health reform offers some potential for cost control but also embraces many strategies that are not likely to be successful. Lessons the United States can learn from other countries' experiences in constraining medical care spending are then explored.

  6. Lixisenatide as add-on therapy to basal insulin

    PubMed Central

    Brown, Dominique Xavier; Butler, Emma Louise; Evans, Marc

    2014-01-01

    Many patients with type 2 diabetes mellitus do not achieve target glycosylated hemoglobin A1c levels despite optimally titrated basal insulin and satisfactory fasting plasma glucose levels. Current evidence suggests that HbA1c levels are dictated by both basal glucose and postprandial glucose levels. This has led to a consensus that postprandial glucose excursions contribute to poor glycemic control in these patients. Lixisenatide is a once-daily, prandial glucagon-like peptide 1 (GLP-1) receptor agonist with a four-fold affinity for the GLP-1 receptor compared with native GLP-1. Importantly, lixisenatide causes a significant delay in gastric emptying time, an important determinant of the once-daily dosing regimen. An exendin-4 mimetic with six lysine residues removed at the C-terminal, lixisenatide has pronounced postprandial glucose-lowering effects, making it a novel incretin agent for use in combination with optimally titrated basal insulin. Lixisenatide exerts profound effects on postprandial glucose through established mechanisms of glucose-dependent insulin secretion and glucagon suppression in combination with delayed gastric emptying. This review discusses the likely place that lixisenatide will occupy in clinical practice, given its profound effects on postprandial glucose and potential to reduce glycemic variability. PMID:24363554

  7. 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...

  8. 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...

  9. Options for Organizing the Tanker Airlift Control Center Flight Dispatch Function: An Exploratory Concept Study

    DTIC Science & Technology

    2000-06-01

    Jeffrey A. Sheppard, Major, USAF AFIT/ GMO /ENS/00E-10 DEPARTMENT OF THE AIR FORCE AIR UNIVERSITY AIR FORCE INSTITUTE OF TECHNOLOGY Wright...Force, Department of Defense, or the U. S. Government. AFIT/ GMO /ENS/00E-10 OPTIONS FOR ORGANIZING THE TANKER AIRLIFT CONTROL CENTER FLIGHT...Program Goal…….……….…61 vi AFIT/ GMO /ENS/00E-10 Abstract The Tanker Airlift Control Center (TACC) is the central execution agency for

  10. Effect and Potential Mechanism of Electroacupuncture Add-On Treatment in Patients with Parkinson's Disease.

    PubMed

    Wang, Fang; Sun, Li; Zhang, Xiao-Zhe; Jia, Jun; Liu, Zhuo; Huang, Xi-Yan; Yu, Shu-Yang; Zuo, Li-Jun; Cao, Chen-Jie; Wang, Xiao-Min; Zhang, Wei

    2015-01-01

    Objectives. To explore effectiveness and mechanisms of electroacupuncture (EA) add-on treatment in Parkinson's disease (PD) patients. Methods. Fifty PD patients were randomly assigned to drug plus EA (D + EA) group and drug alone (D) group. Subjects in D + EA group received stimulation in points of bilateral fengfu, fengchi, hegu, and central dazhui. Participants were evaluated by scales for motor and nonmotor symptoms. Levels of neuroinflammatory factors and neurotransmitters in serum were detected. Results. EA add-on treatment remarkably reduced scores of Unified Parkinson's Disease Rating Scale (UPDRS) III and its subitems of tremor, rigidity, and bradykinesia and conspicuously decreased UPDRS III scores in patients with bradykinesia-rigidity and mixed types and mild severity. Depression and sleep disturbances were eased, which were reflected by decreased scores of Hamilton Depression Rating Scale, Pittsburgh Sleep Quality Index, and elevated noradrenaline level. Effects of EA add-on treatment on motor symptoms and sleep disturbances were superior to drug alone treatment, markedly improving life quality of PD patients. EA add-on treatment decreased nitric oxide level in serum. Conclusions. EA add-on treatment is effective on most motor symptoms and some nonmotor symptoms and is particularly efficacious in PD patients at early stage. Antineuroinflammation may be a mechanism of EA add-on treatment.

  11. Add-on angiotensin II receptor blockade lowers urinary transforming growth factor-beta levels.

    PubMed

    Agarwal, Rajiv; Siva, Senthuran; Dunn, Stephen R; Sharma, Kumar

    2002-03-01

    Progression of renal failure, despite renoprotection with angiotensin-converting enzyme (ACE) inhibitors in patients with proteinuric nephropathies, may be caused by persistent renal production of transforming growth factor-beta1 (TGF-beta1) through the angiotensin II subtype 1 (AT1) receptors. We tested the hypothesis that AT1-receptor blocker therapy added to a background of chronic maximal ACE inhibitor therapy will result in a reduction in urinary TGF-beta1 levels in such patients. Sixteen patients completed a two-period, crossover, randomized, controlled trial, details of which have been previously reported. All patients were administered lisinopril, 40 mg/d, with either losartan, 50 mg/d, or placebo. Blood pressure (BP) was measured using a 24-hour ambulatory BP monitor. Overnight specimens of urine were analyzed for urine TGF-beta1, protein, and creatinine concentrations. Mean age of the study population was 53 +/- 9 (SD) years; body mass index, 38 +/- 5.7 kg/m2; seated BP, 156 +/- 18/88 +/- 12 mm Hg; and urine protein excretion, 3.6 +/- 0.71 g/g of creatinine. Twelve patients had diabetic nephropathy, and the remainder had chronic glomerulonephritis. At baseline, urinary TGF-beta1 levels were significantly increased in the study population compared with healthy controls (13.2 +/- 1.2 versus 1.7 +/- 1.1 ng/g creatinine; P < 0.001). There was a strong correlation between baseline urine protein excretion and urinary TGF-beta1 level (r2 = 0.53; P = 0.001), as well as systolic BP and urinary TGF-beta1 level (r2 = 0.57; P < 0.001). After 4 weeks of add-on losartan therapy, there was a 38% (95% confidence interval [CI], 16% to 55%) decline in urinary TGF-beta1 levels (13.3 [95% CI, 11.4 to 15.5] to 8.2 pg/mg creatinine [95% CI, 6.2 to 10.7]). The reduction in urinary TGF-beta1 levels occurred independent of changes in mean urinary protein excretion or BP. Thus, proteinuric patients with renal failure, despite maximal ACE inhibition, had increased urinary levels of

  12. 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.

  13. 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.

  14. Successful Use of Cyclophosphamide as an Add-On Therapy for Multiple Myeloma Patients with Acquired Resistance to Bortezomib or Lenalidomide

    PubMed Central

    Ito, Shigeki; Oyake, Tatsuo; Murai, Kazunori; Ishida, Yoji

    2013-01-01

    Novel agents such as thalidomide, lenalidomide, and bortezomib have been shown to possess potent activity against multiple myeloma. However, the treatment strategy for patients who acquired resistance to these agents has not been established. In addition to switching drug classes, intensified treatment strategy, including increase in the dosage of current agents and addition of other agents, may be considered for these patients. We here describe 2 myeloma patients with acquired resistance to bortezomib or lenalidomide, in whom add-on therapy with low-dose cyclophosphamide was effective and tolerable. These cases suggest that add-on therapy with cyclophosphamide is one of the treatment options to overcome resistance to novel agents in patients with multiple myeloma. A larger prospective study is needed to clarify the efficacy and safety of this strategy for novel agent-resistant multiple myeloma. PMID:23607005

  15. Evaluation of Efficacy of Curcumin as an Add-on therapy in Patients of Bronchial Asthma

    PubMed Central

    Gupta, Surabhi; Agarwal, Manu; Bhalla, H.L.; Saluja, Mahip

    2014-01-01

    , it is concluded that curcumin is effective and safe as an add-on therapy for the treatment of bronchial asthma. PMID:25302215

  16. 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

  17. Add-on therapy with doxazosin in patients with hypertension influences arterial stiffness and albuterol-mediated arterial vasodilation

    PubMed Central

    Wykretowicz, Andrzej; Guzik, Przemyslaw; Krauze, Tomasz; Adamska, Karolina; Milewska, Agata; Wysocki, Henryk

    2007-01-01

    What is already known about this subject Hypertension is associated with increased arterial stiffness and impaired endothelial function. Arterial vasodilation depends on endothelial function and can be regulated by β2-adrenergic stimulation. Doxazosin is a known and potent antihypertensive agent. However, its effects on arterial stiffness and vasodilation have not been fully established. What this study adds Sixteen-week add-on antihypertensive therapy with 4 mg of doxazosin extended release daily: Reduces arterial stiffness. Improves albuterol-mediated, i.e. endothelium-dependent, arterial vasodilation. Does not influence nitroglycerin-mediated, i.e. endothelium-independent, arterial vasodilation. Aims Doxazosin is an antihypertensive agent with largely unknown effects on arterial stiffness and vasodilation. The aim of this study was to determine the effect of the addition of doxazosin extended-release (ER) to the standard management of hypertension in patients with inadequately controlled blood pressure (BP) on arterial stiffness and arterial vasodilation. Methods Twenty patients with inadequately controlled hypertension were treated with 4 mg doxazosin ER daily for 16 weeks as an adjunct to their existing antihypertensive regimen. Results Doxazosin ER add-on therapy was associated with significantly reduced systolic (P < 0.0001) and diastolic (P = 0.0003) BP, improved arterial stiffness (determined by digital volume pulse analysis (P = 0.048) and albuterol-mediated arterial vasodilation (P = 0.030). Conclusions Add-on therapy with 4 mg of doxazosin ER daily reduces BP and arterial stiffness and improves arterial vasodilation in response to adrenergic stimulation. PMID:17635498

  18. 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.

  19. Xiaoqinglong Granules as Add-On Therapy for Asthma: Latent Class Analysis of Symptom Predictors of Response

    PubMed Central

    Zha, Qinglin; Lin, Seqi; Zhang, Chi; Chang, Christopher; Xue, Hanrong; Lu, Cheng; Jiang, Miao; Liu, Yan; Xiao, Zuke; Liu, Weiyou; Shang, Yunfei; Chen, Jianjian; Wen, Minyong; Lu, Aiping

    2013-01-01

    Xiaoqinglong granules (XQLG) has been shown to be an effective therapy in asthma animal models. We reviewed the literature and conducted this study to assess the impact of XQLG as an add-on therapy to treatment with fluticasone/salmeterol (seretide) in adult patients with mild-to-moderate, persistent asthma. A total of 178 patients were randomly assigned to receive XQLG and seretide or seretide plus placebo for 90 days. Asthma control was assessed by asthma control test (ACT), symptoms scores, FEV1, and PEF. Baseline patient-reported Chinese medicine (CM)-specific symptoms were analyzed to determine whether the symptoms may be possible indicators of treatment response by conducting latent class analysis (LCA). There was no statistically significant difference in ACT score between two groups. In the subset of 70 patients with symptoms defined by CM criteria, XQLG add-on therapy was found to significantly increase the levels of asthma control according to global initiative for asthma (GINA) guidelines (P = 0.0329). There was no significant difference in another subset of 100 patients with relatively low levels of the above-mentioned symptoms (P = 0.1291). Results of LCA suggest that patients with the six typical symptoms defined in CM may benefit from XQLG. PMID:23431348

  20. Demographic effects on the use of genetic options for the control of mosquitofish, Gambusia holbrooki.

    PubMed

    Thresher, Ronald E; Canning, Miles; Bax, Nicholas J

    2013-06-01

    This study tests the sensitivity of genetically based pest control options based on sex ratio distortion to intra- and intersexual aggressive interactions that affect male and female survival and fitness. Data on these interactions and their impacts were gathered for the mosquitofish Gambusia holbrooki (Poeciliidae), a promiscuous species with a strongly male-biased operational sex ratio and well-documented male harassment of females. The experimental design consisted of an orthogonal combination of two population densities and three sex ratios, ranging from strongly male-biased to strongly female-biased, and long-term observations of laboratory populations. Contrary to expectations, the number of males in a population had little evident effect on population demographics. Rather, the density of adult females determined population fecundity (as a result of a stock-recruitment relationship involving females, but not males), constrained male densities (apparently as a result of cannibalism or intersexual aggression), and regulated itself (most likely through effects of intrasexual aggression on female recruitment). The principal effect of males was to constrain their own densities via effects of male-male aggression on adult male mortality rates. Through use of a realistically parameterized genetic/demographic model, we show that of three different genetic options applied to control G. holbrooki, one based on recombinant sex ratio distortion (release of Female Lethal carriers) is marginally more efficient than a sterile male release program, and both outperform an option based on chromosomal sex ratio distortion (Trojan W). Nonlinear dependence of reproductive rate on female density reduces the efficacy of all three approaches. The major effect of intra- and intersexual aggression is mediated through females, whose interactions reduce female numbers and increase the efficacy of a control program based on sex ratio. Socially mediated male mortality has a small impact

  1. 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.

  2. Tiotropium in the add-on treatment of asthma in adults: clinical trial evidence and experience.

    PubMed

    Vogelberg, Christian

    2016-12-01

    Asthma is a chronic inflammatory airway disease, and its treatment is frequently challenging despite detailed national and international guidelines. While basic anti-inflammatory therapy usually consists of inhaled corticosteroids in doses adapted to the asthma severity, add-on treatment with bronchodilators is essential in more severe asthma. Only recently, the long-acting anticholinergic tiotropium was introduced into the GINA guidelines. This review reports on the studies that have been performed with tiotropium in adult asthmatic patients. Following early proof-of-concept studies, several studies with tiotropium as an add-on therapy to inhaled corticosteroids (ICS), with or without a long-acting beta agonist (LABA), demonstrated convincing clinical benefit for patients. Important lung function parameters and quality of life scores significantly improved shortly after onset of the add-on therapy with tiotropium, and some studies even demonstrated non-inferiority against salmeterol. All studies reported an excellent safety profile of tiotropium. The still growing body of tiotropium studies, both in adults and children, will help to identify the position of tiotropium in future asthma guidelines and might also indicate which patients benefit most from an add-on therapy with tiotropium.

  3. 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…

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

    PubMed

    Tashima, Hideaki; Yamaya, Taiga

    2016-10-07

    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.

  5. Effect of "add-on" interventions on exercise training in individuals with COPD: a systematic review.

    PubMed

    Camillo, Carlos A; Osadnik, Christian R; van Remoortel, Hans; Burtin, Chris; Janssens, Wim; Troosters, Thierry

    2016-01-01

    The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Electronic databases were searched, identifying trials comparing exercise training with exercise training plus "add-on" therapy. Outcomes included peak oxygen uptake (V'O2peak), work rate and incremental/endurance cycle and field walking tests. Individual trial effects on exercise capacity were extracted and collated into eight subgroups and pooled for meta-analysis. Sensitivity analyses were conducted to explore the stability of effect estimates across studies employing patient-centred designs and those deemed to be of "high" quality (PEDro score >5 out of 10). 74 studies (2506 subjects) met review inclusion criteria. Interventions spanned a broad scope of clinical practice and were most commonly evaluated via the 6-min walking distance and V'O2peak. Meta-analysis revealed few clinically relevant and statistically significant benefits of "add-on" therapies on exercise performance compared with exercise training. Benefits favouring "add-on" therapies were observed across six different interventions (additional exercise training, noninvasive ventilation, bronchodilator therapy, growth hormone, vitamin D and nutritional supplementation). The sensitivity analyses included considerably fewer studies, but revealed minimal differences to the primary analysis. The lack of systematic benefits of "add-on" interventions is a probable reflection of methodological limitations, such as "one size fits all" eligibility criteria, that are inherent in many of the included studies of "add-on" therapies. Future clarification regarding the exact value of such therapies may only arise from adequately powered, multicentre clinical trials of tailored interventions for carefully selected COPD patient subgroups defined according to distinct clinical phenotypes.

  6. 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.

  7. Control selection options for genome-wide association studies in cohorts.

    PubMed

    Wacholder, Sholom; Rotunno, Melissa

    2009-03-01

    Investigators planning studies within cohorts have many options for choosing an efficient sampling design for genome-wide association and other molecular epidemiology studies. Consideration of person-year and proportional hazards analyses of full cohorts may add further insight into ramifications of different designs. Empirical evidence from genome-wide association studies can supplement intuition and simulations in comparing properties of various case-control designs within cohorts. Additional theoretical and empirical work, justification of sampling choice in publications, and consideration of context and scientific aims can improve designs and, thereby, increase the scientific value and cost effectiveness of future studies.

  8. Scalability of Robotic Controllers: An Evaluation of Controller Options-Experiment II

    DTIC Science & Technology

    2011-09-01

    screen controller was compared with their performance using a baseline Xbox 360 joystick controller. Thirty Soldiers from the Officers’ Candidate...Course completion times were significantly faster with the Xbox controller compared to the Android controller. In addition, there were significantly...fewer driving errors and off-course errors with the Xbox controller. Total workload ratings were significantly lower for the Xbox than for the Android

  9. 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.

