Sample records for combination multiple baseline

  1. Treatment of Comorbid Attention-Deficit/Hyperactivity Disorder and Anxiety in Children : A Multiple Baseline Design Analysis

    ERIC Educational Resources Information Center

    Jarrett, Matthew A.; Ollendick, Thomas H.

    2012-01-01

    Objective: The present study evaluated a 10-week psychosocial treatment designed specifically for children with attention-deficit/hyperactivity disorder (ADHD) and a comorbid anxiety disorder. Method: Using a nonconcurrent multiple baseline design, the authors treated 8 children ages 8-12 with ADHD, combined type, and at least 1 of 3 major anxiety…

  2. The Effects of Task Clarification, Visual Prompts, and Graphic Feedback on Customer Greeting and Up-Selling in a Restaurant

    ERIC Educational Resources Information Center

    Squires, James; Wilder, David A.; Fixsen, Amanda; Hess, Erica; Rost, Kristen; Curran, Ryan; Zonneveld, Kimberly

    2007-01-01

    An intervention consisting of task clarification, visual prompts, and graphic feedback was evaluated to increase customer greeting and up-selling in a restaurant. A combination multiple baseline and reversal design was used to evaluate intervention effects. Although all interventions improved performance over baseline, the delivery of graphic…

  3. Effects of Verbal and Written Performance Feedback on Treatment Adherence: Practical Application of Two Delivery Formats

    ERIC Educational Resources Information Center

    Kaufman, Dahlia; Codding, Robin S.; Markus, Keith A.; Tryon, Georgiana Shick; Kyse, Eden Nagler

    2013-01-01

    Verbal and written performance feedback for improving preschool and kindergarten teachers' treatment integrity of behavior plans was compared using a combined multiple-baseline and multiple-treatment design across teacher-student dyads with order counterbalanced as within-series conditions. Supplemental generalized least square regression analyses…

  4. A Prospective Observational Comparison Between Arm and Wrist Blood Pressure During Scheduled Cesarean Delivery.

    PubMed

    Sebbag, Ilana; Massey, Simon R; Albert, Arianne Y K; Dube, Alison; Gunka, Vit; Douglas, M Joanne

    2015-09-01

    Shivering is common during cesarean delivery (CD) under neuraxial anesthesia and may disrupt the measurement of noninvasive blood pressure (BP). BP measured at the wrist may be less affected by shivering. There have been no studies comparing trends in BP measured on the upper arm and wrist. We hypothesized that wrist systolic blood pressure (sBP) would accurately trend with upper arm sBP measurements (agree within a limit of ±10%) in parturients undergoing elective CD under spinal anesthesia or combined spinal-epidural anesthesia. After initiation of spinal anesthesia, BP measurements were obtained simultaneously from the upper arm and wrist on opposite arms. The interval between measurements was 1 to 2 minutes, and data were collected for 20 minutes or until delivery. The primary outcome was agreement in dynamic changes in sBP measurements between the upper arm and the wrist. Bland-Altman plots indicating the levels of agreement between the methods were drawn for baseline measurements, over multiple measurements, and over multiple measurements on percentage change from baseline. Forty-nine patients were recruited and completed the study. The wrist sBP tended to overestimate the upper sBP for both baseline data (sBP bias = 13.4 mm Hg; 95% confidence interval = +10.4 to +16.4 mm Hg) and data obtained over multiple measurements (sBP bias = 12.8 mm Hg; 95% confidence interval = +9.3 to +16.3 mm Hg). For change in sBP from baseline over multiple measurements, the mean difference between the wrist and the arm sBP was -0.2 percentage points (99% limits of agreement -25 to +25 percentage points). The wrist measurement overestimated the reading relative to the upper arm measurement for multiple measurements over time. However, when the time series for each subject was examined for percentage change from baseline, the 2 methods mirrored each other in most cases. Nevertheless, our hypothesis was rejected as the limits of agreement were higher than ±10%. This finding suggests that wrist BP may not be an accurate method of detecting hypotension or hypertension during spinal or combined spinal-epidural anesthesia for CD.

  5. Atorvastatin calcium in combination with methylprednisolone for the treatment of multiple sclerosis relapse.

    PubMed

    Li, Xiao-ling; Zhang, Zhen-chang; Zhang, Bo; Jiang, Hua; Yu, Chun-mei; Zhang, Wen-jing; Yan, Xiang; Wang, Man-xia

    2014-12-01

    This study aimed to investigate the efficacy of combined atorvastatin calcium and methylprednisolone for the treatment of multiple sclerosis relapse. Patients with multiple sclerosis (MS) at the relapse phase were randomized to receive either combined treatment of atorvastatin calcium and methylprednisolone (n = 19) or methylprednisolone alone (n = 19). Expanded Disability Status Scale (EDSS) was administered at baseline, 1 week, 2 weeks, 4 weeks, 3 months, and 6 months after treatment initiation. The number and volume of brain lesions were evaluated using magnetic resonance imaging at baseline and 6 months. The levels of IL-13, IL-35, IFN-γ, and IL-10 in the cerebrospinal fluid were examined using the enzyme-linked immunosorbent assay method. There was no significant difference in EDSS scores at 1, 2, and 4 weeks. At 3 and 6 months, the combined treatment group showed significantly lower EDSS scores than the monotherapy group (P < 0.05). The number and volume of brain lesions in the combined treatment group were significantly lower than the monotherapy group at 6 months (P < 0.001). The mean time to relapse was significantly extended in the combined treatment group than the monotherapy group (P < 0.001). At 2 and 4 weeks, the combined treatment group had significantly higher levels of IL-13, IL-35, and IL-10 in the cerebrospinal fluid than the monotherapy group (P < 0.05), but significantly lower level of IFN-γ (P < 0.001). The levels of IL-13 and IL-10 in the combined treatment group were positively correlated with EDSS scores (r = 0.632, P = 0.001; r = 0.731, P = 0.002). Combined treatment with atorvastatin calcium and methylprednisolone can improve the outcomes of MS relapse compared with glucocorticosteroid alone. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Increased statistical power with combined independent randomization tests used with multiple-baseline design.

    PubMed

    Tyrrell, Pascal N; Corey, Paul N; Feldman, Brian M; Silverman, Earl D

    2013-06-01

    Physicians often assess the effectiveness of treatments on a small number of patients. Multiple-baseline designs (MBDs), based on the Wampold-Worsham (WW) method of randomization and applied to four subjects, have relatively low power. Our objective was to propose another approach with greater power that does not suffer from the time requirements of the WW method applied to a greater number of subjects. The power of a design that involves the combination of two four-subject MBDs was estimated using computer simulation and compared with the four- and eight-subject designs. The effect of a delayed linear response to treatment on the power of the test was also investigated. Power was found to be adequate (>80%) for a standardized mean difference (SMD) greater than 0.8. The effect size associated with 80% power from combined tests was smaller than that of the single four-subject MBD (SMD=1.3) and comparable with the eight-subject MBD (SMD=0.6). A delayed linear response to the treatment resulted in important reductions in power (20-35%). By combining two four-subject MBD tests, an investigator can detect better effect sizes (SMD=0.8) and be able to complete a comparatively timelier and feasible study. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Evaluation of Attention Training and Metacognitive Facilitation to Improve Reading Comprehension in Aphasia

    ERIC Educational Resources Information Center

    Lee, Jaime B.; Sohlberg, McKay Moore

    2013-01-01

    Purpose: This pilot study investigated the impact of direct attention training combined with metacognitive facilitation on reading comprehension in individuals with aphasia. Method: A single-subject, multiple baseline design was employed across 4 participants to evaluate potential changes in reading comprehension resulting from an 8-week…

  8. A Comparison of Structurally Connected and Multiple Spacecraft Interferometers

    NASA Technical Reports Server (NTRS)

    Surka, Derek M.; Crawley, Edward F.

    1996-01-01

    Structurally connected and multiple spacecraft interferometers are compared in an attempt to establish the maximum baseline (referred to as the "cross-over baseline") for which it is preferable to operate a single-structure interferometer in space rather than an interferometer composed of numerous, smaller spacecraft. This comparison is made using the total launched mass of each configuration as the comparison metric. A framework of study within which structurally connected and multiple spacecraft interferometers can be compared is presented in block diagram form. This methodology is then applied to twenty-two different combinations of trade space parameters to investigate the effects of different orbits, orientations, truss materials, propellants, attitude control actuators, onboard disturbance sources, and performance requirements on the cross-over baseline. Rotating interferometers and the potential advantages of adding active structural control to the connected truss of the structurally connected interferometer are also examined. The minimum mass design of the structurally connected interferometer that meets all performance-requirements and satisfies all imposed constraints is determined as a function of baseline. This minimum mass design is then compared to the design of the multiple spacecraft interferometer. It is discovered that the design of the minimum mass structurally connected interferometer that meets all performance requirements and constraints in solar orbit is limited by the minimum allowable aspect ratio, areal density, and gage of the struts. In the formulation of the problem used in this study, there is no advantage to adding active structural control to the truss for interferometers in solar orbit. The cross-over baseline for missions of practical duration (ranging from one week to thirty years) in solar orbit is approximately 400 m for non-rotating interferometers and 650 m for rotating interferometers.

  9. A Multiple-Sequence Variant of the Multiple-Baseline Design: A Strategy for Analysis of Sequence Effects and Treatment Comparison.

    ERIC Educational Resources Information Center

    Noell, George H.; Gresham, Frank M.

    2001-01-01

    Describes design logic and potential uses of a variant of the multiple-baseline design. The multiple-baseline multiple-sequence (MBL-MS) consists of multiple-baseline designs that are interlaced with one another and include all possible sequences of treatments. The MBL-MS design appears to be primarily useful for comparison of treatments taking…

  10. A Fast Radio Burst Search Method for VLBI Observation

    NASA Astrophysics Data System (ADS)

    Liu, Lei; Tong, Fengxian; Zheng, Weimin; Zhang, Juan; Tong, Li

    2018-02-01

    We introduce the cross-spectrum-based fast radio burst (FRB) search method for Very Long Baseline Interferometer (VLBI) observation. This method optimizes the fringe fitting scheme in geodetic VLBI data post-processing, which fully utilizes the cross-spectrum fringe phase information and therefore maximizes the power of single-pulse signals. Working with cross-spectrum greatly reduces the effect of radio frequency interference compared with using auto-power spectrum. Single-pulse detection confidence increases by cross-identifying detections from multiple baselines. By combining the power of multiple baselines, we may improve the detection sensitivity. Our method is similar to that of coherent beam forming, but without the computational expense to form a great number of beams to cover the whole field of view of our telescopes. The data processing pipeline designed for this method is easy to implement and parallelize, which can be deployed in various kinds of VLBI observations. In particular, we point out that VGOS observations are very suitable for FRB search.

  11. Using iPad Tablets for Self-modeling with Preschoolers: Videos versus Photos

    ERIC Educational Resources Information Center

    McCoy, Dacia M.; Morrison, Julie Q.; Barnett, Dave W.; Kalra, Hilary D.; Donovan, Lauren K.

    2017-01-01

    As technology becomes more accessible and acceptable in the preschool setting, teachers need effective strategies of incorporating it to address challenging behaviors. A nonconcurrent delayed multiple baseline design in combination with an alternating treatment design was utilized to investigate the effects of using iPad tablets to display video…

  12. Improving Science Vocabulary of High School English Language Learners with Reading Disabilities

    ERIC Educational Resources Information Center

    Helman, Amanda L.; Calhoon, Mary Beth; Kern, Lee

    2015-01-01

    This study investigated the effects of a combined contextual and morphemic analysis strategy to increase prediction and analysis of science vocabulary words by three high school (9th--10th grade) English language learners with reading disabilities. A multiple baseline across participants design was used. Students analyzed science words using the…

  13. Blood pressure normalization post-jugular venous balloon angioplasty.

    PubMed

    Sternberg, Zohara; Grewal, Prabhjot; Cen, Steven; DeBarge-Igoe, Frances; Yu, Jinhee; Arata, Michael

    2015-05-01

    This study is the first in a series investigating the relationship between autonomic nervous system dysfunction and chronic cerebrospinal venous insufficiency in multiple sclerosis patients. We screened patients for the combined presence of the narrowing of the internal jugular veins and symptoms of autonomic nervous system dysfunction (fatigue, cognitive dysfunction, sleeping disorders, headache, thermal intolerance, bowel/bladder dysfunction) and determined systolic and diastolic blood pressure responses to balloon angioplasty. The criteria for eligibility for balloon angioplasty intervention included ≥ 50% narrowing in one or both internal jugular veins, as determined by the magnetic resonance venography, and ≥ 3 clinical symptoms of autonomic nervous system dysfunction. Blood pressure was measured at baseline and post-balloon angioplasty. Among patients who were screened, 91% were identified as having internal jugular veins narrowing (with obstructing lesions) combined with the presence of three or more symptoms of autonomic nervous system dysfunction. Balloon angioplasty reduced the average systolic and diastolic blood pressure. However, blood pressure categorization showed a biphasic response to balloon angioplasty. The procedure increased blood pressure in multiple sclerosis patients who presented with baseline blood pressure within lower limits of normal ranges (systolic ≤ 105 mmHg, diastolic ≤ 70 mmHg) but decreased blood pressure in patients with baseline blood pressure above normal ranges (systolic ≥ 130 mmHg, diastolic ≥ 80 mmHg). In addition, gender differences in baseline blood pressure subcategories were observed. The coexistence of internal jugular veins narrowing and symptoms of autonomic nervous system dysfunction suggests that the two phenomena may be related. Balloon angioplasty corrects blood pressure deviation in multiple sclerosis patients undergoing internal jugular vein dilation. Further studies should investigate the association between blood pressure deviation and internal jugular veins narrowing, and whether blood pressure normalization affects Patient's clinical outcomes. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. Predictive Utility of Marketed Volumetric Software Tools in Subjects at Risk for Alzheimer's: Do Regions Outside the Hippocampus Matter?

    PubMed Central

    Tanpitukpongse, Teerath P.; Mazurowski, Maciej A.; Ikhena, John; Petrella, Jeffrey R.

    2016-01-01

    Background and Purpose To assess prognostic efficacy of individual versus combined regional volumetrics in two commercially-available brain volumetric software packages for predicting conversion of patients with mild cognitive impairment to Alzheimer's disease. Materials and Methods Data was obtained through the Alzheimer's Disease Neuroimaging Initiative. 192 subjects (mean age 74.8 years, 39% female) diagnosed with mild cognitive impairment at baseline were studied. All had T1WI MRI sequences at baseline and 3-year clinical follow-up. Analysis was performed with NeuroQuant® and Neuroreader™. Receiver operating characteristic curves assessing the prognostic efficacy of each software package were generated using a univariable approach employing individual regional brain volumes, as well as two multivariable approaches (multiple regression and random forest), combining multiple volumes. Results On univariable analysis of 11 NeuroQuant® and 11 Neuroreader™ regional volumes, hippocampal volume had the highest area under the curve for both software packages (0.69 NeuroQuant®, 0.68 Neuroreader™), and was not significantly different (p > 0.05) between packages. Multivariable analysis did not increase the area under the curve for either package (0.63 logistic regression, 0.60 random forest NeuroQuant®; 0.65 logistic regression, 0.62 random forest Neuroreader™). Conclusion Of the multiple regional volume measures available in FDA-cleared brain volumetric software packages, hippocampal volume remains the best single predictor of conversion of mild cognitive impairment to Alzheimer's disease at 3-year follow-up. Combining volumetrics did not add additional prognostic efficacy. Therefore, future prognostic studies in MCI, combining such tools with demographic and other biomarker measures, are justified in using hippocampal volume as the only volumetric biomarker. PMID:28057634

  15. Synthesizing SMOS Zero-Baselines with Aquarius Brightness Temperature Simulator

    NASA Technical Reports Server (NTRS)

    Colliander, A.; Dinnat, E.; Le Vine, D.; Kainulainen, J.

    2012-01-01

    SMOS [1] and Aquarius [2] are ESA and NASA missions, respectively, to make L-band measurements from the Low Earth Orbit. SMOS makes passive measurements whereas Aquarius measures both passive and active. SMOS was launched in November 2009 and Aquarius in June 2011.The scientific objectives of the missions are overlapping: both missions aim at mapping the global Sea Surface Salinity (SSS). Additionally, SMOS mission produces soil moisture product (however, Aquarius data will eventually be used for retrieving soil moisture too). The consistency of the brightness temperature observations made by the two instruments is essential for long-term studies of SSS and soil moisture. For resolving the consistency, the calibration of the instruments is the key. The basis of the SMOS brightness temperature level is the measurements performed with the so-called zero-baselines [3]; SMOS employs an interferometric measurement technique which forms a brightness temperature image from several baselines constructed by combination of multiple receivers in an array; zero-length baseline defines the overall brightness temperature level. The basis of the Aquarius brightness temperature level is resolved from the brightness temperature simulator combined with ancillary data such as antenna patterns and environmental models [4]. Consistency between the SMOS zero-baseline measurements and the simulator output would provide a robust basis for establishing the overall comparability of the missions.

  16. The Effects of Safety Discrimination Training and Frequent Safety Observations on Safety-Related Behavior

    ERIC Educational Resources Information Center

    Taylor, Matthew A.; Alvero, Alicia M.

    2012-01-01

    The intent of the present study was to assess the effects of discrimination training only and in combination with frequent safety observations on five participants' safety-related behavior in a simulated office setting. The study used a multiple-baseline design across safety-related behaviors. Across all participants and behavior, safety improved…

  17. Effects of Individualized Video Feedback Combined with Group Parent Training on Inappropriate Maternal Behavior

    ERIC Educational Resources Information Center

    Phaneuf, Leah; McIntyre, Laura Lee

    2007-01-01

    The effects of adding individualized video feedback (IVF) to Webster-Stratton's (2000, 2001) group-based parent training program (GT) were evaluated using a multiple baseline design across four mother-child dyads. During all phases of the study, inappropriate maternal behavior was recorded from videotapes of playtime with their preschoolers with…

  18. An Alternating Treatment Comparison of Minimal and Maximal Opposition Sound Selection in Turkish Phonological Disorders

    ERIC Educational Resources Information Center

    Topbas, Seyhun; Unal, Ozlem

    2010-01-01

    A single-subject alternating treatment design in combination with a staggered multiple baseline model across subjects was implemented with two 6:0 year-old girls, monozygotic twins, who were referred to a university clinic for evaluation and treatment. The treatment programme was structured according to variants of "minimal pair contrast…

  19. Video Modeling by Experts with Video Feedback to Enhance Gymnastics Skills

    ERIC Educational Resources Information Center

    Boyer, Eva; Miltenberger, Raymond G.; Batsche, Catherine; Fogel, Victoria

    2009-01-01

    The effects of combining video modeling by experts with video feedback were analyzed with 4 female competitive gymnasts (7 to 10 years old) in a multiple baseline design across behaviors. During the intervention, after the gymnast performed a specific gymnastics skill, she viewed a video segment showing an expert gymnast performing the same skill…

  20. Efficacy of Cognitive-Behavioral Therapy for Comorbid Panic Disorder with Agoraphobia and Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Labrecque, Joane; Marchand, Andre; Dugas, Michel J.; Letarte, Andree

    2007-01-01

    The goal of this study was to evaluate the efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) by combining treatment strategies for both disorders. A single-case, multiple-baseline design across participants was used. Three participants with primary PDA and secondary…

  1. Effects of Visual Working Memory Training and Direct Instruction on Geometry Problem Solving in Students with Geometry Difficulties

    ERIC Educational Resources Information Center

    Zhang, Dake

    2017-01-01

    We examined the effectiveness of (a) a working memory (WM) training program and (b) a combination program involving both WM training and direct instruction for students with geometry difficulties (GD). Four students with GD participated. A multiple-baseline design across participants was employed. During the Phase 1, students received six sessions…

  2. The Impact of Verbal Prompts on Child Safety-Belt Use in Shopping Carts

    ERIC Educational Resources Information Center

    Barker, Mae R.; Bailey, Jon S.; Lee, Natalie

    2004-01-01

    Each year thousands of children are injured by falling from shopping carts. Buckling children into the seats of shopping carts could prevent many of these injuries. A combined reversal and multiple baseline across settings design was used to evaluate the impact of verbal prompts on shopping cart safety-belt use in two stores. Safety-belt use…

  3. A Randomized, Double-Blind Study Assessing Changes in Cognitive Function in Indian School Children Receiving a Combination of Bacopa monnieri and Micronutrient Supplementation vs. Placebo

    PubMed Central

    Mitra-Ganguli, Tora; Kalita, Soumik; Bhushan, Sakshi; Stough, Con; Kean, James; Wang, Nan; Sethi, Vidhu; Khadilkar, Anuradha

    2017-01-01

    Several studies have indicated a chronic cognitive enhancing effect of Bacopa monnieri across different ages and cognitive impairment associated with vitamin and mineral deficiencies in children. Therefore, we investigated the effects of 4-month supplementation with a combination of B. monnieri extract and multiple micronutrients on cognitive functions in Indian school children aged 7–12 years. This was a randomized, double-blind, parallel design, single-center study in which 300 children were randomized to receive a beverage either fortified with B. monnieri and multiple micronutrients (“fortified”) or a non-fortified isocaloric equivalent (“control”) twice-daily for 4 months. Cognitive function was assessed by the Cambridge Neuropsychological Automated Test Battery (CANTAB) administered at baseline, Day 60 and Day 121. The primary endpoint was change in short-term memory (working memory) from baseline in subjects receiving “fortified” vs. “control” beverages after 4 months. Secondary endpoints included sustained attention, episodic memory, and executive function. The “fortified” beverage did not significantly improve short-term memory or any of the secondary outcomes tested relative to the “control” beverage. However, the spatial working memory “strategy” score showed significant improvement on Day 60 (difference between groups in change from baseline: −0.55; p < 0.05), but not on Day 121 due to the active intervention. Study products were well-tolerated. Reasons for these unexpected findings are discussed. PMID:29204115

  4. Effects of virtual reality training with modified constraint-induced movement therapy on upper extremity function in acute stage stroke: a preliminary study.

    PubMed

    Ji, Eun-Kyu; Lee, Sang-Heon

    2016-11-01

    [Purpose] The purpose of this study was to investigate the effects of virtual reality training combined with modified constraint-induced movement therapy on upper extremity motor function recovery in acute stage stroke patients. [Subjects and Methods] Four acute stage stroke patients participated in the study. A multiple baseline single subject experimental design was utilized. Modified constraint-induced movement therapy was used according to the EXplaining PLastICITy after stroke protocol during baseline sessions. Virtual reality training with modified constraint-induced movement therapy was applied during treatment sessions. The Manual Function Test and the Box and Block Test were used to measure upper extremity function before every session. [Results] The subjects' upper extremity function improved during the intervention period. [Conclusion] Virtual reality training combined with modified constraint-induced movement is effective for upper extremity function recovery in acute stroke patients.

  5. Multiple-Baseline Detection of a Geostationary Satellite with the Navy Precision Optical Interferometer

    DTIC Science & Technology

    2015-01-01

    Multiple-baseline detection of a geostationary satellite with the Navy Precision Optical Interferometer J. Thomas Armstronga, Ellyn K. Bainesa...observations of a geostationary satellite using the Navy Precision Optical Inter- ferometer (NPOI) during the glint season of March 2015. We succeeded in...the second night. These baseline lengths correspond to a resolution of ∼4 m at geostationary altitude. This is the first multiple-baseline

  6. Estimation of a Nonlinear Intervention Phase Trajectory for Multiple-Baseline Design Data

    ERIC Educational Resources Information Center

    Hembry, Ian; Bunuan, Rommel; Beretvas, S. Natasha; Ferron, John M.; Van den Noortgate, Wim

    2015-01-01

    A multilevel logistic model for estimating a nonlinear trajectory in a multiple-baseline design is introduced. The model is applied to data from a real multiple-baseline design study to demonstrate interpretation of relevant parameters. A simple change-in-levels (?"Levels") model and a model involving a quadratic function…

  7. Design-Comparable Effect Sizes in Multiple Baseline Designs: A General Modeling Framework

    ERIC Educational Resources Information Center

    Pustejovsky, James E.; Hedges, Larry V.; Shadish, William R.

    2014-01-01

    In single-case research, the multiple baseline design is a widely used approach for evaluating the effects of interventions on individuals. Multiple baseline designs involve repeated measurement of outcomes over time and the controlled introduction of a treatment at different times for different individuals. This article outlines a general…

  8. Predictive Utility of Marketed Volumetric Software Tools in Subjects at Risk for Alzheimer Disease: Do Regions Outside the Hippocampus Matter?

    PubMed

    Tanpitukpongse, T P; Mazurowski, M A; Ikhena, J; Petrella, J R

    2017-03-01

    Alzheimer disease is a prevalent neurodegenerative disease. Computer assessment of brain atrophy patterns can help predict conversion to Alzheimer disease. Our aim was to assess the prognostic efficacy of individual-versus-combined regional volumetrics in 2 commercially available brain volumetric software packages for predicting conversion of patients with mild cognitive impairment to Alzheimer disease. Data were obtained through the Alzheimer's Disease Neuroimaging Initiative. One hundred ninety-two subjects (mean age, 74.8 years; 39% female) diagnosed with mild cognitive impairment at baseline were studied. All had T1-weighted MR imaging sequences at baseline and 3-year clinical follow-up. Analysis was performed with NeuroQuant and Neuroreader. Receiver operating characteristic curves assessing the prognostic efficacy of each software package were generated by using a univariable approach using individual regional brain volumes and 2 multivariable approaches (multiple regression and random forest), combining multiple volumes. On univariable analysis of 11 NeuroQuant and 11 Neuroreader regional volumes, hippocampal volume had the highest area under the curve for both software packages (0.69, NeuroQuant; 0.68, Neuroreader) and was not significantly different ( P > .05) between packages. Multivariable analysis did not increase the area under the curve for either package (0.63, logistic regression; 0.60, random forest NeuroQuant; 0.65, logistic regression; 0.62, random forest Neuroreader). Of the multiple regional volume measures available in FDA-cleared brain volumetric software packages, hippocampal volume remains the best single predictor of conversion of mild cognitive impairment to Alzheimer disease at 3-year follow-up. Combining volumetrics did not add additional prognostic efficacy. Therefore, future prognostic studies in mild cognitive impairment, combining such tools with demographic and other biomarker measures, are justified in using hippocampal volume as the only volumetric biomarker. © 2017 by American Journal of Neuroradiology.

  9. Millennium Cohort: The 2001-2003 Baseline Prevalence of Mental Disorders in the U.S. Military

    DTIC Science & Technology

    2007-01-01

    close relatives (separa- tion anxiety disorder), gaining weight ( anorexia nervosa ), having multiple physical complaints (somatization disor- der), or...items), other anxiety syndrome (6 items), and bulimia nervosa (4 items), and subthreshold disorders (disorders for which criteria encompass fewer...eating and bu- limia nervosa disorders are combined into eating disorders. The PHQ defines alcohol abuse as an indication of at least one of five

  10. The Use of Behavioral Skills Training and in-Situ Training to Teach Children to Solicit Help when Lost: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Pan-Skadden, Jennifer; Wilder, David A.; Sparling, Jessica; Severtson, Erica; Donaldson, Jeanne; Postma, Nicki; Beavers, Gracie; Neidert, Pamela

    2009-01-01

    Behavioral skills training (BST) was combined with in-situ training to teach young children to solicit help when they become lost from a caregiver at a store. Three children were taught to approach a cashier, tell the cashier their name, and inform the cashier that they are lost. A multiple baseline design across participants was used to evaluate…

  11. Increasing the vocal responses of children with autism and developmental disabilities using manual sign mand training and prompt delay.

    PubMed

    Carbone, Vincent J; Sweeney-Kerwin, Emily J; Attanasio, Vivian; Kasper, Tamara

    2010-01-01

    The purpose of this study was to determine the effect of manual sign mand training combined with prompt delay and vocal prompting on the production of vocal responses in nonvocal children with developmental disabilities. A multiple baseline design across participants verified the effectiveness of this intervention. All participants showed increases in vocal responses following the implementation of the independent variables.

  12. Two antenna, two pass interferometric synthetic aperture radar

    DOEpatents

    Martinez, Ana; Doerry, Armin W.; Bickel, Douglas L.

    2005-06-28

    A multi-antenna, multi-pass IFSAR mode utilizing data driven alignment of multiple independent passes can combine the scaling accuracy of a two-antenna, one-pass IFSAR mode with the height-noise performance of a one-antenna, two-pass IFSAR mode. A two-antenna, two-pass IFSAR mode can accurately estimate the larger antenna baseline from the data itself and reduce height-noise, allowing for more accurate information about target ground position locations and heights. The two-antenna, two-pass IFSAR mode can use coarser IFSAR data to estimate the larger antenna baseline. Multi-pass IFSAR can be extended to more than two (2) passes, thereby allowing true three-dimensional radar imaging from stand-off aircraft and satellite platforms.

  13. Comparison of Interferometric Time-Series Analysis Techniques with Implications for Future Mission Design

    NASA Astrophysics Data System (ADS)

    Werner, C. L.; Wegmuller, U.; Strozzi, T.; Wiesmann, A.

    2006-12-01

    Principle contributors to the noise in differential SAR interferograms are temporal phase stability of the surface, geometry relating to baseline and surface slope, and propagation path delay variations due to tropospheric water vapor and the ionosphere. Time series analysis of multiple interferograms generated from a stack of SAR SLC images seeks to determine the deformation history of the surface while reducing errors. Only those scatterers within a resolution element that are stable and coherent for each interferometric pair contribute to the desired deformation signal. Interferograms with baselines exceeding 1/3 the critical baseline have substantial geometrical decorrelation for distributed targets. Short baseline pairs with multiple reference scenes can be combined using least-squares estimation to obtain a global deformation solution. Alternately point-like persistent scatterers can be identified in scenes that do not exhibit geometrical decorrelation associated with large baselines. In this approach interferograms are formed from a stack of SAR complex images using a single reference scene. Stable distributed scatter pixels are excluded however due to the presence of large baselines. We apply both point- based and short-baseline methodologies and compare results for a stack of fine-beam Radarsat data acquired in 2002-2004 over a rapidly subsiding oil field near Lost Hills, CA. We also investigate the density of point-like scatters with respect to image resolution. The primary difficulty encountered when applying time series methods is phase unwrapping errors due to spatial and temporal gaps. Phase unwrapping requires sufficient spatial and temporal sampling. Increasing the SAR range bandwidth increases the range resolution as well as increasing the critical interferometric baseline that defines the required satellite orbital tube diameter. Sufficient spatial sampling also permits unwrapping because of the reduced phase/pixel gradient. Short time intervals further reduce the differential phase due to deformation when the deformation is continuous. Lower frequency systems (L- vs. C-Band) substantially improve the ability to unwrap the phase correctly by directly reducing both interferometric phase amplitude and temporal decorrelation.

  14. Multilevel Analysis of Multiple-Baseline Data Evaluating Precision Teaching as an Intervention for Improving Fluency in Foundational Reading Skills for at Risk Readers

    ERIC Educational Resources Information Center

    Brosnan, Julie; Moeyaert, Mariola; Brooks Newsome, Kendra; Healy, Olive; Heyvaert, Mieke; Onghena, Patrick; Van den Noortgate, Wim

    2018-01-01

    In this article, multiple-baseline across participants designs were used to evaluate the impact of a precision teaching (PT) program, within a Tier 2 Response to Intervention framework, targeting fluency in foundational reading skills with at risk kindergarten readers. Thirteen multiple-baseline design experiments that included participation from…

  15. Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain

    PubMed Central

    Koppenhaver, Shane L.; Fritz, Julie M.; Hebert, Jeffrey J.; Kawchuk, Greg N.; Parent, Eric C.; Gill, Norman W.; Childs, John D.; Teyhen, Deydre S.

    2012-01-01

    Understanding the clinical characteristics of patients with low back pain (LBP) who display improved lumbar multifidus (LM) muscle function after spinal manipulative therapy (SMT) may provide insight into a potentially synergistic interaction between SMT and exercise. Therefore, the purpose of this study was to identify the baseline historical and physical examination factors associated with increased contracted LM muscle thickness one week after SMT. Eighty-one participants with LBP underwent a baseline physical examination and ultrasound imaging assessment of the LM muscle during submaximal contraction before and one week after SMT. The relationship between baseline examination variables and 1-week change in contracted LM thickness was assessed using correlation analysis and hierarchical multiple linear regression. Four variables best predicted the magnitude of increases in contracted LM muscle thickness after SMT. When combined, these variables suggest that patients with LBP, (1) that are fairly acute, (2) have at least a moderately good prognosis without focal and irritable symptoms, and (3) exhibit signs of spinal instability, may be the best candidates for a combined SMT and LSE treatment approach. PMID:22516351

  16. Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain.

    PubMed

    Koppenhaver, Shane L; Fritz, Julie M; Hebert, Jeffrey J; Kawchuk, Greg N; Parent, Eric C; Gill, Norman W; Childs, John D; Teyhen, Deydre S

    2012-10-01

    Understanding the clinical characteristics of patients with low back pain (LBP) who display improved lumbar multifidus (LM) muscle function after spinal manipulative therapy (SMT) may provide insight into a potentially synergistic interaction between SMT and exercise. Therefore, the purpose of this study was to identify the baseline historical and physical examination factors associated with increased contracted LM muscle thickness one week after SMT. Eighty-one participants with LBP underwent a baseline physical examination and ultrasound imaging assessment of the LM muscle during submaximal contraction before and one week after SMT. The relationship between baseline examination variables and 1-week change in contracted LM thickness was assessed using correlation analysis and hierarchical multiple linear regression. Four variables best predicted the magnitude of increases in contracted LM muscle thickness after SMT. When combined, these variables suggest that patients with LBP, (1) that are fairly acute, (2) have at least a moderately good prognosis without focal and irritable symptoms, and (3) exhibit signs of spinal instability, may be the best candidates for a combined SMT and lumbar stabilization exercise (LSE) treatment approach. Published by Elsevier Ltd.

  17. Repression of Multiple Myeloma Growth and Preservation of Bone with Combined Radiotherapy and Anti-angiogenic Agent

    PubMed Central

    Jia, Dan; Koonce, Nathan A.; Halakatti, Roopa; Li, Xin; Yaccoby, Shmuel; Swain, Frances L.; Suva, Larry J.; Hennings, Leah; Berridge, Marc S.; Apana, Scott M.; Mayo, Kevin; Corry, Peter M.; Griffin, Robert J.

    2011-01-01

    The effects of ionizing radiation, with or without the antiangiogenic agent anginex (Ax), on multiple myeloma growth were tested in a SCID-rab mouse model. Mice carrying human multiple myeloma cell-containing pre-implanted bone grafts were treated weekly with various regimens for 8 weeks. Rapid multiple myeloma growth, assessed by bioluminescence intensity (IVIS), human lambda Ig light chain level in serum (ELISA), and the volume of bone grafts (caliper), was observed in untreated mice. Tumor burden in mice receiving combined therapy was reduced to 59% (by caliper), 43% (by ELISA), and 2% (by IVIS) of baseline values after 8 weeks of treatment. Ax or radiation alone slowed but did not stop tumor growth. Four weeks after the withdrawal of the treatments, tumor burden remained minimal in mice given Ax + radiation but increased noticeably in the other three groups. Multiple myeloma suppression by Ax + radiation was accompanied by a marked decrease in the number and activity of osteoclasts in bone grafts assessed by histology. Bone graft integrity was preserved by Ax + radiation but was lost in the other three groups, as assessed by microCT imaging and radiography. These results suggest that radiotherapy, when primed by anti-angiogenic agents, may be a potent therapy for focal multiple myeloma. PMID:20518660

  18. Development and feasibility of the Help to Overcome Problems Effectively (HOPE) self-management intervention for people living with multiple sclerosis.

    PubMed

    Anderson, Joanna K; Turner, Andy; Clyne, Wendy

    2017-06-01

    To describe the development and feasibility of a self-management intervention called the Help to Overcome Problems Effectively (HOPE: MS), aimed at improving the physical and psychological wellbeing of people living with Multiple Sclerosis (MS). HOPE: MS is an innovative, 6-week group-based, manualised self-management intervention combining positive psychology theory and practice, and cognitive behavioural therapy (CBT). Participants (N = 21) recruited via a local East Midlands branch of the MS Society attended one of three HOPE: MS interventions and completed self-reported outcome measures in week 1 and week 6. The following outcome measures were used: The Multiple Sclerosis Impact Scale; Multiple Sclerosis Fatigue Severity Scale; The Multiple Sclerosis Self-Efficacy Scale; The Adult State Hope Scale; The Hospital Anxiety and Depression Scale; The Positive and Negative Affect Scale. Post-intervention (6 weeks) mean scores decreased in the physical impact (baseline M = 65.6, SD = 17.4; 6 weeks M = 55.1, SD = 17.9, 95% CI [-4.39, -16.47] and the psychological impact of MS (baseline M = 24.0, SD = 7.3; 6 weeks M = 18.9; SD = 6.3, 95% CI [-2.54, -7.66]). There was also a decrease mean fatigue severity scores (baseline 49.4, SD = 13.3, 6 weeks M = 41.1, SD = 14.4, 95% CI [-2.65, -13.44]). There was a mean decrease in depression scores (baseline M = 6.9, SD = 3.5; 6 weeks M = 4.2, SD = 2.8, 95% CI [-1.43, -4.00]). There were smaller mean decreases in anxiety (baseline M = 7.6, SD = 3.4; 6 weeks M = 6.7 (4.0), 95% CI [0.69, -2.50]) and negative affect (baseline M = 22.9, SD = 6.8; 6 weeks M = 20.8 (8.1), 95% CI [0.69, -2.50]) refer Table 3 ). Mean MS self-efficacy scores (baseline 21.7, SD = 4.2; 6 weeks M = 24.1, SD = 4.7, 95% CI [0.23, 4.53]), mean total hope scores (baseline M = 23.3, SD = 10.7; 6 weeks M = 32.2 (10.6), 95% CI [4.91, 12.9]), hope agency scores (baseline M = 10.5, SD = 5.7; 6 weeks M = 15.7 (6.2), 95% CI [2.37, 8.01]), hope pathways (baseline M = 12.9, SD = 6.0; 6 weeks M = 16.6 (4.9), 95% CI [2.00, 5.43]) and positive affect scores increased (baseline M = 27.3, SD = 7.1; 6 months M = 32.2, SD = 8.4, 95% CI [0.42, 9.39]). Participants positively rated the intervention quality and delivery. This feasibility study showed that the HOPE: MS was acceptable and useful to people living with MS. Further robust evaluations using a randomised controlled trial design with longer follow ups are needed to confirm early promising results of the HOPE: MS. Implications for rehabilitation Living with MS requires constant adjustments to cope with unpredictable symptoms. Self-management interventions have the potential to help people living with MS to improve their quality of life. A feasibility study of the HOPE: MS self-management group-based intervention showed that it was acceptable and useful to people living with MS.

  19. Training social skills to severely mentally retarded multiply handicapped adolescents.

    PubMed

    Matson, J L; Manikam, R; Coe, D; Raymond, K; Taras, M; Long, N

    1988-01-01

    Three severely mentally retarded, multiply handicapped, adolescents were treated in a classroom setting for social skills deficits. Two of these children exhibited symptoms of autism including periods of echolalia, and fascination with tactile and visual stimulation. One of the pair was deaf. The third child was profoundly mentally retarded and had minimal expressive language skills. All had received sign language training to facilitate communication. Treatment focused on increasing the frequency of eye contact, in seat and response to verbal prompt behaviors, skills deemed necessary to facilitate use of sign language communication and to increase social interaction. Baseline and treatment were evaluated in a multiple baseline, alternating treatment design across children. Baseline was taken on responses to 10 standard questions, asked by the teacher, based on verbal presentation and sign language. This same procedure was then continued during the initial treatment phase following training sessions. During training, the children received social reinforcement, performance feedback and edible reinforcement, in the form of candy, for appropriate performance. Physical and verbal prompts as well as pictorial cues were employed to shape appropriate behavior. In the second treatment phase, training was implemented in the classroom in which baseline data had been collected. Improvement in target behaviors, via training sessions held four days a week, was noted. These data suggest that use of a combination of visual stimuli, operant and social learning methods can remediate social skills deficits in children with multiple psychological and physical deficits. The implications of these findings for current and future research are discussed.

  20. Psychotic Symptoms and Attitudes toward Medication Mediate the Effect of Insight on Personal-Social Functions in Patients with Schizophrenia: One-Year Randomized Controlled Trial and Follow-Up.

    PubMed

    Zheng, Yingjun; Ning, Yuping; She, Shenglin; Deng, Yongjie; Chen, Yuwei; Yi, Wenying; Lu, Xiaodan; Chen, Xinrui; Li, Juanhua; Li, Ruikeng; Zhang, Jie; Xiao, Di; Wu, Haibo; Wu, Chao

    2018-02-14

    This study aimed to investigate the mediating pathway of 3 factors (psychotic symptoms, attitude toward medication, and cognitive processing speed) on the effect of insight on personal-social functioning in patients with schizophrenia. Chinese inpatients with schizophrenia (n = 168; mean age 18 ± 50 years) diagnosed according to the DSM-IV were randomly assigned to treatment with antipsychotic medication alone or combined treatment. Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory (DAI), Assessment of Insight (SAI), and Social-Personal Performance Scale (PSPS) scores were evaluated at baseline and at 3, 6, and 12 months. Cognitive function was assessed at baseline. Multiple mediation analyses were conducted with baseline data, end point data, and changes-in-scale scores between baseline and the end point, respectively. At baseline and at 12 months, only psychotic symptoms mediated the effect of insight on personal-social functioning. For changes-in-scale scores over the 12-month follow-up, in patients receiving treatment with medication alone, the effect of improved insight on improved personal-social function was mediated by psychotic symptoms only; in patients receiving a combined treatment, the effect of improved insight on improved personal-social functioning was mediated by both psychotic symptoms and attitudes toward medication, independently. The link between insight and personal-social functions is mainly mediated by psychotic symptoms. Psychosocial intervention improves the predicting effect of insight on personal-social function by improving both the attitude toward medication and psychotic symptoms independently. © 2018 S. Karger AG, Basel.

  1. Combining information from multiple flood projections in a hierarchical Bayesian framework

    NASA Astrophysics Data System (ADS)

    Le Vine, Nataliya

    2016-04-01

    This study demonstrates, in the context of flood frequency analysis, the potential of a recently proposed hierarchical Bayesian approach to combine information from multiple models. The approach explicitly accommodates shared multimodel discrepancy as well as the probabilistic nature of the flood estimates, and treats the available models as a sample from a hypothetical complete (but unobserved) set of models. The methodology is applied to flood estimates from multiple hydrological projections (the Future Flows Hydrology data set) for 135 catchments in the UK. The advantages of the approach are shown to be: (1) to ensure adequate "baseline" with which to compare future changes; (2) to reduce flood estimate uncertainty; (3) to maximize use of statistical information in circumstances where multiple weak predictions individually lack power, but collectively provide meaningful information; (4) to diminish the importance of model consistency when model biases are large; and (5) to explicitly consider the influence of the (model performance) stationarity assumption. Moreover, the analysis indicates that reducing shared model discrepancy is the key to further reduction of uncertainty in the flood frequency analysis. The findings are of value regarding how conclusions about changing exposure to flooding are drawn, and to flood frequency change attribution studies.

  2. Method, system, and computer-readable medium for determining performance characteristics of an object undergoing one or more arbitrary aging conditions

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

    Gering, Kevin L.

    A method, system, and computer-readable medium are described for characterizing performance loss of an object undergoing an arbitrary aging condition. Baseline aging data may be collected from the object for at least one known baseline aging condition over time, determining baseline multiple sigmoid model parameters from the baseline data, and performance loss of the object may be determined over time through multiple sigmoid model parameters associated with the object undergoing the arbitrary aging condition using a differential deviation-from-baseline approach from the baseline multiple sigmoid model parameters. The system may include an object, monitoring hardware configured to sample performance characteristics ofmore » the object, and a processor coupled to the monitoring hardware. The processor is configured to determine performance loss for the arbitrary aging condition from a comparison of the performance characteristics of the object deviating from baseline performance characteristics associated with a baseline aging condition.« less

  3. Tumor Cell Gene Expression Changes Following Short-term In vivo Exposure to Single Agent Chemotherapeutics are Related to Survival in Multiple Myeloma

    PubMed Central

    Burington, Bart; Barlogie, Bart; Zhan, Fenghuang; Crowley, John; Shaughnessy, John D.

    2013-01-01

    Changes in global gene expression patterns in tumor cells following in vivo therapy may vary by treatment and provide added or synergistic prognostic power over pretherapy gene expression profiles (GEP). This molecular readout of drug-cell interaction may also point to mechanisms of action/resistance. In newly diagnosed patients with multiple myeloma (MM), microarray data were obtained on tumor cells prior to and 48 hours after in vivo treatment using dexamethasone (n = 45) or thalidomide (n = 42); in the case of relapsed MM, microarray data were obtained prior to (n = 36) and after (n = 19) lenalidomide administration. Dexamethasone and thalidomide induced both common and unique GEP changes in tumor cells. Combined baseline and 48-hour changes in GEP in a subset of genes, many related to oxidative stress and cytoskeletal dynamics, were predictive of outcome in newly diagnosed MM patients receiving tandem transplants. Thalidomide-altered genes also changed following lenalidomide exposure and predicted event-free and overall survival in relapsed patients receiving lenalidomide as a single agent. Combined with baseline molecular features, changes in GEP following short-term single-agent exposure may help guide treatment decisions for patients with MM. Genes whose drug-altered expression were found to be related to survival may point to molecular switches related to response and/or resistance to different classes of drugs. PMID:18676754

  4. Modelling multiple threats to water security in the Peruvian Amazon using the WaterWorld Policy Support System

    NASA Astrophysics Data System (ADS)

    van Soesbergen, A. J. J.; Mulligan, M.

    2013-06-01

    This paper explores a multitude of threats to water security in the Peruvian Amazon using the WaterWorld policy support system. WaterWorld is a spatially explicit, physically-based globally-applicable model for baseline and scenario water balance that is particularly well suited to heterogeneous environments with little locally available data (e.g. ungauged basins) and which is delivered through a simple web interface, requiring little local capacity for use. The model is capable of producing a hydrological baseline representing the mean water balance for 1950-2000 and allows for examining impacts of population, climate and land use change as well as land and water management interventions on hydrology. This paper describes the application of WaterWorld to the Peruvian Amazon, an area that is increasingly under pressure from deforestation and water pollution as a result of population growth, rural to urban migration and oil and gas extraction, potentially impacting both water quantity and water quality. By applying single and combined scenarios of: climate change, deforestation around existing and planned roads, population growth and rural-urban migration, mining and oil and gas exploitation, we explore the potential combined impacts of these multiple changes on water resources in the Peruvian Amazon and discuss the likely pathways for adaptation to and mitigation against their worst effects. See Mulligan et al. (2013) for a similar analysis for the entire Amazon Basin.

  5. Unexpected high vulnerability of functions in wilderness areas: evidence from coral reef fishes.

    PubMed

    D'agata, Stéphanie; Vigliola, Laurent; Graham, Nicholas A J; Wantiez, Laurent; Parravicini, Valeriano; Villéger, Sébastien; Mou-Tham, Gerard; Frolla, Philippe; Friedlander, Alan M; Kulbicki, Michel; Mouillot, David

    2016-12-14

    High species richness is thought to support the delivery of multiple ecosystem functions and services under changing environments. Yet, some species might perform unique functional roles while others are redundant. Thus, the benefits of high species richness in maintaining ecosystem functioning are uncertain if functions have little redundancy, potentially leading to high vulnerability of functions. We studied the natural propensity of assemblages to be functionally buffered against loss prior to fishing activities, using functional trait combinations, in coral reef fish assemblages across unfished wilderness areas of the Indo-Pacific: Chagos Archipelago, New Caledonia and French Polynesia. Fish functional diversity in these wilderness areas is highly vulnerable to fishing, explained by species- and abundance-based redundancy packed into a small combination of traits, leaving most other trait combinations (60%) sensitive to fishing, with no redundancy. Functional vulnerability peaks for mobile and sedentary top predators, and large species in general. Functional vulnerability decreases for certain functional entities in New Caledonia, where overall functional redundancy was higher. Uncovering these baseline patterns of functional vulnerability can offer early warning signals of the damaging effects from fishing, and may serve as baselines to guide precautionary and even proactive conservation actions. © 2016 The Author(s).

  6. Unexpected high vulnerability of functions in wilderness areas: evidence from coral reef fishes

    PubMed Central

    Vigliola, Laurent; Graham, Nicholas A. J.; Wantiez, Laurent; Parravicini, Valeriano; Villéger, Sébastien; Mou-Tham, Gerard; Frolla, Philippe; Friedlander, Alan M.; Kulbicki, Michel; Mouillot, David

    2016-01-01

    High species richness is thought to support the delivery of multiple ecosystem functions and services under changing environments. Yet, some species might perform unique functional roles while others are redundant. Thus, the benefits of high species richness in maintaining ecosystem functioning are uncertain if functions have little redundancy, potentially leading to high vulnerability of functions. We studied the natural propensity of assemblages to be functionally buffered against loss prior to fishing activities, using functional trait combinations, in coral reef fish assemblages across unfished wilderness areas of the Indo-Pacific: Chagos Archipelago, New Caledonia and French Polynesia. Fish functional diversity in these wilderness areas is highly vulnerable to fishing, explained by species- and abundance-based redundancy packed into a small combination of traits, leaving most other trait combinations (60%) sensitive to fishing, with no redundancy. Functional vulnerability peaks for mobile and sedentary top predators, and large species in general. Functional vulnerability decreases for certain functional entities in New Caledonia, where overall functional redundancy was higher. Uncovering these baseline patterns of functional vulnerability can offer early warning signals of the damaging effects from fishing, and may serve as baselines to guide precautionary and even proactive conservation actions. PMID:27928042

  7. Anxiety Sensitivity and Pre-Cessation Smoking Processes: Testing the Independent and Combined Mediating Effects of Negative Affect–Reduction Expectancies and Motives

    PubMed Central

    Farris, Samantha G.; Leventhal, Adam M.; Schmidt, Norman B.; Zvolensky, Michael J.

    2015-01-01

    Objective: Anxiety sensitivity appears to be relevant in understanding the nature of emotional symptoms and disorders associated with smoking. Negative-reinforcement smoking expectancies and motives are implicated as core regulatory processes that may explain, in part, the anxiety sensitivity–smoking interrelations; however, these pathways have received little empirical attention. Method: Participants (N = 471) were adult treatment-seeking daily smokers assessed for a smoking-cessation trial who provided baseline data; 157 participants provided within-treatment (pre-cessation) data. Anxiety sensitivity was examined as a cross-sectional predictor of several baseline smoking processes (nicotine dependence, perceived barriers to cessation, severity of prior withdrawal-related quit problems) and pre-cessation processes including nicotine withdrawal and smoking urges (assessed during 3 weeks before the quit day). Baseline negative-reinforcement smoking expectancies and motives were tested as simultaneous mediators via parallel multiple mediator models. Results: Higher levels of anxiety sensitivity were related to higher levels of nicotine dependence, greater perceived barriers to smoking cessation, more severe withdrawal-related problems during prior quit attempts, and greater average withdrawal before the quit day; effects were indirectly explained by the combination of both mediators. Higher levels of anxiety sensitivity were not directly related to pre-cessation smoking urges but were indirectly related through the independent and combined effects of the mediators. Conclusions: These empirical findings bolster theoretical models of anxiety sensitivity and smoking and identify targets for nicotine dependence etiology research and cessation interventions. PMID:25785807

  8. Vitalum study design: RCT evaluating the efficacy of tailored print communication and telephone motivational interviewing on multiple health behaviors

    PubMed Central

    van Keulen, Hilde M; Mesters, Ilse; Brug, Johannes; Ausems, Marlein; Campbell, Marci; Resnicow, Ken; Zwietering, Paul J; van Breukelen, Gerard; van Mechelen, Willem; Severens, Johan L; de Vries, Hein

    2008-01-01

    Background A large proportion of adults fail to meet public health guidelines for physical activity as well as fruit, vegetable and fat intake. Interventions are needed to improve these health behaviors. Both computer tailoring and motivational interviewing have shown themselves to be promising techniques for health behavior change. The Vitalum project aims to compare the efficacy of these techniques in improving the health behaviors of adults aged 45–70. This paper describes the design of the Vitalum study. Methods/Design Dutch general medical practices (N = 23) were recruited via a registration network or by personal invitation. The participants were then enrolled through these general practices using an invitational letter. They (n = 2,881) received a written baseline questionnaire to assess health behaviors, and potential psychosocial and socio-demographic behavioral determinants. A power analysis indicated that 1,600 participants who were failing to meet the guidelines for physical activity and either fruit or vegetable consumption were needed. Eligible participants were stratified based on hypertension status and randomized into one of four intervention groups: tailored print communication, telephone motivational interviewing, combined, and control. The first two groups either received four letters or took part in four interviews, whereas the combined group received two letters and took part in two interviews in turns at 5, 13, 30 and 43 weeks after returning the baseline questionnaire. Each letter and interview focused on physical activity or nutrition behavior. The participants also took part in a telephone survey 25 weeks after baseline to gather new information for tailoring. There were two follow-up questionnaires, at 47 and 73 weeks after baseline, to measure short- and long-term effects. The control group received a tailored letter after the last posttest. The process, efficacy and cost-effectiveness of the interventions will be examined by means of multilevel mixed regression, cost-effectiveness analyses and process evaluation. Discussion The Vitalum study simultaneously evaluates the efficacy of tailored print communication and telephone motivational interviewing, and their combined use for multiple behaviors and people with different motivational stages and education levels. The results can be used by policymakers to contribute to evidence-based prevention of chronic diseases. Trial Registration Dutch Trial Register NTR1068 PMID:18565222

  9. Neuroinflammation and its relationship to changes in brain volume and white matter lesions in multiple sclerosis.

    PubMed

    Datta, Gourab; Colasanti, Alessandro; Rabiner, Eugenii A; Gunn, Roger N; Malik, Omar; Ciccarelli, Olga; Nicholas, Richard; Van Vlierberghe, Eline; Van Hecke, Wim; Searle, Graham; Santos-Ribeiro, Andre; Matthews, Paul M

    2017-11-01

    Brain magnetic resonance imaging is an important tool in the diagnosis and monitoring of multiple sclerosis patients. However, magnetic resonance imaging alone provides limited information for predicting an individual patient's disability progression. In part, this is because magnetic resonance imaging lacks sensitivity and specificity for detecting chronic diffuse and multi-focal inflammation mediated by activated microglia/macrophages. The aim of this study was to test for an association between 18 kDa translocator protein brain positron emission tomography signal, which arises largely from microglial activation, and measures of subsequent disease progression in multiple sclerosis patients. Twenty-one patients with multiple sclerosis (seven with secondary progressive disease and 14 with a relapsing remitting disease course) underwent T1- and T2-weighted and magnetization transfer magnetic resonance imaging at baseline and after 1 year. Positron emission tomography scanning with the translocator protein radioligand 11C-PBR28 was performed at baseline. Brain tissue and lesion volumes were segmented from the T1- and T2-weighted magnetic resonance imaging and relative 11C-PBR28 uptake in the normal-appearing white matter was estimated as a distribution volume ratio with respect to a caudate pseudo-reference region. Normal-appearing white matter distribution volume ratio at baseline was correlated with enlarging T2-hyperintense lesion volumes over the subsequent year (ρ = 0.59, P = 0.01). A post hoc analysis showed that this association reflected behaviour in the subgroup of relapsing remitting patients (ρ = 0.74, P = 0.008). By contrast, in the subgroup of secondary progressive patients, microglial activation at baseline was correlated with later progression of brain atrophy (ρ = 0.86, P = 0.04). A regression model including the baseline normal-appearing white matter distribution volume ratio, T2 lesion volume and normal-appearing white matter magnetization transfer ratio for all of the patients combined explained over 90% of the variance in enlarging lesion volume over the subsequent 1 year. Glial activation in white matter assessed by translocator protein PET significantly improves predictions of white matter lesion enlargement in relapsing remitting patients and is associated with greater brain atrophy in secondary progressive disease over a period of short term follow-up. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Multiple Intravenous Infusions Phase 2b: Laboratory Study

    PubMed Central

    Pinkney, Sonia; Fan, Mark; Chan, Katherine; Koczmara, Christine; Colvin, Christopher; Sasangohar, Farzan; Masino, Caterina; Easty, Anthony; Trbovich, Patricia

    2014-01-01

    Background Administering multiple intravenous (IV) infusions to a single patient via infusion pump occurs routinely in health care, but there has been little empirical research examining the risks associated with this practice or ways to mitigate those risks. Objectives To identify the risks associated with multiple IV infusions and assess the impact of interventions on nurses’ ability to safely administer them. Data Sources and Review Methods Forty nurses completed infusion-related tasks in a simulated adult intensive care unit, with and without interventions (i.e., repeated-measures design). Results Errors were observed in completing common tasks associated with the administration of multiple IV infusions, including the following (all values from baseline, which was current practice): setting up and programming multiple primary continuous IV infusions (e.g., 11.7% programming errors) identifying IV infusions (e.g., 7.7% line-tracing errors) managing dead volume (e.g., 96.0% flush rate errors following IV syringe dose administration) setting up a secondary intermittent IV infusion (e.g., 11.3% secondary clamp errors) administering an IV pump bolus (e.g., 11.5% programming errors) Of 10 interventions tested, 6 (1 practice, 3 technology, and 2 educational) significantly decreased or even eliminated errors compared to baseline. Limitations The simulation of an adult intensive care unit at 1 hospital limited the ability to generalize results. The study results were representative of nurses who received training in the interventions but had little experience using them. The longitudinal effects of the interventions were not studied. Conclusions Administering and managing multiple IV infusions is a complex and risk-prone activity. However, when a patient requires multiple IV infusions, targeted interventions can reduce identified risks. A combination of standardized practice, technology improvements, and targeted education is required. PMID:26316919

  11. Baseline and changes in serum uric acid independently predict 11-year incidence of metabolic syndrome among community-dwelling women.