  10. Physiological control of a rotary blood pump with selectable therapeutic options: control of pulsatility gradient.

    PubMed

    Arndt, Andreas; Nüsser, Peter; Graichen, Kurt; Müller, Johannes; Lampe, Bernhard

    2008-10-01

    A control strategy for rotary blood pumps meeting different user-selectable control objectives is proposed: maximum support with the highest feasible flow rate versus medium support with maximum ventricular washout and controlled opening of the aortic valve (AoV). A pulsatility index (PI) is calculated from the pressure difference, which is deduced from the axial thrust measured by the magnetic bearing of the pump. The gradient of PI with respect to pump speed (GPI) is estimated via online system identification. The outer loop of a cascaded controller regulates GPI to a reference value satisfying the selected control objective. The inner loop controls the PI to a reference value set by the outer loop. Adverse pumping states such as suction and regurgitation can be detected on the basis of the GPI estimates and corrected by the controller. A lumped-parameter computer model of the assisted circulation was used to simulate variations of ventricular contractility, pulmonary venous pressure, and aortic pressure. The performance of the outer control loop was demonstrated by transitions between the two control modes. Fast reaction of the inner loop was tested by stepwise reduction of venous return. For maximum support, a low PI was maintained without inducing ventricular collapse. For maximum washout, the pump worked at a high PI in the transition region between the opening and the permanently closed AoV. The cascaded control of GPI and PI is able to meet different control objectives and is worth testing in vitro and in vivo.

  11. H∞ control option for a combined energy and attitude control system

    NASA Astrophysics Data System (ADS)

    Ban, Ying Siang; Varatharajoo, Renuganth

    2013-10-01

    A combined energy and attitude control system (CEACS) is a hybrid system that uses flywheels to store energy and provide a simultaneous attitude control in satellites. Previous work appeared in Advances in Space Research (ASR) employing the proportional-derivative (PD) control has proven that CEACS works well and achieves its mission requirement. However, the in-orbit system performance uncertainties present a challenge to the CEACS attitude pointing capability. Thus, this paper complements the previous mentioned work, and focuses on employing the H∞ optimal attitude control solution for the CEACS attitude control enhancement. The mathematical model and numerical treatments for the CEACS H∞ control architecture are presented. Numerical results show that a better attitude pointing accuracy at least up to 0.043° can be achieved with the H∞ control method.

  12. 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

  13. Tests on a mock-up of the feedback controlled matching options of the ITER ICRH system

    SciTech Connect

    Grine, D.; Vervier, M.; Messiaen, A.; Dumortier, P.

    2009-11-26

    Automatic control of the matching of the ITER ICRH antenna array on a reference load is presently developed and tested for optimization on a low-powered scaled (1:5) mock-up. Resilience to fast load variations is obtained either by 4 Conjugate-T (CT) or 4 quadrature hybrid circuits, the latter being the reference option. The main results are (i) for the CT option: successful implementation of the simultaneous feedback control of 11 actuators for the matching of the 4 CT and for the control of the array toroidal phasing; (ii) for the hybrid option: the matching and the array current control via feedback control of the decouplers and double stub tuners. This system is being progressively implemented and the simultaneous control of matching and antenna current has already been successfully tested on half of the array for heating and current drive phasings.

  14. The efficacy and safety of DPP4 inhibitors compared to sulfonylureas as add-on therapy to metformin in patients with Type 2 diabetes: A systematic review and meta-analysis.

    PubMed

    Mishriky, Basem M; Cummings, Doyle M; Tanenberg, Robert J

    2015-08-01

    There is no consensus on the selection of specific drug therapies when metformin fails in Type 2 diabetes (T2D). This meta-analysis was performed to determine the efficacy and safety of Dipeptidyl peptidase-4 inhibitors (DPP4-I) compared to sulfonylurea (SU) as add-on therapy to metformin in inadequately controlled T2D patients. We searched MEDLINE, CENTRAL, EMBASE, and CINAHL for randomized trials comparing DPP4-I to SU as add-on therapy to metformin and reported a change in hemoglobin A1c (HbA1c). Sixteen articles were included. There was a significantly greater reduction in HbA1c from baseline to 12 weeks with SU versus DPP4-I (MD[95% CI]=0.21%(2 mmol/mol) [0.06, 0.35]) but no significant difference at 52 and 104 weeks (MD[95% CI]=0.06%(-1 mmol/mol) [-0.03, 0.15] and 0.02%(-1 mmol/mol) [-0.13,0.18] respectively). SU was associated with weight gain and DPP4-I with weight loss at all time-points. The incidence of hypoglycemia at 12, 52, and 104 weeks was significantly greater with SU (20%, 24%, and 27% respectively) compared to DPP4-I (6%, 3%, and 4% respectively). The proportion of patients with HbA1c<7%(53 mmol/mol) without hypoglycemia was significantly higher at 52 and 104 weeks among patients on DPP4-I (RR[95% CI]=1.20 [1.05, 1.37] and 1.53 [1.16, 2.02] respectively). There was no significant difference between the two groups in the incidence of other side effects. While both SU and DPP4-I can be considered as options for add-on therapy to metformin in inadequately controlled T2D, SU results in a significantly increased risk of hypoglycemia and weight gain. By contrast, DPP4-I produce 0.4-0.6% (4-7 mmol/mol) reduction in HbA1c, lower risk of hypoglycemia, and weight loss.

  15. Insulin dose adjustments with add-on glucagon-like peptide-1 receptor (GLP-1R) agonists in clinical practice.

    PubMed

    Artigas, Carla Francés; Stokes, Victoria; Tan, Garry D; Theodorakis, Michael J

    2015-01-01

    Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are gaining ground as therapeutic modalities in combination with insulin in patients with type 2 diabetes mellitus. Exploiting the multiple benefits of incretin-based therapies in certain patient populations, especially in those who would benefit most from potential weight loss or prevention of body weight gain, has provided a valuable add-on option in diabetes management. However, caution needs to be exercised when initiating such a double injectable therapy, as evidence indicates that, in most instances, the insulin dose needs to be re-adjusted. The majority of published studies suggest reduction of insulin dose, especially related to the 'bolus' component; however, some have also recommended that insulin dose should actually be increased, but we found no credible evidence to support the latter. An important determinant of the titration process is the insulin formulation already in use at baseline. As more potent and long-acting GLP-1RAs are introduced, optimal insulin dose scaling is a major challenge, especially in a primary setting. We provide an overview of the current knowledge in this rapidly changing field. Based on currently reported evidence, a reduction of basal insulin by 10% and a decrease of prandial insulin by 30 - 40% is recommended on addition of GLP-1RAs.

  16. 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.

  17. Diagnostic options for radiative divertor feedback control on NSTX-U

    SciTech Connect

    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).

  18. Diagnostic options for radiative divertor feedback control on NSTX-U

    SciTech Connect

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

    2012-10-15

    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 (q{sub peak} Less-Than-Or-Slanted-Equal-To 15 MW/m{sup 2}), radiative divertor experiments have demonstrated a significant reduction of divertor peak heat flux simultaneously with good core H-mode confinement using pre-programmed D{sub 2} or CD{sub 4} 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/m{sup 2}, 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).

  19. Diagnostic options for radiative divertor feedback control on NSTX-U.

    PubMed

    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 (q(peak) ≤ 15 MW/m(2)), radiative divertor experiments have demonstrated a significant reduction of divertor peak heat flux simultaneously with good core H-mode confinement using pre-programmed D(2) or CD(4) 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/m(2), 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).

  20. Inferential and forward projection modeling to evaluate options for controlling invasive mammals on islands.

    PubMed

    Anderson, D P; McMurtrie, P; Edge, K-A; Baxter, P W J; Byrom, A E

    2016-12-01

    Successful pest-mammal eradications from remote islands have resulted in important biodiversity benefits. Near-shore islands can also serve as refuges for native biota but require ongoing effort to maintain low-pest or pest-free status. Three management options are available in the presence of reinvasion risk: (1) control-to-zero density, in which immigration may occur but reinvaders are removed; (2) sustained population suppression (to relatively low numbers); or (3) no action. Biodiversity benefits can result from options one and two. The management challenge is to make evidence-based decisions on the selection of an appropriate objective and to identify a financially feasible control strategy that has a high probability of success. This requires understanding the pest species population dynamics and how it will respond to a range of potential management strategies, each with an associated financial cost. We developed a two-stage modeling approach that consisted of (1) Bayesian inferential modeling to estimate parameters for a model of pest population dynamics and control, and (2) a forward projection model to simulate a range of plausible management scenarios and quantify the probability of obtaining zero density within four years. We applied the model to an ongoing, six-year trapping program to control stoats (Mustela erminea) on Resolution Island, New Zealand. Zero density has not yet been achieved. Results demonstrate that management objectives were impeded by a combination of a highly fecund population, insufficient trap attractiveness, and a substantial proportion of the population that did not enter traps. Immigration is known to occur because the founding population arrived on the island by swimming from the mainland. However, immigration rate during this study was indistinguishable from zero. The forward projection modeling showed that control-to-zero density was feasible but required greater than a two-fold budget increase to intensify the trapping

  1. A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds

    PubMed Central

    Akhmetova, Alma; Allan, Iain U.; Illsley, Matthew J.; Nurgozhin, Talgat; Mikhalovsky, Sergey

    2016-01-01

    The process of wound healing is often accompanied by bacterial infection or critical colonization, resulting in protracted inflammation, delayed reepithelization, and production of pungent odors. The malodor produced by these wounds may lower health-related quality of life and produce psychological discomfort and social isolation. Current management focuses on reducing bacterial activity within the wound site and absorbing malodorous gases. For example, charcoal-based materials have been incorporated into dressing for direct adsorption of the responsible gases. In addition, multiple topical agents, including silver, iodine, honey, sugar, and essential oils, have been suggested for incorporation into dressings in an attempt to control the underlying bacterial infection. This review describes options for controlling malodor in chronic wounds, the benefits and drawbacks of each topical agent, and their mode of action. We also discuss the use of subjective odor evaluation techniques to assess the efficacy of odor-controlling therapies. The perspectives of employing novel biomaterials and technologies for wound odor management are also presented. PMID:27684356

  2. Collimator based tracking with an add-on multileaf collimator: Moduleaf

    NASA Astrophysics Data System (ADS)

    Böhler, A.; Weichenberger, H.; Gaisberger, C.; Sedlmayer, F.; Deutschmann, H.

    2015-04-01

    Radiotherapy is one of the most important methods used for the treatment of cancer. Irradiating a moving target is also one of the most challenging tasks to accomplish in modern radiotherapy. We have developed a tracking system by modifying an add-on collimator, the Siemens Moduleaf, for realtime applications in radiotherapy. As the add-on collimator works nearly completely independently of the linear accelerator (LinAc), no modifications to the latter were necessary. The adaptations to the Moduleaf were mainly software-based. In order to reduce the complexity of the system, outdated electronic parts were replaced with newer components where practical. Verification was performed by measuring the latency of the system as well as the impact on applied dose to a predefined target volume, moving in the leaf’s travel direction. Latency measurements in the software were accomplished by comparing the target and current positions of the leaves. For dose measurements, a Gafchromic EBT2 film was placed beneath the target 4D phantom, in between solid water plates and moved alongside with it. Comparing the dose distribution on the film with a moving target between ‘tracking disabled’ towards ‘tracking enabled’ functions resulted in penumbra widths of 23 mm to 4 mm for 0.1 Hz sinusoidal movements with an amplitude of 32 mm, respectively. The maximum speed was therefore 20 mm s-1. Latency was measured to be less than 50 ms for the signal runtimes. Based on the results, a tracking-capable add-on collimator seems to be a useful tool for reducing the margins for the treatment of small, slow-moving targets.

  3. 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.

  4. 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.

  5. 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…

  6. 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.

  7. Laboratory study of efficient add-on treatments for interior noise control in light aircraft

    NASA Technical Reports Server (NTRS)

    Mixson, J. S.; Roussos, L. A.; Barton, C. K.; Vaicaitist, R.; Slazak, M.

    1981-01-01

    Experimental and theoretical studies of the transmission loss (TL) of 1.15 x 1.46 m flat stiffened-skin aluminum panels are described. Panel configurations included panels with no treatment and eight combinations of treatments consisting of a fiberglass-septum layer, a foam-foil damping material, and a plywood double wall trim panel. Measured TL of the untreated panel and the panel with a damping layer showed characteristics of the double mass law: at low frequencies the TL followed a mass law trend associated with the average mass of both skin and stiffness, while at higher frequencies the TL followed a mass law trend associated with skin mass only. A comparison of TL for panels treated with a damping layer, a fiberglass layer, or a trim panel showed that the effects of damping are frequency dependent with some performing better below 500 Hz and others performing better above 500 Hz. Treatment combinations showed that two treatments with the same mass could have TL values different by about 10 dB, while other combinations having weights different by a factor of two could have TL values within a few dB over most of the frequency range. The highest TL values (50 dB at 1000 Hz) were obtained with a treatment consisting of a fiberglass layer, a trim panel, and damping layers on both the stiffened panel and the trim panel.

  8. 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

  9. 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.

  10. 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.

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

    MedlinePlus

    ... Non-surgical Treatment Options for Urinary Incontinence in Women What is UI? “Taking Control” (5-minute video) “ ... video in a new window) Are there other women like me? (8-minute video) Urinary incontinence happens ...

  12. 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.

  13. 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.

  14. A 12-week, randomized, parallel-group, proof-of-concept study of tulobuterol patch and salmeterol inhaler as add-on therapy in adult-onset mild-to-moderate asthma.

    PubMed

    Inoue, Hideki; Niimi, Akio; Matsumoto, Hisako; Ito, Isao; Oguma, Tsuyoshi; Otsuka, Kojiro; Takeda, Tomoshi; Nakaji, Hitoshi; Tajiri, Tomoko; Iwata, Toshiyuki; Nagasaki, Tadao; Mishima, Michiaki

    2017-01-01

    Patch formulation of tulobuterol has been used in asthma treatment as a long-acting β2 -agonist (LABA) through sustained skin absorption. Its treatment efficacy, especially in small airways, remains poorly understood. The study aim was to investigate LABA add-on effects of tulobuterol patch (TP) and salmeterol inhaler (SA) on pulmonary function, asthma control and health status. Patients who had adult-onset under-control asthma, despite taking inhaled corticosteroids, were enrolled in a randomized, open-label, parallel-group, proof-of-concept study of 12-week add-on treatment with TP (n=16) or SA (n=17). Spirometry, impulse oscillometry (IOS), exhaled nitric oxide levels, and clinical questionnaires of asthma control, health status (St. George's Respiratory Questionnaire: SGRQ), and symptoms were evaluated every 4 weeks. Add-on treatment of SA significantly improved the spirometric indices of small airway obstruction (forced expiratory flow between 25% and 75% of FVC: FEF25-75 , and maximum expiratory flow at 25% of FVC: MEF25 ) and IOS indices of whole respiratory resistance (resistance at 5 Hz) as compared to TP. In intra-group comparisons, add-on treatment of TP improved the scores of the asthma control test and the total SGRQ, as well as the symptom and impact components of the SGRQ. SA add-on treatment improved FEV1 and IOS parameters of resistance at 20 Hz and reactance at 5 Hz. Neither of the treatments improved exhaled nitric oxide levels. In conclusion, add-on treatment of TP improved asthma control and health status, whereas SA improved pulmonary function measures associated with large and small airway involvement among patients with adult-onset mild-to-moderate asthma.

  15. 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

  16. Rethinking School Choice: Educational Options, Control, and Sovereignty in Indian Country

    ERIC Educational Resources Information Center

    Castagno, Angelina E.; Garcia, David R.; Blalock, Nicole

    2016-01-01

    Despite the plethora of schooling options in Indigenous communities, the public policy debate, research, and discourse on school choice is almost entirely absent a specific engagement with how school choice intersects issues relevant to American Indian youth and tribal nations. This article suggests that Indian Country is an important and unique…

  17. 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

  18. Insulin versus an oral antidiabetic agent as add-on therapy in type 2 diabetes after failure of an oral antidiabetic regimen: a meta-analysis

    PubMed Central

    Gamble, JM; Brown, Lauren C; Johnson, Jeffrey A

    2008-01-01

    Background Although evidence-based guidelines for the treatment of type 2 diabetes mellitus provide clear recommendations for initial therapy, evidence on an optimal treatment strategy after secondary failure is unclear. Purpose To compare the efficacy of add-on therapy using basal insulin versus an additional oral antidiabetic agent in patients with type 2 diabetes and secondary failure. Data sources We searched the following electronic databases from inception until June 2007: MEDLINE; EMBASE; Cochrane Central Register of Controlled Trials; Web of Science; Scopus; CINAHL; International Pharmaceutical Abstracts; Academic OneFile; PASCAL; Global Health Database; LILACS; HealthSTAR; PubMed. Reference lists of potentially relevant articles and clinical trial databases were searched, pharmaceutical manufacturers were contacted, and grey literature sources were sought. Study selection Randomized controlled trials (RCTs) involving subjects with type 2 diabetes with secondary failure who were randomly assigned to receive additional basal insulin therapy (insulin glargine, detemir, or NPH [neutral protamine Hagedorn]) versus another oral antidiabetic agent from any class. Data extraction Two reviewers independently screened articles, extracted data and assessed methodological quality. Our primary outcome was glycemic control measured by change in glycosylated hemoglobin (HbA1C) and the proportion of subjects achieving a HbA1C value of ≤ 7%. Data synthesis To compare overall efficacy between the 2 treatment strategies, change in HbA1C was pooled across studies using a random-effects model and weighted mean difference (WMD). Eleven RCTs, involving 757 participants with a median age of 56 and a median known duration of diabetes of 11 years, were included in our analysis. Insulin treatment demonstrated a small but statistically significant improvement in HbA1C compared with the use of an additional oral agent as add-on therapy (WMD -0.17; 95% CI [confidence interval] -0

  19. 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.

  20. 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).

  1. 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.

  2. 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

  3. Aromatase inhibitors as add-on treatment for men with epilepsy.

    PubMed

    Harden, Cynthia; MacLusky, Neil J

    2005-01-01

    Manipulation of neurosteroids to treat epilepsy has been an area of active research. The effect of testosterone on brain excitability and seizure threshold has been mixed; the estradiol metabolite of testosterone increases brain excitability, while the reduced metabolite of testosterone, 3alpha-androstanediol, decreases brain excitability, likely through an action at the gamma-amino butyric acid A receptor. Therefore, the metabolites of testosterone produce opposite effects on brain excitability in seizure models. Aromatase is the enzyme for the conversion of testosterone to 17beta-estradiol. Aromatase inhibitors could decrease brain excitability by decreasing local estradiol levels and therefore, could be beneficial for the treatment of epilepsy. Aromatase inhibitors are US Food and Drug Administration-approved and have a long history of safe use in menopausal women with breast cancer. This review presents the results of using anastrazole in an open-label, add-on manner in a small group of men with epilepsy in order to improve seizures. The results suggested some effect on reduction of seizures and no side effects. Testosterone levels did increase, but not to above the normal range. Letrozole used in a single case was also beneficial for seizures. It was concluded that aromatase inhibitors may be a useful adjunct to the treatment of epilepsy, but habituation to the treatment may be limiting. Many men with epilepsy have low testosterone, and aromatase inhibition may be helpful in restoring levels to normal. Modulation of reproductive hormones by aromatase inhibition as well as enhancement of the 3alpha-androstanediol pathway may be an avenue of epilepsy treatment that would not produce sedative side effects, which is often a limiting factor with standard antiseizure medications. A further interesting result is that elevated follicle stimulating hormone and luteal stimulating hormone levels were associated with seizure reduction, suggesting that they may be a

  4. Pregabalin as mono- or add-on therapy for patients with refractory chronic neuropathic pain: a post-marketing prescription-event monitoring study.

    PubMed

    Lampl, Christian; Schweiger, Christine; Haider, Bernhard; Lechner, Anita

    2010-08-01

    This observational study examined the outcome of two different therapeutic strategies in the treatment of chronic neuropathic pain by including pregabalin (PGB) as mono- or add-on therapy in one of two treatment options. Patients with a pain score of > or =4, refractory to usual care for neuropathic pain for at least 6 months, were allocated consecutively to one of two treatment strategies according to the decision of the physician: complete switch to a flexible-dosage, monotherapeutic or add-on therapy with pregabalin (PGB group), or change established doses and combinations of pre-existing mono- or combination therapy without pregabalin (non-PGB group). After 4 weeks (primary endpoint) a significant improvement in pain reduction was documented in both intention-to treat (ITT) analysis (PGB group, n = 85: mean pain score reduction of 3.53, SD 2.03, p < 0.001; non-PGB group, n = 102; mean pain score reduction of 2.83, SD 2.23, p < 0.001) and per-protocol (PP) analysis (PGB group, n = 79: mean pain score reduction 3.53 vs. 2.83, p < 0.05; non-PGB group, n = 81; 3.5 vs. 2.9, p < 0.05) compared to baseline. Comparison of the results observed in the two groups shows that patients in the PGB group achieved significantly greater pain reduction. These results demonstrate that PGB administered twice daily is superior to treatment regimes without PGB in reducing pain and pain-related interference in quality of life.

  5. Add-on therapy with anagliptin in Japanese patients with type-2 diabetes mellitus treated with metformin and miglitol can maintain higher concentrations of biologically active GLP-1/total GIP and a lower concentration of leptin.

    PubMed

    Osonoi, Takeshi; Saito, Miyoko; Hariya, Natsuyo; Goto, Moritaka; Mochizuki, Kazuki

    2016-12-01

    Metformin, α-glucosidase inhibitors (α-GIs), and dipeptidyl peptidase 4 inhibitors (DPP-4Is) reduce hyperglycemia without excessive insulin secretion, and enhance postprandial plasma concentration of glucagon-like peptide-1 (GLP-1) in type-2 diabetes mellitus (T2DM) patients. We assessed add-on therapeutic effects of DPP-4I anagliptin in Japanese T2DM patients treated with metformin, an α-GI miglitol, or both drugs on postprandial responses of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), and on plasma concentration of the appetite-suppressing hormone leptin. Forty-two Japanese T2DM patients with inadequately controlled disease (HbA1c: 6.5%-8.0%) treated with metformin (n=14), miglitol (n=14) or a combination of the two drugs (n=14) received additional treatment with anagliptin (100mg, p.o., b.i.d.) for 52 weeks. We assessed glycemic control, postprandial responses of GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), and on plasma concentration of leptin in those patients. Add-on therapy with anagliptin for 52 weeks improved glycemic control and increased the area under the curve of biologically active GLP-1 concentration without altering obesity indicators. Total GIP concentration at 52 weeks was reduced by add-on therapy in groups treated with miglitol compared with those treated with metformin. Add-on therapy reduced leptin concentrations. Add-on therapy with anagliptin in Japanese T2DM patients treated with metformin and miglitol for 52 weeks improved glycemic control and enhanced postprandial concentrations of active GLP-1/total GIP, and reduce the leptin concentration.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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 ...

  11. 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…

  12. 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 ...

  13. 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.

  14. Decision support system for the evaluation of urban air pollution control options: application for particulate pollution in Thessaloniki, Greece.

    PubMed

    Vlachokostas, Ch; Achillas, Ch; Moussiopoulos, Nu; Hourdakis, E; Tsilingiridis, G; Ntziachristos, L; Banias, G; Stavrakakis, N; Sidiropoulos, C

    2009-11-15

    Development of strategies to control urban air pollution is a complex and multi-disciplinary process involving a wide range of scientists with different expertise and interests. This paper presents an integrated assessment methodological scheme for the evaluation of air pollution control measures that are put forward in order to reduce sufficiently air pollution levels in urban areas. Forming long-term, efficient air pollution control strategies requires knowledge of the costs associated with their implementation, the emission inventories and emission reductions to be achieved, as well as the concentration variations that represent air quality levels in the area examined. In contrast to the majority of the currently employed assessment approaches, the presented scheme enables the evaluation of any proposed air pollution control option in terms of its combined impact on air quality and social welfare, by correlating economic and health impact assessment issues. The approach presented in this paper brings together air quality modelling and mathematical programming techniques and provides a decision support system for the determination of optimal bundles of air pollution control options according to the particular features and needs of the areas examined. Both cost-effectiveness and cost-benefit approaches are taken into account in order to put the problem on the basis of economic efficiency from a societal perspective. The methodology is implemented for the case of Thessaloniki, Greece, which is selected on the grounds that the area is considered as one of the most polluted--if not the most polluted--cities within Europe, especially with respect to airborne particles.

  15. 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.

  16. No changes of cardiometabolic and body composition parameters after 6-month add-on treatment with sarcosine in patients with schizophrenia.

    PubMed

    Strzelecki, Dominik; Kałużyńska, Olga; Szyburska, Justyna; Wlazło, Agata; Wysokiński, Adam

    2015-12-15

    This study was undertaken with the purpose to determine if there are changes in metabolic parameters during 6-month add-on treatment with sarcosine in patients with schizophrenia. This was a randomized double blind, placebo-controlled and parallel group study. Eligible participants were randomly assigned to receive 2g of sarcosine (n=30) or placebo (n=29). Sarcosine was administered as supplementation to the ongoing antipsychotic treatment. Augmentation with sarcosine had no effect on any of the analyzed cardiometabolic parameters. Also, augmentation with sarcosine had no effect on any of the analyzed body composition parameters. This is the first randomized placebo-controlled study to examine the metabolic safety of sarcosine in patients with schizophrenia. Clinically, this observation is of high importance considering how prevalent are metabolic abnormalities in patients with schizophrenia.

  17. An add-on video compression codec based on content-adaptive sparse super-resolution reconstructions

    NASA Astrophysics Data System (ADS)

    Yang, Shu; Jiang, Jianmin

    2017-02-01

    In this paper, we introduce an idea of content-adaptive sparse reconstruction to achieve optimized magnification quality for those down sampled video frames, to which two stages of pruning are applied to select the closest correlated images for construction of an over-complete dictionary and drive the sparse representation of its enlarged frame. In this way, not only the sampling and dictionary training process is accelerated and optimized in accordance with the input frame content, but also an add-on video compression codec can be further developed by applying such scheme as a preprocessor to any standard video compression algorithm. Our extensive experiments illustrate that (i) the proposed content-adaptive sparse reconstruction outperforms the existing benchmark in terms of super-resolution quality; (ii) When applied to H.264, one of the international video compression standards, the proposed add-on video codec can achieve three times more compression while maintaining competitive decoding quality.

  18. Space station systems technology study (add-on task). Volume 3: Technology advancement program plan

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Program plans are given for an integrating controller for space station autonomy as well as for controls and displays. The technical approach, facility requirements and candidate facilities, development schedules, and resource requirements estimates are given.

  19. 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.

  20. Phenobarbital or potassium bromide as an add-on antiepileptic drug for the management of canine idiopathic epilepsy refractory to imepitoin.

    PubMed

    Royaux, E; Van Ham, L; Broeckx, B J G; Van Soens, I; Gielen, I; Deforce, D; Bhatti, S F M

    2017-02-01

    Imepitoin has recently been approved in Europe for the management of dogs with idiopathic epilepsy. Currently, there is no evidence-based information available on the efficacy of antiepileptic drugs used as additions to the therapeutic regimen in dogs with idiopathic epilepsy that are not well controlled with imepitoin. The goal of this study was to evaluate the efficacy of phenobarbital or potassium bromide (KBr) as add-on antiepileptic drugs for controlling dogs refractory to a maximum dose of imepitoin (30 mg/kg twice daily). The study was performed as a prospective, randomised, controlled clinical trial. The efficacy of phenobarbital and KBr was evaluated by comparing monthly seizure frequency (MSF), monthly seizure day frequency (MSDF), the presence of cluster seizures during a retrospective 2-month period with a prospective follow-up of 6 months, and the overall responder rate. Twenty-seven dogs were included in the study, 14 dogs in the phenobarbital group and 13 dogs in the KBr group. Both median MSF and MSDF decreased in the phenobarbital group (both P = 0.001) and in the KBr group (P = 0.004 and P = 0.003, respectively). Overall, the number of dogs with cluster seizures decreased (P = 0.0005). The responder rate was 79% vs. 69% in the phenobarbital and KBr groups, respectively. We conclude that phenobarbital or KBr add-on treatment decreases median MSF and MSDF in epileptic dogs refractory to a maximum dose of imepitoin. Combination therapy was generally well tolerated and resulted in an improvement in seizure management in the majority of the dogs.

  1. 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

  2. Enhanced s-triazine Degradation and Sugar Cane Weed Control Options

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil borne bacteria on all continents except Antarctica have developed the ability to rapidly degrade the herbicide atrazine. Reduced residual weed control with atrazine in soils exhibiting enhanced degradation was confirmed under Mississippi Delta corn production and is expected to be occurring in...

  3. 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…

  4. 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…

  5. 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.

  6. Diagnostics for schistosomiasis in Africa and Arabia: a review of present options in control and future needs for elimination.

    PubMed

    Stothard, J Russell; Stanton, Michelle C; Bustinduy, Amaya L; Sousa-Figueiredo, José C; Van Dam, Govert J; Betson, Martha; Waterhouse, David; Ward, Steve; Allan, Fiona; Hassan, Amir A; Al-Helal, Mohammad A; Memish, Ziad A; Rollinson, David

    2014-12-01

    Within the World Health Organization 2012-2020 roadmap for control and elimination of schistosomiasis, the scale-up of mass drug administration with praziquantel is set to change the epidemiological landscape across Africa and Arabia. Central in measuring progress is renewed emphasis upon diagnostics which operate at individual, community and environmental levels by assessing reductions in disease, infections and parasite transmission. However, a fundamental tension is revealed between levels for present diagnostic tools, and methods applied in control settings are not necessarily adequate for application in elimination scenarios. Indeed navigating the transition from control to elimination needs careful consideration and planning. In the present context of control, we review current options for diagnosis of schistosomiasis at different levels, highlighting several strengths and weaknesses therein. Future challenges in elimination are raised and we propose that more cost-effective diagnostics and clinical staging algorithms are needed. Using the Kingdom of Saudi Arabia as a contemporary example, embedding new diagnostic methods within the primary care health system is discussed with reference to both urogenital and intestinal schistosomiasis.

  7. 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

  8. 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

  9. 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.

  10. Particulate monitoring, modeling, and management: natural sources, long-range transport, and emission control options: a case study of Cyprus

    NASA Astrophysics Data System (ADS)

    Kleanthous, Savvas; Savvides, Chrysanthos; Christofides, Ioannis; Hadjimitsis, Diofantos G.; Themistocleous, Kyriacos; Achilleos, Constantia; Akylas, Evangelos; Demetriadou, Chrystalla; Christodoulides, Pavlos; Douros, Ioannis; Moussiopoulos, Nicolas; Panayiotou, Charalambos; Gregoris, Charalambous; Fedra, Kurt; Kubat, Milan; Mihalopoulos, Nicolaos

    2013-08-01

    The LIFE+ Project PM3: Particulate Monitoring, Modeling, Management is coordinated by the Department of Labour Inspection in Cyprus and funded in part by LIFE+ Environment Policy & Governance. The project aims at the analysis of dust emissions, transport, and control options for Cyprus, as well as at the identification of "natural" contributions (Directive 2008/50/EC). The ultimate objective is to provide inputs for the design of a dust management plan to improve compliance to EC Directives and minimise impacts to human health and environment. This paper presents a short analysis of historical monitoring data and their patterns as well as a description of a dynamic dust entrainment model. The pyrogenic PM10 emissions combined with the wind driven emissions, are subject to a two phase non-linear multi-criteria emission control optimization procedure. The resulting emission scenarios with an hourly resolution provide input to the Comprehensive Air quality Model with extensions (CAMx) 3D fate and transport model, implemented for the 4,800 km master domain and embedded subdomains (270 km around the island of Cyprus and embedded smaller city domains of up to 30 km down to street canyon modeling). The models test the feasibility of candidate emission control solutions over a range of weather conditions. Model generated patterns of local emissions and long-range transport are discussed compared with the monitoring data, remote sensing (MODIS derived AOT), and the chemical analysis of dust samples.

  11. Diffraction order control in overlay metrology: a review of the roadmap options

    NASA Astrophysics Data System (ADS)

    Adel, Mike; Kandel, Daniel; Levinski, Vladimir; Seligson, Joel; Kuniavsky, Alex

    2008-03-01

    Resolution enhancement in advanced optical lithography will reach a new plateau of complexity at the 32 nm design rule manufacturing node. In order to circumvent the fundamental optical resolution limitations, ultra low k I printing processes are being adopted, which typically involve multiple exposure steps. Since alignment performance is not fundamentally limited by resolution, it is expected to yield a greater contribution to the effort to tighten lithographic error budgets. In the worst case, the positioning budget usually allocated to a single patterning step is divided between two. A concurrent emerging reality is that of high order overlay modeling and control. In tandem with multiple exposures, this trend creates great pressure to reduce scribeline target real estate per exposure. As the industry migrates away from metrology targets formed from large isolated features, the adoption of dense periodic array proxies brings improved process compatibility and information density as epitomized by the AIM target1. These periodic structures enable a whole range of new metrology sensor architectures, both imaging and scatterometry based, that rely on the principle of diffraction order control and which are no longer aberration limited. Advanced imaging techniques remain compatible with side-by-side targets while scatterometry methods require grating-over-grating targets. In this paper, a number of different imaging and scatterometry architectures are presented and compared in terms of random errors, systematic errors and scribespace requirements. It is asserted that an optimal solution must combine the TMU peak performance capabilities of scatterometry with the cost of ownership advantages of target size and multi-layer capabilities of imaging.

  12. Comparative behavioral and neurochemical analysis of phenytoin and valproate treatment on epilepsy induced learning and memory deficit: Search for add on therapy.

    PubMed

    Mishra, Awanish; Goel, Rajesh Kumar

    2015-08-01

    Our previous work demonstrated, chronic epilepsy affects learning and memory of rodents along with peculiar neurochemical changes in discrete brain parts. Most commonly used antiepileptic drugs (phenytoin and sodium valproate) also worsen learning and memory in the patients with epilepsy. Therefore this study was designed to carry out comparison of behavioral and neurochemical changes with phenytoin and sodium valproate treatment in pentylenetetrazole-kindling induced learning and memory deficit to devise add on therapy for this menace. For the experimental epilepsy, animals were kindled using PTZ (35 mg/kg; i.p., at 48 ± 2 h intervals) and successful kindled animals were involved in the study. These kindled animals were treated with saline, phenytoin (30 mg/kg/day, i.p.) and sodium valproate (300 mg/kg/day, i.p.) for 20 days. These animals were challenged with PTZ challenging dose (35 mg/kg) on day 5, 10, 15 and 20 to evaluate the effect on seizure severity score on different days. Effect on learning and memory was evaluated using elevated plus maze and passive shock avoidance paradigm. On day 20, after behavioral evaluations, animals were sacrificed to analyze glutamate, GABA, norepinephrine, dopamine, serotonin, total nitrite level and acetylcholinesterase level in cortex and hippocampus. Behavioral evaluations suggested that phenytoin and sodium valproate treatment significantly reduced seizure severity in the kindled animals, while sodium valproate treatment controls seizures with least memory deficit in comparison to phenytoin. Neurochemical findings revealed that elevated cortical acetylcholinesterase level could be one of the responsible factors leading to memory deficit in phenytoin treated animals. However sodium valproate treatment reduced cortical acetylcholinesterase level and had least debilitating consequences on memory deficit. Therefore, attenuation of elevated AChE activity can be one of add-on approach for management of memory deficit

  13. Accident analysis and control options in support of the sludge water system safety analysis

    SciTech Connect

    HEY, B.E.