    PubMed

    Kawamoto, R; Ninomiya, D; Kasai, Y; Senzaki, K; Kusunoki, T; Ohtsuka, N; Kumagi, T

    2018-02-19

    Metabolic syndrome (MetS) is associated with an increased risk of major cardiovascular events. In women, increased serum uric acid (SUA) levels are associated with MetS and its components. However, whether baseline and changes in SUA predict incidence of MetS and its components remains unclear. The subjects comprised 407 women aged 71 ± 8 years from a rural village. We have identified participants who underwent a similar examination 11 years ago, and examined the relationship between baseline and changes in SUA, and MetS based on the modified criteria of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP) III report. Of these subjects, 83 (20.4%) women at baseline and 190 (46.7%) women at follow-up had MetS. Multiple linear regression analysis was performed to evaluate the contribution of each confounding factor for MetS; both baseline and changes in SUA as well as history of cardiovascular disease, low-density lipoprotein cholesterol, and estimated glomerular filtration ratio (eGFR) were independently and significantly associated with the number of MetS components during an 11-year follow-up. The adjusted odds ratios (ORs) (95% confidence interval) for incident MetS across tertiles of baseline SUA and changes in SUA were 1.00, 1.47 (0.82-2.65), and 3.11 (1.66-5.83), and 1.00, 1.88 (1.03-3.40), and 2.49 (1.38-4.47), respectively. In addition, the combined effect between increased baseline and changes in SUA was also a significant and independent determinant for the accumulation of MetS components (F = 20.29, p < 0.001). The ORs for incident MetS were significant only in subjects with age ≥ 55 years, decline in eGFR, and no baseline MetS. These results suggested that combined assessment of baseline and changes in SUA levels provides increased information for incident MetS, independent of other confounding factors in community-dwelling women.

  12. A case of bilateral vocal fold mucosal bridges, bilateral trans-vocal fold type III sulci vocales, and an intracordal polyp.

    PubMed

    Tan, Melin; Pitman, Michael J

    2011-07-01

    We present a patient with a novel finding of bilateral mucosal bridges, bilateral type III trans-vocal fold sulci vocales, and a vocal fold polyp. Although sulci and mucosal bridges occur in the vocal folds, it is rare to find multiples of these lesions in a single patient, and it is even more uncommon when they occur in conjunction with a vocal fold polyp. To our knowledge, this is the first description of a vocal fold polyp in combination with multiple vocal fold bridges and multiple type III sulci vocales in a single patient. To describe and visually present the diagnosis and treatment of a patient with an intracordal polyp, bilateral mucosal bridges, as well as bilateral type III trans-vocal fold sulci vocales. Presentation of a set of high definition intraoperative photos displaying the extent of the vocal fold lesions and the resection of the intracordal polyp. This patient presented with only 6 months of significant dysphonia. It was felt that the recent change in voice was because of the polyp and not the bridges or sulci vocales. Considering the patient's presentation and the possible morbidity of resection of mucosal bridges and sulci, only the polyp was excised. Postoperatively, the patient's voice returned to his acceptable mild baseline dysphonia, and the benefit has persisted 6 months postoperatively. The combination of bilateral mucosal bridges, bilateral type III sulcus vocalis, and an intracordal polyp in one patient is rare if not novel. Treatment of the polyp alone returned the patient's voice to his lifelong baseline of mild dysphonia. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  13. Mechanistic correlates of clinical responses to omalizumab in the setting of oral immunotherapy for milk allergy.

    PubMed

    Frischmeyer-Guerrerio, Pamela A; Masilamani, Madhan; Gu, Wenjuan; Brittain, Erica; Wood, Robert; Kim, Jennifer; Nadeau, Kari; Jarvinen, Kirsi M; Grishin, Alexander; Lindblad, Robert; Sampson, Hugh A

    2017-10-01

    In our recent clinical trial, the addition of omalizumab to oral immunotherapy (OIT) for milk allergy improved safety, but no significant clinical benefit was detected. We sought to investigate mechanisms by which omalizumab modulates immunity in the context of OIT and to identify baseline biomarkers that predict subgroups of patients most likely to benefit from omalizumab. Blood was obtained at baseline and multiple time points during a placebo-controlled trial of OIT for milk allergy in which subjects were randomized to receive omalizumab or placebo. Immunologic outcomes included measurement of basophil CD63 expression and histamine release and casein-specific CD4 + regulatory T-cell proliferation. Biomarkers were analyzed in relationship to measurements of safety and efficacy. Milk-induced basophil CD63 expression was transiently reduced in whole blood samples from both omalizumab- and placebo-treated subjects. However, IgE-dependent histamine release increased in washed cell preparations from omalizumab- but not placebo-treated subjects. No increase in regulatory T-cell frequency was evident in either group. Subjects with lower rates of adverse reactions, regardless of arm, experienced better clinical outcomes. Pre-OIT basophil reactivity positively associated with occurrence of symptoms during OIT, whereas the baseline milk IgE/total IgE ratio correlated with the likelihood of achieving sustained unresponsiveness. A combination of baseline basophil and serologic biomarkers defined a subset of patients in which adjunctive therapy with omalizumab was associated with attainment of sustained unresponsiveness and a reduction in adverse reactions. Combining omalizumab therapy with milk OIT led to distinct alterations in basophil reactivity but not T-cell responses. Baseline biomarkers can identify subjects most likely to benefit from adjunctive therapy with omalizumab. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  14. Improving Baseline Model Assumptions: Evaluating the Impacts of Typical Methodological Approaches in Watershed Models

    NASA Astrophysics Data System (ADS)

    Muenich, R. L.; Kalcic, M. M.; Teshager, A. D.; Long, C. M.; Wang, Y. C.; Scavia, D.

    2017-12-01

    Thanks to the availability of open-source software, online tutorials, and advanced software capabilities, watershed modeling has expanded its user-base and applications significantly in the past thirty years. Even complicated models like the Soil and Water Assessment Tool (SWAT) are being used and documented in hundreds of peer-reviewed publications each year, and likely more applied in practice. These models can help improve our understanding of present, past, and future conditions, or analyze important "what-if" management scenarios. However, baseline data and methods are often adopted and applied without rigorous testing. In multiple collaborative projects, we have evaluated the influence of some of these common approaches on model results. Specifically, we examined impacts of baseline data and assumptions involved in manure application, combined sewer overflows, and climate data incorporation across multiple watersheds in the Western Lake Erie Basin. In these efforts, we seek to understand the impact of using typical modeling data and assumptions, versus using improved data and enhanced assumptions on model outcomes and thus ultimately, study conclusions. We provide guidance for modelers as they adopt and apply data and models for their specific study region. While it is difficult to quantitatively assess the full uncertainty surrounding model input data and assumptions, recognizing the impacts of model input choices is important when considering actions at the both the field and watershed scales.

  15. The influence of family stress and conflict on depressive symptoms among working married women: A longitudinal study.

    PubMed

    Ju, Yeong Jun; Park, Eun-Cheol; Ju, Hyun-Jun; Lee, Sang Ah; Lee, Joo Eun; Kim, Woorim; Chun, Sung-Youn; Kim, Tae Hyun

    2018-03-01

    In the present study, researchers examined the association between depressive symptoms and family stress and conflict from multiple roles, along with the combined effect of family stress and family-work conflict. We used data from the 2008-2012 Korean Welfare Panel Study, consisting of 4,663 baseline participants. We measured depressive symptoms using the 11-item Center for Epidemiologic Studies Depression Scale. There was a significant relationship between depressive symptoms and family stress and conflict among working married women. With regard to the combined analysis, working married women who reported both family stress and family-work conflict exhibited the highest odds of depressive symptoms.

  16. Clinical outcomes after combined therapy with dutasteride plus tamsulosin or either monotherapy in men with benign prostatic hyperplasia (BPH) by baseline characteristics: 4-year results from the randomized, double-blind Combination of Avodart and Tamsulosin (CombAT) trial.

    PubMed

    Roehrborn, Claus G; Barkin, Jack; Siami, Paul; Tubaro, Andrea; Wilson, Timothy H; Morrill, Betsy B; Gagnier, R Paul

    2011-03-01

    • To investigate the influence of baseline variables on the 4-year incidence of acute urinary retention (AUR), benign prostatic hyperplasia (BPH)-related surgery and overall clinical progression in men treated with tamsulosin, dutasteride, or a combination of both. • The 4-year Combination of Avodart® and Tamsulosin (CombAT) study was a multicenter, randomized, double-blind, parallel-group study of clinical outcomes in men aged ≥ 50 years with symptomatic (International Prostate Symptom Score [IPSS]≥ 12) BPH, with prostate-specific antigen (PSA) levels of ≥ 1.5 ng/mL and ≤ 10 ng/mL, and a prostate volume (PV) of ≥ 30 mL. • Eligible patients received tamsulosin 0.4 mg, dutasteride 0.5 mg, or a combination of both. • The primary endpoint was time to first AUR or BPH-related surgery. Secondary endpoints included clinical progression of BPH and symptoms. Posthoc analyses of the influence of baseline variables (including age, IPSS health-related quality of life [HRQL], PV, PSA, IPSS, peak urinary flow rate [Q(max) ] and body-mass index [BMI]) on the incidence of AUR or BPH-related surgery, clinical progression of BPH, and symptoms were performed. • There were 4844 men in the intent-to-treat population. Overall baseline characteristics were similar across all patient groups. • Regardless of baseline subgroup, the incidence of AUR or BPH-related surgery was higher in men treated with tamsulosin than in those treated with dutasteride or combined therapy. • Combined therapy was statistically better than tamsulosin in reducing the risk of AUR or BPH-related surgery in subgroups of baseline PV > 42.0 mL, in all subgroups of baseline PSA level, and all other baseline subgroups (P ≤ 0.001). • Across treatment groups, the incidence of clinical progression was highest in men with a baseline IPSS of < 20 or IPSS HRQL score of < 4. The incidence of clinical progression was also higher in men receiving tamsulosin than dutasteride or combined therapy in all baseline subgroups, except for men with a baseline PV of < 40 mL. Combined therapy reduced the relative risk (RR) of clinical progression compared with tamsulosin across all baseline subgroups and compared with dutasteride across most baseline subgroups. • Symptom deterioration was the most common progression event in each treatment group regardless of baseline subgroup, except in those men with an IPSS of ≥ 20 at baseline. Combined therapy reduced the RR of symptom deterioration compared with tamsulosin across all but one baseline subgroup (the reduction was not significant for men with a baseline PV of < 40 mL) and compared with dutasteride in most subgroups. • Men with a baseline PV of ≥ 40 mL and any baseline PSA level of ≥1.5 ng/mL had greater reductions in the RR of AUR or BPH-related surgery and greater reductions in the RR of clinical progression and symptom deterioration on combined therapy or dutasteride monotherapy than on tamsulosin monotherapy. • These analyses support the long-term use of combined therapy with dutasteride plus tamsulosin in men with moderate-to-severe BPH symptoms and a slightly enlarged prostate. © 2011 THE AUTHORS; BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  17. A randomised controlled trial of combined EEG feedback and methylphenidate therapy for the treatment of ADHD.

    PubMed

    Li, Li; Yang, Li; Zhuo, Chuan-jun; Wang, Yu-Feng

    2013-08-22

    To evaluate the efficacy of combined methylphenidate and EEG feedback treatment for children with ADHD. Forty patients with ADHD were randomly assigned to the combination group (methylphenidate therapy and EEG feedback training) or control group (methylphenidate therapy and non-feedback attention training) in a 1:1 ratio using the double-blind method. These patients, who met the DSM-IV diagnostic criteria and were aged between 7 and 16 years, had obtained optimal therapeutic effects by titrating the methylphenidate dose prior to the trial. The patients were assessed using multiple parameters at baseline, after 20 treatment sessions, after 40 treatment sessions, and in 6-month follow-up studies. Compared to the control group, patients in the combination group had reduced ADHD symptoms and improved in related behavioural and brain functions. The combination of EEG feedback and methylphenidate treatment is more effective than methylphenidate alone. The combined therapy is especially suitable for children and adolescents with ADHD who insufficiently respond to single drug treatment or experience drug side effects.

  18. Survival and echocardiographic data in dogs with congestive heart failure caused by mitral valve disease and treated by multiple drugs: a retrospective study of 21 cases.

    PubMed

    de Madron, Eric; King, Jonathan N; Strehlau, Günther; White, Regina Valle

    2011-11-01

    This retrospective study reports the survival time [onset of congestive heart failure (CHF) to death from any cause] of 21 dogs with mitral regurgitation (MR) and CHF treated with a combination of furosemide, angiotensin-converting enzyme inhibitor (ACEI, benazepril, or enalapril), pimobendan, spironolactone, and amlodipine. Baseline echocardiographic data: end-systolic and end-diastolic volume indices (ESVI and EDVI), left atrium to aorta ratio (LA/Ao), and regurgitant fraction (RF) are reported. Median survival time (MST) was 430 d. Initial dosage of furosemide (P = 0.0081) and LA/Ao (P = 0.042) were negatively associated with survival. Baseline echocardiographic indices (mean ± standard deviation) were 40.24 ± 16.76 for ESVI, 161.48 ± 44.49 mL/m(2) for EDVI, 2.11 ± 0.75 for LA/Ao, and 64.71 ± 16.85% for RF. Combining furosemide, ACEI, pimobendan, spironolactone, and amlodipine may result in long survival times in dogs with MR and CHF. Severity of MR at onset of CHF is at least moderate.

  19. Survival and echocardiographic data in dogs with congestive heart failure caused by mitral valve disease and treated by multiple drugs: A retrospective study of 21 cases

    PubMed Central

    de Madron, Eric; King, Jonathan N.; Strehlau, Günther; White, Regina Valle

    2011-01-01

    This retrospective study reports the survival time [onset of congestive heart failure (CHF) to death from any cause] of 21 dogs with mitral regurgitation (MR) and CHF treated with a combination of furosemide, angiotensin-converting enzyme inhibitor (ACEI, benazepril, or enalapril), pimobendan, spironolactone, and amlodipine. Baseline echocardiographic data: end-systolic and end-diastolic volume indices (ESVI and EDVI), left atrium to aorta ratio (LA/Ao), and regurgitant fraction (RF) are reported. Median survival time (MST) was 430 d. Initial dosage of furosemide (P = 0.0081) and LA/Ao (P = 0.042) were negatively associated with survival. Baseline echocardiographic indices (mean ± standard deviation) were 40.24 ± 16.76 for ESVI, 161.48 ± 44.49 mL/m2 for EDVI, 2.11 ± 0.75 for LA/Ao, and 64.71 ± 16.85% for RF. Combining furosemide, ACEI, pimobendan, spironolactone, and amlodipine may result in long survival times in dogs with MR and CHF. Severity of MR at onset of CHF is at least moderate. PMID:22547843

  20. The Value of Interrupted Time-Series Experiments for Community Intervention Research

    PubMed Central

    Biglan, Anthony; Ary, Dennis; Wagenaar, Alexander C.

    2015-01-01

    Greater use of interrupted time-series experiments is advocated for community intervention research. Time-series designs enable the development of knowledge about the effects of community interventions and policies in circumstances in which randomized controlled trials are too expensive, premature, or simply impractical. The multiple baseline time-series design typically involves two or more communities that are repeatedly assessed, with the intervention introduced into one community at a time. It is particularly well suited to initial evaluations of community interventions and the refinement of those interventions. This paper describes the main features of multiple baseline designs and related repeated-measures time-series experiments, discusses the threats to internal validity in multiple baseline designs, and outlines techniques for statistical analyses of time-series data. Examples are given of the use of multiple baseline designs in evaluating community interventions and policy changes. PMID:11507793

  1. Improving Graduate Students' Graphing Skills of Multiple Baseline Designs with Microsoft[R] Excel 2007

    ERIC Educational Resources Information Center

    Lo, Ya-yu; Starling, A. Leyf Peirce

    2009-01-01

    This study examined the effects of a graphing task analysis using the Microsoft[R] Office Excel 2007 program on the single-subject multiple baseline graphing skills of three university graduate students. Using a multiple probe across participants design, the study demonstrated a functional relationship between the number of correct graphing…

  2. FAST INdiCATE Trial protocol. Clinical efficacy of functional strength training for upper limb motor recovery early after stroke: neural correlates and prognostic indicators.

    PubMed

    Pomeroy, Valerie M; Ward, Nick S; Johansen-Berg, Heidi; van Vliet, Paulette; Burridge, Jane; Hunter, Susan M; Lemon, Roger N; Rothwell, John; Weir, Christopher J; Wing, Alan; Walker, Andrew A; Kennedy, Niamh; Barton, Garry; Greenwood, Richard J; McConnachie, Alex

    2014-02-01

    Functional strength training in addition to conventional physical therapy could enhance upper limb recovery early after stroke more than movement performance therapy plus conventional physical therapy. To determine (a) the relative clinical efficacy of conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy for upper limb recovery; (b) the neural correlates of response to conventional physical therapy combined with functional strength training and conventional physical therapy combined with movement performance therapy; (c) whether any one or combination of baseline measures predict motor improvement in response to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Randomized, controlled, observer-blind trial. The sample will consist of 288 participants with upper limb paresis resulting from a stroke that occurred within the previous 60 days. All will be allocated to conventional physical therapy combined with functional strength training or conventional physical therapy combined with movement performance therapy. Functional strength training and movement performance therapy will be undertaken for up to 1·5 h/day, five-days/week for six-weeks. Measurements will be undertaken before randomization, six-weeks thereafter, and six-months after stroke. Primary efficacy outcome will be the Action Research Arm Test. Explanatory measurements will include voxel-wise estimates of brain activity during hand movement, brain white matter integrity (fractional anisotropy), and brain-muscle connectivity (e.g. latency of motor evoked potentials). The primary clinical efficacy analysis will compare treatment groups using a multilevel normal linear model adjusting for stratification variables and for which therapist administered the treatment. Effect of conventional physical therapy combined with functional strength training versus conventional physical therapy combined with movement performance therapy will be summarized using the adjusted mean difference and 95% confidence interval. To identify the neural correlates of improvement in both groups, we will investigate associations between change from baseline in clinical outcomes and each explanatory measure. To identify baseline measurements that independently predict motor improvement, we will develop a multiple regression model. © 2013 The Authors. International Journal of Stroke published by John Wiley & Sons Ltd on behalf of World Stroke Organization.

  3. Supporting the patient's role in guideline compliance: a controlled study.

    PubMed

    Rosenberg, Stephen N; Shnaiden, Tatiana L; Wegh, Arnold A; Juster, Iver A

    2008-11-01

    Clinical messages alerting physicians to gaps in the care of specific patients have been shown to increase compliance with evidence-based guidelines. This study sought to measure any additional impact on compliance when alerting messages also were sent to patients. For alerts that were generated by computerized clinical rules applied to claims, compliance was determined by subsequent claims evidence (eg, that recommended tests were performed). Compliance was measured in the baseline year and the study year for 4 study group employers (combined membership >100,000) that chose to add patient messaging in the study year, and 28 similar control group employers (combined membership >700,000) that maintained physician messaging but did not add patient messaging. The impact of patient messaging was assessed by comparing changes in compliance from baseline to study year in the 2 groups. Multiple logistic regression was used to control for differences between the groups. Because a given member or physician could receive multiple alerts, generalized estimating equations with clustering by patient and physician were used. Controlling for differences in age, sex, and the severity and types of clinical alerts between the study and control groups, the addition of patient messaging increased compliance by 12.5% (P <.001). This increase was primarily because of improved responses to alerts regarding the need for screening, diagnostic, and monitoring tests. Supplementing clinical alerts to physicians with messages directly to their patients produced a statistically significant increase in compliance with the evidence-based guidelines underlying the alerts.

  4. Using Multiple Schedules During Functional Communication Training to Promote Rapid Transfer of Treatment Effects

    PubMed Central

    Fisher, Wayne W.; Greer, Brian D.; Fuhrman, Ashley M.; Querim, Angie C.

    2016-01-01

    Multiple schedules with signaled periods of reinforcement and extinction have been used to thin reinforcement schedules during functional communication training (FCT) to make the intervention more practical for parents and teachers. We evaluated whether these signals would also facilitate rapid transfer of treatment effects from one setting to the next and from one therapist to the next. With two children, we conducted FCT in the context of mixed (baseline) and multiple (treatment) schedules introduced across settings or therapists using a multiple baseline design. Results indicated that when the multiple schedules were introduced, the functional communication response came under rapid discriminative control, and problem behavior remained at near-zero rates. We extended these findings with another individual by using a more traditional baseline in which problem behavior produced reinforcement. Results replicated those of the previous participants and showed rapid reductions in problem behavior when multiple schedules were implemented across settings. PMID:26384141

  5. Using multiple schedules during functional communication training to promote rapid transfer of treatment effects.

    PubMed

    Fisher, Wayne W; Greer, Brian D; Fuhrman, Ashley M; Querim, Angie C

    2015-12-01

    Multiple schedules with signaled periods of reinforcement and extinction have been used to thin reinforcement schedules during functional communication training (FCT) to make the intervention more practical for parents and teachers. We evaluated whether these signals would also facilitate rapid transfer of treatment effects across settings and therapists. With 2 children, we conducted FCT in the context of mixed (baseline) and multiple (treatment) schedules introduced across settings or therapists using a multiple baseline design. Results indicated that when the multiple schedules were introduced, the functional communication response came under rapid discriminative control, and problem behavior remained at near-zero rates. We extended these findings with another individual by using a more traditional baseline in which problem behavior produced reinforcement. Results replicated those of the previous participants and showed rapid reductions in problem behavior when multiple schedules were implemented across settings. © Society for the Experimental Analysis of Behavior.

  6. High current polarized electron source for future eRHIC

    NASA Astrophysics Data System (ADS)

    Wang, Erdong

    2018-05-01

    The high current and high bunch charge polarized electron source is essential for cost reduction of Linac-Ring (L-R) eRHIC. In the baseline design, electron beam from multiple guns (probably 4-8) will be combined using deflection plates or accumulate ring. Each gun aims to deliver electron beam with 10 mA average current and 5.3 nC bunch charge. With total 50 mA and 5.3 nC electron beam, this beam combining design could use for generating positron too. The gun has been designed, fabricated and expected to start commissioning by the mid of this year. In this paper, we will present the DC gun design parameters and beam combine schemes. Also, we will describe the details of gun design and the strategies to demonstrate high current high charge polarized electron beam from this source.

  7. Atrophied Brain Lesion Volume: A New Imaging Biomarker in Multiple Sclerosis.

    PubMed

    Dwyer, Michael G; Bergsland, Niels; Ramasamy, Deepa P; Jakimovski, Dejan; Weinstock-Guttman, Bianca; Zivadinov, Robert

    2018-06-01

    Lesion accrual in multiple sclerosis (MS) is an important and clinically relevant measure, used extensively as an imaging trial endpoint. However, lesions may also shrink or disappear entirely due to atrophy. Although generally ignored or treated as a nuisance, this phenomenon may actually be an important stand-alone imaging biomarker. Therefore, we investigated the rate of brain lesion loss due to atrophy (atrophied lesion volume) in MS subtypes compared to baseline lesion volume and to new and enlarging lesion volumes, and evaluated the independent predictive value of this phenomenon for clinical disability. A total of 192 patients (18 clinically isolated syndrome, 126 relapsing-remitting MS, and 48 progressive) received 3T magnetic resonance imaging at baseline and 5 years. Lesions were quantified at baseline, and new/enlarging lesion volumes were calculated over the study interval. Atrophied lesion volume was calculated by combining baseline lesion masks with follow-up SIENAX-derived cerebrospinal fluid partial volume maps. Measures were compared between disease subgroups, and correlations with disability change (Expanded Disability Status Scale [EDSS]) were evaluated. Hierarchical regression was employed to determine the unique additive value of atrophied lesion volume. Atrophied lesion volume was different between MS subtypes (P = .02), and exceeded new lesion volume accumulation in progressive MS (298.1 vs. 75.5 mm 3 ). Atrophied lesion volume was the only significant correlate of EDSS change (r = .192 relapsing, r = .317 progressive, P < .05), and explained significant additional variance when controlling for brain atrophy and new/enlarging lesion volume (R 2 .092 vs. .045, P = .003). Atrophied lesion volume is a unique and clinically relevant imaging marker in MS, with particular promise in progressive MS. Copyright © 2018 by the American Society of Neuroimaging.

  8. Identifying risk profiles for childhood obesity using recursive partitioning based on individual, familial, and neighborhood environment factors.

    PubMed

    Van Hulst, Andraea; Roy-Gagnon, Marie-Hélène; Gauvin, Lise; Kestens, Yan; Henderson, Mélanie; Barnett, Tracie A

    2015-02-15

    Few studies consider how risk factors within multiple levels of influence operate synergistically to determine childhood obesity. We used recursive partitioning analysis to identify unique combinations of individual, familial, and neighborhood factors that best predict obesity in children, and tested whether these predict 2-year changes in body mass index (BMI). Data were collected in 2005-2008 and in 2008-2011 for 512 Quebec youth (8-10 years at baseline) with a history of parental obesity (QUALITY study). CDC age- and sex-specific BMI percentiles were computed and children were considered obese if their BMI was ≥95th percentile. Individual (physical activity and sugar-sweetened beverage intake), familial (household socioeconomic status and measures of parental obesity including both BMI and waist circumference), and neighborhood (disadvantage, prestige, and presence of parks, convenience stores, and fast food restaurants) factors were examined. Recursive partitioning, a method that generates a classification tree predicting obesity based on combined exposure to a series of variables, was used. Associations between resulting varying risk group membership and BMI percentile at baseline and 2-year follow up were examined using linear regression. Recursive partitioning yielded 7 subgroups with a prevalence of obesity equal to 8%, 11%, 26%, 28%, 41%, 60%, and 63%, respectively. The 2 highest risk subgroups comprised i) children not meeting physical activity guidelines, with at least one BMI-defined obese parent and 2 abdominally obese parents, living in disadvantaged neighborhoods without parks and, ii) children with these characteristics, except with access to ≥1 park and with access to ≥1 convenience store. Group membership was strongly associated with BMI at baseline, but did not systematically predict change in BMI. Findings support the notion that obesity is predicted by multiple factors in different settings and provide some indications of potentially obesogenic environments. Alternate group definitions as well as longer duration of follow up should be investigated to predict change in obesity.

  9. VIDEO MODELING BY EXPERTS WITH VIDEO FEEDBACK TO ENHANCE GYMNASTICS SKILLS

    PubMed Central

    Boyer, Eva; Miltenberger, Raymond G; Batsche, Catherine; Fogel, Victoria

    2009-01-01

    The effects of combining video modeling by experts with video feedback were analyzed with 4 female competitive gymnasts (7 to 10 years old) in a multiple baseline design across behaviors. During the intervention, after the gymnast performed a specific gymnastics skill, she viewed a video segment showing an expert gymnast performing the same skill and then viewed a video replay of her own performance of the skill. The results showed that all gymnasts demonstrated improved performance across three gymnastics skills following exposure to the intervention. PMID:20514194

  10. Video modeling by experts with video feedback to enhance gymnastics skills.

    PubMed

    Boyer, Eva; Miltenberger, Raymond G; Batsche, Catherine; Fogel, Victoria

    2009-01-01

    The effects of combining video modeling by experts with video feedback were analyzed with 4 female competitive gymnasts (7 to 10 years old) in a multiple baseline design across behaviors. During the intervention, after the gymnast performed a specific gymnastics skill, she viewed a video segment showing an expert gymnast performing the same skill and then viewed a video replay of her own performance of the skill. The results showed that all gymnasts demonstrated improved performance across three gymnastics skills following exposure to the intervention.

  11. Implementation of RF Circuitry for Real-Time Digital Beam-Forming SAR Calibration Schemes

    NASA Technical Reports Server (NTRS)

    Horst, Stephen J.; Hoffman, James P.; Perkovic-Martin, Dragana; Shaffer, Scott; Thrivikraman, Tushar; Yates, Phil; Veilleux, Louise

    2012-01-01

    The SweepSAR architecture for space-borne remote sensing applications is an enabling technology for reducing the temporal baseline of repeat-pass interferometers while maintaining near-global coverage. As part of this architecture, real-time digital beam-forming would be performed on the radar return signals across multiple channels. Preserving the accuracy of the combined return data requires real-time calibration of the transmit and receive RF paths on each channel. This paper covers several of the design considerations necessary to produce a practical implementation of this concept.

  12. Investigation of key parameters for the development of reliable ITER baseline operation scenarios using CORSICA

    NASA Astrophysics Data System (ADS)

    Kim, S. H.; Casper, T. A.; Snipes, J. A.

    2018-05-01

    ITER will demonstrate the feasibility of burning plasma operation by operating DT plasmas in the ELMy H-mode regime with a high ratio of fusion power gain Q ~ 10. 15 MA ITER baseline operation scenario has been studied using CORSICA, focusing on the entry to burn, flat-top burning plasma operation and exit from burn. The burning plasma operation for about 400 s of the current flat-top was achieved in H-mode within the various engineering constraints imposed by the poloidal field coil and power supply systems. The target fusion gain (Q ~ 10) was achievable in the 15 MA ITER baseline operation with a moderate amount of the total auxiliary heating power (~50 MW). It has been observed that the tungsten (W) concentration needs to be maintained low level (n w/n e up to the order of 1.0  ×  10-5) to avoid the radiative collapse and uncontrolled early termination of the discharge. The dynamic evolution of the density can modify the H-mode access unless the applied auxiliary heating power is significantly higher than the H-mode threshold power. Several qualitative sensitivity studies have been performed to provide guidance for further optimizing the plasma operation and performance. Increasing the density profile peaking factor was quite effective in increasing the alpha particle self-heating power and fusion power multiplication factor. Varying the combination of auxiliary heating power has shown that the fusion power multiplication factor can be reduced along with the increase in the total auxiliary heating power. As the 15 MA ITER baseline operation scenario requires full capacity of the coil and power supply systems, the operation window for H-mode access and shape modification was narrow. The updated ITER baseline operation scenarios developed in this work will become a basis for further optimization studies necessary along with the improvement in understanding the burning plasma physics.