    2003-01-16

    A hazards analysis was initiated for the SWS in July 2001 (SNF-8626, K Basin Sludge and Water System Preliminary Hazard Analysis) and updated in December 2001 (SNF-10020 Rev. 0, Hazard Evaluation for KE Sludge and Water System - Project A16) based on conceptual design information for the Sludge Retrieval System (SRS) and 60% design information for the cask and container. SNF-10020 was again revised in September 2002 to incorporate new hazards identified from final design information and from a What-if/Checklist evaluation of operational steps. The process hazards, controls, and qualitative consequence and frequency estimates taken from these efforts have been incorporated into Revision 5 of HNF-3960, K Basins Hazards Analysis. The hazards identification process documented in the above referenced reports utilized standard industrial safety techniques (AIChE 1992, Guidelines for Hazard Evaluation Procedures) to systematically guide several interdisciplinary teams through the system using a pre-established set of process parameters (e.g., flow, temperature, pressure) and guide words (e.g., high, low, more, less). The teams generally included representation from the U.S. Department of Energy (DOE), K Basins Nuclear Safety, T Plant Nuclear Safety, K Basin Industrial Safety, fire protection, project engineering, operations, and facility engineering.

  14. Options for reducing food waste by 'Quality Controlled Logistics' using intelligent packaging along the supply chain.

    PubMed

    Heising, Jenneke K; Claassen, G D H; Dekker, Matthijs

    2017-04-04

    Optimizing supply chain management can help to reduce food waste. This article describes how intelligent packaging can be used to reduce food waste when used in supply chain management based on Quality Controlled Logistics (QCL). Intelligent packaging senses compounds in the package that correlate with the critical quality attribute of a food product. The information on the quality of each individual packaged food item that is provided by the intelligent packaging can be used for QCL. In a conceptual approach is explained that monitoring food quality by intelligent packaging sensors makes it possible to obtain information about the variation in the quality of foods and use a dynamic expiration date (IP-DED) on a food package. The conceptual approach is supported by quantitative data from simulations on the effect of using the information of intelligent packaging in supply chain management with the goal to reduce food waste. This simulation shows that QCL by using the information on the quality of products that is provided by intelligent packaging can substantially reduce food waste. When QCL is combined with dynamic pricing based on the predicted expiry dates a further waste reduction is envisaged.

  15. 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

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. Quetiapine add-on therapy improves the depressive behaviors and hippocampal neurogenesis in fluoxetine treatment resistant depressive rats.

    PubMed

    Wang, Ying; Chang, Ting; Chen, Yun-Chun; Zhang, Rui-Guo; Wang, Hua-Ning; Wu, Wen-Jun; Peng, Zheng-Wu; Tan, Qing-Rong

    2013-09-15

    Quetiapine, an atypical antipsychotic, may have efficacy as augmentation therapy in treatment resistant depression (TRD), but evidence is limited and the underlying mechanism remains poorly understood. Therefore, this study was aimed to investigate whether and how quetiapine can be served as an augmentation agent in fluoxetine treatment resistant depressive rats induced by chronic unpredictable mild stress (CUMS). In this study, the effects of CUMS regimen and antidepressant treatment were assessed by behavioral tests and hippocampal neurogenesis. Approximately 20-30% of depressive rats respond poorly to fluoxetine treatment. In their hippocampus, a significant decrease of neurogenesis was also observed. However, quetiapine add-on therapy significantly improved the depressive behaviors and increased the number of the newborn neurons in the hippocampus of fluoxetine treatment resistant depressive rats. Thus, our results suggest that quetiapine may be used as an augmentation agent in the treatment resistant depression partly mediated by increasing the number of newborn neurons in the hippocampus.

  1. Novel "Add-On" Molecule Based on Evans Blue Confers Superior Pharmacokinetics and Transforms Drugs to Theranostic Agents.

    PubMed

    Chen, Haojun; Jacobson, Orit; Niu, Gang; Weiss, Ido D; Kiesewetter, Dale O; Liu, Yi; Ma, Ying; Wu, Hua; Chen, Xiaoyuan

    2017-04-01

    One of the major design considerations for a drug is its pharmacokinetics in the blood. A drug with a short half-life in the blood is less available at a target organ. Such a limitation dictates treatment with either high doses or more frequent doses, both of which may increase the likelihood of undesirable side effects. To address the need for additional methods to improve the blood half-life of drugs and molecular imaging agents, we developed an "add-on" molecule that contains 3 groups: a truncated Evans blue dye molecule that binds to albumin with a low micromolar affinity and provides a prolonged half-life in the blood; a metal chelate that allows radiolabeling for imaging and radiotherapy; and maleimide for easy conjugation to drug molecules. Methods: The truncated Evans blue molecule was conjugated with the chelator NOTA or DOTA, and the resulting conjugate was denoted as NMEB or DMEB, respectively. As a proof of concept, we coupled NMEB and DMEB to c(RGDfK), which is a small cyclic arginine-glycine-aspartic acid (RGD) peptide, for targeting integrin αvβ3 NMEB and DMEB were radiolabeled with (64)Cu and (90)Y, respectively, and tested in xenograft models. Results: The resulting radiolabeled conjugates showed a prolonged circulation half-life and enhanced tumor accumulation in integrin αvβ3-expressing tumors. Tumor uptake was markedly improved over that with NOTA- or DOTA-conjugated c(RGDfK). Tumor radiotherapy experiments in mice with (90)Y-DMEB-RGD showed promising results; existing tumors were eliminated. Conclusion: Conjugation of our novel add-on molecule, NMEB or DMEB, to potential tracers or therapeutic agents improved blood half-life and tumor uptake and could transform such agents into theranostic entities.

  2. 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.

  3. 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

    ... device emission destruction or removal efficiency? 63.4766 Section 63.4766 Protection of Environment... Pollutants: Surface Coating of Wood Building Products Compliance Requirements for the Emission Rate with Add... removal efficiency? You must use the procedures and test methods in this section to determine the...

  4. 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

    ... = Concentration of organic compounds as carbon in the vent gas, as determined by Method 25 or Method 25A, ppmvd... molar volume, kg-moles per cubic meter (mol/m3) (@ 293 Kelvin (K) and 760 millimeters of mercury...

  5. 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... molar volume, kg-moles per cubic meter (mole/m3) (@ 293 Kelvin (K) and 760 millimeters of mercury...

  6. 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

    ... rate, kg per hour (h). Cc = Concentration of organic compounds as carbon in the vent gas, as determined... per cubic meter (mol/m3) (@ 293 Kelvin (K) and 760 millimeters of mercury (mmHg). (e) For each...

  7. 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...

  8. 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...

  9. 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

    ... catalyst bed in any 3-hour period must not fall below the limit established according to § 63.3167(b); and... 3-hour block averages; and iii. Maintaining the 3-hour average temperature before the catalyst bed... catalyst bed in any 3-hour period does not fall below the temperature difference limit...

  10. 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

    ... the catalyst bed in any 3-hour period must not fall below the limit established according to § 63.5160... 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...

  11. 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

    ... the catalyst bed in any 3-hour period must not fall below the limit established according to § 63.5160... 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...

  12. 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

    .... 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...

  13. 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...

  14. 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...

  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

    ... 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 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...

  18. 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

    ... 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...

  19. 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...

  20. 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

    ... 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...

  1. 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...

  2. 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...

  3. 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

    ... 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...

  4. 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

    ... 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...

  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. Career options.

    PubMed

    2011-06-24

    Practitioners at all levels can plan their future career options through the NHS Nursing Career Framework interactive tool. The tool builds on the pathway-based framework set out in the post-registration career framework for nurses. Career pathways are outlined under each branch and the specialties within the branches, and cover topics including clinical careers, management and moving into education or research.

  7. 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.

  8. Should sulfonylureas remain an acceptable first-line add-on to metformin therapy in patients with type 2 diabetes? Yes, they continue to serve us well!

    PubMed

    Abrahamson, Martin J

    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 point narrative presented below, 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 following counterpoint narrative, 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.

  9. 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.

  10. 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.

  11. Exercise as an add-on strategy for the treatment of major depressive disorder: a systematic review.

    PubMed

    Mura, Gioia; Moro, Maria Francesca; Patten, Scott B; Carta, Mauro G

    2014-12-01

    Antidepressants are currently the treatment of choice for major depressive disorder (MDD). Nevertheless, a high percentage of patients do not respond to a first-line antidepressant drug, and combination treatments and augmentation strategies increase the risk of side effects. Moreover, a significant proportion of patients are treatment-resistant. In the last 30 years, a number of studies have sought to establish whether exercise could be regarded as an alternative to antidepressants, but so far no specific analysis has examined the efficacy of exercise as an adjunctive treatment in combination with antidepressants. We carried out a systematic review to evaluate the effectiveness of exercise as an adjunctive treatment with antidepressants on depression. A search of relevant papers was carried out in PubMed/Medline, Google Scholar, and Scopus with the following keywords: "exercise," "physical activity," "physical fitness," "depressive disorder," "depression," "depressive symptoms," "add-on," "augmentation," "adjunction," and "combined therapy." Twenty-two full-text articles were retrieved by the search. Among the 13 papers that fulfilled our inclusion criteria, we found methodological weaknesses in the majority. However, the included studies showed a strong effectiveness of exercise combined with antidepressants. Further analyses and higher quality studies are needed; nevertheless, as we have focused on a particular intervention (exercise in adjunction to antidepressants) that better reflects clinical practice, we can hypothesize that this strategy could be appropriately and safely translated into real-world practice.

  12. Demonstration of an add-on effect of probucol and cilostazol on the statin-induced anti-atherogenic effects.

    PubMed

    Wang, Yanli; Bai, Liang; Lin, Yan; Guan, Hua; Zhu, Ninghong; Chen, Yulong; Li, Yafeng; Gao, Shoucui; Zhao, Sihai; Fan, Jianglin; Liu, Enqi

    2014-12-01

    Statins are often prescribed for treatment of cardiovascular diseases, although there are still many patients who cannot be effectively treated by statins alone. Both probucol and cilostazol exhibit anti-atherogenic effects. In the current study, we attempted to investigate whether a probucol and cilostazol combination had any add-on effects on atorvastatin. To examine this hypothesis, we fed Japanese white rabbits with a cholesterol-rich diet supplemented with atorvastatin alone (Statin group), probucol and cilostazol (PC group), atorvastatin, probucol and cilostazol (APC group), and compared their effects on plasma lipids and aortic atherosclerosis. All three drug-treated groups had lowered total cholesterol levels compared with the vehicle group but high-density lipoproteins cholesterol levels of the atorvastatin group were higher than other groups. Although aortic atherosclerosis was significantly reduced in all drug-treated groups, the most prominent atheroprotective effect was seen in APC group (APC: 67% reduction> PC: 43% reduction> Statin group: 42% reduction over the vehicle). Morphometric analysis revealed that the reduced aortic atherosclerosis in all three groups was mainly attributed to the reduction of intimal macrophages and smooth muscle cells. These results suggest that a combination of probucol and cilostazol with statin enhances statin's anti-atherogenic functions, which may be beneficial for those patients who are less responsive to statin therapy alone.

  13. Add-on Lamotrigine Treatment for Subsyndromal Depression after Manic or Mixed States in Bipolar Disorder Improved the Quality of Life

    PubMed Central

    Muneoka, Katsumasa; Kon, Katsushi; Kawabe, Masaharu; Ui, Rui; Miura, Taichi; Iimura, Touta; Kimura, Shou

    2012-01-01

    Two cases of patients experienced subsyndromal depression after manic or mixed hypomanic and depressive episodes due to bipolar I (case 1) and II (case 2) disorders prior to the use of lamotrigine. Case 1 showed episodes of mood switching induced by antidepressants and seasonal mood instability. Case 2 showed hippocampal atrophy and a persistent dull headache that preceded the use of lamotrigine. Both were successfully treated with add-on lamotrigine therapy, and the dull headache was effectively treated with olanzapine. Both patients improved in social activity and work performance after these add-on treatments. Thus, add-on treatment with lamotrigine alone or in combination with olanzapine was an effective strategy to improve the quality of life in bipolar depression. Subsyndromal depression that present after the disappearance of the manic or mixed state was suggested to be practical indication for the use of lamotrigine. PMID:23049569

  14. Treatment Options in Psoriasis

    PubMed Central

    Dantow, James E.

    1992-01-01

    Psoriasis is a common skin disease with a variety of clinical presentations. Fortunately, many treatment options are available to the patient and to the physician. Topical, systemic, and physical therapies can be tailored to the patient's needs. Patient compliance and a knowledgeable, caring physician are vital to successful control of the disease. Continuing research offers hope for the chronically disabled. PMID:21221381

  15. Teletext: Assessing the Options.

    ERIC Educational Resources Information Center

    Carey, John; Nisenholtz, Martin

    1980-01-01

    This discussion of broadcast teletext explores some of the options available to public broadcasters and potential obstacles to implementing a teletext service. Topics covered include transmission alternatives, factors affecting service, design specifications, marketing possibilities, financial support, editorial control of information, standards…

  16. Peginterferon add-on results in more HBsAg decline compared to monotherapy in HBeAg-positive chronic hepatitis B patients.

    PubMed

    Brouwer, W P; Sonneveld, M J; Xie, Q; Guo, S; Zhang, N; Zeuzem, S; Tabak, F; Zhang, Q; Simon, K; Akarca, U S; Streinu-Cercel, A; Hansen, B E; Janssen, H L A

    2016-06-01

    It is unknown whether peginterferon (PEG-IFN) add-on to entecavir (ETV) leads to more HBsAg decline compared to PEG-IFN monotherapy or combination therapy, and whether ETV therapy may prevent HBsAg increase after PEG-IFN cessation. We performed a post hoc analysis of 396 HBeAg-positive patients treated for 72 weeks with ETV + 24 weeks PEG-IFN add-on from week 24 to 48 (add-on, n = 85), 72 weeks with ETV monotherapy (n = 90), 52 weeks with PEG-IFN monotherapy (n = 111) and 52 weeks PEG-IFN + lamivudine (combination, n = 110) within 2 randomized trials. HBsAg decline was assessed at the end of PEG-IFN (EOP) and 6 months after PEG-IFN (EOF) discontinuation. Differences in baseline characteristics were accounted for using inversed probability of treatment weights. At EOP, a HBsAg reduction of ≥1log10 IU/mL was more frequently achieved for patients in the add-on or combination therapy arms (both 36%), compared to PEG-IFN mono (20%) or ETV (8%) (add-on vs PEG-IFN mono P = 0.050). At EOF, the HBsAg reduction ≥1log10 IU/mL was only sustained in patients treated with ETV consolidation (add-on vs combination and PEG-IFN mono: 40% vs 23% and 18%, P = 0.029 and P = 0.003, respectively). For add-on, combination, PEG-IFN mono and ETV, the mean HBsAg-level change at EOF was -0.84, -0.81, -0.68 and -0.33 log10 IU/mL, respectively (P > 0.05 for PEG-IFN arms). HBeAg loss at EOF was 36%, 31%, 33% and 20%, respectively (P > 0.05). PEG-IFN add-on for 24 weeks results in more on-treatment HBsAg decline than does 52 weeks of PEG-IFN monotherapy. ETV therapy may maintain the HBsAg reduction achieved with PEG-IFN.

  17. 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.

  18. Add-on therapy with a nighttime dose of doxazosin in patients with uncontrolled hypertension: effects on autonomic modulation of the cardiovascular system.

    PubMed

    Guzik, Przemyslaw; Wykretowicz, Andrzej; Krauze, Tomasz; Piskorski, Jaroslaw; Adamska, Karolina; Milewska, Agata; Wesseling, Karel H; Wysocki, Henryk

    2008-03-01

    This study was designed to determine whether or not the addition of a single nighttime dose of doxazosin in extended-release form (GITS; gastrointestinal therapeutic system) would affect the autonomic modulation of the cardiovascular system in patients with uncontrolled hypertension treated with a multi-drug regimen. Resting 5-min noninvasive finger blood pressure and ECG signals, as well as 24-h Holter ECGs, were recorded in 30 patients with uncontrolled hypertension on multi-drug treatment before and after 16-week add-on therapy with doxazosin GITS. Cardiovascular autonomic modulation was evaluated by spectral analysis of heart rate variability (HRV) and a cross-correlation method for spontaneous baroreflex sensitivity (BRS) in 5-min resting recordings, and by the analysis of Poincaré plots and phase-rectified signal averaging of the duration of cardiac cycles in 24-h ECG recordings. This combined therapy significantly reduced systolic pressure (19.4+/-3.5 mmHg; p<0.0001), diastolic blood pressure (9.4+/-2.0 mmHg; p=0.0003), and pulse pressure (10.0+/-2.8 mmHg; p=0.0021). Concomitantly, there was a significant increase in resting spontaneous BRS (p=0.0191) and increases in 24-h short-term (p=0.0129) and total (p=0.0153) HRV, but with no significant change in heart rate or other measures of HRV. The improvements in HRV and BRS were observed mainly in patients already treated with thiazide diuretics. There was a significant association (r=0.49; p=0.0065) between the degree of change in diastolic blood pressure and short-term HRV caused by the combined treatment. The addition of 4 mg doxazosin GITS to multi-drug antihypertensive therapy is associated with an improvement in cardiovascular autonomic control.

  19. Entecavir plus adefovir combination therapy versus lamivudine add-on adefovir for lamivudine-resistant chronic hepatitis B: A meta-analysis.

    PubMed

    Zeng, Teng; Xu, Hua; Liu, Jun-Ying; Lei, Yu; Zhong, Shan; Zhou, Zhi

    2014-09-01

    To determine whether adefovir (ADV) in combination with entecavir (ETV) is more effective than with lamivudine (LAM) in patients with lamivudine-resistant chronic HBV infection, electronic databases were searched through May 10th, 2013 to obtain relevant trials which met the inclusion criteria. Meta-analysis was performed on randomized controlled trials (RCTs) and non-randomized studies. Four trials containing a total of 323 patients were included. Serum HBV DNA reductions after 3 and 6 months of treatment in the ETV + ADV group were greater than that of LAM + ADV group (mean difference (MD) = 0.90, 95% confidence interval (CI): 0.74-1.07, P < 0.00001; MD = 0.81, 95% CI: 0.57-1.06, P < 0.00001). The rate of 6 months HBV DNA undetectability with ETV and ADV was higher than that of LAM and ADV (relative risk (RR) = 1.63, 95% CI: 1.14-2.34, P < 0.007). There were higher rates of serum ALT normalization than those in LAM + ADV group after 6 months of treatment (RR = 1.40, 95% CI: 1.11-1.77, P < 0.005). The ETV + ADV group had lower viral breakthrough and genotypic mutation rates than LAM + ADV group after 12 months of treatment (RR = 0.24, 95% CI: 0.10-0.58, P = 0.002). The combination of ETV plus ADV is a more effective rescue therapy than LAM add-on ADV in patients with LAM-resistant HBV.

  20. Promoting invasive species control and eradication in the sea: options for managing the tunicate invader Didemnum vexillum in Sitka, Alaska.

    PubMed

    McCann, Linda D; Holzer, Kimberly K; Davidson, Ian C; Ashton, Gail V; Chapman, Marnie D; Ruiz, Gregory M

    2013-12-15

    Bioinvasions are a significant force of change--and economic and ecological threat--in marine ecosystems. The threat now encroaches on Alaska, which has had relatively few invasions compared to other global regions, prompting need to develop new incursion response tools. We appraised five 'eco-friendly' immersion treatment options (dilute acetic acid, dilute bleach, freshwater, brine and hypoxia) at either minute- or hour-scale exposures to kill the invasive tunicate Didemnum vexillum. Data revealed 100% treatment efficacy after two minutes in acetic acid, ten minutes in bleach, four hours in freshwater and over four hours in brine solution. We also demonstrated the importance of monitoring D. vexillum recovery for at least three weeks, since seemingly destroyed colonies rebounded during this timeframe. Combined, these findings provide insights towards a bay-scale eradication and post-border management plan applicable to the recent D. vexillum incursion in Whiting Harbor, Alaska and other shallow, inshore invasion sites.

  1. Targeting Accuracy, Procedure Times and User Experience of 240 Experimental MRI Biopsies Guided by a Clinical Add-On Navigation System

    PubMed Central

    Busse, Harald; Riedel, Tim; Garnov, Nikita; Thörmer, Gregor; Kahn, Thomas; Moche, Michael

    2015-01-01

    Objectives MRI is of great clinical utility for the guidance of special diagnostic and therapeutic interventions. The majority of such procedures are performed iteratively ("in-and-out") in standard, closed-bore MRI systems with control imaging inside the bore and needle adjustments outside the bore. The fundamental limitations of such an approach have led to the development of various assistance techniques, from simple guidance tools to advanced navigation systems. The purpose of this work was to thoroughly assess the targeting accuracy, workflow and usability of a clinical add-on navigation solution on 240 simulated biopsies by different medical operators. Methods Navigation relied on a virtual 3D MRI scene with real-time overlay of the optically tracked biopsy needle. Smart reference markers on a freely adjustable arm ensured proper registration. Twenty-four operators – attending (AR) and resident radiologists (RR) as well as medical students (MS) – performed well-controlled biopsies of 10 embedded model targets (mean diameter: 8.5 mm, insertion depths: 17-76 mm). Targeting accuracy, procedure times and 13 Likert scores on system performance were determined (strong agreement: 5.0). Results Differences in diagnostic success rates (AR: 93%, RR: 88%, MS: 81%) were not significant. In contrast, between-group differences in biopsy times (AR: 4:15, RR: 4:40, MS: 5:06 min:sec) differed significantly (p<0.01). Mean overall rating was 4.2. The average operator would use the system again (4.8) and stated that the outcome justifies the extra effort (4.4). Lowest agreement was reported for the robustness against external perturbations (2.8). Conclusions The described combination of optical tracking technology with an automatic MRI registration appears to be sufficiently accurate for instrument guidance in a standard (closed-bore) MRI environment. High targeting accuracy and usability was demonstrated on a relatively large number of procedures and operators. Between

  2. Functional Modeling, Scenario Development, and Options Analysis to Support Optimized Crewing for Damage Control. Phase 2: Scenario Development

    DTIC Science & Technology

    2007-03-31

    foulée de sa récente activité de planification stratégique, la Marine canadienne planifie actuellement une restructuration importante de ses...recently, Kim Vicente and his colleagues have performed a large body of research about human adaptation in a process control micro-world that treats...control loops and the processes that they control. All four of these design factors are likely to contribute to human-automation challenges in

  3. Functional Modelling, Scenario Development, and Options Analysis to Support Optimized Crewing for Damage Control. Phase 2: Scenario Development

    DTIC Science & Technology

    2007-03-31

    foulée de sa récente activité de planification stratégique, la Marine canadienne planifie actuellement une restructuration importante de ses...recently, Kim Vicente and his colleagues have performed a large body of research about human adaptation in a process control micro-world that treats...control loops and the processes that they control. All four of these design factors are likely to contribute to human-automation challenges in

  4. 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

  5. Effect of add-on aliskiren to type 1 angiotensin receptor blocker therapy on endothelial function and autonomic nervous system in hypertensive patients with ischemic heart disease.

    PubMed

    Ozeki, Atsuko; Amiya, Eisuke; Watanabe, Masafumi; Hosoya, Yumiko; Takata, Munenori; Watanabe, Aya; Kawarasaki, Shuichi; Nakao, Tomoko; Watanabe, Shogo; Omori, Kazuko; Yamada, Namie; Tahara, Yukiko; Hirata, Yasunobu; Nagai, Ryozo

    2014-08-01

    The aim of this study was to evaluate the add-on effect of aliskiren to valsartan on endothelial-dependent vasodilation in hypertensive patients with ischemic heart disease (IHD). After 4 weeks of treatment with 80 mg of valsartan, 28 patients were allocated to either continued treatment with valsartan or an add-on treatment with valsartan plus 150 mg of aliskiren. Aliskiren significantly decreased plasma renin activity, whereas endothelium-dependent vasodilation measured by flow-mediated dilation (FMD) did not change. In contrast, heart rate significantly decreased (73.1 ± 9.8 to 66.3 ± 7.0 beats per minute at baseline and 24 weeks, respectively [P = .009]) and the standard deviation of the R-R intervals (SDNN) significantly increased in the aliskiren group. The add-on aliskiren to valsartan therapy may not improve endothelial functions, although it significantly reduced resting heart rate via regulation of the autonomic nervous system in hypertensive patients with IHD.

  6. [Add-on effect of dutasteride in patients with benign prostatic hyperplasia treated with alpha blocker : its effect on overactive bladder].

    PubMed

    Wada, Naoki; Hashidume, Kazumi; Tamaki, Gaku; Kita, Masafumi; Iwata, Tatsuya; Matsumoto, Seiji; Kakizaki, Hidehiro

    2012-09-01

    We investigated the add-on effect of dutasteride (0.5 mg once a day) on lower urinary tract symptoms (LUTS), prostate volume (PV), and serum prostate specific antigen (PSA) and testosterone level in 72 patients with benign prostatic hyperplasia (BPH) who had been treated with alpha-blocker monotherapy. Inclusion criteria were men with BPH who had PV ≧30 ml and international prostate symptom score (IPSS) ≧8 or quality of life (QOL) index ≧3 under alpha-blocker monotherapy for more than 3 months. At the baseline, 12 and 24 weeks after dutasteride add-on, we assessed IPSS, overactive bladder symptom score (OABSS), PV, serum PSA and testosterone. Among 47 patients (65%) with OAB diagnosed by OABSS, responders were defined as those with urgency score of OABSS <2 or total score of OABSS <3. At the 24th week, dutasteride significantly improved IPSS (-4.2) and OABSS (-1.9) and reduced PV (-29%) compared with the baseline. Furthermore, dutasteride significantly decreased serum PSA (-45%) and increased testosterone (36%). Among OAB patients, dutasteride significantly improved urgency and urgency incontinence but not nocturia. Responders had lower OABSS, urgency incontinence score and serum testosterone at the baseline than non-responders. In conclusion, dutasteride add-on therapy is beneficial in patients with BPH who do not show enough improvement with alpha-blocker monotherapy.

  7. Numerical Algorithm for Delta of Asian Option.

    PubMed

    Zhang, Boxiang; Yu, Yang; Wang, Weiguo

    2015-01-01

    We study the numerical solution of the Greeks of Asian options. In particular, we derive a close form solution of Δ of Asian geometric option and use this analytical form as a control to numerically calculate Δ of Asian arithmetic option, which is known to have no explicit close form solution. We implement our proposed numerical method and compare the standard error with other classical variance reduction methods. Our method provides an efficient solution to the hedging strategy with Asian options.

  8. 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

  9. A Review of the Tawny Crazy Ant, Nylanderia fulva, an Emergent Ant Invader in the Southern United States: Is Biological Control a Feasible Management Option?

    PubMed Central

    Wang, Zinan; Moshman, Lori; Kraus, Emily C.; Wilson, Blake E.; Acharya, Namoona; Diaz, Rodrigo

    2016-01-01

    The tawny crazy ant, Nylanderia fulva (Mayr) (Hymenoptera: Formicidae), has invaded states of the U.S. including Texas, Louisiana, Mississippi, Alabama, Florida, and Georgia. Native to South America, N. fulva is considered a pest in the U.S. capable of annoying homeowners and farmers, as well as displacing native ant species. As it continues to expand its range, there is a growing need to develop novel management techniques to control the pest and prevent further spread. Current management efforts rely heavily on chemical control, but these methods have not been successful. A review of the biology, taxonomy, ecology, and distribution of N. fulva, including discussion of ecological and economic consequences of this invasive species, is presented. Options for future management are suggested focusing on biological control, including parasitoid flies in the genus Pseudacteon, the microsporidian parasite Myrmecomorba nylanderiae, and a novel polynucleotide virus as potential biological control agents. We suggest further investigation of natural enemies present in the adventive range, as well as foreign exploration undertaken in the native range including Paraguay, Brazil, and Argentina. We conclude that N. fulva may be a suitable candidate for biological control. PMID:27983690

  10. 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...

  11. 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.

  12. 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.

  13. Field Collection Methods for an EPA Pilot Study Evaluating Personal, Housing, and Community Factors Influencing Children’s Potential Exposures to Indoor Contaminants at Various Lifestages (EPA Pilot Study Add-On to the GreenHousing Study)

    EPA Science Inventory

    This compilation of field collection standard operating procedures (SOPs) was assembled for the U.S. Environmental Protection Agency’s (EPA) Pilot Study add-on to the Green Housing Study (GHS). A detailed description of this add-on study can be found in the peer reviewed research...

  14. Making real options really work.

    PubMed

    van Putten, Alexander B; MacMillan, Ian C

    2004-12-01

    As a way to value growth opportunities, real options have had a difficult time catching on with managers. Many CFOs believe the method ensures the overvaluation of risky projects. This concern is legitimate, but abandoning real options as a valuation model isn't the solution. Companies that rely solely on discounted cash flow (DCF) analysis underestimate the value of their projects and may fail to invest enough in uncertain but highly promising opportunities. CFOs need not--and should not--choose one approach over the other. Far from being a replacement for DCF analysis, real options are an essential complement, and a project's total value should encompass both. DCF captures a base estimate of value; real options take into account the potential for big gains. This is not to say that there aren't problems with real options. As currently applied, they focus almost exclusively on the risks associated with revenues, ignoring the risks associated with a project's costs. It's also true that option valuations almost always ignore assets that an initial investment in a subsequently abandoned project will often leave the company. In this article, the authors present a simple formula for combining DCF and option valuations that addresses these two problems. Using an integrated approach, managers will, in the long run, select better projects than their more timid competitors while keeping risk under control. Thus, they will outperform their rivals in both the product and the capital markets.

  15. 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.

  16. Reduced self-control leads to disregard of an unfamiliar behavioral option: an experimental approach to the study of neuroenhancement

    PubMed Central

    2013-01-01

    Background Neuroenhancement (NE), the use of psychoactive substances in order to enhance a healthy individual’s cognitive functioning from a proficient to an even higher level, is prevalent in student populations. According to the strength model of self-control, people fail to self-regulate and fall back on their dominant behavioral response when finite self-control resources are depleted. An experiment was conducted to test the hypothesis that ego-depletion will prevent students who are unfamiliar with NE from trying it. Findings 130 undergraduates, who denied having tried NE before (43% female, mean age = 22.76 ± 4.15 years old), were randomly assigned to either an ego-depletion or a control condition. The dependent variable was taking an “energy-stick” (a legal nutritional supplement, containing low doses of caffeine, taurine and vitamin B), offered as a potential means of enhancing performance on the bogus concentration task that followed. Logistic regression analysis showed that ego-depleted participants were three times less likely to take the substance, OR = 0.37, p = .01. Conclusion This experiment found that trying NE for the first time was more likely if an individual’s cognitive capacities were not depleted. This means that mental exhaustion is not predictive for NE in students for whom NE is not the dominant response. Trying NE for the first time is therefore more likely to occur as a thoughtful attempt at self-regulation than as an automatic behavioral response in stressful situations. We therefore recommend targeting interventions at this inter-individual difference. Students without previous reinforcing NE experience should be provided with information about the possible negative health outcomes of NE. Reconfiguring structural aspects in the academic environment (e.g. lessening workloads) might help to deter current users. PMID:24314053

  17. 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

  18. TOPEX satellite option study

    NASA Technical Reports Server (NTRS)

    1982-01-01

    The basic design of the fleet satellite communication spacecraft (FLTSATCOM) can easily accommodate any of the three payload options for the ocean dynamic topography experiment (TOPEX). The principal mission requirements as well as the payload accommodations and communications systems needed for launching this payload are reviewed. The existing FLTSATCOM satellite design is identified and the approaches for the proposed propulsion system are described in addition to subsystems for mechanical; power; attitude and velocity control; and telemetry, tracking and control are described. The compatability of FLTSATCOM with the launch vehicle is examined and its capabilities vs TOPEX requirements are summarized. Undetermined changes needed to meet data storage, thermal control, and area to mass ratio requirements are discussed. Cost estimates are included for budgetary and planning purposes. The availability of the described design is assessed based on the continuing production of FLTSATCOM spacecraft during the schedule span planned for TOPEX.

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. Antianginal Efficacy and Tolerability of Ranolazine as an Add-on Drug to Concomitant Medications Primarily Metoprolol in Chronic Stable Angina Patients: A Prospective, Open-Label Study

    PubMed Central

    Khot, Anant Mahaveer; Anuradha, H. V.; Prakash, V. S.; Shivamurathy, M. C.

    2017-01-01

    Objective: To evaluate the efficacy and tolerability of ranolazine as an add-on drug in chronic stable angina patients and the impact of ranolazine on the quality of life in chronic stable angina patients receiving other antianginal medications. Materials and Methods: It was a prospective, open-label, hospital-based study involving 144 patients with chronic stable angina. First group received either metoprolol 12.5 or 25 mg/day or other antianginal medications; if the symptoms persist, the dose of metoprolol was increased to 50 mg/day, and to the second group, ranolazine 500 mg BD or 1 g OD was added along with metoprolol or others if the anginal attacks were not subsiding. The patients were followed up to 6 months with electrocardiography, treadmill test, and quality of life questionnaire. Adverse events were recorded at each visit during the study. Results: There was a statistically significant reduction in weekly anginal frequency (P < 0.001) and improvement in an exercise tolerance in both the groups, but more in the ranolazine group. Adverse events reported were mild, infrequent. Conclusion: Ranolazine is could be used as an add-on drug in chronic angina patients not improved with metoprolol or antianginal medications.

  4. 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

  5. Donepezil as add-on treatment of psychotic symptoms in patients with dementia of the Alzheimer's type.

    PubMed

    Bergman, Joseph; Brettholz, Izidor; Shneidman, Michael; Lerner, Vladimir

    2003-01-01

    -label study and there is need for larger studies with double-blind control and a long-term study design to define the efficacy of donepezil for patients with AD and psychotic symptoms.