  13. Measuring happiness in individuals with profound multiple disabilities.

    PubMed

    Darling, Joseph A; Circo, Deborah K

    2015-12-01

    This quantitative study assessed whether presentation of preferred items and activities during multiple periods of the day (and over multiple days) increased indices of happiness (over time/sustained) in individuals with PMD. A multiple baseline design across participants was utilized to measure changes in indices of happiness of the participants. Participants were recruited from an adult day activity program specializing in providing assistance to individuals with disabilities. For Mary, baseline indices of happiness were 26.67% of intervals, increasing 6.76% during intervention to 33.43%. For Caleb, baseline indices of happiness were 20.84% of intervals, increasing 6.34% during intervention to 27.18%. For Mark, baseline indices of happiness were 40.00% of intervals, increasing 12.75% during intervention to 52.75%. Overall interobserver agreement was 82.8%, with interobserver agreement observations occurring during 63.04% of the observations. The results of the investigation demonstrated that presenting preferred items and activities increased the indices of happiness compared to baseline rates of indices of happiness. Results may have been more robust if the participants were assessed for overall responsiveness patterns prior to the initiation of measurement of indices of happiness. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Training generalized improvisation of tools by preschool children1

    PubMed Central

    Parsonson, Barry S.; Baer, Donald M.

    1978-01-01

    The development of new, “creative” behaviors was examined in a problem-solving context. One form of problem solving, improvisation, was defined as finding a substitute to replace the specifically designated, but currently unavailable, tool ordinarily used to solve the problem. The study examined whether preschool children spontaneously displayed generalized improvisation skills, and if not, whether they could be trained to do so within different classes of tools. Generalization across different tool classes was monitored but not specifically trained. Five preschool children participated in individual sessions that first probed their skill at improvising tools, and later trained and probed generalized improvisation in one or more of three tool classes (Hammers, Containers, and Shoelaces), using a multiple-baseline design. All five children were trained with Hammers, two were trained in two classes, and two were trained in all three tool classes. Four of the five children improvised little in Baseline. During Training, all five showed increased generalized improvisation within the trained class, but none across classes. Tools fabricated by item combinations were rare in Baseline, but common in Training. Followup probes showed that the training effects were durable. PMID:16795596

  15. Baseline Levels, and Changes Over Time in Body Mass Index and Fasting Insulin, and Their Relationship to Change in Metabolic Trait Clustering

    PubMed Central

    Sullivan, Lisa M.; Fox, Caroline S.; Wilson, Peter W.F.; Nathan, David M.; Vasan, Ramachandran S.; D'Agostino, Ralph B.; Meigs, James B.

    2014-01-01

    Abstract Background: Multiple abnormal metabolic traits are found together or “cluster” within individuals more often than is predicted by chance. The individual and combined role of adiposity and insulin resistance (IR) on metabolic trait clustering is uncertain. We tested the hypothesis that change in trait clustering is a function of both baseline level and change in these measures. Methods: In 2616 nondiabetic Framingham Offspring Study participants, body mass index (BMI) and fasting insulin were related to a within-person 7-year change in a trait score of 0–4 Adult Treatment Panel III metabolic syndrome traits (hypertension, high triglycerides, low high-density lipoprotein cholesterol, hyperglycemia). Results: At baseline assessment, mean trait score was 1.4 traits, and 7-year mean (SEM) change in trait score was +0.25 (0.02) traits, P<0.0001. In models with BMI predictors only, for every quintile difference in baseline BMI, the 7-year trait score increase was 0.14 traits, and for every quintile increase in BMI during 7-year follow-up, the trait score increased by 0.3 traits. Baseline level and change in fasting insulin were similarly related to trait score change. In models adjusted for age–sex–baseline cluster score, 7-year change in trait score was significantly related to both a 1-quintile difference in baseline BMI (0.07 traits) and fasting insulin (0.18 traits), and to both a 1-quintile 7-year increase in BMI (0.21 traits) and fasting insulin (0.18 traits). Conclusions: Change in metabolic trait clustering was significantly associated with baseline levels and changes in both BMI and fasting insulin, highlighting the importance of both obesity and IR in the clustering of metabolic traits. PMID:25007010

  16. Using time-delay to improve social play skills with peers for children with autism.

    PubMed

    Liber, Daniella B; Frea, William D; Symon, Jennifer B G

    2008-02-01

    Interventions that teach social communication and play skills are crucial for the development of children with autism. The time delay procedure is effective in teaching language acquisition, social use of language, discrete behaviors, and chained activities to individuals with autism and developmental delays. In this study, three boys with autism, attending a non-public school, were taught play activities that combined a play sequence with requesting peer assistance, using a graduated time delay procedure. A multiple-baseline across subjects design demonstrated the success of this procedure to teach multiple-step social play sequences. Results indicated an additional gain of an increase in pretend play by one of the participants. Two also demonstrated a generalization of the skills learned through the time delay procedure.

  17. On Internal Validity in Multiple Baseline Designs

    ERIC Educational Resources Information Center

    Pustejovsky, James E.

    2014-01-01

    Single-case designs are a class of research designs for evaluating intervention effects on individual cases. The designs are widely applied in certain fields, including special education, school psychology, clinical psychology, social work, and applied behavior analysis. The multiple baseline design (MBD) is the most frequently used single-case…

  18. Effects of Functional Mobility Skills Training for Adults with Severe Multiple Disabilities

    ERIC Educational Resources Information Center

    Whinnery, Stacie B.; Whinnery, Keith W.

    2011-01-01

    This study investigated the effects of a functional mobility program on the functional standing and walking skills of five adults with developmental disabilities. The Mobility Opportunities Via Education (MOVE) Curriculum was implemented using a multiple-baseline across subjects design. Repeated measures were taken during baseline, intervention…

  19. Fluent Persuasive Writing with Counterarguments for Students with Emotional Disturbance

    ERIC Educational Resources Information Center

    Mastropieri, Margo A.; Scruggs, Thomas E.; Cerar, Nancy Irby; Allen-Bronaugh, Dannette; Thompson, Catherine; Guckert, Mary; Leins, Pat; Hauth, Clara; Cuenca-Sanchez, Yojanna

    2014-01-01

    Twelve seventh- and eighth-grade students with emotional disturbance participated in a multiple probe, multiple baseline design two-phase intervention study to improve persuasive writing skills. The first phase after baseline taught students to plan and write persuasive essays including counterarguments. In the second phase, students were taught…

  20. Neurofilament light chain in cerebrospinal fluid and prediction of disease activity in clinically isolated syndrome and relapsing-remitting multiple sclerosis.

    PubMed

    Håkansson, I; Tisell, A; Cassel, P; Blennow, K; Zetterberg, H; Lundberg, P; Dahle, C; Vrethem, M; Ernerudh, J

    2017-05-01

    Improved biomarkers are needed to facilitate clinical decision-making and as surrogate endpoints in clinical trials in multiple sclerosis (MS). We assessed whether neurodegenerative and neuroinflammatory markers in cerebrospinal fluid (CSF) at initial sampling could predict disease activity during 2 years of follow-up in patients with clinically isolated syndrome (CIS) and relapsing-remitting MS. Using multiplex bead array and enzyme-linked immunosorbent assay, CXCL1, CXCL8, CXCL10, CXCL13, CCL20, CCL22, neurofilament light chain (NFL), neurofilament heavy chain, glial fibrillary acidic protein, chitinase-3-like-1, matrix metalloproteinase-9 and osteopontin were analysed in CSF from 41 patients with CIS or relapsing-remitting MS and 22 healthy controls. Disease activity (relapses, magnetic resonance imaging activity or disability worsening) in patients was recorded during 2 years of follow-up in this prospective longitudinal cohort study. In a logistic regression analysis model, NFL in CSF at baseline emerged as the best predictive marker, correctly classifying 93% of patients who showed evidence of disease activity during 2 years of follow-up and 67% of patients who did not, with an overall proportion of 85% (33 of 39 patients) correctly classified. Combining NFL with either neurofilament heavy chain or osteopontin resulted in 87% overall correctly classified patients, whereas combining NFL with a chemokine did not improve results. This study demonstrates the potential prognostic value of NFL in baseline CSF in CIS and relapsing-remitting MS and supports its use as a predictive biomarker of disease activity. © 2017 EAN.

  1. Combining clinical and magnetic resonance imaging markers enhances prediction of 12-year disability in multiple sclerosis.

    PubMed

    Uher, Tomas; Vaneckova, Manuela; Sobisek, Lukas; Tyblova, Michaela; Seidl, Zdenek; Krasensky, Jan; Ramasamy, Deepa; Zivadinov, Robert; Havrdova, Eva; Kalincik, Tomas; Horakova, Dana

    2017-01-01

    Disease progression and treatment efficacy vary among individuals with multiple sclerosis. Reliable predictors of individual disease outcomes are lacking. To examine the accuracy of the early prediction of 12-year disability outcomes using clinical and magnetic resonance imaging (MRI) parameters. A total of 177 patients from the original Avonex-Steroids-Azathioprine study were included. Participants underwent 3-month clinical follow-ups. Cox models were used to model the associations between clinical and MRI markers at baseline or after 12 months with sustained disability progression (SDP) over the 12-year observation period. At baseline, T2 lesion number, T1 and T2 lesion volumes, corpus callosum (CC), and thalamic fraction were the best predictors of SDP (hazard ratio (HR) = 1.7-4.6; p ⩽ 0.001-0.012). At 12 months, Expanded Disability Status Scale (EDSS) and its change, number of new or enlarging T2 lesions, and CC volume % change were the best predictors of SDP over the follow-up (HR = 1.7-3.5; p ⩽  0.001-0.017). A composite score was generated from a subset of the best predictors of SDP. Scores of ⩾4 had greater specificity (90%-100%) and were associated with greater cumulative risk of SDP (HR = 3.2-21.6; p < 0.001) compared to the individual predictors. The combination of established MRI and clinical indices with MRI volumetric predictors improves the prediction of SDP over long-term follow-up and may provide valuable information for therapeutic decisions.

  2. Multiple Chronic Conditions and Hospitalizations Among Recipients of Long-Term Services and Supports

    PubMed Central

    Van Cleave, Janet H.; Egleston, Brian L.; Abbott, Katherine M.; Hirschman, Karen B.; Rao, Aditi; Naylor, Mary D.

    2016-01-01

    Background Among older adults receiving long term-services and supports (LTSS), debilitating hospitalizations is a pervasive clinical and research problem. Multiple chronic conditions (MCC) are prevalent in LTSS recipients. However, the combination of MCC and diseases associated with hospitalizations of LTSS recipients is unclear. Objective The purpose of this analysis was to determine the association between classes of MCC in newly enrolled LTSS recipients and the number of hospitalizations over a one-year period following enrollment. Methods This report is based on secondary analysis of extant data from a longitudinal cohort study of 470 new recipients of LTSS, ages 60 years and older, receiving services in assisted living facilities, nursing homes, or through home- and community-based services. Using baseline chronic conditions reported in medical records, latent class analysis (LCA) was used to identify classes of MCC and posterior probabilities of membership in each class. Poisson regressions were used to estimate the relative ratio between posterior probabilities of class membership and number of hospitalizations during the 3 month period prior to the start of LTSS (baseline) and then every three months forward through 12 months. Results Three latent MCC-based classes named Cardiopulmonary, Cerebrovascular/Paralysis, and All Other Conditions were identified. The Cardiopulmonary class was associated with elevated numbers of hospitalization compared to the All Other Conditions class (relative ratio [RR] = 1.88, 95% CI [1.33, 2.65], p < .001). Conclusion Older LTSS recipients with a combination of MCCs that includes cardiopulmonary conditions have increased risk for hospitalization. PMID:27801713

  3. The combined approach to lysis utilizing eptifibatide and rt-PA in acute ischemic stroke: the CLEAR stroke trial.

    PubMed

    Pancioli, Arthur M; Broderick, Joseph; Brott, Thomas; Tomsick, Thomas; Khoury, Jane; Bean, Judy; del Zoppo, Gregory; Kleindorfer, Dawn; Woo, Daniel; Khatri, Pooja; Castaldo, John; Frey, James; Gebel, James; Kasner, Scott; Kidwell, Chelsea; Kwiatkowski, Thomas; Libman, Richard; Mackenzie, Richard; Scott, Phillip; Starkman, Sidney; Thurman, R Jason

    2008-12-01

    Multiple approaches are being studied to enhance the rate of thrombolysis for acute ischemic stroke. Treatment of myocardial infarction with a combination of a reduced-dose fibrinolytic agent and a glycoprotein (GP) IIb/IIIa receptor antagonist has been shown to improve the rate of recanalization versus fibrinolysis alone. The combined approach to lysis utilizing eptifibatide and recombinant tissue-type plasminogen activator (rt-PA) (CLEAR) stroke trial assessed the safety of treating acute ischemic stroke patients within 3 hours of symptom onset with this combination. The CLEAR trial was a National Institutes of Health/National Institute of Neurological Disorders and Stroke-funded multicenter, double-blind, randomized, dose-escalation and safety study. Patients were randomized 3:1 to either low-dose rt-PA (tier 1=0.3 mg/kg, tier 2=0.45 mg/kg) plus eptifibatide (75 microg/kg bolus followed by 0.75 microg/kg per min infusion for 2 hours) or standard-dose rt-PA (0.9 mg/kg). The primary safety end point was the incidence of symptomatic intracerebral hemorrhage within 36 hours. Secondary analyses were performed regarding clinical efficacy. Ninety-four patients (40 in tier 1 and 54 in tier 2) were enrolled. The combination group of the 2 dose tiers (n=69) had a median age of 71 years and a median baseline National Institutes of Health Stroke Scale (NIHSS) score of 14, and the standard-dose rt-PA group (n=25) had a median age of 61 years and a median baseline NIHSS score of 10 (P=0.01 for NIHSS score). Fifty-two (75%) of the combination treatment group and 24 (96%) of the standard treatment group had a baseline modified Rankin scale score of 0 (P=0.04). There was 1 (1.4%; 95% CI, 0% to 4.3%) symptomatic intracranial hemorrhage in the combination group and 2 (8.0%; 95% CI, 0% to 19.2%) in the rt-PA-only arm (P=0.17). During randomization in tier 2, a review by the independent data safety monitoring board demonstrated that the safety profile of combination therapy at the tier 2 doses was such that further enrollment was statistically unlikely to indicate inadequate safety for the combination treatment group, the ultimate outcome of the study. Thus, the study was halted. There was a trend toward increased clinical efficacy of standard-dose rt-PA compared with the combination treatment group. The safety of the combination of reduced-dose rt-PA plus eptifibatide justifies further dose-ranging trials in acute ischemic stroke.

  4. Cumulative Effects of Concussion History on Baseline Computerized Neurocognitive Test Scores: Systematic Review and Meta-analysis.

    PubMed

    Alsalaheen, Bara; Stockdale, Kayla; Pechumer, Dana; Giessing, Alexander; He, Xuming; Broglio, Steven P

    It is unclear whether individuals with a history of single or multiple clinically recovered concussions exhibit worse cognitive performance on baseline testing compared with individuals with no concussion history. To analyze the effects of concussion history on baseline neurocognitive performance using a computerized neurocognitive test. PubMed, CINAHL, and psycINFO were searched in November 2015. The search was supplemented by a hand search of references. Studies were included if participants completed the Immediate Post-concussion Assessment and Cognitive Test (ImPACT) at baseline (ie, preseason) and if performance was stratified by previous history of single or multiple concussions. Systematic review and meta-analysis. Level 2. Sample size, demographic characteristics of participants, as well as performance of participants on verbal memory, visual memory, visual-motor processing speed, and reaction time were extracted from each study. A random-effects pooled meta-analysis revealed that, with the exception of worsened visual memory for those with 1 previous concussion (Hedges g = 0.10), no differences were observed between participants with 1 or multiple concussions compared with participants without previous concussions. With the exception of decreased visual memory based on history of 1 concussion, history of 1 or multiple concussions was not associated with worse baseline cognitive performance.

  5. Intensive (Daily) Behavior Therapy for School Refusal: A Multiple Baseline Case Series

    ERIC Educational Resources Information Center

    Tolin, David F.; Whiting, Sara; Maltby, Nicholas; Diefenbach, Gretchen J.; Lothstein, Mary Anne; Hardcastle, Surrey; Catalano, Amy; Gray, Krista

    2009-01-01

    The following multiple baseline case series examines school refusal behavior in 4 male adolescents. School refusal symptom presentation was ascertained utilizing a functional analysis from the School Refusal Assessment Scale (Kearney, 2002). For the majority of cases, treatment was conducted within a 15-session intensive format over a 3-week…

  6. Value of evidence from syndromic surveillance with cumulative evidence from multiple data streams with delayed reporting.

    PubMed

    Struchen, R; Vial, F; Andersson, M G

    2017-04-26

    Delayed reporting of health data may hamper the early detection of infectious diseases in surveillance systems. Furthermore, combining multiple data streams, e.g. aiming at improving a system's sensitivity, can be challenging. In this study, we used a Bayesian framework where the result is presented as the value of evidence, i.e. the likelihood ratio for the evidence under outbreak versus baseline conditions. Based on a historical data set of routinely collected cattle mortality events, we evaluated outbreak detection performance (sensitivity, time to detection, in-control run length) under the Bayesian approach among three scenarios: presence of delayed data reporting, but not accounting for it; presence of delayed data reporting accounted for; and absence of delayed data reporting (i.e. an ideal system). Performance on larger and smaller outbreaks was compared with a classical approach, considering syndromes separately or combined. We found that the Bayesian approach performed better than the classical approach, especially for the smaller outbreaks. Furthermore, the Bayesian approach performed similarly well in the scenario where delayed reporting was accounted for to the scenario where it was absent. We argue that the value of evidence framework may be suitable for surveillance systems with multiple syndromes and delayed reporting of data.

  7. Model-Based Localization and Tracking Using Bluetooth Low-Energy Beacons

    PubMed Central

    Cemgil, Ali Taylan

    2017-01-01

    We introduce a high precision localization and tracking method that makes use of cheap Bluetooth low-energy (BLE) beacons only. We track the position of a moving sensor by integrating highly unreliable and noisy BLE observations streaming from multiple locations. A novel aspect of our approach is the development of an observation model, specifically tailored for received signal strength indicator (RSSI) fingerprints: a combination based on the optimal transport model of Wasserstein distance. The tracking results of the entire system are compared with alternative baseline estimation methods, such as nearest neighboring fingerprints and an artificial neural network. Our results show that highly accurate estimation from noisy Bluetooth data is practically feasible with an observation model based on Wasserstein distance interpolation combined with the sequential Monte Carlo (SMC) method for tracking. PMID:29109375

  8. Model-Based Localization and Tracking Using Bluetooth Low-Energy Beacons.

    PubMed

    Daniş, F Serhan; Cemgil, Ali Taylan

    2017-10-29

    We introduce a high precision localization and tracking method that makes use of cheap Bluetooth low-energy (BLE) beacons only. We track the position of a moving sensor by integrating highly unreliable and noisy BLE observations streaming from multiple locations. A novel aspect of our approach is the development of an observation model, specifically tailored for received signal strength indicator (RSSI) fingerprints: a combination based on the optimal transport model of Wasserstein distance. The tracking results of the entire system are compared with alternative baseline estimation methods, such as nearest neighboring fingerprints and an artificial neural network. Our results show that highly accurate estimation from noisy Bluetooth data is practically feasible with an observation model based on Wasserstein distance interpolation combined with the sequential Monte Carlo (SMC) method for tracking.

  9. Efficacy of Human Umbilical Stem Cells Cultured on Polylactic/ Polyglycolic Acid Membrane in the Treatment of Multiple Gingival Recession Defects: a Randomized Controlled Clinical Study

    PubMed Central

    Zanwar, Kushal; Kumar Ganji, Kiran; Bhongade, Manohar L

    2017-01-01

    Statement of the Problem: Recently allogenic mesenchymal stem cells are proposed to have multipotential progenitor cell capabilities to differentiate into cementoblasts, osteoblasts, and periodontal ligament fibroblasts. Purpose: The aim of the present study was to compare the efficacy of human umbilical stem cells cultured on polylactic acid (PLA), polyglycolic acid (PGA) membrane with PLA/PGA membrane alone in the treatment of multiple gingival recession defects. Materials and Method: A total number of 14 cases of multiple gingival recession (Miller’s Class I or II) located in the anterior region were randomly selected and divided into test (stem cells in combination with PLA/PGA membrane) and control group (PLA/PGA membrane alone). Clinical parameters including gingival recession, probing pocket depth, clinical attachment level, and width of keratinized gingiva were recorded at baseline, and at 6 months postoperative. Results: At baseline, there was 2.28 mm and 2.14mm mean gingival recession at 16 sites and 14 sites in test and control groups respectively. At 6 months post-surgery, test group showed 1.57 mm mean reduction of gingival recession indicating 66% root coverage, while the control group showed 1.24mm mean reduction of gingival recession indicating 57% root coverage. Conclusion: In the present study, the stem cell with PLA/PGA membrane showed significantly higher mean root coverage compared to only PLA/PGA membrane group. PMID:28620633

  10. Bayesian Inference of Baseline Fertility and Treatment Effects via a Crop Yield-Fertility Model

    PubMed Central

    Chen, Hungyen; Yamagishi, Junko; Kishino, Hirohisa

    2014-01-01

    To effectively manage soil fertility, knowledge is needed of how a crop uses nutrients from fertilizer applied to the soil. Soil quality is a combination of biological, chemical and physical properties and is hard to assess directly because of collective and multiple functional effects. In this paper, we focus on the application of these concepts to agriculture. We define the baseline fertility of soil as the level of fertility that a crop can acquire for growth from the soil. With this strict definition, we propose a new crop yield-fertility model that enables quantification of the process of improving baseline fertility and the effects of treatments solely from the time series of crop yields. The model was modified from Michaelis-Menten kinetics and measured the additional effects of the treatments given the baseline fertility. Using more than 30 years of experimental data, we used the Bayesian framework to estimate the improvements in baseline fertility and the effects of fertilizer and farmyard manure (FYM) on maize (Zea mays), barley (Hordeum vulgare), and soybean (Glycine max) yields. Fertilizer contributed the most to the barley yield and FYM contributed the most to the soybean yield among the three crops. The baseline fertility of the subsurface soil was very low for maize and barley prior to fertilization. In contrast, the baseline fertility in this soil approximated half-saturated fertility for the soybean crop. The long-term soil fertility was increased by adding FYM, but the effect of FYM addition was reduced by the addition of fertilizer. Our results provide evidence that long-term soil fertility under continuous farming was maintained, or increased, by the application of natural nutrients compared with the application of synthetic fertilizer. PMID:25405353

  11. The effects of multiple aerospace environmental stressors on human performance

    NASA Technical Reports Server (NTRS)

    Popper, S. E.; Repperger, D. W.; Mccloskey, K.; Tripp, L. D.

    1992-01-01

    An extended Fitt's law paradigm reaction time (RT) task was used to evaluate the effects of acceleration on human performance in the Dynamic Environment Simulator (DES) at Armstrong Laboratory, Wright-Patterson AFB, Ohio. This effort was combined with an evaluation of the standard CSU-13 P anti-gravity suit versus three configurations of a 'retrograde inflation anti-G suit'. Results indicated that RT and error rates increased 17 percent and 14 percent respectively from baseline to the end of the simulated aerial combat maneuver and that the most common error was pressing too few buttons.

  12. Reducing risk of pressure sores: effects of watch prompts and alarm avoidance on wheelchair push-ups.

    PubMed Central

    White, G W; Mathews, R M; Fawcett, S B

    1989-01-01

    People who use wheelchairs are at risk for developing pressure sores. Regular pressure relief, in the form of a wheelchair push-up, is one way to reduce the likelihood of pressure sores. We examined the effects of antecedent (i.e., instructions, audible prompts) and consequent (i.e., alarm avoidance) events on wheelchair push-ups, using a multiple baseline analysis with 2 participants with spina bifida. Results suggest that the combined procedure was more effective than either antecedent or consequent events alone, and there is some evidence suggesting maintenance of effects over time. PMID:2793635

  13. Current concepts of metabolic abnormalities in HIV patients: focus on lipodystrophy.

    PubMed

    Kolter, Donald P

    2003-12-01

    HIV infection is associated with a number of metabolic abnormalities, including lipodystrophy, a difficult-to-define disorder whose characteristics include hyperlipidemia, insulin resistance, and fat redistribution. Current data suggest that lipodystrophy is caused by multiple factors. Dual-nucleoside reverse transcriptase inhibitor therapy combined with protease inhibitor therapy has been shown to increase the risk of metabolic abnormalities, but susceptibility independent of drug effects has also been shown. While many of the treatments for the broad range of signs and symptoms of lipodystrophy bring about improvements in patient status, none have been demonstrated to bring about a return to baseline levels.

  14. Forest Attributes from Radar Interferometric Structure and its Fusion with Optical Remote Sensing

    NASA Technical Reports Server (NTRS)

    Treuhaft, Robert N.; Law, Beverly E.; Asner, Gregory P.

    2004-01-01

    The possibility of global, three-dimensional remote sensing of forest structure with interferometric synthetic aperture radar (InSAR) bears on important forest ecological processes, particularly the carbon cycle. InSAR supplements two-dimensional remote sensing with information in the vertical dimension. Its strengths in potential for global coverage complement those of lidar (light detecting and ranging), which has the potential for high-accuracy vertical profiles over small areas. InSAR derives its sensitivity to forest vertical structure from the differences in signals received by two, spatially separate radar receivers. Estimation of parameters describing vertical structure requires multiple-polarization, multiple-frequency, or multiple-baseline InSAR. Combining InSAR with complementary remote sensing techniques, such as hyperspectral optical imaging and lidar, can enhance vertical-structure estimates and consequent biophysical quantities of importance to ecologists, such as biomass. Future InSAR experiments will supplement recent airborne and spaceborne demonstrations, and together with inputs from ecologists regarding structure, they will suggest designs for future spaceborne strategies for measuring global vegetation structure.

  15. Real-Time Visualization of Network Behaviors for Situational Awareness

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

    Best, Daniel M.; Bohn, Shawn J.; Love, Douglas V.

    Plentiful, complex, and dynamic data make understanding the state of an enterprise network difficult. Although visualization can help analysts understand baseline behaviors in network traffic and identify off-normal events, visual analysis systems often do not scale well to operational data volumes (in the hundreds of millions to billions of transactions per day) nor to analysis of emergent trends in real-time data. We present a system that combines multiple, complementary visualization techniques coupled with in-stream analytics, behavioral modeling of network actors, and a high-throughput processing platform called MeDICi. This system provides situational understanding of real-time network activity to help analysts takemore » proactive response steps. We have developed these techniques using requirements gathered from the government users for which the tools are being developed. By linking multiple visualization tools to a streaming analytic pipeline, and designing each tool to support a particular kind of analysis (from high-level awareness to detailed investigation), analysts can understand the behavior of a network across multiple levels of abstraction.« less

  16. The 30/20 Gigahertz transponder study. [wideband multichannel transponders for a communications satellite

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Design features and performance parameters are described for three types of wideband multiple channel satellite transponders for use in a 30/20 GHz communications satellite, which provides high data rate trunking service to ten ground station terminals. The three types of transponder are frequency division multiplex (FDM), time division multiplex (TDM), and a hybrid transponder using a combination of FDM and TDM techniques. The wideband multiple beam trunking concept, the traffic distribution between the trunking terminals, and system design constraints are discussed. The receiver front end design, the frequency conversion scheme, and the local oscillator design are described including the thermal interface between the transponders and the satellite. The three designs are compared with regard to performance, weight, power, cost and initial technology. Simplified block diagrams of the baseline transponder designs are included.

  17. Dual wing, swept forward swept rearward wing, and single wing design optimization for high performance business airplanes

    NASA Technical Reports Server (NTRS)

    Rhodes, M. D.; Selberg, B. P.

    1982-01-01

    An investigation was performed to compare closely coupled dual wing and swept forward swept rearward wing aircraft to corresponding single wing 'baseline' designs to judge the advantages offered by aircraft designed with multiple wing systems. The optimum multiple wing geometry used on the multiple wing designs was determined in an analytic study which investigated the two- and three-dimensional aerodynamic behavior of a wide range of multiple wing configurations in order to find the wing geometry that created the minimum cruise drag. This analysis used a multi-element inviscid vortex panel program coupled to a momentum integral boundary layer analysis program to account for the aerodynamic coupling between the wings and to provide the two-dimensional aerodynamic data, which was then used as input for a three-dimensional vortex lattice program, which calculated the three-dimensional aerodynamic data. The low drag of the multiple wing configurations is due to a combination of two dimensional drag reductions, tailoring the three dimensional drag for the swept forward swept rearward design, and the structural advantages of the two wings that because of the structural connections permitted higher aspect ratios.

  18. The Contributions of Eye Contact and Contingent Praise to Effective Instruction Delivery in Compliance Training

    ERIC Educational Resources Information Center

    Everett, Gregory E.; Olmi, D. Joe; Edwards, Ron P.; Tingstrom, Daniel H.

    2005-01-01

    The present study, using a multiple baseline across subjects design for two children and a nonconcurrent multiple baseline across subjects design for two additional children, evaluated whether the addition of eye contact and then contingent praise for compliance (CP) would lead to increases in childhood compliance for both statement and question…

  19. DIF Detection Using Multiple-Group Categorical CFA with Minimum Free Baseline Approach

    ERIC Educational Resources Information Center

    Chang, Yu-Wei; Huang, Wei-Kang; Tsai, Rung-Ching

    2015-01-01

    The aim of this study is to assess the efficiency of using the multiple-group categorical confirmatory factor analysis (MCCFA) and the robust chi-square difference test in differential item functioning (DIF) detection for polytomous items under the minimum free baseline strategy. While testing for DIF items, despite the strong assumption that all…

  20. Acceptance and Commitment Therapy for Self-Stigma around Sexual Orientation: A Multiple Baseline Evaluation

    ERIC Educational Resources Information Center

    Yadavaia, James E.; Hayes, Steven C.

    2012-01-01

    This study evaluated the effectiveness of 6 to 10 sessions of Acceptance and Commitment Therapy (ACT) for self-stigma around sexual orientation linked to same-sex attraction (what has generally been referred to as internalized homophobia; IH) in a concurrent multiple-baseline across-participants design. Three men and 2 women showed sizeable…

  1. Visual Analysis of Multiple Baseline across Participants Graphs when Change Is Delayed

    ERIC Educational Resources Information Center

    Lieberman, Rebecca G.; Yoder, Paul J.; Reichow, Brian; Wolery, Mark

    2010-01-01

    A within-subjects group experimental design was used to test whether three manipulated characteristics of multiple baseline across participants (MBL-P) data showing at least a month delayed change in slope affected experts' inference of a functional relation and agreement on this judgment. Thirty-six experts completed a survey composed of 16 MBL-P…

  2. Cholinergic Potentiation and Audiovisual Repetition-Imitation Therapy Improve Speech Production and Communication Deficits in a Person with Crossed Aphasia by Inducing Structural Plasticity in White Matter Tracts

    PubMed Central

    Berthier, Marcelo L.; De-Torres, Irene; Paredes-Pacheco, José; Roé-Vellvé, Núria; Thurnhofer-Hemsi, Karl; Torres-Prioris, María J.; Alfaro, Francisco; Moreno-Torres, Ignacio; López-Barroso, Diana; Dávila, Guadalupe

    2017-01-01

    Donepezil (DP), a cognitive-enhancing drug targeting the cholinergic system, combined with massed sentence repetition training augmented and speeded up recovery of speech production deficits in patients with chronic conduction aphasia and extensive left hemisphere infarctions (Berthier et al., 2014). Nevertheless, a still unsettled question is whether such improvements correlate with restorative structural changes in gray matter and white matter pathways mediating speech production. In the present study, we used pharmacological magnetic resonance imaging to study treatment-induced brain changes in gray matter and white matter tracts in a right-handed male with chronic conduction aphasia and a right subcortical lesion (crossed aphasia). A single-patient, open-label multiple-baseline design incorporating two different treatments and two post-treatment evaluations was used. The patient received an initial dose of DP (5 mg/day) which was maintained during 4 weeks and then titrated up to 10 mg/day and administered alone (without aphasia therapy) during 8 weeks (Endpoint 1). Thereafter, the drug was combined with an audiovisual repetition-imitation therapy (Look-Listen-Repeat, LLR) during 3 months (Endpoint 2). Language evaluations, diffusion weighted imaging (DWI), and voxel-based morphometry (VBM) were performed at baseline and at both endpoints in JAM and once in 21 healthy control males. Treatment with DP alone and combined with LLR therapy induced marked improvement in aphasia and communication deficits as well as in selected measures of connected speech production, and phrase repetition. The obtained gains in speech production remained well-above baseline scores even 4 months after ending combined therapy. Longitudinal DWI showed structural plasticity in the right frontal aslant tract and direct segment of the arcuate fasciculus with both interventions. VBM revealed no structural changes in other white matter tracts nor in cortical areas linked by these tracts. In conclusion, cholinergic potentiation alone and combined with a model-based aphasia therapy improved language deficits by promoting structural plastic changes in right white matter tracts. PMID:28659776

  3. Just showing up is not enough: Homework adherence and outcome in cognitive-behavioral therapy for cocaine dependence

    PubMed Central

    Decker, Suzanne E.; Kiluk, Brian. D.; Frankforter, Tami; Babuscio, Theresa; Nich, Charla; Carroll, Kathleen M.

    2017-01-01

    Objective Homework in cognitive behavioral therapy (CBT) provides opportunities to practice skills. In prior studies, homework adherence was associated with improved outcome across a variety of disorders. Few studies have examined whether the relationship between homework adherence and outcome is maintained after treatment end or is independent of treatment attendance. Method This study combined data from four randomized clinical trials of CBT for cocaine dependence to examine relationships among homework adherence, participant variables, and cocaine use outcomes during treatment and at follow-up. The dataset included only participants who attended at least two CBT sessions to allow for assignment and return of homework (N = 158). Results Participants returned slightly less than half (41.1%) of assigned homework. Longitudinal random effects regression suggested a greater reduction in cocaine use during treatment and through 12 month follow-up for participants who completed half or more of assigned homework (3 way interaction F(2, 910.69) = 4.28, p = .01). In multiple linear regression, the percentage of homework adherence was associated with greater number of cocaine-negative urine toxicology screens during treatment, even when accounting for baseline cocaine use frequency and treatment attendance; at three-months follow-up, multiple logistic regression indicated homework adherence was associated with cocaine-negative urine toxicology screen, controlling for baseline cocaine use and treatment attendance. Conclusions These results extend findings from prior studies regarding the importance of homework adherence by demonstrating associations among homework and cocaine use outcomes during treatment and up to 12 months after, independent of treatment attendance and baseline cocaine use severity. PMID:27454780

  4. Prevalence of diabetic peripheral neuropathy and relation to glycemic control therapies at baseline in the BARI 2D cohort.

    PubMed

    Pop-Busui, Rodica; Lu, Jiang; Lopes, Neuza; Jones, Teresa L Z

    2009-03-01

    We evaluated the associations between glycemic therapies and prevalence of diabetic peripheral neuropathy (DPN) at baseline among participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial on medical and revascularization therapies for coronary artery disease (CAD) and on insulin-sensitizing vs. insulin-providing treatments for diabetes. A total of 2,368 patients with type 2 diabetes and CAD was evaluated. DPN was defined as clinical examination score >2 using the Michigan Neuropathy Screening Instrument (MNSI). DPN odds ratios across different groups of glycemic therapy were evaluated by multiple logistic regression adjusted for multiple covariates including age, sex, hemoglobin A1c (HbA1c), and diabetes duration. Fifty-one percent of BARI 2D subjects with valid baseline characteristics and MNSI scores had DPN. After adjusting for all variables, use of insulin was significantly associated with DPN (OR = 1.57, 95% CI: 1.15-2.13). Patients on sulfonylurea (SU) or combination of SU/metformin (Met)/thiazolidinediones (TZD) had marginally higher rates of DPN than the Met/TZD group. This cross-sectional study in a cohort of patients with type 2 diabetes and CAD showed association of insulin use with higher DPN prevalence, independent of disease duration, glycemic control, and other characteristics. The causality between a glycemic control strategy and DPN cannot be evaluated in this cross-sectional study, but continued assessment of DPN and randomized therapies in BARI 2D trial may provide further explanations on the development of DPN.

  5. Sequential Monte Carlo tracking of the marginal artery by multiple cue fusion and random forest regression.

    PubMed

    Cherry, Kevin M; Peplinski, Brandon; Kim, Lauren; Wang, Shijun; Lu, Le; Zhang, Weidong; Liu, Jianfei; Wei, Zhuoshi; Summers, Ronald M

    2015-01-01

    Given the potential importance of marginal artery localization in automated registration in computed tomography colonography (CTC), we have devised a semi-automated method of marginal vessel detection employing sequential Monte Carlo tracking (also known as particle filtering tracking) by multiple cue fusion based on intensity, vesselness, organ detection, and minimum spanning tree information for poorly enhanced vessel segments. We then employed a random forest algorithm for intelligent cue fusion and decision making which achieved high sensitivity and robustness. After applying a vessel pruning procedure to the tracking results, we achieved statistically significantly improved precision compared to a baseline Hessian detection method (2.7% versus 75.2%, p<0.001). This method also showed statistically significantly improved recall rate compared to a 2-cue baseline method using fewer vessel cues (30.7% versus 67.7%, p<0.001). These results demonstrate that marginal artery localization on CTC is feasible by combining a discriminative classifier (i.e., random forest) with a sequential Monte Carlo tracking mechanism. In so doing, we present the effective application of an anatomical probability map to vessel pruning as well as a supplementary spatial coordinate system for colonic segmentation and registration when this task has been confounded by colon lumen collapse. Published by Elsevier B.V.

  6. Effects of exposure in single and multiple contexts on fear renewal: The moderating role of threat-specific and nonspecific emotionality.

    PubMed

    Olatunji, Bunmi O; Tomarken, Andrew; Wentworth, Brian; Fritzsche, Laura

    2017-03-01

    The current study examines effects of exposure in multiple contexts on fear reduction and renewal and the moderating effect of baseline threat-specific and nonspecific emotionality. Snake-fearful participants received a negative or neutral emotion induction and were randomized to video exposure to a snake in a single context, multiple context, or a no exposure control group. Anxiety in response to video presentations of a snake was significantly reduced in the two exposure groups compared to the control group, especially among those with heightened baseline threat-specific emotionality as indicated by snake anxiety ratings at baseline. Although the two exposure groups did not differ in responding when confronted with a novel snake, both exposure groups reported significantly lower snake anxiety and arousal than the control group. Subsequent analysis did show that compared to controls, the single context group demonstrated greater increase in anxiety and arousal from post-exposure to exposure to the novel snake among those with heightened snake anxiety at baseline. Furthermore, the multiple context group was less avoidant and less fearful than the single context group on a post-exposure behavioral test. The study used an analogue exposure paradigm with an analogue sample and findings may not be generalizable to a clinical population. These findings suggest that baseline threat-specific emotionality influences fear reduction and renewal. The benefits of exposure in multiple contexts are discussed in relation to a distinct pattern of symptom change that is in line with an inhibitory learning approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Factors affecting the effectiveness of biomedical document indexing and retrieval based on terminologies.

    PubMed

    Dinh, Duy; Tamine, Lynda; Boubekeur, Fatiha

    2013-02-01

    The aim of this work is to evaluate a set of indexing and retrieval strategies based on the integration of several biomedical terminologies on the available TREC Genomics collections for an ad hoc information retrieval (IR) task. We propose a multi-terminology based concept extraction approach to selecting best concepts from free text by means of voting techniques. We instantiate this general approach on four terminologies (MeSH, SNOMED, ICD-10 and GO). We particularly focus on the effect of integrating terminologies into a biomedical IR process, and the utility of using voting techniques for combining the extracted concepts from each document in order to provide a list of unique concepts. Experimental studies conducted on the TREC Genomics collections show that our multi-terminology IR approach based on voting techniques are statistically significant compared to the baseline. For example, tested on the 2005 TREC Genomics collection, our multi-terminology based IR approach provides an improvement rate of +6.98% in terms of MAP (mean average precision) (p<0.05) compared to the baseline. In addition, our experimental results show that document expansion using preferred terms in combination with query expansion using terms from top ranked expanded documents improve the biomedical IR effectiveness. We have evaluated several voting models for combining concepts issued from multiple terminologies. Through this study, we presented many factors affecting the effectiveness of biomedical IR system including term weighting, query expansion, and document expansion models. The appropriate combination of those factors could be useful to improve the IR performance. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Differential Roles for the Thyroarytenoid and Lateral Cricoarytenoid Muscles in Phonation

    PubMed Central

    Chhetri, Dinesh K.; Neubauer, Juergen

    2015-01-01

    Objective Laryngeal adductor muscle dysfunction is common cause of voice disorders. Reconstitution of adductor muscle function is often the target of therapy, but the effects of these muscles on voice production remain to be fully understood. This study investigated the differential roles of thyroarytenoid (TA) and lateral cricoarytenoid (LCA) muscles on voice production. Study Design Basic science study using an in vivo canine model of phonation. Methods The TA and LCA muscle nerve branches were stimulated to obtain 7 graded levels of muscle activation, from threshold to maximal contraction. The effects of LCA activation alone, TA activation alone, and combined TA and LCA activation on phonation onset parameters were investigated. Phonatory posture, phonation onset type, fundamental frequency (F0), phonation onset pressure, and airflow were evaluated. Results LCA activation closed the posterior glottis but mid-membranous gap remained. TA activation closed the membranous glottis but posterior gap remained. Complete glottal closure was obtained only with combined TA and LCA activation. Phonation onset with LCAs alone was characterized by multiple modes (soft, aperiodic, periodic), while with TAs alone was abrupt and periodic but had significant baseline noise. Combined muscle activation led to elimination of baseline noise with stable abrupt periodic onset of phonation. Combined muscle activation was also necessary for F0 variation. LCA assisted the TA in increasing subglottal pressure while concurrently reducing phonation onset airflow. Conclusion TA is necessary for F0 variation, stable onset phonation, and increased subglottal pressure but needs LCA for optimal effectiveness and to reduce airflow requirements with increased activation. PMID:26198167

  9. The individual and combined effects of phenmetrazine and mgluR2/3 agonist LY379268 on the motivation to self-administer cocaine.

    PubMed

    Karkhanis, Anushree N; Beveridge, Thomas J R; Blough, Bruce E; Jones, Sara R; Ferris, Mark J

    2016-09-01

    The US Food and Drug Administration has not approved a treatment for cocaine addiction, possibly due in part to the fact that repeated cocaine use results in dysregulation of multiple neurotransmitter systems, including glutamate and dopamine, and an emergence of increased negative affective states and heightening motivation to take cocaine despite negative consequences. We used a combination therapy approach to assess whether modulation of both glutamate and dopamine transmission would reduce the motivation to self- administer cocaine compared to modulation of either system alone. The metabotropic glutamate 2/3 receptor agonist, LY379268, and the monoamine releaser, phenmetrazine, were used to assess their individual and combined ability to decrease the reinforcing efficacy of cocaine because they modulate glutamate and dopamine levels, respectively. Cocaine breakpoints and cocaine intake was assessed, using a progressive ratio schedule, at baseline in three groups based on dose of cocaine (0.19, 0.38, 0.75mg/kg/infusion), and following LY379268 (0.03 or 0.30mg/kg; i.p.), phenmetrazine (25mg/kg/day; osmotic minipump), and a combination of the two drugs. LY379268 and phenmetrazine alone reduced breakpoints for all doses of cocaine. The combination of the two drugs showed a concerted effect in reducing breakpoints for all doses of cocaine, with the lowest dose of cocaine reduced by as much as 70%. These data support combination therapy of dopamine and glutamate systems as an effective means to reduce the motivation to take cocaine since a combination of drugs can address neurobiological dysfunction in multiple neurotransmitter systems compared to therapies using single drugs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. The impact of alcohol marketing on youth drinking behaviour: a two-stage cohort study.

    PubMed

    Gordon, Ross; MacKintosh, Anne Marie; Moodie, Crawford

    2010-01-01

    To examine whether awareness of, and involvement with alcohol marketing at age 13 is predictive of initiation of drinking, frequency of drinking and units of alcohol consumed at age 15. A two-stage cohort study, involving a questionnaire survey, combining interview and self-completion, was administered in respondents' homes. Respondents were drawn from secondary schools in three adjoining local authority areas in the West of Scotland, UK. From a baseline sample of 920 teenagers (aged 12-14, mean age 13), in 2006, a cohort of 552 was followed up 2 years later (aged 14-16, mean age 15). Data were gathered on multiple forms of alcohol marketing and measures of drinking initiation, frequency and consumption. At follow-up, logistic regression demonstrated that, after controlling for confounding variables, involvement with alcohol marketing at baseline was predictive of both uptake of drinking and increased frequency of drinking. Awareness of marketing at baseline was also associated with an increased frequency of drinking at follow-up. Our findings demonstrate an association between involvement with, and awareness of, alcohol marketing and drinking uptake or increased drinking frequency, and we consider whether the current regulatory environment affords youth sufficient protection from alcohol marketing.

  11. Supporting First-Grade Writers Who Fail to Learn: Multiple Single-Case Evaluation of a Response to Intervention Approach

    ERIC Educational Resources Information Center

    Arrimada, María; Torrance, Mark; Fidalgo, Raquel

    2018-01-01

    We report a multiple-baseline single-case study, based in the response to intervention framework, evaluating transcription-only and transcription-and-planning interventions for young, struggling writers. In a baseline phase, 8 classes of Spanish children at the start of their first year of primary (elementary) education completed short, probe…

  12. The Effect of Strategy Instruction on the Reading Comprehension of High School Students with ADHD

    ERIC Educational Resources Information Center

    Johnson, Joseph W.

    2011-01-01

    The purpose of this study was to determine the effect of strategy instruction on the reading comprehension of high school students with ADHD. The research design was a multiple baseline across participants design with multiple probes during baseline (Kazdin, 1982). The participants were three female high school students with ADHD who were also…

  13. Early Discharge After Primary Percutaneous Coronary Intervention: The Added Value of N‐Terminal Pro–Brain Natriuretic Peptide to the Zwolle Risk Score

    PubMed Central

    Schellings, Dirk A. A. M.; Adiyaman, Ahmet; Giannitsis, Evangelos; Hamm, Christian; Suryapranata, Harry; ten Berg, Jurrien M.; Hoorntje, Jan C. A.; van‘t Hof, Arnoud W. J.

    2014-01-01

    Background The Zwolle Risk Score (ZRS) identifies ST‐elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI) eligible for early discharge. We aimed to investigate whether baseline N‐terminal pro–brain natriuretic peptide (NT‐proBNP) is also able to identify these patients and could improve future risk strategies. Methods and Results PPCI patients included in the Ongoing Tirofiban in Myocardial Infarction Evaluation (On‐TIME) II study were candidates (N=861). We analyzed whether ZRS and baseline NT‐proBNP predicted 30‐day mortality and assessed the occurrence of major adverse cardiac events (MACEs) and major bleeding. Receiver operating characteristic curve analysis was used to assess discriminative accuracy for ZRS, NT‐pro‐BNP, and their combination. After multiple imputation, 845 patients were included. Both ZRS >3 (hazard ratio [HR]=9.42; P<0.001) and log NT‐pro‐BNP (HR=2.61; P<0.001) values were associated with 30‐day mortality. On multivariate analysis, both the ZRS (HR=1.41; 95% confidence interval [CI]=1.27 to 1.56; P<0.001) and log NT‐proBNP (HR=2.09; 95% CI=1.59 to 2.74; P<0.001) independently predicted death at 30 days. The area under the curve for 30‐day mortality for combined ZRS/NT‐proBNP was 0.94 (95% CI=0.90 to 0.99), with optimal predictive values of a ZRS ≥2 and a NT‐proBNP value of ≥200 pg/mL. Using these cut‐off values, 64% of the study population could be identified as very low risk with zero mortality at 30 days follow‐up and low occurrence of MACEs and major bleeding between 48 hours and 10 days (1.3% and 0.6%, respectively). Conclusion Baseline NT‐proBNP identifies a large group of low‐risk patients who may be eligible for early (48‐ to 72‐hour) discharge, whereas optimal predictive accuracy is reached by the combination of both baseline NT‐proBNP and ZRS. PMID:25389283

  14. A hybrid systems strategy for automated spacecraft tour design and optimization

    NASA Astrophysics Data System (ADS)

    Stuart, Jeffrey R.

    As the number of operational spacecraft increases, autonomous operations is rapidly evolving into a critical necessity. Additionally, the capability to rapidly generate baseline trajectories greatly expands the range of options available to analysts as they explore the design space to meet mission demands. Thus, a general strategy is developed, one that is suitable for the construction of flight plans for both Earth-based and interplanetary spacecraft that encounter multiple objects, where these multiple encounters comprise a ``tour''. The proposed scheme is flexible in implementation and can readily be adjusted to a variety of mission architectures. Heuristic algorithms that autonomously generate baseline tour trajectories and, when appropriate, adjust reference solutions in the presence of rapidly changing environments are investigated. Furthermore, relative priorities for ranking the targets are explicitly accommodated during the construction of potential tour sequences. As a consequence, a priori, as well as newly acquired, knowledge concerning the target objects enhances the potential value of the ultimate encounter sequences. A variety of transfer options are incorporated, from rendezvous arcs enabled by low-thrust engines to more conventional impulsive orbit adjustments via chemical propulsion technologies. When advantageous, trajectories are optimized in terms of propellant consumption via a combination of indirect and direct methods; such a combination of available technologies is an example of hybrid optimization. Additionally, elements of hybrid systems theory, i.e., the blending of dynamical states, some discrete and some continuous, are integrated into the high-level tour generation scheme. For a preliminary investigation, this strategy is applied to mission design scenarios for a Sun-Jupiter Trojan asteroid tour as well as orbital debris removal for near-Earth applications.

  15. Treatment with a combination of intra-oral sensory stimulation and electropalatography in a child with severe developmental dyspraxia.

    PubMed

    Lundeborg, Inger; McAllister, Anita

    2007-01-01

    This paper describes the use of a combination of intra-oral sensory stimulation and electropalatography (EPG) in the treatment of a case with severe developmental verbal dyspraxia. A multiple-baseline design was used. The treatment duration was 11 months and started when the subject was 5 years old. The efficacy of the treatment was assessed by calculations of percentage of correctly articulated words, percentage of consonants correct, percentage of phonemes correct and percentage of words correct. Intelligibility assessments were conducted by both naïve and expert listeners. The experts also assessed visual deviances in articulatory gestures from video recordings. Qualitative analysis of EPG data was made. The subject's speech was significantly improved by the treatment in all aspects. The results and their generalization to other cases of developmental verbal dyspraxia are discussed.

  16. Field Science Ethnography: Methods For Systematic Observation on an Expedition

    NASA Technical Reports Server (NTRS)

    Clancey, William J.; Clancy, Daniel (Technical Monitor)

    2001-01-01

    The Haughton-Mars expedition is a multidisciplinary project, exploring an impact crater in an extreme environment to determine how people might live and work on Mars. The expedition seeks to understand and field test Mars facilities, crew roles, operations, and computer tools. I combine an ethnographic approach to establish a baseline understanding of how scientists prefer to live and work when relatively unemcumbered, with a participatory design approach of experimenting with procedures and tools in the context of use. This paper focuses on field methods for systematically recording and analyzing the expedition's activities. Systematic photography and time-lapse video are combined with concept mapping to organize and present information. This hybrid approach is generally applicable to the study of modern field expeditions having a dozen or more multidisciplinary participants, spread over a large terrain during multiple field seasons.

  17. Missing continuous outcomes under covariate dependent missingness in cluster randomised trials

    PubMed Central

    Diaz-Ordaz, Karla; Bartlett, Jonathan W

    2016-01-01

    Attrition is a common occurrence in cluster randomised trials which leads to missing outcome data. Two approaches for analysing such trials are cluster-level analysis and individual-level analysis. This paper compares the performance of unadjusted cluster-level analysis, baseline covariate adjusted cluster-level analysis and linear mixed model analysis, under baseline covariate dependent missingness in continuous outcomes, in terms of bias, average estimated standard error and coverage probability. The methods of complete records analysis and multiple imputation are used to handle the missing outcome data. We considered four scenarios, with the missingness mechanism and baseline covariate effect on outcome either the same or different between intervention groups. We show that both unadjusted cluster-level analysis and baseline covariate adjusted cluster-level analysis give unbiased estimates of the intervention effect only if both intervention groups have the same missingness mechanisms and there is no interaction between baseline covariate and intervention group. Linear mixed model and multiple imputation give unbiased estimates under all four considered scenarios, provided that an interaction of intervention and baseline covariate is included in the model when appropriate. Cluster mean imputation has been proposed as a valid approach for handling missing outcomes in cluster randomised trials. We show that cluster mean imputation only gives unbiased estimates when missingness mechanism is the same between the intervention groups and there is no interaction between baseline covariate and intervention group. Multiple imputation shows overcoverage for small number of clusters in each intervention group. PMID:27177885

  18. Missing continuous outcomes under covariate dependent missingness in cluster randomised trials.

    PubMed

    Hossain, Anower; Diaz-Ordaz, Karla; Bartlett, Jonathan W

    2017-06-01

    Attrition is a common occurrence in cluster randomised trials which leads to missing outcome data. Two approaches for analysing such trials are cluster-level analysis and individual-level analysis. This paper compares the performance of unadjusted cluster-level analysis, baseline covariate adjusted cluster-level analysis and linear mixed model analysis, under baseline covariate dependent missingness in continuous outcomes, in terms of bias, average estimated standard error and coverage probability. The methods of complete records analysis and multiple imputation are used to handle the missing outcome data. We considered four scenarios, with the missingness mechanism and baseline covariate effect on outcome either the same or different between intervention groups. We show that both unadjusted cluster-level analysis and baseline covariate adjusted cluster-level analysis give unbiased estimates of the intervention effect only if both intervention groups have the same missingness mechanisms and there is no interaction between baseline covariate and intervention group. Linear mixed model and multiple imputation give unbiased estimates under all four considered scenarios, provided that an interaction of intervention and baseline covariate is included in the model when appropriate. Cluster mean imputation has been proposed as a valid approach for handling missing outcomes in cluster randomised trials. We show that cluster mean imputation only gives unbiased estimates when missingness mechanism is the same between the intervention groups and there is no interaction between baseline covariate and intervention group. Multiple imputation shows overcoverage for small number of clusters in each intervention group.

  19. Using an iPad® App to Improve Sight Word Reading Fluency for At-Risk First Graders

    ERIC Educational Resources Information Center

    Musti-Rao, Shobana; Lo, Ya-yu; Plati, Erin

    2015-01-01

    We used a multiple baseline across word lists design nested within a multiple baseline across participants design to examine the effects of instruction delivered using an iPad® app on sight word fluency and oral reading fluency of six first graders identified as at risk for reading failure. In Study 1, three students participated in…

  20. Early sign of microangiopathy in systemic sclerosis: The significance of cold stress test in dynamic laser Doppler flowmetry.

    PubMed

    Yu, Sebastian; Hu, Stephen Chu-Sung; Yu, Hsin-Su; Chin, Yi-Ying; Cheng, Yang-Chun; Lee, Chih-Hung

    2018-06-05

    Skin physiology measurement is receiving more attention for detecting vasculopathy in systemic sclerosis (SSc). Laser Doppler flowmetry (LDF) is a widely used physiological measurement to assess cutaneous microcirculation. However, findings of LDF may be normal during early stage of microangiopathy in SSc. We hypothesized that cold stress test combined with LDF could detect early-stage microangiopathy in patients with SSc. A 67-year-old male came with multiple ulcerations on his fingers for one year. After excluding diseases such as diabetes mellitus-related peripheral arterial occlusive disease and smoking-related Buerger's disease, the diagnosis of SSc was made according to the 2013 ACR/EULAR criteria. We performed LDF and angiography for a patient with SSc and compared the results. Although occlusions of right ulnar and digital arteries were obvious in angiography, the baseline skin temperature and perfusion unit on right fingers remained within normal limits. While the microcirculatory abnormalities measured by LDF alone are subtle, LDF combined with cold stress test detected a significant slow recovery of skin blood flow 40 minutes after cold immersion. In conclusion, there may be discordance between macrovasculopathy and baseline microcirculatory blood flow in SSc. In such a case, cold immersion test is essential to measure the dynamic change and slow recovery of blood flow.

  1. Uncertainty of future projections of species distributions in mountainous regions.

    PubMed

    Tang, Ying; Winkler, Julie A; Viña, Andrés; Liu, Jianguo; Zhang, Yuanbin; Zhang, Xiaofeng; Li, Xiaohong; Wang, Fang; Zhang, Jindong; Zhao, Zhiqiang

    2018-01-01

    Multiple factors introduce uncertainty into projections of species distributions under climate change. The uncertainty introduced by the choice of baseline climate information used to calibrate a species distribution model and to downscale global climate model (GCM) simulations to a finer spatial resolution is a particular concern for mountainous regions, as the spatial resolution of climate observing networks is often insufficient to detect the steep climatic gradients in these areas. Using the maximum entropy (MaxEnt) modeling framework together with occurrence data on 21 understory bamboo species distributed across the mountainous geographic range of the Giant Panda, we examined the differences in projected species distributions obtained from two contrasting sources of baseline climate information, one derived from spatial interpolation of coarse-scale station observations and the other derived from fine-spatial resolution satellite measurements. For each bamboo species, the MaxEnt model was calibrated separately for the two datasets and applied to 17 GCM simulations downscaled using the delta method. Greater differences in the projected spatial distributions of the bamboo species were observed for the models calibrated using the different baseline datasets than between the different downscaled GCM simulations for the same calibration. In terms of the projected future climatically-suitable area by species, quantification using a multi-factor analysis of variance suggested that the sum of the variance explained by the baseline climate dataset used for model calibration and the interaction between the baseline climate data and the GCM simulation via downscaling accounted for, on average, 40% of the total variation among the future projections. Our analyses illustrate that the combined use of gridded datasets developed from station observations and satellite measurements can help estimate the uncertainty introduced by the choice of baseline climate information to the projected changes in species distribution.