  6. Add-on bevacizumab can prevent early clinical deterioration and prolong survival in newly diagnosed partially resected glioblastoma patients with a poor performance status

    PubMed Central

    Hata, Nobuhiro; Yoshimoto, Koji; Hatae, Ryusuke; Kuga, Daisuke; Akagi, Yojiro; Sangatsuda, Yuhei; Suzuki, Satoshi O; Shono, Tadahisa; Mizoguchi, Masahiro; Iihara, Koji

    2017-01-01

    Purpose The AVAglio trial established the beneficial effect of add-on bevacizumab (BEV) for the treatment of newly diagnosed glioblastomas (nd-GBMs) that led to the approval of BEV for the treatment of these patients in Japan. However, the rationality of using BEV as a first-line treatment for nd-GBMs remains controversial. The purpose of this study was to analyze the outcomes of a case series of nd-GBM patients. Patients and methods The outcomes of 69 nd-GBM patients treated after 2006 were retrospectively analyzed. Clinical and genetic analyses were performed, and estimates of progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan–Meier method. Since add-on BEV therapy was only used for partially resected GBMs (pr-GBMs) after its approval in 2013, the patients were subdivided into 3 treatment groups: Type I, partial removal with temozolomide (TMZ)/BEV and concurrent radiotherapy (CCRT); Type II, partial removal with TMZ and CCRT; and Type III, gross total removal with TMZ and CCRT. Results The PFS rate of Type I patients was significantly higher than that of Type II patients (P=0.014), but comparable to that of Type III patients. Differences in OS rates between Type I and Type II patients were less apparent (P=0.075), although the median OS of Type I patients was ~8 months higher than that of Type II patients (17.4 vs 9.8 months, respectively). The clinical deterioration rate during initial treatment was significantly (P=0.024) lower in Type I than in Type II patients (7.7% vs 47.4%, respectively). Differences in OS rates between Type I and Type II patients with a poor performance status (PS) were significant (P=0.017). Conclusion Our findings suggest that add-on BEV can prevent early clinical deterioration of pr-GBM patients and contribute to a prolonged survival, especially for those with a poor PS. PMID:28176936

  7. 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

  8. 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.

  9. Seizure control in Unverricht-Lundborg disease: a single-centre study.

    PubMed

    Roivainen, Reina; Karvonen, Matti K; Puumala, Tarja

    2014-06-01

    New antiepileptic drug (AED) options for generalised seizure types have been adopted for use as treatment for Unverricht-Lundborg disease. Whether this has led to improved seizure control or functional outcome in ULD patients remains obscure. We retrospectively identified all patients seen at Helsinki University Hospital due to Unverricht-Lundborg disease during 2003-2008 in order to determine which AED treatments had been retained for long-term use. The majority of the patients had severe functional disabilities. In the year preceding the last hospital visit, all patients (n=20) were receiving polytherapy and 14 patients had been free of tonic-clonic seizures. During follow-up, improvement in myoclonia had been recorded for the majority of patients with either add-on piracetam, topiramate, or levetiracetam, but valproate was still in use by all patients. Treatment with lamotrigine had been started and retained less often relative to other AEDs. Add-on AED treatment was often associated with significant adverse effects. Unverricht-Lundborg disease patients may benefit from add-on treatment with levetiracetam or topiramate for seizure control. Treatment of eventual comorbidities with other than AEDs is also discussed.

  10. 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

  11. 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.

  12. 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

  13. The Role of the Pharmacist in Managing Type 2 Diabetes with Glucagon-Like Peptide-1 Receptor Agonists as Add-On Therapy.

    PubMed

    Meece, Jerry

    2017-02-16

    The prevalence and associated clinical burden of type 2 diabetes (T2D) is increasing in the USA and other countries. As a consequence, the role of the pharmacist in managing T2D is expanding, and it is becoming increasingly important for pharmacists to have a complete understanding of the disease course and treatment options. Pharmacists have a key role in the use of injectable therapies, including incretin-based treatment with glucagon-like peptide-1 receptor agonists (GLP-1RAs). This article discusses the role of the pharmacist in the management of patients with T2D, particularly with respect to the use of GLP-1RAs to achieve glycemic control. GLP-1RAs are a class of injectable agents used as an adjunct to diet and exercise to improve glycemic control in adults with T2D. GLP-1RAs have been shown to lower glucose levels, slow gastric emptying, enhance satiety, and reduce body weight without increasing the risk of hypoglycemia. GLP-1RAs currently approved in the USA include exenatide twice daily, liraglutide once daily, and albiglutide, dulaglutide, and exenatide once weekly. Pharmacists can work with physicians to help identify patients for whom GLP-1RA therapy is appropriate. In addition, pharmacists can educate patients regarding medication storage, preparation, and injection techniques, glycated hemoglobin (HbA1c) targets, pre- and post-meal blood glucose goals, adverse events and management strategies, and the long-term benefits of reducing HbA1c. As members of the diabetes care team, pharmacists play an important role in improving patient outcomes.

  14. Pediatric Glaucoma: Pharmacotherapeutic Options.

    PubMed

    Samant, Monica; Medsinge, Anagha; Nischal, Ken K

    2016-06-01

    Childhood glaucoma is a major therapeutic challenge for pediatric ophthalmologists and glaucoma specialists worldwide. Management depends on the etiology and age at presentation. A variety of drugs are available for the control of intraocular pressure in children; however, none of these drugs have been licensed by the regulatory agencies for use in children. Furthermore, evidence gained from randomized controlled trials in the pediatric population is sparse, and little is known regarding the use of newer anti-glaucoma preparations. This evidence-based review aims to discuss the available pharmacotherapeutic options for glaucoma in children. Topical adrenoceptor blockers, topical and systemic carbonic anhydrase inhibitors, prostaglandin (PG) analogs, adrenoceptor agonists, parasympathomimetics, and combined preparations are available for use in children, but usually as an off-label indication. Therefore, it is important to recognize that serious side effects have been reported, even with topical drops, and measures to reduce systemic absorption should be taken. Most drugs have been shown to have comparable ocular hypotensive effects, with the lowest occurrence of systemic side effects with PG analogs. Whereas a newly introduced prostaglandin analog, tafluprost, and some other preservative-free preparations have shown promising results in adult glaucoma patients, no pediatric reports are available as yet. Future studies may describe their role in treating pediatric glaucoma. This review also shares some suggested treatment pathways for primary congenital glaucoma (PCG), juvenile open angle glaucoma (JOAG), developmental glaucoma, aphakic/pseudophakic glaucoma, and uveitic glaucoma.

  15. 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.

  16. 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

  17. 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

    .... The average gas volumetric flow rate or duct static pressure in each duct between a capture device and... or duct static pressure limit established for that capture device according to § 63.5725(f)(5); and b.... Collecting the gas volumetric flow rate or duct static pressure for each capture device according to §...

  18. 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

    ....5719(b) a. The average gas volumetric flow rate or duct static pressure in each duct between a capture... flow rate or duct static pressure limit established for that capture device according to § 63.5725(f)(5...)(5) i. Collecting the gas volumetric flow rate or duct static pressure for each capture...

  19. 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

    ....5719(b) a. The average gas volumetric flow rate or duct static pressure in each duct between a capture... flow rate or duct static pressure limit established for that capture device according to § 63.5725(f)(5...)(5) i. Collecting the gas volumetric flow rate or duct static pressure for each capture...

  20. 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

    .... The average gas volumetric flow rate or duct static pressure in each duct between a capture device and... or duct static pressure limit established for that capture device according to § 63.5725(f)(5); and b.... Collecting the gas volumetric flow rate or duct static pressure for each capture device according to §...

  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, 2010 CFR

    2010-07-01

    ... organic compounds as carbon in the vent gas, as determined by Method 25 or Method 25A, ppmvd. Qsd... volume, kg-moles per cubic meter (mol/m3) (@ 293 Kelvin (K) and 760 millimeters of mercury (mmHg))....

  2. 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

    ... 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 the... the catalyst bed and the average temperature difference across the catalyst bed maintained during...

  3. 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

    ... just before the catalyst bed and the temperature difference across the catalyst bed at least once every... to calculate and record the average temperature just before the catalyst bed and the average temperature difference across the catalyst bed maintained during the performance test. These are the...

  4. 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

    ... 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 the... the catalyst bed and the average temperature difference across the catalyst bed maintained during...

  5. 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

    ... 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...

  6. 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

    ... 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 the data collected during the performance test to calculate and record the average temperature just before the catalyst...

  7. 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

    ... must monitor and record the temperature 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 the data... catalyst bed maintained during the performance test. This is the minimum operating limit for your...

  8. 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

    ... 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...

  9. 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

    ... at the inlet to the catalyst bed and the temperature difference across the catalyst bed at least once... test to calculate and record the average temperature at the inlet to the catalyst bed and the average temperature difference across the catalyst bed maintained during the performance test. The average...

  10. 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

    ... just before the catalyst bed and the temperature difference across the catalyst bed at least once every... to calculate and record the average temperature just before the catalyst bed and the average temperature difference across the catalyst bed maintained during the performance test. These are the...

  11. 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...

  12. 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...

  13. 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

    ... monitor and record the temperature 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 the data collected... catalyst bed maintained during the performance test. This is the minimum operating limit for your...

  14. 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

    ... 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 runs. (2) Use the data collected during the performance test to calculate and record the average temperature at the inlet to the...

  15. 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

    ... 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...

  16. 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

    ... 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 runs. (2) Use the data collected during the performance test to calculate and record the average temperature at the inlet to the...

  17. 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

    ... performance test, you must monitor and record the temperature 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... difference across the catalyst bed maintained during the performance test. This is the minimum...

  18. 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

    ... 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...

  19. 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

    ... 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...

  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, 2010 CFR

    2010-07-01

    ... 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 runs. (2) Use the data... catalyst bed and the average temperature difference across the catalyst bed maintained during...

  1. 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

    ... 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 the data collected during the performance test to calculate and record the average temperature just before the catalyst...

  2. 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

    ... the 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... temperature just before the catalyst bed and the average temperature difference across the catalyst...

  3. 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

    ... the 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... temperature just before the catalyst bed and the average temperature difference across the catalyst...

  4. 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

    ... 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...

  5. 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

    ... 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 runs. (2) Use the data... catalyst bed and the average temperature difference across the catalyst bed maintained during...

  6. 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

    ... 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 the data collected during the performance test to calculate and record the average temperature just before the catalyst...

  7. 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

    ... 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...

  8. 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...

  9. 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

    ... the 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... temperature just before the catalyst bed and the average temperature difference across the catalyst...

  10. 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...

  11. 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 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 runs. (2) Use the... to the catalyst bed and the average temperature difference across the catalyst bed maintained...

  12. 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

    ... 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 the data collected during the performance test to calculate and record the average temperature just before the catalyst...

  13. 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

    ... 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 the data collected during the performance test to calculate and record the average temperature just before the catalyst...

  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, 2011 CFR

    2011-07-01

    ... 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 the data collected during the performance test to calculate and record the average temperature just before the catalyst...

  15. 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

    ... 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 the data collected during the performance test to calculate and record the average temperature just before the catalyst...

  16. 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...

  17. 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

    ... 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 runs. (2) Use the data collected during the performance test to calculate and record the average temperature at the inlet to the...

  18. 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

    ... at the inlet to the catalyst bed and the temperature difference across the catalyst bed at least once... test to calculate and record the average temperature at the inlet to the catalyst bed and the average temperature difference across the catalyst bed maintained during the performance test. The average...

  19. 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

    ... 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...

  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, 2013 CFR

    2013-07-01

    ... 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 runs. (2) Use the data... catalyst bed and the average temperature difference across the catalyst bed maintained during...

  1. 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

    ... performance test, you must monitor and record the temperature 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... difference across the catalyst bed maintained during the performance test. This is the minimum...

  2. 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

    ... the 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... temperature just before the catalyst bed and the average temperature difference across the catalyst...

  3. 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

    ... just before the catalyst bed and the temperature difference across the catalyst bed at least once every... to calculate and record the average temperature just before the catalyst bed and the average temperature difference across the catalyst bed maintained during the performance test. These are the...

  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, 2010 CFR

    2010-07-01

    ... 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 the data collected during the performance test to calculate and record the average temperature just before the catalyst...

  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

    ... just before the catalyst bed and the temperature difference across the catalyst bed at least once every... to calculate and record the average temperature just before the catalyst bed and the average temperature difference across the catalyst bed maintained during the performance test. These are the...

  6. 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

    ... the 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... temperature just before the catalyst bed and the average temperature difference across the catalyst...

  7. 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 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 runs. (2) Use the... to the catalyst bed and the average temperature difference across the catalyst bed maintained...

  8. 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

    ... just before the catalyst bed and the temperature difference across the catalyst bed at least once every... to calculate and record the average temperature just before the catalyst bed and the average temperature difference across the catalyst bed maintained during the performance test. These are the...

  9. 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

    ... 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 the... the catalyst bed and the average temperature difference across the catalyst bed maintained during...

  10. 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

    ... 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 the... the catalyst bed and the average temperature difference across the catalyst bed maintained during...

  11. 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

    ... monitor and record the temperature 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 the data collected... catalyst bed maintained during the performance test. This is the minimum operating limit for your...

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. Objective and subjective sleep quality: Melatonin versus placebo add-on treatment in patients with schizophrenia or bipolar disorder withdrawing from long-term benzodiazepine use.

    PubMed

    Baandrup, Lone; Glenthøj, Birte Yding; Jennum, Poul Jørgen

    2016-06-30

    Benzodiazepines are frequently long-term prescribed for the treatment of patients with severe mental illness. This prescribing practice is problematic because of well-described side effects including risk of dependence. We examined the efficacy of prolonged-release melatonin on objective and subjective sleep quality during benzodiazepine discontinuation and whether sleep variables were associated with benzodiazepine withdrawal. Eligible patients included adults with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder and long-term use of benzodiazepines in combination with antipsychotics. All participants gradually tapered the use of benzodiazepines after randomization to add-on treatment with melatonin versus placebo. Here we report a subsample of 23 patients undergoing sleep recordings (one-night polysomnography) and 55 patients participating in subjective sleep quality ratings. Melatonin had no effect on objective sleep efficiency, but significantly improved self-reported sleep quality. Reduced benzodiazepine dosage at the 24-week follow-up was associated with a significantly decreased proportion of stage 2 sleep. These results indicate that prolonged-release melatonin has some efficacy for self-reported sleep quality after gradual benzodiazepine dose reduction, and that benzodiazepine discontinuation is not associated with rebound insomnia in medicated patients with severe mental illness. However, these findings were limited by a small sample size and a low retention rate.

  17. Clobetasol propionate spray 0.05% add-on therapy to a stable regimen of biologic treatment in patients with moderate to very severe plaque psoriasis.

    PubMed

    Feldman, Steven R; Koo, John Y M; Johnson, Lori A; Preston, Norman J

    2009-10-01

    0.05%). Because those participants who entered the study already were receiving one medication (the biologic agent), it is believed that most of the reported AEs were due to the addition of clobetasol propionate spray 0.05%, and those AEs associated with the biologic agent and/or the combination of the two may be underreported. Although the results of this study are intriguing, further research is needed to evaluate if the addition of topical therapies, such as superpotent corticosteroids, are effective and safe options for treating psoriasis plaques when control with biologic therapy is not fully effective on its own.

  18. Treatment Options Summary

    MedlinePlus

    ... imaging Typical Advantages of Microsurgery over Radiation Typical Advantages of Microsurgery over Radiation Surgery removes the tumor ... area. Typical Advantages of Radiation over Microsurgery Typical Advantages of Radiation over Microsurgery Good option for patients ...

  19. Life Options Rehabilitation Program

    MedlinePlus

    ... at our CE credit website . Free Life Options Materials Download our free print materials, research-based fact ... sheets are also available in Spanish! Vaccination Education Materials Easy-to-read patient education fact sheets will ...

  20. 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

  1. Superior antidepressant effect occurring 1 month after rTMS: add-on rTMS for subjects with medication-resistant depression

    PubMed Central

    Chen, Shaw-Ji; Chang, Chung-Hung; Tsai, Hsin-Chi; Chen, Shao-Tsu; Lin, Chaucer CH

    2013-01-01

    Depression is a major psychiatric disorder. The standard treatment for depression is antidepressant medication, but the responses to antidepressant treatment are only partial, even poor, among 30%–45% of patients. Refractory depression is defined as depression that does not respond to antidepressant therapy after 4 weeks of use. There is evidence that repetitive transcranial magnetic stimulation (rTMS) may exert effects in treating psychiatric disorder through moderating focal neuronal functions. High-frequency rTMS on the left prefrontal area and low-frequency rTMS on the right prefrontal area were shown to be effective in alleviating depressive symptoms. Given the statistically significant antidepressant effectiveness noted, the clinical application of rTMS as a depression treatment warrants further studies. Application of rTMS as an add-on therapy would be a practical research model. High-frequency (5–20 Hz) rTMS over the left dorsolateral prefrontal cortex was found to have a significant effect on medication-resistant depression. In the present study, we not only measured the acute antidepressant effect of rTMS during treatment and immediately after its completion but also evaluated participants 1 month after completion of the treatment protocol. Study participants were divided into two groups: an active rTMS group (n = 10) and a sham group (n = 10). The active rTMS group was defined as participants who received the rTMS protocol, and the sham group was defined as participants who received a sham rTMS procedure. A significant Hamilton Depression Rating Scale score reduction was observed in both groups after the fifth and tenth treatments. However, those in the active rTMS group maintained their improvement as measured one month after completion of the rTMS protocol. Participants who received active rTMS were more likely to have persistent improvement in depression scores than participants who received sham rTMS. PMID:23576870

  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. Options for fuel management

    SciTech Connect

    Reardon, L.D. Jr.; Chance, R.C.

    1996-12-31

    The key to cofiring wood or other biomass with coal in existing power stations is fuel management. Fuel management includes the procurement, receiving, processing, storage, and blending of the biomass with coal. Procurement options may include the purchase of lower cost biomass fuels, receipt of subsidies to make capital modifications to cofire biomass {open_quotes}waste{close_quotes} fuels or receive tipping fees where biomass waste disposal options for a particular area are expensive. Biomass receiving options include delivery methods, unloading, measurement, and inspection. Processing options are associated with screen types, drying systems, final particle size required, and associated questions of fuel supply reliability. Issues include the ability of the coal yard to accept this processing operation, handling convenience, traffic patterns, staffing requirements, and ultimately the cost of fuel at the burner. Issues associated with storage include locating the facility, managing dust, managing moisture pick-up, and managing runoff. Blending options include pre-blending or designing a system to blend the fuels as they are transported from the coal yard to the bunkers. This paper reviews the major decisions that have to be made, and discusses some of the options available. It draws upon existing experience in cofiring systems to achieve a low cost, high reliability system to use biomass at coal-fired electricity generating stations.

  4. 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

  5. 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

  6. Expanding contraceptive options.

    PubMed

    1989-01-01

    The goals of Family Health International (FHI) have been to introduce a variety of birth control options to people in developing countries, and to provide information to the user on the advantages and disadvantages of each method. FHI has worked with many developing countries in clinical trials of established as well as new contraceptive methods. These trials played an important part in making 2 sterilization procedures, laparoscopy and minilaparotomy popular for women. Further research improved the methods and have made them the most popular in the world, chosen by 130 million users. FHI is doing clinical trials on a new IUD, that is a copper bearing T-shaped device called the TCu380A. they have collected data on over 10,000 women using IUD's and early analysis indicates TCu380A is more effective than others. FHI is also evaluating devices such as Norplant that will prevent pregnancy up to 5 years by implanting the capsules in the arm. More than 8,000 women are being tested to determine the acceptability of implants in different geographical locations. Other research groups are doing work in 10 additional countries: Bangladesh will expand its program to 24,000 women and Nepal to 8,000 women. Trials are also being conducted on progestogen pills, since they do not lesson the volume of milk in breast feeding. FHI has also worked to introduce creative community-based distribution channels. In one case, specially trained health workers delivered contraceptives door-to-door in over 150,000 households. They found that 2 of 3 women accepted the pills and in a follow up survey 90% were still using them. FHI is now focusing on ways to improve moving new contraceptives from clinical testing on everyday use. They will coordinate training programs, educational material, media campaigns, and efforts with other international organizations, government agencies, and family planning groups.

  7. 17 CFR 32.13 - Exemption from prohibition of commodity option transactions for trade options on certain...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... trade option merchant's internal controls with respect to market risk, credit risk, and other risks... disclosure statement: This brief statement does not disclose all of the risks and other significant aspects... from sources other than the person selling you this option about the use and risks of option...

  8. A systematic review and meta-analysis of the evidence base for add-on treatment for patients with major depressive disorder who have not responded to antidepressant treatment: a European perspective.

    PubMed

    Turner, Pauline; Kantaria, Rakesh; Young, Allan H

    2014-02-01

    Previous comparative reviews of add-on therapies for patients with major depressive disorder (MDD) with an inadequate response to antidepressants have not used meta-analytic techniques to compare different drug classes and have included non-licensed therapies. This meta-analysis reviewed all published peer-reviewed evidence for the efficacy of EU-licensed therapies in patients with MDD and an inadequate response to antidepressant monotherapy. Papers concerning randomized clinical trials (RCTs) were identified using criteria from the Cochrane Handbook for Systematic Reviews of Interventions. Add-on therapies reviewed were antidepressants, quetiapine XR, lithium, and S-adenosyl-l-methionine (SAMe). Seven RCTs that reported response and remission in a way that allowed quantitative analysis were included in this meta-analysis. Comparison of the different drug classes indicated that most interventions had similar efficacy. The likelihood of response was significantly greater with SAMe versus placebo and lithium and with quetiapine XR versus placebo. Most add-on interventions demonstrated comparable efficacy in patients with MDD and an inadequate response to initial antidepressants. However, there is currently a paucity of high-quality data regarding the use of add-on treatments in patients with MDD who are inadequate responders to antidepressants, with quetiapine XR presenting the most comprehensive evidence base to date.

  9. 20 CFR 416.2035 - Optional supplementation: Additional State options.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Optional supplementation: Additional State options. 416.2035 Section 416.2035 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2035 Optional supplementation: Additional State options. (a) Residency requirement. A State...

  10. 20 CFR 416.2035 - Optional supplementation: Additional State options.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Optional supplementation: Additional State options. 416.2035 Section 416.2035 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2035 Optional supplementation: Additional State options. (a) Residency requirement. A State...

  11. 20 CFR 416.2035 - Optional supplementation: Additional State options.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Optional supplementation: Additional State options. 416.2035 Section 416.2035 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2035 Optional supplementation: Additional State options. (a) Residency requirement. A State...

  12. 20 CFR 416.2035 - Optional supplementation: Additional State options.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Optional supplementation: Additional State options. 416.2035 Section 416.2035 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2035 Optional supplementation: Additional State options. (a) Residency requirement. A State...

  13. 20 CFR 416.2035 - Optional supplementation: Additional State options.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Optional supplementation: Additional State options. 416.2035 Section 416.2035 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2035 Optional supplementation: Additional State options. (a) Residency requirement. A State...

  14. Salvia officinalis (Sage) Leaf Extract as Add-on to Statin Therapy in Hypercholesterolemic Type 2 Diabetic Patients: a Randomized Clinical Trial

    PubMed Central

    Kianbakht, Saeed; Nabati, Farzaneh; Abasi, Behrooz

    2016-01-01

    The efficacy and safety of Salvia officinalis combined with statin have not been evaluated in dyslipidemic diabetes mellitus type 2 (DDMT2) so far. The plant extract antioxidant activity was determined by the DPPH radical scavenging assay. The total flavonoid, total phenolic and quercetin contents of the capsules containing the plant extract were also measured. Moreover, the effects of 2-month extract intake (500 mg capsule three times a day) as add-on to daily use of 15 mg glyburide, 2000 mg metformin and 10 mg atorvastatin on the blood levels of fasting glucose (FG), 2 h postprandial glucose (2hPPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride, high-density lipoprotein cholesterol (HDL-C), serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), creatinine and body mass index were studied in 50 patients and compared with the placebo group (n=50).The extract IC50 in the DPPH assay was 87.26±0.003 µg/mL (mean±SD), whereas the ascorbic acid IC50 was 5.626± 0.001 µg/mL (mean±SD). The total flavonoid, total phenolic and quercetin contents of the capsule containing the plant extract were 39.76±3.58 mg of rutin equivalents (mean±SD), 30.33±1.23 mg of gallic acid (mean±SD) and 0.13 mg, respectively. The extract lowered FG, 2hPPG, HbA1c, TC, LDL-C and triglyceride levels, but increased HDL-C level compared to the placebo at the endpoint (P<0.05). The extract did not affect the other parameters significantly and no adverse effect was reported. The extract has substantial antioxidant activity which may be beneficial for the prevention of the cardiovascular complications of DDMT2. Moreover, addition of the extract to statin therapy is apparently safe and further improves lipid profile. PMID:27942500

  15. Salvia officinalis (Sage) Leaf Extract as Add-on to Statin Therapy in Hypercholesterolemic Type 2 Diabetic Patients: a Randomized Clinical Trial.

    PubMed

    Kianbakht, Saeed; Nabati, Farzaneh; Abasi, Behrooz

    2016-01-01

    The efficacy and safety of Salvia officinalis combined with statin have not been evaluated in dyslipidemic diabetes mellitus type 2 (DDMT2) so far. The plant extract antioxidant activity was determined by the DPPH radical scavenging assay. The total flavonoid, total phenolic and quercetin contents of the capsules containing the plant extract were also measured. Moreover, the effects of 2-month extract intake (500 mg capsule three times a day) as add-on to daily use of 15 mg glyburide, 2000 mg metformin and 10 mg atorvastatin on the blood levels of fasting glucose (FG), 2 h postprandial glucose (2hPPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride, high-density lipoprotein cholesterol (HDL-C), serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), creatinine and body mass index were studied in 50 patients and compared with the placebo group (n=50).The extract IC50 in the DPPH assay was 87.26±0.003 µg/mL (mean±SD), whereas the ascorbic acid IC50 was 5.626± 0.001 µg/mL (mean±SD). The total flavonoid, total phenolic and quercetin contents of the capsule containing the plant extract were 39.76±3.58 mg of rutin equivalents (mean±SD), 30.33±1.23 mg of gallic acid (mean±SD) and 0.13 mg, respectively. The extract lowered FG, 2hPPG, HbA1c, TC, LDL-C and triglyceride levels, but increased HDL-C level compared to the placebo at the endpoint (P<0.05). The extract did not affect the other parameters significantly and no adverse effect was reported. The extract has substantial antioxidant activity which may be beneficial for the prevention of the cardiovascular complications of DDMT2. Moreover, addition of the extract to statin therapy is apparently safe and further improves lipid profile.

  16. 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.

  17. 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

  18. 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.

  19. 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…

  20. 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.

  1. 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…

  2. CFB repowering options

    SciTech Connect

    Gittinger, J.

    1996-12-31

    Circulating fluidized bed CFB repowering options are summarized. The following topics are discussed: why repower with CFB technology; advantages of repowering; two forms of of repowering; B and N`s internal recirculation CFB; space-saving design features; cost-saving design features; Ukrainian repowering project; and candidates for repowering.

  3. Option Y, Statistics.

    ERIC Educational Resources Information Center

    Singer, Arlene

    This guide outlines a one semester Option Y course, which has seven learner objectives. The course is designed to provide students with an introduction to the concerns and methods of statistics, and to equip them to deal with the many statistical matters of importance to society. Topics covered include graphs and charts, collection and…

  4. Exploring Career Options.

    ERIC Educational Resources Information Center

    Hellerman, Susan B., Ed.

    1994-01-01

    This newsletter theme issue offers advice to academically talented youth on exploring career options. It begins with an article titled "How To Think about Your Career When You Haven't Even Decided Where To Go to College." The article notes the hazards of early career choice and recognizes the career indecision often brought on by…

  5. Public health risks of enterobacterial isolates producing extended-spectrum β-lactamases or AmpC β-lactamases in food and food-producing animals: an EU perspective of epidemiology, analytical methods, risk factors, and control options.

    PubMed

    Liebana, Ernesto; Carattoli, Alessandra; Coque, Teresa M; Hasman, Henrik; Magiorakos, Anna-Pelagia; Mevius, Dik; Peixe, Luisa; Poirel, Laurent; Schuepbach-Regula, Gertraud; Torneke, Karolina; Torren-Edo, Jordi; Torres, Carmen; Threlfall, John

    2013-04-01

    The blaESBL and blaAmpC genes in Enterobacteriaceae are spread by plasmid-mediated integrons, insertion sequences, and transposons, some of which are homologous in bacteria from food animals, foods, and humans. These genes have been frequently identified in Escherichia coli and Salmonella from food animals, the most common being blaCTX-M-1, blaCTX-M-14, and blaCMY-2. Identification of risk factors for their occurrence in food animals is complex. In addition to generic antimicrobial use, cephalosporin usage is an important risk factor for selection and spread of these genes. Extensive international trade of animals is a further risk factor. There are no data on the effectiveness of individual control options in reducing public health risks. A highly effective option would be to stop or restrict cephalosporin usage in food animals. Decreasing total antimicrobial use is also of high priority. Implementation of measures to limit strain dissemination (increasing farm biosecurity, controls in animal trade, and other general postharvest controls) are also important.

  6. Evaluating technology service options.

    PubMed

    Blumberg, D F

    1997-05-01

    Four service and support options are available to healthcare organizations for maintaining their growth arsenals of medical and information technology. These options include maintaining and servicing all equipment using a facility-based biomedical engineering and MIS service department; using a combination of facility-based service and subcontracted service; expanding facility-based biomedical and MIS service departments to provide service to other healthcare organizations to achieve economies of scale; and outsourcing all maintenance, repair, and technical support services. Independent service companies and original equipment manufacturers (OEMs) are offering healthcare organizations a wider array of service and support capabilities than ever before. However, some health systems have successfully developed their own independent service organizations to take care of their own--and other healthcare organizations'--service and support needs.

  7. Osteoporosis: Therapeutic Options.

    PubMed

    Ivanova, Stefka; Vasileva, Liliya; Ivanova, Stanislava; Peikova, Lily; Obreshkova, Danka

    2015-01-01

    The definition of osteoporosis was originally formulated at a conference of the World Health Organization (WHO) in 1993 as 'a systemic skeletal disease characterized by decreased bone mass and altered micro-architecture of bone tissue, leading to enhanced bone fragility and risk of fractures'. Osteoporosis is characterized by low bone mineral density (BMD) and loss of the structural and bio-mechanical properties that are required to maintain bone homeostasis. This review aims to address the currently available options in prevention and treatment of osteoporosis. Management of osteoporosis includes non-pharmacological treatment - diet rich of calcium and vitamin D, healthy lifestyle, proper exercise plan, and pharmacological therapy. Combination of non-pharmacological and pharmacological treatment options have to be considered for prevention of osteoporosis and minimization of the risk of fractures. Given the heterogeneity of osteoporosis syndrome and lack of significant number of comparative studies, the choice of a pharmacological agents should be individualized.

  8. The Fusion Energy Option

    NASA Astrophysics Data System (ADS)

    Dean, Stephen O.

    2004-06-01

    Presentations from a Fusion Power Associates symposium, The Fusion Energy Option, are summarized. The topics include perspectives on fossil fuel reserves, fusion as a source for hydrogen production, status and plans for the development of inertial fusion, planning for the construction of the International Thermonuclear Experimental Reactor, status and promise of alternate approaches to fusion and the need for R&D now on fusion technologies.

  9. Transarterial embolization (TAE) as add-on to percutaneous radiofrequency ablation (RFA) for the treatment of renal tumors: Review of the literature, overview of state-of-the-art embolization materials and further perspective of advanced image-guided tumor ablation.

    PubMed

    Sommer, C M; Pallwein-Prettner, L; Vollherbst, D F; Seidel, R; Rieder, C; Radeleff, B A; Kauczor, H U; Wacker, F; Richter, G M; Bücker, A; Rodt, T; Massmann, A; Pereira, P L

    2017-01-01

    Percutaneous radiofrequency ablation (RFA) for the treatment of stage I renal cell carcinoma has recently gained significant attention as the now available long-term and controlled data demonstrate that RFA can result in disease-free and cancer-specific survival comparable with partial and/or radical nephrectomy. In the non-controlled single center trials, however, the rates of treatment failure vary. Operator experience and ablation technique may explain some of the different outcomes. In the controlled trials, a major limitation is the lack of adequate randomization. In case reports, original series and overview articles, transarterial embolization (TAE) before percutaneous RFA was promising to increase tumor control and to reduce complications. The purpose of this study was to systematically review the literature on TAE as add-on to percutaneous RFA for renal tumors. Specific data regarding technique, tumor and patient characteristics as well as technical, clinical and oncologic outcomes have been analyzed. Additionally, an overview of state-of-the-art embolization materials and the radiological perspective of advanced image-guided tumor ablation (TA) will be discussed. In conclusion, TAE as add-on to percutaneous RFA is feasible and very effective and safe for the treatment of T1a tumors in difficult locations and T1b tumors. Advanced radiological techniques and technologies such as microwave ablation, innovative embolization materials and software-based solutions are now available, or will be available in the near future, to reduce the limitations of bland RFA. Clinical implementation is extremely important for performing image-guided TA as a highly standardized effective procedure even in the most challenging cases of localized renal tumors.

  10. Neurocognitive performance, subjective well-being, and psychosocial functioning after benzodiazepine withdrawal in patients with schizophrenia or bipolar disorder: a randomized clinical trial of add-on melatonin versus placebo.

    PubMed

    Baandrup, Lone; Fagerlund, Birgitte; Glenthoj, Birte

    2017-03-01

    Chronic benzodiazepine use is common in patients with mental illness and is associated with cognitive impairment. It is unclear whether benzodiazepine-induced cognitive impairment is reversible. Amelioration of cognitive dysfunction may be facilitated during benzodiazepine tapering by add-on melatonin due to its anti-inflammatory and neuroprotective properties. We examined how melatonin and benzodiazepine withdrawal affect cognition, subjective well-being, and psychosocial functioning. Eighty patients with schizophrenia or bipolar disorder were randomized to add-on treatment once daily with either prolonged-release melatonin or placebo in a 24-week, double-blind clinical trial. All participants gradually tapered usual benzodiazepine dosage in a closely monitored treatment setting. We used the Brief Assessment of Cognition in Schizophrenia (BACS) to assess neurocognitive performance with additional assessments of subjective well-being and psychosocial functioning. BACS composite and subscale scores (except motor speed) significantly improved in parallel with benzodiazepine dose reduction, but there was no additional effect of melatonin. Cognitive performance was still markedly impaired post-tapering compared with normative data. Neither benzodiazepine withdrawal nor treatment group affected subjective well-being or psychosocial functioning. In conclusion, add-on melatonin does not seem to affect cognition, well-being, or psychosocial functioning in patients with severe mental illness. The observed improvement in cognitive performance could not be distinguished from retest effects, which may in turn have been facilitated by the benzodiazepine tapering.

  11. Option B+ in Mozambique: Formative Research Findings for the Design of a Facility-Level Clustered Randomized Controlled Trial to Improve ART Retention in Antenatal Care

    PubMed Central

    Napúa, Manuel; Chale, Falume; Hoek, Roxanne; Manuel, Joao; Michel, Cathy; Cowan, Jessica G.; Cowan, James F.; Gimbel, Sarah; Sherr, Kenneth; Gloyd, Stephen; Chapman, Rachel R.