  2. Uncertainty of future projections of species distributions in mountainous regions

    PubMed Central

    Tang, Ying; Viña, Andrés; Liu, Jianguo; Zhang, Yuanbin; Zhang, Xiaofeng; Li, Xiaohong; Wang, Fang; Zhang, Jindong; Zhao, Zhiqiang

    2018-01-01

    Multiple factors introduce uncertainty into projections of species distributions under climate change. The uncertainty introduced by the choice of baseline climate information used to calibrate a species distribution model and to downscale global climate model (GCM) simulations to a finer spatial resolution is a particular concern for mountainous regions, as the spatial resolution of climate observing networks is often insufficient to detect the steep climatic gradients in these areas. Using the maximum entropy (MaxEnt) modeling framework together with occurrence data on 21 understory bamboo species distributed across the mountainous geographic range of the Giant Panda, we examined the differences in projected species distributions obtained from two contrasting sources of baseline climate information, one derived from spatial interpolation of coarse-scale station observations and the other derived from fine-spatial resolution satellite measurements. For each bamboo species, the MaxEnt model was calibrated separately for the two datasets and applied to 17 GCM simulations downscaled using the delta method. Greater differences in the projected spatial distributions of the bamboo species were observed for the models calibrated using the different baseline datasets than between the different downscaled GCM simulations for the same calibration. In terms of the projected future climatically-suitable area by species, quantification using a multi-factor analysis of variance suggested that the sum of the variance explained by the baseline climate dataset used for model calibration and the interaction between the baseline climate data and the GCM simulation via downscaling accounted for, on average, 40% of the total variation among the future projections. Our analyses illustrate that the combined use of gridded datasets developed from station observations and satellite measurements can help estimate the uncertainty introduced by the choice of baseline climate information to the projected changes in species distribution. PMID:29320501

  3. Photogrammetry of a 5m Inflatable Space Antenna With Consumer Digital Cameras

    NASA Technical Reports Server (NTRS)

    Pappa, Richard S.; Giersch, Louis R.; Quagliaroli, Jessica M.

    2000-01-01

    This paper discusses photogrammetric measurements of a 5m-diameter inflatable space antenna using four Kodak DC290 (2.1 megapixel) digital cameras. The study had two objectives: 1) Determine the photogrammetric measurement precision obtained using multiple consumer-grade digital cameras and 2) Gain experience with new commercial photogrammetry software packages, specifically PhotoModeler Pro from Eos Systems, Inc. The paper covers the eight steps required using this hardware/software combination. The baseline data set contained four images of the structure taken from various viewing directions. Each image came from a separate camera. This approach simulated the situation of using multiple time-synchronized cameras, which will be required in future tests of vibrating or deploying ultra-lightweight space structures. With four images, the average measurement precision for more than 500 points on the antenna surface was less than 0.020 inches in-plane and approximately 0.050 inches out-of-plane.

  4. Impact of mutational profiles on response of primary oestrogen receptor-positive breast cancers to oestrogen deprivation.

    PubMed

    Gellert, Pascal; Segal, Corrinne V; Gao, Qiong; López-Knowles, Elena; Martin, Lesley-Ann; Dodson, Andrew; Li, Tiandao; Miller, Christopher A; Lu, Charles; Mardis, Elaine R; Gillman, Alexa; Morden, James; Graf, Manuela; Sidhu, Kally; Evans, Abigail; Shere, Michael; Holcombe, Christopher; McIntosh, Stuart A; Bundred, Nigel; Skene, Anthony; Maxwell, William; Robertson, John; Bliss, Judith M; Smith, Ian; Dowsett, Mitch

    2016-11-09

    Pre-surgical studies allow study of the relationship between mutations and response of oestrogen receptor-positive (ER+) breast cancer to aromatase inhibitors (AIs) but have been limited to small biopsies. Here in phase I of this study, we perform exome sequencing on baseline, surgical core-cuts and blood from 60 patients (40 AI treated, 20 controls). In poor responders (based on Ki67 change), we find significantly more somatic mutations than good responders. Subclones exclusive to baseline or surgical cores occur in ∼30% of tumours. In phase II, we combine targeted sequencing on another 28 treated patients with phase I. We find six genes frequently mutated: PIK3CA, TP53, CDH1, MLL3, ABCA13 and FLG with 71% concordance between paired cores. TP53 mutations are associated with poor response. We conclude that multiple biopsies are essential for confident mutational profiling of ER+ breast cancer and TP53 mutations are associated with resistance to oestrogen deprivation therapy.

  5. Predictors of response to neuroleptic treatment in schizophrenia.

    PubMed

    Stern, R G; Kahn, R S; Davidson, M

    1993-06-01

    Baseline symptom severity, early reduction in symptom severity, initial subjective response to neuroleptic treatment, the degree of brain atrophy, and early changes in pHVA levels appear to predict treatment outcome in schizophrenic patients. Computerized EEG results, neuropsychological and neurophysiologic tests, and baseline pHVA concentrations require further examination. Only a limited proportion of variance in treatment response, however, could be explained by either of the nine predictors alone or combined. Therefore, further research is necessary to discover yet unidentified determinants of treatment response. Future studies should test the validity and reliability of these five promising predictors in large groups of male and female patients, employ high standards for assessment reliability of clinical parameters, and use absolute rating scores on psychopathology as well as functional scales for the definition of good and poor treatment response. Furthermore, the statistical approach for data analysis should take in consideration the need for appropriate corrections when multiple correlations are performed and should test the extent to which these predictors are interdependent.

  6. Treatment of giant intradural (perimedullary) arteriovenous fistulas.

    PubMed

    Halbach, V V; Higashida, R T; Dowd, C F; Fraser, K W; Edwards, M S; Barnwell, S L

    1993-12-01

    Ten patients with giant intradural spinal arteriovenous fistulas (perimedullary Types II and III) were treated with embolization alone (three patients) or in combination with surgery (seven patients). Their ages at the time of treatment ranged from 2 to 40 years, with a mean of 19.5 years. The indications for treatment included progressive myelopathy in five patients, spinal subarachnoid hemorrhage in four, and acute paraplegia in one. Associated conditions included Rendu-Osler-Weber syndrome in two patients, and Cobb's syndrome in two patients. In one patient, the cause of the fistula may have been related to epidural anesthesia traumatizing a low tethered cord. Angiographically, the fistulas were subclassified in three groups: a single-hole fistula supplied by a single feeding medullary artery (three patients); a single-hole fistula supplied by multiple medullary arteries (three patients); and multiple separate fistulas supplied by multiple medullary arteries (four patients). Eight patients were classified as perimedullary Type III and two as perimedullary Type II. Embolic agents were delivered from transarterial routes in 14 procedures and transvenous routes in 2 procedures. A total of 16 embolizations and 8 operations were performed in 10 patients. Seven patients were cured of their fistula (as demonstrated by angiography), two patients had 5% residual filling and are scheduled for future therapy. One refused a follow-up angiographic examination. Complications related to embolization included rupture of the anterior spinal artery by a detachable balloon, resulting in transient worsening of paraplegia with recovery to baseline. Transient worsening of symptoms after surgery was common, but all patients returned to baseline or better. Dramatic improvement was observed in four patients.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Predictors of the physical impact of Multiple Sclerosis following community-based, exercise trial.

    PubMed

    Kehoe, M; Saunders, J; Jakeman, P; Coote, S

    2015-04-01

    Studies evaluating exercise interventions in people with multiple sclerosis (PwMS) demonstrate small to medium positive effects and large variability on a number of outcome measures. No study to date has tried to explain this variability. This paper presents a novel exploration of data examining the predictors of outcome for PwMS with minimal gait impairment following a randomised, controlled trial evaluating community-based exercise interventions (N = 242). The primary variable was the physical component of the Multiple Sclerosis Impact Scale-29, version 2 (MSIS-29, v2) after a 10-week, controlled intervention period. Predictors were identified a priori and were measured at baseline. Multiple linear regression was conducted. Four models are presented lower MSIS-29, v2 scores after the intervention period were best predicted by a lower baseline MSIS-29,v2, a lower baseline Modified Fatigue Impact Score (physical subscale), randomisation to an exercise intervention, a longer baseline walking distance measured by the Six Minute Walk Test and female gender. This model explained 57.4% of the variance (F (5, 211) = 59.24, p < 0.01). These results suggest that fatigue and walking distance at baseline contribute significantly to predicting MSIS-29, v29 (physical component) after intervention, and thus should be the focus of intervention and assessment. Exercise is an important contributor to minimising the physical impact of MS, and gender-specific interventions may be warranted. © The Author(s), 2014.

  8. Baseline correction combined partial least squares algorithm and its application in on-line Fourier transform infrared quantitative analysis.

    PubMed

    Peng, Jiangtao; Peng, Silong; Xie, Qiong; Wei, Jiping

    2011-04-01

    In order to eliminate the lower order polynomial interferences, a new quantitative calibration algorithm "Baseline Correction Combined Partial Least Squares (BCC-PLS)", which combines baseline correction and conventional PLS, is proposed. By embedding baseline correction constraints into PLS weights selection, the proposed calibration algorithm overcomes the uncertainty in baseline correction and can meet the requirement of on-line attenuated total reflectance Fourier transform infrared (ATR-FTIR) quantitative analysis. The effectiveness of the algorithm is evaluated by the analysis of glucose and marzipan ATR-FTIR spectra. BCC-PLS algorithm shows improved prediction performance over PLS. The root mean square error of cross-validation (RMSECV) on marzipan spectra for the prediction of the moisture is found to be 0.53%, w/w (range 7-19%). The sugar content is predicted with a RMSECV of 2.04%, w/w (range 33-68%). Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Just showing up is not enough: Homework adherence and outcome in cognitive-behavioral therapy for cocaine dependence.

    PubMed

    Decker, Suzanne E; Kiluk, Brian D; Frankforter, Tami; Babuscio, Theresa; Nich, Charla; Carroll, Kathleen M

    2016-10-01

    Homework in cognitive-behavioral therapy (CBT) provides opportunities to practice skills. In prior studies, homework adherence was associated with improved outcome across a variety of disorders. Few studies have examined whether the relationship between homework adherence and outcome is maintained after treatment end or is independent of treatment attendance. This study combined data from 4 randomized clinical trials of CBT for cocaine dependence to examine relationships among homework adherence, participant variables, and cocaine use outcomes during treatment and at follow-up. The data set included only participants who attended at least 2 CBT sessions to allow for assignment and return of homework (N = 158). Participants returned slightly less than half (41.1%) of assigned homework. Longitudinal random effects regression suggested a greater reduction in cocaine use during treatment and through 12-month follow-up for participants who completed half or more of assigned homework (3-way interaction), F(2, 910.69) = 4.28, p = .01. In multiple linear regression, the percentage of homework adherence was associated with greater number of cocaine-negative urine toxicology screens during treatment, even when accounting for baseline cocaine use frequency and treatment attendance; at 3 months follow-up, multiple logistic regression indicated homework adherence was associated with cocaine-negative urine toxicology screen, controlling for baseline cocaine use and treatment attendance. These results extend findings from prior studies regarding the importance of homework adherence by demonstrating associations among homework and cocaine use outcomes during treatment and up to 12 months after, independent of treatment attendance and baseline cocaine use severity. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Eye Movement Desensitisation and Reprocessing Therapy for Posttraumatic Stress Disorder in a Child and an Adolescent with Mild to Borderline Intellectual Disability: A Multiple Baseline across Subjects Study

    ERIC Educational Resources Information Center

    Mevissen, Liesbeth; Didden, Robert; Korzilius, Hubert; de Jongh, Ad

    2017-01-01

    Background: This study explored the effectiveness of eye movement desensitisation and reprocessing (EMDR) therapy for post-traumatic stress disorder (PTSD) in persons with mild to borderline intellectual disability (MBID) using a multiple baseline across subjects design. Methods: One child and one adolescent with MBID, who met diagnostic criteria…

  11. Fatness predicts decreased physical activity and increased sedentary time, but not vice versa: support from a longitudinal study in 8- to 11-year-old children.

    PubMed

    Hjorth, M F; Chaput, J-P; Ritz, C; Dalskov, S-M; Andersen, R; Astrup, A; Tetens, I; Michaelsen, K F; Sjödin, A

    2014-07-01

    To examine independent and combined cross-sectional associations between movement behaviors (physical activity (PA), sedentary time, sleep duration, screen time and sleep disturbance) and fat mass index (FMI), as well as to examine longitudinal associations between movement behaviors and FMI. Cross-sectional and longitudinal analyses were done using data from the OPUS school meal study on 785 children (52% boys, 13.4% overweight, ages 8-11 years). Total PA, moderate-to-vigorous PA (MVPA), sedentary time and sleep duration (7 days and 8 nights) were assessed by an accelerometer and FMI was determined by dual-energy X-ray absorptiometry (DXA) on three occasions over 200 days. Demographic characteristics, screen time and sleep disturbance (Children's Sleep Habits Questionnaire) were also obtained. Total PA, MVPA and sleep duration were negatively associated with FMI, while sedentary time and sleep disturbances were positively associated with FMI (P⩽0.01). However, only total PA, MVPA and sleep duration were independently associated with FMI after adjustment for multiple covariates (P<0.001). Nevertheless, combined associations revealed synergistic effects among the different movement behaviors. Changes over time in MVPA were negatively associated with changes in FMI (P<0.001). However, none of the movement behaviors at baseline predicted changes in FMI (P>0.05), but higher FMI at baseline predicted a decrease in total PA and MVPA, and an increase in sedentary time (P⩽0.001), even in normal-weight children (P⩽0.03). Total PA, MVPA and sleep duration were independently associated with FMI, and combined associations of movement behaviors showed a synergistic effect with FMI. In the longitudinal study design, a high FMI at baseline was associated with lower PA and higher sedentary time after 200 days but not vice versa, even in normal-weight children. Our results suggest that adiposity is a better predictor of PA and sedentary behavior changes than the other way around.

  12. Prevalence of polymorphisms with significant resistance to NS5A inhibitors in treatment-naive patients with hepatitis C virus genotypes 1a and 3a in Sweden.

    PubMed

    Lindström, Ida; Kjellin, Midori; Palanisamy, Navaneethan; Bondeson, Kåre; Wesslén, Lars; Lannergard, Anders; Lennerstrand, Johan

    2015-08-01

    The future treatment of hepatitis C virus (HCV) infection will be combinations of direct-acting antivirals (DAAs) that not only target multiple viral targets, but are also effective against different HCV genotypes. Of the many drug targets in HCV, one promising target is the non-structural 5A protein (NS5A), against which inhibitors, namely daclatasvir, ledipasvir and ombitasvir, have shown potent efficacy. However, since HCV is known to have very high sequence diversity, development of resistance is a problem against but not limited to NS5A inhibitors (i.e. resistance also found against NS3-protease and NS5B non-nucleoside inhibitors), when used in suboptimal combinations. Furthermore, it has been shown that natural resistance against DAAs is present in treatment-naïve patients and such baseline resistance will potentially complicate future treatment strategies. A pan-genotypic population-sequencing method with degenerated primers targeting the NS5A region was developed. We have investigated the prevalence of baseline resistant variants in 127 treatment-naïve patients of HCV genotypes 1a, 1b, 2b and 3a. The method could successfully sequence more than 95% of genotype 1a, 1b and 3a samples. Interpretation of fold resistance data against the NS5A inhibitors was done with the help of earlier published phenotypic data. Baseline resistance variants associated with high resistance (1000-50,000-fold) was found in three patients: Q30H or Y93N in genotype 1a patients and further Y93H in a genotype 3a patient. Using this method, baseline resistance can be examined and the data could have a potential role in selecting the optimal and cost-efficient treatment for the patient.

  13. Use and effectiveness of a fixed-ratio combination of insulin degludec/liraglutide (IDegLira) in a real-world population with type 2 diabetes: Results from a European, multicentre, retrospective chart review study.

    PubMed

    Price, Hermione; Blüher, Matthias; Prager, Rudolf; Phan, Tra-Mi; Thorsted, Brian L; Schultes, Bernd

    2018-04-01

    To describe the real-world use and effectiveness of IDegLira, a fixed-ratio combination of the basal insulin degludec, and the glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide. This European, multicentre, retrospective chart review comprised adults (n = 611) with type 2 diabetes, who started IDegLira ≥6 months before data collection. Clinical characteristics were assessed at baseline (defined as the most recent recording during the 6 months before the first IDegLira prescription) and 3, 6, 9 and 12 months (± 45 days for each time point) after commencing IDegLira, where data were available. Baseline regimens included non-injectable medications (19%), basal insulin (19%), GLP-1RA (10%), free combination therapy (insulin/GLP-1RA, 24%) and multiple daily-dose insulin injections (MDI, 28%), all ± oral antidiabetic drugs. After 6 months, significant glycated haemoglobin (HbA1c) reductions were observed in patients overall and in all subgroups (-10 mmol/mol [-0.9%] overall; P < .0001), and a significant reduction in mean body weight (-0.7 kg; P < .05) was observed in patients overall and in patients receiving MDI (-2.4 kg; P < .0001). The mean IDegLira dose was 22, 30 and 32 dose steps at initiation, and at 6 and 12 months follow-up, respectively. In total, only 67 patients reached the maximum 50 dose steps, with most coming from the free combination therapy (n = 31) or MDI (n = 15) baseline regimen groups. Hypoglycaemia rates were reduced by 82% (rate ratio 0.18; P < .0001) in the 6-month period after vs before IDegLira initiation. Overall, a total of 12 patients experienced 15 events in the 6 months after IDegLira initiation. In real-world practice, after 6 months and at a moderate dose, IDegLira resulted in substantial reductions in HbA1c and body weight, with a reduced risk of hypoglycaemia. © 2017 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  14. Pre-treatment red blood cell distribution width provides prognostic information in multiple myeloma.

    PubMed

    Zhou, Di; Xu, Peipei; Peng, Miaoxin; Shao, Xiaoyan; Wang, Miao; Ouyang, Jian; Chen, Bing

    2018-06-01

    The red blood cell distribution width (RDW), a credible marker for abnormal erythropoiesis, has recently been studied as a prognostic factor in oncology, but its role in multiple myeloma (MM) hasn't been thoroughly investigated. We performed a retrospective study in 162 patients with multiple myeloma. Categorical parameters were analyzed using Pearson chi-squared test. The Mann-Whitney and Wilcoxon tests were used for group comparisons. Comparisons of repeated samples data were analyzed with the general linear model repeated-measures procedure. The Kaplan-Meier product-limit method was used to determine OS and PFS, and the differences were assessed by the log-rank test. High RDW baseline was significantly associated with indexes including haemoglobin, bone marrow plasma cell infiltration, and cytogenetics risk stratification. After chemotherapy, the overall response rate (ORR) decreased as RDW baseline increased. In 24 patients with high RDW baseline, it was revealed RDW value decreased when patients achieved complete remission (CR), but increased when the disease progressed. The normal-RDW baseline group showed both longer overall survival (OS) and progression-free survival (PFS) than the high-RDW baseline group. Our study suggests pre-treatment RDW level is a prognostic factor in MM and should be regarded as an important parameter for assessment of therapeutic efficiency. Copyright © 2018. Published by Elsevier B.V.

  15. The effects of response cost and response restriction on a multiple-response repertoire with humans

    PubMed Central

    Crosbie, John

    1993-01-01

    In two experiments a multiple-response repertoire of four free-operant responses was developed with university students as subjects using monetary gain as reinforcement. Following baseline, one of the responses was reduced either by making monetary loss contingent upon it (response cost) or by removing it from the repertoire (response restriction). In Experiment 1 a multielement baseline design was employed in which baseline and restriction or response-cost contingencies alternated semirandomly every 3 minutes. In Experiment 2 a reversal design was employed (i.e., baseline, restriction or response cost, then baseline), and each response required a different amount of effort. Both experiments had the following results: (a) The target response decreased substantially; (b) most nontarget responses increased, and the rest remained near their baseline levels; and (c) no support was found for Dunham's hierarchical, most frequent follower, or greatest temporal similarity rules. For several subjects, the least probable responses during baseline increased most, and the most probable responses increased least. Furthermore, in Experiment 2, responses with the lowest frequency of reinforcement increased most (for all 7 subjects), and those with the greatest frequency of reinforcement increased least (for 5 subjects). PMID:16812683

  16. Palatability and oral cavity tolerability of THC:CBD oromucosal spray and possible improvement measures in multiple sclerosis patients with resistant spasticity: a pilot study.

    PubMed

    Lus, Giacomo; Cantello, Roberto; Danni, Maura Chiara; Rini, Agusto; Sarchielli, Paola; Tassinari, Tiziana; Signoriello, Elisabetta

    2018-04-01

    Complaints about Δ 9 -tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray (Sativex ® ; GW Pharma Ltd, Salisbury, UK) in the management of multiple sclerosis spasticity include unpleasant taste and oral mucosal anomalies. This pilot study assessed the use of sugar-free chewing gum and/or a refrigerated bottle of THC:CBD oromucosal spray to mitigate these effects. Patients with multiple sclerosis spasticity (n = 52) at six sites in Italy who were receiving THC:CBD oromucosal spray and had associated oral mucosal effects were randomized into Group A (chewing gum; n = 15); Group B (cold bottle; n = 20); and Group C (cold bottle + chewing gum; n = 17). Taste perception in patients receiving chewing gum ± cold bottle intervention (Groups A and C combined) was significantly (p = 0.0001) improved from baseline to week 4 while maintaining spasticity control. Patient comfort, satisfaction and treatment adherence may benefit from these interventions.

  17. Delayed P100-Like Latencies in Multiple Sclerosis: A Preliminary Investigation Using Visual Evoked Spread Spectrum Analysis

    PubMed Central

    Kiiski, Hanni S. M.; Ní Riada, Sinéad; Lalor, Edmund C.; Gonçalves, Nuno R.; Nolan, Hugh; Whelan, Robert; Lonergan, Róisín; Kelly, Siobhán; O'Brien, Marie Claire; Kinsella, Katie; Bramham, Jessica; Burke, Teresa; Ó Donnchadha, Seán; Hutchinson, Michael; Tubridy, Niall; Reilly, Richard B.

    2016-01-01

    Conduction along the optic nerve is often slowed in multiple sclerosis (MS). This is typically assessed by measuring the latency of the P100 component of the Visual Evoked Potential (VEP) using electroencephalography. The Visual Evoked Spread Spectrum Analysis (VESPA) method, which involves modulating the contrast of a continuous visual stimulus over time, can produce a visually evoked response analogous to the P100 but with a higher signal-to-noise ratio and potentially higher sensitivity to individual differences in comparison to the VEP. The main objective of the study was to conduct a preliminary investigation into the utility of the VESPA method for probing and monitoring visual dysfunction in multiple sclerosis. The latencies and amplitudes of the P100-like VESPA component were compared between healthy controls and multiple sclerosis patients, and multiple sclerosis subgroups. The P100-like VESPA component activations were examined at baseline and over a 3-year period. The study included 43 multiple sclerosis patients (23 relapsing-remitting MS, 20 secondary-progressive MS) and 42 healthy controls who completed the VESPA at baseline. The follow-up sessions were conducted 12 months after baseline with 24 MS patients (15 relapsing-remitting MS, 9 secondary-progressive MS) and 23 controls, and again at 24 months post-baseline with 19 MS patients (13 relapsing-remitting MS, 6 secondary-progressive MS) and 14 controls. The results showed P100-like VESPA latencies to be delayed in multiple sclerosis compared to healthy controls over the 24-month period. Secondary-progressive MS patients had most pronounced delay in P100-like VESPA latency relative to relapsing-remitting MS and controls. There were no longitudinal P100-like VESPA response differences. These findings suggest that the VESPA method is a reproducible electrophysiological method that may have potential utility in the assessment of visual dysfunction in multiple sclerosis. PMID:26726800

  18. Effectiveness of a program using a vehicle tracking system, incentives, and disincentives to reduce the speeding behavior of drivers with ADHD.

    PubMed

    Markham, Paula T; Porter, Bryan E; Ball, J D

    2013-04-01

    In this article, the authors investigated the effectiveness of a behavior modification program using global positioning system (GPS) vehicle tracking devices with contingency incentives and disincentives to reduce the speeding behavior of drivers with ADHD. Using an AB multiple-baseline design, six participants drove a 5-mile stable driving route weekly while GPS devices recorded speeds. The dependent variable was percentage of feet speeding. Following an initial baseline period, five participants received treatment. One participant remained at baseline. Visual inspection of individual participant graphs, reductions in mean percentages of speeding from baseline to treatment across participants (M = 82%), C-statistic analyses, and visual graphs with applied binomial formula supported a treatment effect. The between-participant analysis using R n Test of Ranks was significant, R n = 6, p < .01, and complemented a clean multiple-baseline result. Results indicated that this treatment program was effective in reducing speeding by drivers with ADHD and warrants replication.

  19. Using multiple-accumulator CMACs to improve efficiency of the X part of an input-buffered FX correlator

    NASA Astrophysics Data System (ADS)

    Lapshev, Stepan; Hasan, S. M. Rezaul

    2017-04-01

    This paper presents the approach of using complex multiplier-accumulators (CMACs) with multiple accumulators to reduce the total number of memory operations in an input-buffered architecture for the X part of an FX correlator. A processing unit of this architecture uses an array of CMACs that are reused for different groups of baselines. The disadvantage of processing correlations in this way is that each input data sample has to be read multiple times from the memory because each input signal is used in many of these baseline groups. While a one-accumulator CMAC cannot switch to a different baseline until it is finished integrating the current one, a multiple-accumulator CMAC can. Thus, the array of multiple-accumulator CMACs can switch between processing different baselines that share some input signals at any moment to reuse the current data in the processing buffers. In this way significant reductions in the number of memory read operations are achieved with only a few accumulators per CMAC. For example, for a large number of input signals three-accumulator CMACs reduce the total number of memory operations by more than a third. Simulated energy measurements of four VLSI designs in a high-performance 28 nm CMOS technology are presented in this paper to demonstrate that using multiple accumulators can also lead to reduced power dissipation of the processing array. Using three accumulators as opposed to one has been found to reduce the overall energy of 8-bit CMACs by 1.4% through the reduction of the switching activity within their circuits, which is in addition to a more than 30% reduction in the memory.

  20. Prevalence and predictors of fatigue in glioblastoma: a prospective study

    PubMed Central

    Valko, Philipp O.; Siddique, Asim; Linsenmeier, Claudia; Zaugg, Kathrin; Held, Ulrike; Hofer, Silvia

    2015-01-01

    Background The main goal of this study was to assess frequency, clinical correlates, and independent predictors of fatigue in a homogeneous cohort of well-defined glioblastoma patients at baseline prior to combined radio-chemotherapy. Methods We prospectively included 65 glioblastoma patients at postsurgical baseline and assessed fatigue, sleepiness, mean bedtimes, mood disturbances, and clinical characteristics such as clinical performance status, presenting symptomatology, details on neurosurgical procedure, and tumor location and diameter as well as pharmacological treatment including antiepileptic drugs, antidepressants, and use of corticosteroids. Data on fatigue and sleepiness were measured with the Fatigue Severity Scale and the Epworth Sleepiness Scale, respectively, and compared with 130 age- and sex-matched healthy controls. Results We observed a significant correlation between fatigue and sleepiness scores in both patients (r = 0.26; P = .04) and controls (r = 0.36; P < .001). Only fatigue appeared to be more common in glioblastoma patients than in healthy controls (48% vs 11%; P < .001) but not the frequency of sleepiness (22% vs 19%; P = .43). Female sex was associated with increased fatigue frequency among glioblastoma patients but not among control participants. Multiple linear regression analyses identified depression, left-sided tumor location, and female sex as strongest associates of baseline fatigue severity. Conclusions Our findings indicate that glioblastoma patients are frequently affected by fatigue at baseline, suggesting that factors other than those related to radio- or chemotherapy have significant impact, particularly depression and tumor localization. PMID:25006033

  1. Observational Model for Precision Astrometry with the Space Interferometry Mission

    NASA Technical Reports Server (NTRS)

    Turyshev, Slava G.; Milman, Mark H.

    2000-01-01

    The Space Interferometry Mission (SIM) is a space-based 10-m baseline Michelson optical interferometer operating in the visible waveband that is designed to achieve astrometric accuracy in the single digits of the microarcsecond domain. Over a narrow field of view SIM is expected to achieve a mission accuracy of 1 microarcsecond. In this mode SIM will search for planetary companions to nearby stars by detecting the astrometric "wobble" relative to a nearby reference star. In its wide-angle mode, SIM will provide 4 microarcsecond precision absolute position measurements of stars, with parallaxes to comparable accuracy, at the end of its 5-year mission. The expected proper motion accuracy is around 3 microarcsecond/year, corresponding to a transverse velocity of 10 m/ s at a distance of 1 kpc. The basic astrometric observable of the SIM instrument is the pathlength delay. This measurement is made by a combination of internal metrology measurements that determine the distance the starlight travels through the two arms of the interferometer, and a measurement of the white light stellar fringe to find the point of equal pathlength. Because this operation requires a non-negligible integration time, the interferometer baseline vector is not stationary over this time period, as its absolute length and orientation are time varying. This paper addresses how the time varying baseline can be "regularized" so that it may act as a single baseline vector for multiple stars, as required for the solution of the astrometric equations.