    2016-01-01

    Introduction: With the rollout of “Option B+” in Mozambique in 2013, initial data indicated major challenges to early retention in antiretroviral therapy (ART) among HIV-positive pregnant women. We sought to develop and test a pilot intervention in 6 large public clinics in central Mozambique to improve retention of mothers starting ART in antenatal care. The results from the formative research from this study described here were used to design the intervention. Methods: The research was initiated in early 2013 and completed in early 2014 in each of the 6 study clinics and consisted of (1) patient flow mapping and measurement of retention through collection of health systems data from antenatal care registries, pharmacy registries, ART clinic databases, (2) workforce assessment and measurement of patient waiting times, and (3) patient and worker individual interviews and focus groups. Results: Coverage of HIV testing and ART initiation were over 90% at all sites, but retention at 30-, 60-, and 90-day pharmacy refill visits was very low ranging from only 5% at 1 site to 30% returning at 90 days. These data revealed major systemic bottlenecks that contributed to poor adherence and retention in the first month after ART initiation. Long wait times, short consultations, and poor counseling were identified as barriers. Conclusions: Based on these findings, we designed an intervention with these components: (1) workflow modification to redefine nurse tasks, shift tasks to community health workers, and enhance patient tracking and (2) an adherence and retention package to systematize active patient follow-up, ensure home visits by community health workers, use text messaging, and intensify counseling by health staff. This intervention is currently under evaluation using a stepped wedge design. PMID:27355507

  12. 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.

  13. Achilles tendinosis: treatment options.

    PubMed

    Lopez, Roberto Gabriel L; Jung, Hong-Geun

    2015-03-01

    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.

  14. 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

  15. Options for commercial tokamaks

    SciTech Connect

    Dabiri, A.E.; Keeton, D.C.; Thomson, S.L.

    1986-07-01

    Systems studies have been performed at the Fusion Engineering Design Center (FEDC) to assess commercial tokamak options. One study investigates the economics of high-beta operation and determines an optimum operating range of 10 to 20% beta, with a corresponding neutron wall loading of 6 to 8 MW/m/sup 2/. A second study determines conditions under which small, low-power tokamaks can be economically combined into a 1200-MW(electric) multiplex power plant. The results of these studies have directed future efforts at the FEDC toward a high-beta, tokamak design using a modular maintenance configuration.

  16. 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.

  17. 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.

  18. 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).

  19. The diet game. Weighing the options.

    PubMed Central

    Lemaire, D.

    1993-01-01

    As a major source of nutrition information for the public, physicians have a responsibility to assist their patients to make safe choices about weight loss programs. While most diet programs result in weight loss, the "quick fix" potentially is harmful. This article describes weight control options and their strengths and weaknesses. PMID:8471909

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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.

  5. Sodium–glucose cotransporter-2 inhibitor combination therapy to optimize glycemic control and tolerability in patients with type 2 diabetes: focus on dapagliflozin–metformin

    PubMed Central

    Schwartz, Stanley S; Katz, Arie

    2016-01-01

    In type 2 diabetes (T2D), early combination therapy using agents that target a number of the underlying pathophysiologic defects contributing to hyperglycemia may improve patient outcomes. For many patients, the combination of metformin with a sodium–glucose cotransporter-2 (SGLT-2) inhibitor may be a good option because these agents have complementary mechanisms of action, neutral-to-positive effects on body weight, and a low risk of hypoglycemia. This review focuses on the combination of metformin with dapagliflozin, a member of the SGLT-2 inhibitor class of antidiabetes agents. In clinical trials, the combination of dapagliflozin with metformin produced significant and sustained reductions in glycated hemoglobin and body weight in a broad range of adult patients with T2D, including those initiating pharmacotherapy and those with more advanced disease. These reductions were accompanied by modest decreases in blood pressure. Dapagliflozin as add-on therapy to metformin was well tolerated and associated with low rates of hypoglycemia. Genital infections and, in some studies, urinary tract infections were more frequent with dapagliflozin than with placebo. Early combination therapy with dapagliflozin and metformin may be a safe and appropriate treatment option that enables patients with T2D to achieve individualized glycemic goals as either initial combination therapy in treatment-naïve patients or as dapagliflozin add-on in patients inadequately controlled with metformin therapy. PMID:27042132

  6. Transferring control demands across incidental learning tasks - stronger sequence usage in serial reaction task after shortcut option in letter string checking.

    PubMed

    Gaschler, Robert; Marewski, Julian N; Wenke, Dorit; Frensch, Peter A

    2014-01-01

    After incidentally learning about a hidden regularity, participants can either continue to solve the task as instructed or, alternatively, apply a shortcut. Past research suggests that the amount of conflict implied by adopting a shortcut seems to bias the decision for vs. against continuing instruction-coherent task processing. We explored whether this decision might transfer from one incidental learning task to the next. Theories that conceptualize strategy change in incidental learning as a learning-plus-decision phenomenon suggest that high demands to adhere to instruction-coherent task processing in Task 1 will impede shortcut usage in Task 2, whereas low control demands will foster it. We sequentially applied two established incidental learning tasks differing in stimuli, responses and hidden regularity (the alphabet verification task followed by the serial reaction task, SRT). While some participants experienced a complete redundancy in the task material of the alphabet verification task (low demands to adhere to instructions), for others the redundancy was only partial. Thus, shortcut application would have led to errors (high demands to follow instructions). The low control demand condition showed the strongest usage of the fixed and repeating sequence of responses in the SRT. The transfer results are in line with the learning-plus-decision view of strategy change in incidental learning, rather than with resource theories of self-control.

  7. Why are simple control options for Toxocara vitulorum not being implemented by cattle and buffalo smallholder farmers in South-East Asia?

    PubMed

    Rast, Luzia; Toribio, Jenny-Ann L M L; Dhand, Navneet K; Khounsy, Syseng; Windsor, Peter A

    2014-02-01

    Toxocara vitulorum infection in large ruminants is endemic in many tropical countries and particularly in South-East Asia. A single treatment of calves with pyrantel at 14-21 days of age effectively controls the parasite. Despite this treatment being readily available, T. vitulorum infection remains common and widespread. To understand drivers of effective control of T. vitulorum infection, we examined treatment practices and knowledge of smallholder farmers of this parasite plus determined annual calf morbidity and mortality and identified potential risk factors for these estimates. Interviews were conducted with 273 smallholder farmers who had calves tested for T. vitulorum 4-6 months earlier. Reproductive rates of 0.6 and 0.4 calf per annum in cattle and buffalo respectively, and annual calf morbidity and mortality of 42.6% (CI 0.38-0.47) and 37.3% (CI 0.33-0.42) respectively, were identified. Interviewed farmers had either none (80.6%) or only minimal (19.4%) knowledge about T. vitulorum and only 2.5% of the farmers treated their calves for T. vitulorum using the recommended control regime. Multivariable logistic regression analyses with random effects showed that the number of adult cattle per household, T. vitulorum infection status of the household herd and farmer knowledge of T. vitulorum were significantly associated with calf morbidity and mortality. Financial analysis using partial budgeting showed a net benefit of USD 3.69, 7.46, 11.09 or 14.86 per calf when treating calves with pyrantel and attributing 25%, 50%, 75% or 100% of morbidity and mortality to T. vitulorum infection. The study identified that poor reproduction, high calf morbidity and mortality combined with very limited farmer knowledge and effective control of endemic Toxocariasis, contribute to suboptimal large ruminant production in mixed smallholder farming systems in South-East Asia. The large net benefit per calf achievable by a single pyrantel treatment should drive implementation of

  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. 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.

  10. 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.

  11. 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.

  12. Early amplification options.

    PubMed

    Gabbard, Sandra Abbott; Schryer, Jennifer

    2003-01-01

    Children with permanent hearing loss have been remediated with hearing amplification devices for decades. The influx of young infants identified with hearing loss through successful newborn hearing screening programs has established a need for amplification resources for infants within the first six months of life. For the approximately two of every 1000 infants born who are identified with bilateral hearing loss [Mehl and Thomson, 1998, Pediatrics 101, p. e4], the use of amplification is commonly the first step in treating the sequella of their loss. The use of hearing aids, combined with early intervention, has been shown to significantly improve the speech and language skills of young children with hearing loss [Yoshinaga-Itano, 2000, Seminars in Hearing 21, p. 309]. Speech and language delays have contributed to compromised academic performance of school aged children with hearing loss [Johnson et al., 1997, Educational Audiology Handbook, Singular Publishing, San Diego]. Most hard-of-hearing and deaf children use hearing aids and other assistive listening devices every day throughout their lifetime and the life expectancy of a hearing aid is only five to eight years. The current challenge for pediatric audiologists is selecting and evaluating the available amplification to provide the best options for children and their families. Amplification technology has seen an explosion in growth the past few years and the options continue to expand rapidly. This article examines currently available amplification technology and reviews the selection criteria that may be used for infants and young children. Issues such as style, type, amplification features, signal processing strategies, and verification and validation tools are also discussed.

  13. 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

  14. 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.

  15. 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…

  16. Option price and market instability

    NASA Astrophysics Data System (ADS)

    Baaquie, Belal E.; Yu, Miao

    2017-04-01

    An option pricing formula, for which the price of an option depends on both the value of the underlying security as well as the velocity of the security, has been proposed in Baaquie and Yang (2014). The FX (foreign exchange) options price was empirically studied in Baaquie et al., (2014), and it was found that the model in general provides an excellent fit for all strike prices with a fixed model parameters-unlike the Black-Scholes option price Hull and White (1987) that requires the empirically determined implied volatility surface to fit the option data. The option price proposed in Baaquie and Cao Yang (2014) did not fit the data during the crisis of 2007-2008. We make a hypothesis that the failure of the option price to fit data is an indication of the market's large deviation from its near equilibrium behavior due to the market's instability. Furthermore, our indicator of market's instability is shown to be more accurate than the option's observed volatility. The market prices of the FX option for various currencies are studied in the light of our hypothesis.

  17. Dose-Ranging Effects of Canagliflozin, a Sodium-Glucose Cotransporter 2 Inhibitor, as Add-On to Metformin in Subjects With Type 2 Diabetes

    PubMed Central

    Rosenstock, Julio; Aggarwal, Naresh; Polidori, David; Zhao, Yue; Arbit, Deborah; Usiskin, Keith; Capuano, George; Canovatchel, William

    2012-01-01

    OBJECTIVE To evaluate the effects of canagliflozin, a sodium-glucose cotransporter 2 inhibitor, in type 2 diabetes mellitus inadequately controlled with metformin monotherapy. RESEARCH DESIGN AND METHODS This was a double-blind, placebo-controlled, parallel-group, multicenter, dose-ranging study in 451 subjects randomized to canagliflozin 50, 100, 200, or 300 mg once daily (QD) or 300 mg twice daily (BID), sitagliptin 100 mg QD, or placebo. Primary end point was change in A1C from baseline through week 12. Secondary end points included change in fasting plasma glucose (FPG), body weight, and overnight urinary glucose-to-creatinine ratio. Safety and tolerability were also assessed. RESULTS Canagliflozin was associated with significant reductions in A1C from baseline (7.6–8.0%) to week 12: −0.79, −0.76, −0.70, −0.92, and −0.95% for canagliflozin 50, 100, 200, 300 mg QD and 300 mg BID, respectively, versus −0.22% for placebo (all P < 0.001) and −0.74% for sitagliptin. FPG was reduced by −16 to −27 mg/dL, and body weight was reduced by −2.3 to −3.4%, with significant increases in urinary glucose-to-creatinine ratio. Adverse events were transient, mild to moderate, and balanced across arms except for a non–dose-dependent increase in symptomatic genital infections with canagliflozin (3–8%) versus placebo and sitagliptin (2%). Urinary tract infections were reported without dose dependency in 3–9% of canagliflozin, 6% of placebo, and 2% of sitagliptin arms. Overall incidence of hypoglycemia was low. CONCLUSIONS Canagliflozin added onto metformin significantly improved glycemic control in type 2 diabetes and was associated with low incidence of hypoglycemia and significant weight loss. The safety/tolerability profile of canagliflozin was favorable except for increased frequency of genital infections in females. PMID:22492586

  18. 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

  19. 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…

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. Bounds for Asian basket options

    NASA Astrophysics Data System (ADS)

    Deelstra, Griselda; Diallo, Ibrahima; Vanmaele, Michèle

    2008-09-01

    In this paper we propose pricing bounds for European-style discrete arithmetic Asian basket options in a Black and Scholes framework. We start from methods used for basket options and Asian options. First, we use the general approach for deriving upper and lower bounds for stop-loss premia of sums of non-independent random variables as in Kaas et al. [Upper and lower bounds for sums of random variables, Insurance Math. Econom. 27 (2000) 151-168] or Dhaene et al. [The concept of comonotonicity in actuarial science and finance: theory, Insurance Math. Econom. 31(1) (2002) 3-33]. We generalize the methods in Deelstra et al. [Pricing of arithmetic basket options by conditioning, Insurance Math. Econom. 34 (2004) 55-57] and Vanmaele et al. [Bounds for the price of discrete sampled arithmetic Asian options, J. Comput. Appl. Math. 185(1) (2006) 51-90]. Afterwards we show how to derive an analytical closed-form expression for a lower bound in the non-comonotonic case. Finally, we derive upper bounds for Asian basket options by applying techniques as in Thompson [Fast narrow bounds on the value of Asian options, Working Paper, University of Cambridge, 1999] and Lord [Partially exact and bounded approximations for arithmetic Asian options, J. Comput. Finance 10 (2) (2006) 1-52]. Numerical results are included and on the basis of our numerical tests, we explain which method we recommend depending on moneyness and time-to-maturity.

  5. 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…

  6. Low-dose add-on memantine treatment may improve cognitive performance and self-reported health conditions in opioid-dependent patients undergoing methadone-maintenance-therapy

    PubMed Central

    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

  7. 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.

  8. 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.

  9. 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

  10. Emerging therapeutic options for asthma.

    PubMed

    Colice, Gene L

    2011-04-01

    Asthma is characterized by eosinophilic airway inflammation and elevated serum immunoglobulin E (IgE) levels. Due to these pathologic features, the foundation of asthma treatment has historically been anti-inflammatory therapy with inhaled corticosteroids (ICSs). Numerous factors in addition to IgE and eosinophils, however, likely play important roles in mediating the airway inflammatory response characteristic of asthma. ICSs are effective therapy for some patients with persistent asthma, but clinical trials have shown that even increasing doses of ICSs under carefully controlled situations does not always result in acceptable asthma control. Consequently, other classes of medications, in addition to ICSs, are recommended in those patients with more severe asthma. The class of medication most commonly used in more severe asthma, along with ICSs, is long-acting inhaled beta2-agonists, but leukotriene modifying agents and anti-IgE monoclonal antibodies may also be used. Agents such as tiotropium, a long-acting inhaled anti-muscarinic agent, and those aimed at inhibiting cytokines, such as mepoluzimab, daclizumab, and etanercept, hold promise in the treatment of asthma. Other agents under investigation include phosphodiesterase type 4 inhibitors and oligonucleotides. Bronchial thermoplasty, a nonpharmacologic option, may also be beneficial in patients with poorly controlled asthma. As our understanding of the complex pathophysiology of asthma increases, it will enable the development of novel therapeutic approaches for patients who are not responding well to traditional treatments. Although more studies are necessary to ensure the efficacy and safety of both pharmacologic and nonpharmacologic approaches, there is future promise for therapeutic advances in severe, persistent asthma.

  11. 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

  12. 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 ...

  13. 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...

  14. Option Generation Techniques for Command and Control.

    DTIC Science & Technology

    1983-01-01

    elted in Slock 20, it different from Repot) Same I$. SUPPLEMENTARY NOTES RADC Project Engineer: James R. Jecen (COAD) This effort was funded totally...beneficial in prompting the decision maker trainee , when he is stuck, to select and begin a next appropriate action, instructing him on the use of any...associated tool. It could also point out when the trainee is likely to suffer the effects of the various types of biases. For example, an evaluation tool

  15. 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.

  16. 48 CFR 552.217-71 - Notice Regarding Option(s).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Notice Regarding Option(s... Notice Regarding Option(s). As prescribed in 517.208(b), insert the following provision: Notice Regarding Option(s) (NOV 1992) The General Services Administration (GSA) has included an option to in order...

  17. 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.

  18. 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...

  19. Choosing the cooperative option

    SciTech Connect

    English, G. )

    1999-06-01

    Cooperatives do not ask to be exempted from the law. They do ask that laws and regulations be designed to allow them to meet the needs of their consumer-owners in accordance with cooperative principles, at a time that the marginal consumers being abandoned by for-profit utilities may be ready to gravitate toward cooperatives. The cooperative principles are worth reviewing because they explain the focus on the consumer and the cooperative concept of service: cooperatives are voluntary organizations, open to all persons able to use their services and willing to accept the responsibilities of membership; cooperatives are democratic organizations controlled by their members, who actively participate in setting policies and making decisions, the elected representatives are accountable to the membership; members contribute equitably to, and democratically control, the capital of their cooperative; cooperatives are autonomous, self-help organizations controlled by their members, if they enter into agreements with other organizations, including governments, they do so on terms that ensure democratic control by their members and maintain their cooperative autonomy; cooperatives provide education and training for their members, elected representatives, managers, and employees so they can contribute effectively to the development of their cooperatives, they inform the general public, particularly young people and opinion leaders, about the nature and benefits of cooperation; cooperatives serve their members most effectively and strength the cooperative movement by working together through local, national, regional, and international structures; and while focusing on member needs, cooperatives work for the sustainable development of their communities through policies accepted by their members.

  20. Options for Heart Valve Replacement

    MedlinePlus

    ... which may include human or animal donor tissue) Ross Procedure — “Borrowing” your healthy valve and moving it ... Considerations for Surgery Medications Valve Repair Valve Replacement - Ross Procedure - Newer Surgery Options - What is TAVR? - Types ...