  2. Health perceptions and clinical characteristics of relapsing-remitting multiple sclerosis patients: baseline data from an international clinical trial.

    PubMed

    Robinson, D; Zhao, N; Gathany, T; Kim, L-L; Cella, D; Revicki, D

    2009-05-01

    Baseline clinical and health-related quality of life (HRQoL) data from a phase 2, multi-site, international, randomized, controlled trial were analyzed to: (1) characterize the health status of patients with relapsing-remitting multiple sclerosis (RRMS), (2) explore cross-sectional relationships between HRQoL and clinical measures, and (3) evaluate differences in HRQoL scores for subsequent validation as minimally important differences (MID). www.clinicaltrials.gov, NCT00207727. Baseline clinical and HRQoL data were selected and analyzed. HRQoL questionnaires included the Short Form-36 (SF-36), Fatigue Severity Scale (FSS), a Patient Assessment of multiple sclerosis (MS) Impact (PAMSI), and MS-specific symptom scales for Bladder and Bowel Control, Cognition, and Sexual Satisfaction. Standard summary statistics described the population while Pearson and Spearman correlations evaluated the baseline association between HRQoL and clinical measures. Cross-sectional estimates of MID in HRQoL scores were derived using several clinical anchors, the PAMSI, and two tests: Tukey multiple comparisons and adjacent mean difference. Patients (n = 249) had a mean age of 39.0 (Standard deviation, SD = 10.5), 70% were female, 63% resided in Europe, and 96% were Caucasian. Baseline median Expanded Disability Severity Scale (EDSS) was 2.5 (range = 0.0-6.5); median disease duration was 1.9 years (range = 0.1-33.6). The worst baseline mean (normalized) SF-36 scores were for General Health (39.9), Role Physical (40.4), Physical Functioning (41.0), and Vitality (42.7). The worst MS symptom mean scores were for Cognition (6.3) and FSS (4.4). Fatigue scores indicated substantial burden and were consistent with SF-36 Vitality results. Baseline HRQoL scores (SF-36, FSS, MS symptom scales) correlated most with EDSS, Multiple Sclerosis Functional Composite (MSFC), age and disease duration. Lesion count and pre-baseline relapse rate had no meaningful association with HRQoL or other clinical measures. The MID for several HRQoL measures are proposed for confirmation in longitudinal patient datasets. Clinical and HRQoL assessments documented health impairments in physical functioning, fatigue, and cognition among these RRMS patients with relatively short disease duration. HRQoL data varied with clinical measures and contributed new information regarding disease burden. The association between clinical and HRQoL measures was limited to cross-sectional analysis and requires confirmation in longitudinal datasets. These findings reflect an ambulatory, early-stage RRMS population that was mostly European in location or descent. The PAMSI also requires further validation as a measure of patient health status.

  3. Effect of depression before breast cancer diagnosis on mortality among postmenopausal women.

    PubMed

    Liang, Xiaoyun; Margolis, Karen L; Hendryx, Michael; Reeves, Katherine; Wassertheil-Smoller, Sylvia; Weitlauf, Julie; Danhauer, Suzanne C; Chlebowski, Rowan T; Caan, Bette; Qi, Lihong; Lane, Dorothy; Lavasani, Sayeh; Luo, Juhua

    2017-08-15

    Few previous studies investigating depression before the diagnosis of breast cancer and breast cancer-specific mortality have examined depression measured at more than 1 time point. This study investigated the effect of depression (combining depressive symptoms alone with antidepressant use) measured at 2 time points before the diagnosis of breast cancer on all-cause mortality and breast cancer-specific mortality among older postmenopausal women. A large prospective cohort, the Women's Health Initiative, was used. The study included 3095 women with incident breast cancer who had measures of depressive symptoms and antidepressant use before their diagnosis at the baseline and at year 3. Multivariate Cox proportional hazards regression was used to estimate adjusted hazard ratios (HRs) between depression at the baseline, depression at year 3, and combinations of depression at these time points and all-cause mortality and breast cancer-specific mortality. Depression at year 3 before a breast cancer diagnosis was associated with higher all-cause mortality after adjustments for multiple covariates (HR, 1.35; 95% confidence interval [CI], 1.02-1.78). There was no statistically significant association of baseline depression and all-cause mortality or breast cancer-specific mortality whether or not depression was also present at year 3. In women with late-stage (regional- or distant-stage) breast cancer, newly developed depression at year 3 was significantly associated with both all-cause mortality (HR, 2.00; 95% CI, 1.13-3.56) and breast cancer-specific mortality (HR, 2.42; 95% CI, 1.24-4.70). Women with newly developed depression before the diagnosis of breast cancer had a modestly but significantly increased risk for death from any cause and for death from breast cancer at a late stage. Cancer 2017;123:3107-15. © 2017 American Cancer Society. © 2017 American Cancer Society.

  4. Switching to multiple daily injection therapy with glulisine improves glycaemic control, vascular damage and treatment satisfaction in basal insulin glargine-injected diabetic patients.

    PubMed

    Yanagisawa, Katsuyuki; Ashihara, Junya; Obara, Shinji; Wada, Norio; Takeuchi, Masayoshi; Nishino, Yuri; Maeda, Sayaka; Ishibashi, Yuji; Yamagishi, Sho-ichi

    2014-11-01

    Basal and bolus insulin therapy is required for strict blood control in diabetic patients, which could lead to prevention of vascular complications in diabetes. However, the optimal combination regimen is not well established. Fifty-nine diabetic patients (49 type 1 and 10 type 2; 52.9 ± 13.3 years old) whose blood glucose levels were uncontrolled (HbA1c  > 6.2%) by combination treatment of basal insulin glargine with multiple daily pre-meal injections of bolus short-acting insulin [aspart (n = 19), lispro (n = 37) and regular human insulin (n = 3)] for at least 8 weeks were enrolled in this study. We examined whether glycaemic control and vascular injury were improved by replacement of short-acting insulin with glulisine. Patient satisfaction was assessed with Diabetes Treatment Satisfaction Questionnaire. Although bolus and basal insulin doses were almost unchanged before and after replacement therapy, switching to glulisine insulin for 24 weeks significantly decreased level of HbA1c , advanced glycation end products (AGEs), soluble receptor for AGEs (sRAGE), monocyte chemoattractant protein-1 (MCP-1) and urinary albumin excretion. In multiple stepwise regression analysis, change in MCP-1 values from baseline (ΔMCP-1) was a sole determinant of log urinary albumin excretion. ΔAGEs and ΔsRAGE were independently correlated with each other. The relationship between ΔMCP-1 and ΔsRAGE was marginally significant (p = 0.05). Replacement of short-acting insulin by glulisine significantly increased Diabetes Treatment Satisfaction Questionnaire scores. Our present study suggests that combination therapy of glargine with multiple daily pre-meal injections of glulisine might show superior efficacy in controlling blood glucose, preventing vascular damage and improving treatment satisfaction in diabetic patients. Copyright © 2014 John Wiley & Sons, Ltd.

  5. Impact of favorite stimuli automatically delivered on step responses of persons with multiple disabilities during their use of walker devices.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Campodonico, Francesca; Piazzolla, Giorgia; Scalini, Lorenza; Oliva, Doretta

    2005-01-01

    Favorite stimuli were automatically delivered contingent on the performance of steps by two persons (a boy and a woman) with multiple disabilities during their use of support walker devices. The study lasted about 4 months and was carried out according to a multiple baseline design across participants. Recording concerned the participants' frequencies of steps and their indices of happiness during baseline and intervention sessions. Data showed that both participants had a significant increase in each of these two measures during the intervention phase. Implications of the findings and new research issues are discussed.

  6. Clinical time series prediction: Toward a hierarchical dynamical system framework.

    PubMed

    Liu, Zitao; Hauskrecht, Milos

    2015-09-01

    Developing machine learning and data mining algorithms for building temporal models of clinical time series is important for understanding of the patient condition, the dynamics of a disease, effect of various patient management interventions and clinical decision making. In this work, we propose and develop a novel hierarchical framework for modeling clinical time series data of varied length and with irregularly sampled observations. Our hierarchical dynamical system framework for modeling clinical time series combines advantages of the two temporal modeling approaches: the linear dynamical system and the Gaussian process. We model the irregularly sampled clinical time series by using multiple Gaussian process sequences in the lower level of our hierarchical framework and capture the transitions between Gaussian processes by utilizing the linear dynamical system. The experiments are conducted on the complete blood count (CBC) panel data of 1000 post-surgical cardiac patients during their hospitalization. Our framework is evaluated and compared to multiple baseline approaches in terms of the mean absolute prediction error and the absolute percentage error. We tested our framework by first learning the time series model from data for the patients in the training set, and then using it to predict future time series values for the patients in the test set. We show that our model outperforms multiple existing models in terms of its predictive accuracy. Our method achieved a 3.13% average prediction accuracy improvement on ten CBC lab time series when it was compared against the best performing baseline. A 5.25% average accuracy improvement was observed when only short-term predictions were considered. A new hierarchical dynamical system framework that lets us model irregularly sampled time series data is a promising new direction for modeling clinical time series and for improving their predictive performance. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Multidimensional student skills with collaborative filtering

    NASA Astrophysics Data System (ADS)

    Bergner, Yoav; Rayyan, Saif; Seaton, Daniel; Pritchard, David E.

    2013-01-01

    Despite the fact that a physics course typically culminates in one final grade for the student, many instructors and researchers believe that there are multiple skills that students acquire to achieve mastery. Assessment validation and data analysis in general may thus benefit from extension to multidimensional ability. This paper introduces an approach for model determination and dimensionality analysis using collaborative filtering (CF), which is related to factor analysis and item response theory (IRT). Model selection is guided by machine learning perspectives, seeking to maximize the accuracy in predicting which students will answer which items correctly. We apply the CF to response data for the Mechanics Baseline Test and combine the results with prior analysis using unidimensional IRT.

  8. A comparison of peer video modeling and self video modeling to teach textual responses in children with autism.

    PubMed

    Marcus, Alonna; Wilder, David A

    2009-01-01

    Peer video modeling was compared to self video modeling to teach 3 children with autism to respond appropriately to (i.e., identify or label) novel letters. A combination multiple baseline and multielement design was used to compare the two procedures. Results showed that all 3 participants met the mastery criterion in the self-modeling condition, whereas only 1 of the participants met the mastery criterion in the peer-modeling condition. In addition, the participant who met the mastery criterion in both conditions reached the criterion more quickly in the self-modeling condition. Results are discussed in terms of their implications for teaching new skills to children with autism.

  9. Production of graphic symbol sentences by individuals with aphasia: efficacy of a computer-based augmentative and alternative communication intervention.

    PubMed

    Koul, Rajinder; Corwin, Melinda; Hayes, Summer

    2005-01-01

    The study employed a single-subject multiple baseline design to examine the ability of 9 individuals with severe Broca's aphasia or global aphasia to produce graphic symbol sentences of varying syntactical complexity using a software program that turns a computer into a speech output communication device. The sentences ranged in complexity from simple two-word phrases to those with morphological inflections, transformations, and relative clauses. Overall, results indicated that individuals with aphasia are able to access, manipulate, and combine graphic symbols to produce phrases and sentences of varying degrees of syntactical complexity. The findings are discussed in terms of the clinical and public policy implications.

  10. Relationship of pressure to be thin with gains in body weight and fat mass in adolescents.

    PubMed

    Suelter, C S; Schvey, N; Kelly, N R; Shanks, M; Thompson, K A; Mehari, R; Brady, S; Yanovski, S Z; Melby, C L; Tanofsky-Kraff, M; Yanovski, J A; Shomaker, L B

    2018-01-01

    Sociocultural pressure to be thin is commonly reported by adolescents; yet, to what extent such pressure is associated with weight gain has not been evaluated longitudinally. Examine whether pressure to be thin was positively associated with weight and fat gain in adolescents. Participants were 196 healthy adolescent (age 15 ± 1 years old) girls (65%) and boys of varying weights (BMI 25 ± 7 kg/m 2 ) studied at baseline and 1-year follow-up. At baseline, adolescents and their mothers reported pressure to be thin by questionnaire. At baseline and follow-up, BMI was calculated, and fat mass was assessed with air displacement plethysmography. Multiple regression was used to examine associations between baseline pressure to be thin and 1-year changes in BMI and fat mass. Accounting for multiple covariates, including baseline BMI or fat, adolescent-reported pressure from parents and peers and mother-reported pressure toward their teen were associated with greater gains in either adolescent BMI or fat (ps < .05). Adolescent weight status was a moderator of multiple effects (ps < .05). Parental and peer pressure to be thin were associated with increases in BMI and fat mass during adolescence, particularly in heavier adolescents. Further research is necessary to clarify how this association operates reciprocally and to identify underlying explanatory mechanisms. © 2016 World Obesity Federation.

  11. Randomized trial of brinzolamide/brimonidine versus brinzolamide plus brimonidine for open-angle glaucoma or ocular hypertension.

    PubMed

    Gandolfi, Stefano A; Lim, John; Sanseau, Ana Cristina; Parra Restrepo, Juan Camilo; Hamacher, Thomas

    2014-12-01

    Fixed-combination intraocular pressure (IOP)-lowering medications simplify treatment regimens for patients requiring 2 ocular hypotensive agents to maintain sufficiently low IOP. The aim of this study was to evaluate the safety and efficacy of fixed-combination brinzolamide 1%/brimonidine 0.2% (BBFC) versus concomitant administration of brinzolamide 1% plus brimonidine 0.2% (BRINZ + BRIM) in patients with open-angle glaucoma or ocular hypertension. This was a prospective, phase 3, multicenter, double-masked, 6-month trial. Patients who had insufficient IOP control with monotherapy or who were receiving 2 IOP-lowering medications were randomized 1:1 to receive twice-daily BBFC or BRINZ + BRIM. IOP was assessed at 9 a.m. and 11 a.m. during week 2, week 6, month 3, and month 6 visits. The primary efficacy endpoint was mean diurnal IOP change from baseline to month 3; noninferiority was concluded if the upper limit of the 95% CI of the between-group difference was <1.5 mmHg. Supportive endpoints included mean IOP, IOP change from baseline, and percentage of patients with IOP <18 mmHg. Adverse events were recorded. The mean diurnal IOP change from baseline with BBFC (least squares mean ± standard error -8.5 ± 0.16 mmHg) was noninferior to that with BRINZ + BRIM (-8.3 ± 0.16 mmHg; mean difference -0.1 mmHg; 95% CI -0.5 to 0.2 mmHg). The upper limits of the 95% CIs were <1.5 mmHg at all time points. Decreases from baseline >8 mmHg were observed for least squares mean diurnal IOP in both groups as early as week 2 and continued to the end of the study. The results of all other supportive endpoints were similar to the primary efficacy endpoint. The most common ocular adverse drug reactions were hyperemia of the eye (reported as ocular or conjunctival hyperemia), visual disturbances, ocular allergic reactions, and ocular discomfort. Common systemic adverse drug reactions included dysgeusia, oral dryness, and fatigue/drowsiness. Brinzolamide 1%/brimonidine 0.2% fixed combination was as well tolerated and effective as concomitant therapy with its components. BBFC reduces treatment burden in patients who require multiple IOP-lowering medications.

  12. Discriminant analysis of multiple cortical changes in mild cognitive impairment

    NASA Astrophysics Data System (ADS)

    Wu, Congling; Guo, Shengwen; Lai, Chunren; Wu, Yupeng; Zhao, Di; Jiang, Xingjun

    2017-02-01

    To reveal the differences in brain structures and morphological changes between the mild cognitive impairment (MCI) and the normal control (NC), analyze and predict the risk of MCI conversion. First, the baseline and 2-year longitudinal follow-up magnetic resonance (MR) images of 73 NC, 46 patients with stable MCI (sMCI) and 40 patients with converted MCI (cMCI) were selected. Second, the FreeSurfer was used to extract the cortical features, including the cortical thickness, surface area, gray matter volume and mean curvature. Third, the support vector machine-recursive feature elimination method (SVM-RFE) were adopted to determine salient features for effective discrimination. Finally, the distribution and importance of essential brain regions were described. The experimental results showed that the cortical thickness and gray matter volume exhibited prominent capability in discrimination, and surface area and mean curvature behaved relatively weak. Furthermore, the combination of different morphological features, especially the baseline combined with the longitudinal changes, can be used to evidently improve the performance of classification. In addition, brain regions with high weights predominately located in the temporal lobe and the frontal lobe, which were relative to emotional control and memory functions. It suggests that there were significant different patterns in the brain structure and changes between the compared group, which could not only be effectively applied for classification, but also be used to evaluate and predict the conversion of the patients with MCI.

  13. Effects of a contraceptive containing drospirenone and ethinyl estradiol on blood pressure and autonomic tone: a prospective controlled clinical trial.

    PubMed

    Nisenbaum, Marcelo Gil; de Melo, Nilson Roberto; Giribela, Cassiana Rosa Galvão; de Morais, Tércio Lemos; Guerra, Grazia Maria; de Angelis, Katia; Mostarda, Cristiano; Baracat, Edmund Chada; Consolim-Colombo, Fernanda Marciano

    2014-04-01

    The use of combined oral contraceptives has been associated with an increased risk of adverse cardiovascular events. Whether these drugs alter cardiac autonomic nervous system control is not completely determined. To evaluate the effect of a contraceptive containing 20mcg of ethinyl estradiol and 3mg of drospirenone on the heart rate variability, baroreflex sensitivity and blood pressure of healthy women. Prospective controlled trial with 69 healthy women allocated in two groups: 36 volunteers under oral combined contraceptive use and 33 volunteers using of non-hormonal contraceptive methods. Subjects were tested before the introduction of the contraceptive method and 6 months after its use. For data acquisition, we used continuous non-invasive beat-to-beat blood pressure curve recordings. Multiple ANOVA was used to determine differences between groups and moments and p< 0.05 was considered statistically significant. At baseline, there were no differences in demographic and autonomic parameters between groups. Comparing cardiac sympatho-vagal modulation, baroreceptor sensitivity and blood pressure measurements between baseline and after 6 months, no significant difference was detected in each group or between groups. A contraceptive containing 20mcg of ethinyl estradiol and 3mg of drospirenone causes no significant changes in clinical, hemodynamic and autonomic parameters of normal women. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. 76 FR 6607 - Combined Notice of Filings No. 2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-07

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings No. 2 January...--Baseline Compliance All Volumes to be effective 5/28/ 2010. Filed Date: 01/24/2011. Accession Number... 154.203: DTI--Baseline Compliance Subsequent Filing 1 to be effective 7/1/2010. Filed Date: 01/24/2011...

  15. 76 FR 4099 - Combined Notice of Filings No. 2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ....L.C. submits tariff filing per 154.203: Caledonia Energy Partners Baseline Tariff to be effective 9... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings No. 2 January...: Baseline Compliance Filing to be effective 6/30/ 2010. Filed Date: 01/13/2011. Accession Number: 20110113...

  16. 75 FR 51258 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-19

    ... Group Maine, LLC submits tariff filing per 35.12: Constellation Energy Commodities Group Maine Baseline... 35.12: Luminant Energy Company LLC MBR Baseline to be effective 8/11/ 2010. Filed Date: 08/11/2010... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 August 11...

  17. 76 FR 5571 - Combined Notice of Filings No. 2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-01

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings No. 2 January.... Description: Freebird Gas Storage, L.L.C. submits tariff filing per 154.203: Freebird Gas Storage Baseline....203: ASC Baseline Compliance Filing, to be effective 1/19/2011. Filed Date: 01/19/2011. Accession...

  18. The Combined Quantification and Interpretation of Multiple Quantitative Magnetic Resonance Imaging Metrics Enlightens Longitudinal Changes Compatible with Brain Repair in Relapsing-Remitting Multiple Sclerosis Patients.

    PubMed

    Bonnier, Guillaume; Maréchal, Benedicte; Fartaria, Mário João; Falkowskiy, Pavel; Marques, José P; Simioni, Samanta; Schluep, Myriam; Du Pasquier, Renaud; Thiran, Jean-Philippe; Krueger, Gunnar; Granziera, Cristina

    2017-01-01

    Quantitative and semi-quantitative MRI (qMRI) metrics provide complementary specificity and differential sensitivity to pathological brain changes compatible with brain inflammation, degeneration, and repair. Moreover, advanced magnetic resonance imaging (MRI) metrics with overlapping elements amplify the true tissue-related information and limit measurement noise. In this work, we combined multiple advanced MRI parameters to assess focal and diffuse brain changes over 2 years in a group of early-stage relapsing-remitting MS patients. Thirty relapsing-remitting MS patients with less than 5 years disease duration and nine healthy subjects underwent 3T MRI at baseline and after 2 years including T1, T2, T2* relaxometry, and magnetization transfer imaging. To assess longitudinal changes in normal-appearing (NA) tissue and lesions, we used analyses of variance and Bonferroni correction for multiple comparisons. Multivariate linear regression was used to assess the correlation between clinical outcome and multiparametric MRI changes in lesions and NA tissue. In patients, we measured a significant longitudinal decrease of mean T2 relaxation times in NA white matter ( p  = 0.005) and a decrease of T1 relaxation times in the pallidum ( p  < 0.05), which are compatible with edema reabsorption and/or iron deposition. No longitudinal changes in qMRI metrics were observed in controls. In MS lesions, we measured a decrease in T1 relaxation time ( p -value < 2.2e-16) and a significant increase in MTR ( p -value < 1e-6), suggesting repair mechanisms, such as remyelination, increased axonal density, and/or a gliosis. Last, the evolution of advanced MRI metrics-and not changes in lesions or brain volume-were correlated to motor and cognitive tests scores evolution (Adj- R 2  > 0.4, p  < 0.05). In summary, the combination of multiple advanced MRI provided evidence of changes compatible with focal and diffuse brain repair at early MS stages as suggested by histopathological studies.

  19. Schema therapy for personality disorders in older adults: a multiple-baseline study.

    PubMed

    Videler, Arjan C; van Alphen, Sebastiaan P J; van Royen, Rita J J; van der Feltz-Cornelis, Christina M; Rossi, Gina; Arntz, Arnoud

    2018-06-01

    No studies have been conducted yet into the effectiveness of treatment of personality disorders in later life. This study is a first test of the effectiveness of schema therapy for personality disorders in older adults. Multiple-baseline design with eight cluster C personality disorder patients, with a mean age of   69. After a baseline phase with random length, schema therapy was given during the first year, followed by follow-up sessions during six months. Participants weekly rated the credibility of dysfunctional core beliefs. Symptomatic distress, early maladaptive schemas, quality of life and target complaints were assessed every six months and personality disorder diagnosis was assessed before baseline and after follow-up. Data were analyzed with mixed regression analyses. Results revealed significant linear trends during treatment phases, but not during baseline and follow-up. The scores during follow-up remained stable and were significantly lower compared to baseline, with high effect sizes. Seven participants remitted from their personality disorder diagnosis. Schema therapy appears an effective treatment for cluster C personality disorders in older adults. This finding is highly innovative as this is the first study exploring the effectiveness of psychotherapy, in this case schema therapy, for personality disorders in older adults.

  20. Modeling Rabbit Responses to Single and Multiple Aerosol ...

    EPA Pesticide Factsheets

    Journal Article Survival models are developed here to predict response and time-to-response for mortality in rabbits following exposures to single or multiple aerosol doses of Bacillus anthracis spores. Hazard function models were developed for a multiple dose dataset to predict the probability of death through specifying dose-response functions and the time between exposure and the time-to-death (TTD). Among the models developed, the best-fitting survival model (baseline model) has an exponential dose-response model with a Weibull TTD distribution. Alternative models assessed employ different underlying dose-response functions and use the assumption that, in a multiple dose scenario, earlier doses affect the hazard functions of each subsequent dose. In addition, published mechanistic models are analyzed and compared with models developed in this paper. None of the alternative models that were assessed provided a statistically significant improvement in fit over the baseline model. The general approach utilizes simple empirical data analysis to develop parsimonious models with limited reliance on mechanistic assumptions. The baseline model predicts TTDs consistent with reported results from three independent high-dose rabbit datasets. More accurate survival models depend upon future development of dose-response datasets specifically designed to assess potential multiple dose effects on response and time-to-response. The process used in this paper to dev

  1. Impact of Active Climate Control Seats on Energy Use, Fuel Use, and CO2 Emissions

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

    Kreutzer, Cory J; Rugh, John P; Titov, Eugene V

    A project was developed through collaboration between Gentherm and NREL to determine the impact of climate control seats for light-duty vehicles in the United States. The project used a combination of experimentation and analysis, with experimental results providing critical input to the analysis process. First, outdoor stationary vehicle testing was performed at NREL's facility in Golden, CO using multiple occupants. Two pre-production Ford Focus electric vehicles were used for testing; one containing a standard inactive seat and the second vehicle containing a Gentherm climate control seat. Multiple maximum cool-down and steady-state cooling tests were performed in late summer conditions. Themore » two vehicles were used to determine the increase in cabin temperature when using the climate control seat in comparison to the baseline vehicle cabin temperature with a standard seat at the equivalent occupant whole-body sensation. The experiments estimated that on average, the climate control seats allowed for a 2.61 degrees Celsius increase in vehicle cabin temperature at equivalent occupant body sensation compared to the baseline vehicle. The increased cabin air temperature along with their measured energy usage were then used as inputs to the national analysis process. The national analysis process was constructed from full vehicle cabin, HVAC, and propulsion models previously developed by NREL. In addition, three representative vehicle platforms, vehicle usage patterns, and vehicle registration weighted environmental data were integrated into the analysis process. Both the baseline vehicle and the vehicle with climate control seats were simulated, using the experimentally determined cabin temperature offset of 2.61degrees Celsius and added seat energy as inputs to the climate control seat vehicle model. The U.S. composite annual fuel use savings for the climate control seats over the baseline A/C system was determined to be 5.1 gallons of gasoline per year per vehicle, corresponding to 4.0 grams of CO2/mile savings. Finally, the potential impact of 100 percent adoption of climate control seats on U.S. light-duty fleet A/C fuel use was calculated to be 1.3 billion gallons of gasoline annually with a corresponding CO2 emissions reduction of 12.7 million tons. Direct comparison of the impact of the CCS to the ventilated seat off-cycle credit was not possible because the NREL analysis calculated a combined car/truck savings and the baseline A/C CO2 emissions were higher than EPA. To enable comparison, the CCS national A/C CO2 emissions were split into car/truck components and the ventilated seat credit was scaled up. The split CO2 emissions savings due to the CCS were 3.5 g/mi for a car and 4.4 g/mi for a truck. The CCS saved an additional 2.0 g/mi and 2.5 g/mi over the adjusted ventilated seat credit for a car and truck, respectively.« less

  2. Estimating lava volume by precision combination of multiple baseline spaceborne and airborne interferometric synthetic aperture radar: The 1997 eruption of Okmok Volcano, Alaska

    USGS Publications Warehouse

    Lu, Z.; Fielding, E.; Patrick, M.R.; Trautwein, C.M.

    2003-01-01

    Interferometric synthetic aperture radar (InSAR) techniques are used to calculate the volume of extrusion at Okmok volcano, Alaska by constructing precise digital elevation models (DEMs) that represent volcano topography before and after the 1997 eruption. The posteruption DEM is generated using airborne topographic synthetic aperture radar (TOPSAR) data where a three-dimensional affine transformation is used to account for the misalignments between different DEM patches. The preeruption DEM is produced using repeat-pass European Remote Sensing satellite data; multiple interferograms are combined to reduce errors due to atmospheric variations, and deformation rates are estimated independently and removed from the interferograms used for DEM generation. The extrusive flow volume associated with the 1997 eruption of Okmok volcano is 0.154 ?? 0.025 km3. The thickest portion is approximately 50 m, although field measurements of the flow margin's height do not exceed 20 m. The in situ measurements at lava edges are not representative of the total thickness, and precise DEM data are absolutely essential to calculate eruption volume based on lava thickness estimations. This study is an example that demonstrates how InSAR will play a significant role in studying volcanoes in remote areas.

  3. Extracting similar terms from multiple EMR-based semantic embeddings to support chart reviews.

    PubMed

    Cheng Ye, M S; Fabbri, Daniel

    2018-05-21

    Word embeddings project semantically similar terms into nearby points in a vector space. When trained on clinical text, these embeddings can be leveraged to improve keyword search and text highlighting. In this paper, we present methods to refine the selection process of similar terms from multiple EMR-based word embeddings, and evaluate their performance quantitatively and qualitatively across multiple chart review tasks. Word embeddings were trained on each clinical note type in an EMR. These embeddings were then combined, weighted, and truncated to select a refined set of similar terms to be used in keyword search and text highlighting. To evaluate their quality, we measured the similar terms' information retrieval (IR) performance using precision-at-K (P@5, P@10). Additionally a user study evaluated users' search term preferences, while a timing study measured the time to answer a question from a clinical chart. The refined terms outperformed the baseline method's information retrieval performance (e.g., increasing the average P@5 from 0.48 to 0.60). Additionally, the refined terms were preferred by most users, and reduced the average time to answer a question. Clinical information can be more quickly retrieved and synthesized when using semantically similar term from multiple embeddings. Copyright © 2018. Published by Elsevier Inc.

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

    Hale, Richard Edward; Cetiner, Sacit M.; Fugate, David L.

    The Small Modular Reactor (SMR) Dynamic System Modeling Tool project is in the third year of development. The project is designed to support collaborative modeling and study of various advanced SMR (non-light water cooled) concepts, including the use of multiple coupled reactors at a single site. The objective of the project is to provide a common simulation environment and baseline modeling resources to facilitate rapid development of dynamic advanced reactor SMR models, ensure consistency among research products within the Instrumentation, Controls, and Human-Machine Interface (ICHMI) technical area, and leverage cross-cutting capabilities while minimizing duplication of effort. The combined simulation environmentmore » and suite of models are identified as the Modular Dynamic SIMulation (MoDSIM) tool. The critical elements of this effort include (1) defining a standardized, common simulation environment that can be applied throughout the program, (2) developing a library of baseline component modules that can be assembled into full plant models using existing geometry and thermal-hydraulic data, (3) defining modeling conventions for interconnecting component models, and (4) establishing user interfaces and support tools to facilitate simulation development (i.e., configuration and parameterization), execution, and results display and capture.« less

  5. Evaluation of the effectiveness and efficiency of two stimulus prompt strategies with severely handicapped students.

    PubMed Central

    Steege, M W; Wacker, D P; McMahon, C M

    1987-01-01

    In this study we compared the effectiveness and efficiency of two treatment packages that used stimulus prompt sequences and task analyses for teaching community living skills to severely handicapped students. Four severely and multiply handicapped students were trained to perform four tasks: (a) making toast, (b) making popcorn, (c) operating a clothes dryer, and (d) operating a washing machine. Following baseline, each student was exposed to two types of training procedures, each involving a task analysis of the target behavior. Training Procedure 1 (Traditional) utilized a least-to-most restrictive prompt sequence. Training Procedure 2 (Prescriptive) utilized ongoing behavioral assessment data to identify discriminative stimuli. The assessment data were used to prescribe instructional prompts across successive training trials. Performance on the tasks was evaluated within a combination multiple baseline (across subjects) and probe (across tasks) design. Training conditions were counterbalanced across subjects and tasks. Results indicated that both training procedures were equally effective in increasing independent task acquisition for subjects on all tasks; however, the prescriptive procedure was the more efficient procedure. PMID:3667479

  6. Modelling fluid accumulation in the neck using simple baseline fluid metrics: implications for sleep apnea.

    PubMed

    Vena, Daniel; Yadollahi, A; Bradley, T Douglas

    2014-01-01

    Obstructive sleep apnea (OSA) is a common respiratory disorder among adults. Recently we have shown that sedentary lifestyle causes an increase in diurnal leg fluid volume (LFV), which can shift into the neck at night when lying down to sleep and increase OSA severity. The purpose of this work was to investigate various metrics that represent baseline fluid retention in the legs and examine their correlation with neck fluid volume (NFV) and to develop a robust model for predicting fluid accumulation in the neck. In 13 healthy awake non-obese men, LFV and NFV were recorded continuously and simultaneously while standing for 5 minutes and then lying supine for 90 minutes. Simple regression was used to examine correlations between baseline LFV, baseline neck circumference (NC) and change in LFV with the outcome variables: change in NC (ΔNC) and in NFV (ΔNFV90) after lying supine for 90 minutes. An exhaustive grid search was implemented to find combinations of input variables which best modeled outcomes. We found strong positive correlations between baseline LFV (supine and standing) and ΔNFV90. Models developed for predicting ΔNFV90 included baseline standing LFV, baseline NC combined with change in LFV after lying supine for 90 minutes. These correlations and the developed models suggest that a greater baseline LFV might contribute to increased fluid accumulation in the neck. These results give more evidence that sedentary lifestyle might play a role in the pathogenesis of OSA by increasing the baseline LFV. The best models for predicting ΔNC include baseline LFV and NC; they improved accuracies of estimating ΔNC over individual predictors, suggesting that a combination of baseline fluid metrics is a good predictor of the change in NC while lying supine. Future work is aimed at adding additional baseline demographic features to improve model accuracy and eventually use it as a screening tool to predict severity of OSA prior to sleep.

  7. 76 FR 61351 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-04

    ... Trading LLC submits tariff filing per 35.1: DB Energy Trading LLC Rate Schedule FERC No. 1 Baseline Filing... Energy FERC Electric Tariff, Volume No. 1 Baseline to be effective 9/23/2011. Filed Date: 09/23/2011... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 Take notice...

  8. Effect of fortification with multiple micronutrients and n-3 fatty acids on growth and cognitive performance in Indian schoolchildren: the CHAMPION (Children's Health and Mental Performance Influenced by Optimal Nutrition) Study.

    PubMed

    Muthayya, Sumithra; Eilander, Ans; Transler, Catherine; Thomas, Tinku; van der Knaap, Henk C M; Srinivasan, Krishnamachari; van Klinken, B Jan Willem; Osendarp, Saskia J M; Kurpad, Anura V

    2009-06-01

    Fortification with multiple micronutrients has been shown to improve growth and cognitive performance among children in developing countries, but it is unknown whether higher concentrations are more effective than lower concentrations. We compared the effect of 2 different concentrations of a combination of micronutrients and n-3 (omega-3) fatty acids on indicators of growth and cognitive performance in low-income, marginally nourished schoolchildren in Bangalore, India. In a 2-by-2 factorial, double-blind, randomized controlled trial, 598 children aged 6-10 y were individually allocated to 1 of 4 intervention groups to receive foods fortified with either 100% or 15% of the Recommended Dietary Allowance of micronutrients in combination with either 900 mg alpha-linolenic acid plus 100 mg docosahexaenoic acid or 140 mg alpha-linolenic acid for 12 mo. Anthropometric and biochemical assessments were performed at baseline and 12 mo. Cognitive performance was measured at baseline and at 6 and 12 mo. The high micronutrient treatment significantly improved linear growth at 12 mo (0.19 cm; 0.01, 0.36) and short-term memory at 6 mo (0.11 SD; 0.01, 0.20) and was less beneficial on fluid reasoning at 6 (-0.10 SD; -0.17, -0.03) and 12 (-0.12 SD; -0.20, -0.04) mo than was the low micronutrient treatment, whereas no differences were observed on weight, retrieval ability, cognitive speediness, and overall cognitive performance. No significant differences were found between the n-3 treatments. The high micronutrient treatment was more beneficial for linear growth than was the low micronutrient treatment. However, with some small differential effects, higher micronutrient concentrations were as effective as lower concentrations on cognitive performance. This trial was registered at clinicaltrials.gov as NCT00467909.

  9. Addition of Rice Bran Arabinoxylan to Curcumin Therapy May Be of Benefit to Patients With Early-Stage B-Cell Lymphoid Malignancies (Monoclonal Gammopathy of Undetermined Significance, Smoldering Multiple Myeloma, or Stage 0/1 Chronic Lymphocytic Leukemia)

    PubMed Central

    Golombick, Terry; Diamond, Terrence H.; Manoharan, Arumugam; Ramakrishna, Rajeev

    2016-01-01

    Hypothesis. Prior studies on patients with early B-cell lymphoid malignancies suggest that early intervention with curcumin may lead to delay in progressive disease and prolonged survival. These patients are characterized by increased susceptibility to infections. Rice bran arabinoxylan (Ribraxx) has been shown to have immunostimulatory, anti-inflammatory, and proapoptotic effects. We postulated that addition of Ribraxx to curcumin therapy may be of benefit. Study design. Monoclonal gammopathy of undetermined significance (MGUS)/smoldering multiple myeloma (SMM) or stage 0/1 chronic lymphocytic leukemia (CLL) patients who had been on oral curcumin therapy for a period of 6 months or more were administered both curcumin (as Curcuforte) and Ribraxx. Methods. Ten MGUS/SMM patients and 10 patients with stage 0/1 CLL were administered 6 g of curcumin and 2 g Ribraxx daily. Blood samples were collected at baseline and at 2-month intervals for a period of 6 months, and various markers were monitored. MGUS/SMM patients included full blood count (FBC); paraprotein; free light chains/ratio; C-reactive protein (CRP)and erythrocyte sedimentation rate (ESR); B2 microglobulin and immunological markers. Markers monitored for stage 0/1 CLL were FBC, CRP and ESR, and immunological markers. Results. Of 10 MGUS/SMM patients,5 (50%) were neutropenic at baseline, and the Curcuforte/Ribraxx combination therapy showed an increased neutrophil count, varying between 10% and 90% among 8 of the 10 (80%) MGUS/SMM patients. An additional benefit of the combination therapy was the potent effect in reducing the raised ESR in 4 (44%) of the MGUS/SMM patients. Conclusion. Addition of Ribraxx to curcumin therapy may be of benefit to patients with early-stage B-cell lymphoid malignancies. PMID:27154182

  10. The influence of coping styles on long-term employment in multiple sclerosis: A prospective study.

    PubMed

    Grytten, Nina; Skår, Anne Br; Aarseth, Jan Harald; Assmus, Jorg; Farbu, Elisabeth; Lode, Kirsten; Nyland, Harald I; Smedal, Tori; Myhr, Kjell Morten

    2017-06-01

    The aim was to investigate predictive values of coping styles, clinical and demographic factors on time to unemployment in patients diagnosed with multiple sclerosis (MS) during 1998-2002 in Norway. All patients ( N = 108) diagnosed with MS 1998-2002 in Hordaland and Rogaland counties, Western Norway, were invited to participate in the long-term follow-up study in 2002. Baseline recordings included disability scoring (Expanded Disability Status Scale (EDSS)), fatigue (Fatigue Severity Scale (FSS)), depression (Beck Depression Inventory (BDI)), and questionnaire assessing coping (the Dispositional Coping Styles Scale (COPE)). Logistic regression analysis was used to identify factors associated with unemployed at baseline, and Cox regression analysis to identify factors at baseline associated with time to unemployment during follow-up. In all, 41 (44%) were employed at baseline. After 13 years follow-up in 2015, mean disease duration of 22 years, 16 (17%) were still employed. Median time from baseline to unemployment was 6 years (±5). Older age at diagnosis, female gender, and depression were associated with patients being unemployed at baseline. Female gender, long disease duration, and denial as avoidant coping strategy at baseline predicted shorter time to unemployment. Avoidant coping style, female gender, and longer disease duration were associated with shorter time to unemployment. These factors should be considered when advising patients on MS and future employment.

  11. Multiple Acquisition InSAR Analysis: Persistent Scatterer and Small Baseline Approaches

    NASA Astrophysics Data System (ADS)

    Hooper, A.

    2006-12-01

    InSAR techniques that process data from multiple acquisitions enable us to form time series of deformation and also allow us to reduce error terms present in single interferograms. There are currently two broad categories of methods that deal with multiple images: persistent scatterer methods and small baseline methods. The persistent scatterer approach relies on identifying pixels whose scattering properties vary little with time and look angle. Pixels that are dominated by a singular scatterer best meet these criteria; therefore, images are processed at full resolution to both increase the chance of there being only one dominant scatterer present, and to reduce the contribution from other scatterers within each pixel. In images where most pixels contain multiple scatterers of similar strength, even at the highest possible resolution, the persistent scatterer approach is less optimal, as the scattering characteristics of these pixels vary substantially with look angle. In this case, an approach that interferes only pairs of images for which the difference in look angle is small makes better sense, and resolution can be sacrificed to reduce the effects of the look angle difference by band-pass filtering. This is the small baseline approach. Existing small baseline methods depend on forming a series of multilooked interferograms and unwrapping each one individually. This approach fails to take advantage of two of the benefits of processing multiple acquisitions, however, which are usually embodied in persistent scatterer methods: the ability to find and extract the phase for single-look pixels with good signal-to-noise ratio that are surrounded by noisy pixels, and the ability to unwrap more robustly in three dimensions, the third dimension being that of time. We have developed, therefore, a new small baseline method to select individual single-look pixels that behave coherently in time, so that isolated stable pixels may be found. After correction for various error terms, the phase values of the selected pixels are unwrapped using a new three-dimensional algorithm. We apply our small baseline method to an area in southern Iceland that includes Katla and Eyjafjallajökull volcanoes, and retrieve a time series of deformation that shows transient deformation due to intrusion of magma beneath Eyjafjallajökull. We also process the data using the Stanford method for persistent scatterers (StaMPS) for comparison.

  12. Pre-surgery Disability Compensation Predicts Long-Term Disability among Workers with Carpal Tunnel Syndrome

    PubMed Central

    Spector, June T.; Turner, Judith A.; Fulton-Kehoe, Deborah; Franklin, Gary

    2012-01-01

    Background We sought to identify early risk factors for work disability compensation prior to and after carpal tunnel syndrome (CTS) surgery, and to determine whether pre-surgery disability compensation is associated with long-term disability. Methods Washington State workers’ compensation administrative data and data from interviews with workers 18 days (median) after submitting new workers’ compensation claims for CTS were examined. Baseline risk factors for pre-surgery disability compensation and for long-term disability (≥365 days of work disability compensation prior to two years after claim filing) were evaluated for workers who underwent CTS surgery and had at least one day of disability compensation (N=670). Results After adjustment for baseline long-term disability risk factors, workers with pre-surgery disability compensation had over five times the odds of long-term disability. Baseline factors in multiple domains, including job, psychosocial, clinical, and worker pain and function, were associated with both pre-surgery disability compensation and long-term disability. Conclusions Risk factors for work disability prior to and after CTS surgery are similar, and early work disability is a risk factor for long-term CTS-related disability. An integrated approach to CTS-related disability prevention could include identifying and addressing combined risk factors soon after claim filing, more efficient use of conservative treatments and appropriate work modifications to minimize early work loss, and, when indicated, timely surgical intervention. PMID:22392804

  13. Progressive decline of decision-making performances during multiple sclerosis.

    PubMed

    Simioni, Samanta; Ruffieux, Christiane; Kleeberg, Joerg; Bruggimann, Laure; du Pasquier, Renaud A; Annoni, Jean-Marie; Schluep, Myriam

    2009-03-01

    The purpose of this study was to evaluate longitudinally, using the Iowa Gambling Task (IGT), the dynamics of decision-making capacity at a two-year interval (median: 2.1 years) in a group of patients with multiple sclerosis (MS) (n = 70) and minor neurological disability [Expanded Disability Status Scale (EDSS) < or = 2.5 at baseline]. Cognition (memory, executive functions, attention), behavior, handicap, and perceived health status were also investigated. Standardized change scores [(score at retest-score at baseline)/standard deviation of baseline score] were computed. Results showed that IGT performances decreased from baseline to retest (from 0.3, SD = 0.4 to 0.1, SD = 0.3, p = .005). MS patients who worsened in the IGT were more likely to show a decreased perceived health status and emotional well-being (SEP-59; p = .05 for both). Relapsing rate, disability progression, cognitive, and behavioral changes were not associated with decreased IGT performances. In conclusion, decline in decision making can appear as an isolated deficit in MS.

  14. Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms.

    PubMed

    Klimek, Ludger; Schumacher, Helmut; Schütt, Tanja; Gräter, Heidemarie; Mueck, Tobias; Michel, Martin C

    2017-02-01

    The aim of this study was to explore factors affecting efficacy of treatment of common cold symptoms with an over-the-counter ibuprofen/pseudoephedrine combination product. Data from an anonymous survey among 1770 pharmacy customers purchasing the combination product for treatment of own common cold symptoms underwent post-hoc descriptive analysis. Scores of symptoms typically responsive to ibuprofen (headache, pharyngeal pain, joint pain and fever), typically responsive to pseudoephedrine (congested nose, congested sinus and runny nose), considered non-specific (sneezing, fatigue, dry cough, cough with expectoration) and comprising all 11 symptoms were analysed. Multiple regression analysis was applied to explore factors associated with greater reduction in symptom intensity or greater probability of experiencing a symptom reduction of at least 50%. After intake of first dose of medication, typically ibuprofen-sensitive, pseudoephedrine-responsive, non-specific and total symptoms were reduced by 60.0%, 46.3%, 45.4% and 52.8%, respectively. A symptom reduction of at least 50% was reported by 73.6%, 55.1%, 50.9% and 61.6% of participants, respectively. A high baseline score was associated with greater reductions in symptom scores but smaller probability of achieving an improvement of at least 50%. Across both multiple regression approaches, two tablets at first dosing were more effective than one and (except for ibuprofen-sensitive symptoms) starting treatment later than day 2 of the cold was generally less effective. Efficacy of an ibuprofen/pseudoephedrine combination in the treatment of common cold symptoms was dose-dependent and greatest when treatment started within the first 2 days after onset of symptoms. © 2016 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

  15. Combined visual and motor evoked potentials predict multiple sclerosis disability after 20 years.

    PubMed

    Schlaeger, Regina; Schindler, Christian; Grize, Leticia; Dellas, Sophie; Radue, Ernst W; Kappos, Ludwig; Fuhr, Peter

    2014-09-01

    The development of predictors of multiple sclerosis (MS) disability is difficult due to the complex interplay of pathophysiological and adaptive processes. The purpose of this study was to investigate whether combined evoked potential (EP)-measures allow prediction of MS disability after 20 years. We examined 28 patients with clinically definite MS according to Poser's criteria with Expanded Disability Status Scale (EDSS) scores, combined visual and motor EPs at entry (T0), 6 (T1), 12 (T2) and 24 (T3) months, and a cranial magnetic resonance imaging (MRI) scan at T0 and T2. EDSS testing was repeated at year 14 (T4) and year 20 (T5). Spearman rank correlation was used. We performed a multivariable regression analysis to examine predictive relationships of the sum of z-transformed EP latencies (s-EPT0) and other baseline variables with EDSST5. We found that s-EPT0 correlated with EDSST5 (rho=0.72, p<0.0001) and ΔEDSST5-T0 (rho=0.50, p=0.006). Backward selection resulted in the prediction model: E (EDSST5)=3.91-2.22×therapy+0.079×age+0.057×s-EPT0 (Model 1, R (2)=0.58) with therapy as binary variable (1=any disease-modifying therapy between T3 and T5, 0=no therapy). Neither EDSST0 nor T2-lesion or gadolinium (Gd)-enhancing lesion quantities at T0 improved prediction of EDSST5. The area under the receiver operating characteristic (ROC) curve was 0.89 for model 1. These results further support a role for combined EP-measures as predictors of long-term disability in MS. © The Author(s) 2014.

  16. Error Modeling of Multi-baseline Optical Truss. Part II; Application to SIM Metrology Truss Field Dependent Error

    NASA Technical Reports Server (NTRS)

    Zhang, Liwei Dennis; Milman, Mark; Korechoff, Robert

    2004-01-01

    The current design of the Space Interferometry Mission (SIM) employs a 19 laser-metrology-beam system (also called L19 external metrology truss) to monitor changes of distances between the fiducials of the flight system's multiple baselines. The function of the external metrology truss is to aid in the determination of the time-variations of the interferometer baseline. The largest contributor to truss error occurs in SIM wide-angle observations when the articulation of the siderostat mirrors (in order to gather starlight from different sky coordinates) brings to light systematic errors due to offsets at levels of instrument components (which include comer cube retro-reflectors, etc.). This error is labeled external metrology wide-angle field-dependent error. Physics-based model of field-dependent error at single metrology gauge level is developed and linearly propagated to errors in interferometer delay. In this manner delay error sensitivity to various error parameters or their combination can be studied using eigenvalue/eigenvector analysis. Also validation of physics-based field-dependent model on SIM testbed lends support to the present approach. As a first example, dihedral error model is developed for the comer cubes (CC) attached to the siderostat mirrors. Then the delay errors due to this effect can be characterized using the eigenvectors of composite CC dihedral error. The essence of the linear error model is contained in an error-mapping matrix. A corresponding Zernike component matrix approach is developed in parallel, first for convenience of describing the RMS of errors across the field-of-regard (FOR), and second for convenience of combining with additional models. Average and worst case residual errors are computed when various orders of field-dependent terms are removed from the delay error. Results of the residual errors are important in arriving at external metrology system component requirements. Double CCs with ideally co-incident vertices reside with the siderostat. The non-common vertex error (NCVE) is treated as a second example. Finally combination of models, and various other errors are discussed.

  17. Phenome-driven disease genetics prediction toward drug discovery.

    PubMed

    Chen, Yang; Li, Li; Zhang, Guo-Qiang; Xu, Rong

    2015-06-15

    Discerning genetic contributions to diseases not only enhances our understanding of disease mechanisms, but also leads to translational opportunities for drug discovery. Recent computational approaches incorporate disease phenotypic similarities to improve the prediction power of disease gene discovery. However, most current studies used only one data source of human disease phenotype. We present an innovative and generic strategy for combining multiple different data sources of human disease phenotype and predicting disease-associated genes from integrated phenotypic and genomic data. To demonstrate our approach, we explored a new phenotype database from biomedical ontologies and constructed Disease Manifestation Network (DMN). We combined DMN with mimMiner, which was a widely used phenotype database in disease gene prediction studies. Our approach achieved significantly improved performance over a baseline method, which used only one phenotype data source. In the leave-one-out cross-validation and de novo gene prediction analysis, our approach achieved the area under the curves of 90.7% and 90.3%, which are significantly higher than 84.2% (P < e(-4)) and 81.3% (P < e(-12)) for the baseline approach. We further demonstrated that our predicted genes have the translational potential in drug discovery. We used Crohn's disease as an example and ranked the candidate drugs based on the rank of drug targets. Our gene prediction approach prioritized druggable genes that are likely to be associated with Crohn's disease pathogenesis, and our rank of candidate drugs successfully prioritized the Food and Drug Administration-approved drugs for Crohn's disease. We also found literature evidence to support a number of drugs among the top 200 candidates. In summary, we demonstrated that a novel strategy combining unique disease phenotype data with system approaches can lead to rapid drug discovery. nlp. edu/public/data/DMN © The Author 2015. Published by Oxford University Press.

  18. Cox Regression Models with Functional Covariates for Survival Data.

    PubMed

    Gellar, Jonathan E; Colantuoni, Elizabeth; Needham, Dale M; Crainiceanu, Ciprian M

    2015-06-01

    We extend the Cox proportional hazards model to cases when the exposure is a densely sampled functional process, measured at baseline. The fundamental idea is to combine penalized signal regression with methods developed for mixed effects proportional hazards models. The model is fit by maximizing the penalized partial likelihood, with smoothing parameters estimated by a likelihood-based criterion such as AIC or EPIC. The model may be extended to allow for multiple functional predictors, time varying coefficients, and missing or unequally-spaced data. Methods were inspired by and applied to a study of the association between time to death after hospital discharge and daily measures of disease severity collected in the intensive care unit, among survivors of acute respiratory distress syndrome.

  19. A COMPARISON OF PEER VIDEO MODELING AND SELF VIDEO MODELING TO TEACH TEXTUAL RESPONSES IN CHILDREN WITH AUTISM

    PubMed Central

    Marcus, Alonna; Wilder, David A

    2009-01-01

    Peer video modeling was compared to self video modeling to teach 3 children with autism to respond appropriately to (i.e., identify or label) novel letters. A combination multiple baseline and multielement design was used to compare the two procedures. Results showed that all 3 participants met the mastery criterion in the self-modeling condition, whereas only 1 of the participants met the mastery criterion in the peer-modeling condition. In addition, the participant who met the mastery criterion in both conditions reached the criterion more quickly in the self-modeling condition. Results are discussed in terms of their implications for teaching new skills to children with autism. PMID:19949521

  20. A Practical Comparison of Motion Planning Techniques for Robotic Legs in Environments with Obstacles

    NASA Technical Reports Server (NTRS)

    Smith, Tristan B.; Chavez-Clemente, Daniel

    2009-01-01

    ATHLETE is a large six-legged tele-operated robot. Each foot is a wheel; travel can be achieved by walking, rolling, or some combination of the two. Operators control ATHLETE by selecting parameterized commands from a command dictionary. While rolling can be done efficiently, any motion involving steps is cumbersome - each step can require multiple commands and take many minutes to complete. In this paper, we consider four different algorithms that generate a sequence of commands to take a step. We consider a baseline heuristic, a randomized motion planning algorithm, and two variants of A* search. Results for a variety of terrains are presented, and we discuss the quantitative and qualitative tradeoffs between the approaches.

  1. Should multiple imputation be the method of choice for handling missing data in randomized trials?

    PubMed Central

    Sullivan, Thomas R; White, Ian R; Salter, Amy B; Ryan, Philip; Lee, Katherine J

    2016-01-01

    The use of multiple imputation has increased markedly in recent years, and journal reviewers may expect to see multiple imputation used to handle missing data. However in randomized trials, where treatment group is always observed and independent of baseline covariates, other approaches may be preferable. Using data simulation we evaluated multiple imputation, performed both overall and separately by randomized group, across a range of commonly encountered scenarios. We considered both missing outcome and missing baseline data, with missing outcome data induced under missing at random mechanisms. Provided the analysis model was correctly specified, multiple imputation produced unbiased treatment effect estimates, but alternative unbiased approaches were often more efficient. When the analysis model overlooked an interaction effect involving randomized group, multiple imputation produced biased estimates of the average treatment effect when applied to missing outcome data, unless imputation was performed separately by randomized group. Based on these results, we conclude that multiple imputation should not be seen as the only acceptable way to handle missing data in randomized trials. In settings where multiple imputation is adopted, we recommend that imputation is carried out separately by randomized group. PMID:28034175

  2. Should multiple imputation be the method of choice for handling missing data in randomized trials?

    PubMed

    Sullivan, Thomas R; White, Ian R; Salter, Amy B; Ryan, Philip; Lee, Katherine J

    2016-01-01

    The use of multiple imputation has increased markedly in recent years, and journal reviewers may expect to see multiple imputation used to handle missing data. However in randomized trials, where treatment group is always observed and independent of baseline covariates, other approaches may be preferable. Using data simulation we evaluated multiple imputation, performed both overall and separately by randomized group, across a range of commonly encountered scenarios. We considered both missing outcome and missing baseline data, with missing outcome data induced under missing at random mechanisms. Provided the analysis model was correctly specified, multiple imputation produced unbiased treatment effect estimates, but alternative unbiased approaches were often more efficient. When the analysis model overlooked an interaction effect involving randomized group, multiple imputation produced biased estimates of the average treatment effect when applied to missing outcome data, unless imputation was performed separately by randomized group. Based on these results, we conclude that multiple imputation should not be seen as the only acceptable way to handle missing data in randomized trials. In settings where multiple imputation is adopted, we recommend that imputation is carried out separately by randomized group.

  3. Effect of Bone Marrow-Derived Mononuclear Cell Treatment, Early or Late After Acute Myocardial Infarction: Twelve Months CMR and Long-Term Clinical Results.

    PubMed

    Sürder, Daniel; Manka, Robert; Moccetti, Tiziano; Lo Cicero, Viviana; Emmert, Maximilian Y; Klersy, Catherine; Soncin, Sabrina; Turchetto, Lucia; Radrizzani, Marina; Zuber, Michel; Windecker, Stephan; Moschovitis, Aris; Bühler, Ines; Kozerke, Sebastian; Erne, Paul; Lüscher, Thomas F; Corti, Roberto

    2016-07-22

    Intracoronary delivery of autologous bone marrow-derived mononuclear cells (BM-MNC) may improve remodeling of the left ventricle (LV) after acute myocardial infarction (AMI). To demonstrate long-term efficacy of BM-MNC treatment after AMI. In a multicenter study, we randomized 200 patients with large AMI in a 1:1:1 pattern into an open-labeled control and 2 BM-MNC treatment groups. In the BM-MNC groups, cells were either administered 5 to 7 days (early) or 3 to 4 weeks (late) after AMI. Cardiac magnetic resonance imaging was performed at baseline and after 12 months. The current analysis investigates the change from baseline to 12 months in global LV ejection fraction, LV volumes, scar size, and N-terminal pro-brain natriuretic peptide values comparing the 2 treatment groups with control in a linear regression model. Besides the complete case analysis, multiple imputation analysis was performed to address for missing data. Furthermore, the long-term clinical event rate was computed. The absolute change in LV ejection fraction from baseline to 12 months was -1.9±9.8% for control (mean±SD), -0.9±10.5% for the early treatment group, and -0.7±10.1% for the late treatment group. The difference between the groups was not significant, both for complete case analysis and multiple imputation analysis. A combined clinical end point occurred equally in all the groups. Overall, 1-year mortality was low (2.25%). Among patients with AMI and LV dysfunction, treatment with BM-MNC either 5 to 7 days or 3 to 4 weeks after AMI did not improve LV function at 12 months, compared with control. The results are limited by an important drop out rate. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00355186. © 2016 American Heart Association, Inc.

  4. Intersession consistency of single-trial classification of the prefrontal response to mental arithmetic and the no-control state by NIRS.

    PubMed

    Power, Sarah D; Kushki, Azadeh; Chau, Tom

    2012-01-01

    Near-infrared spectroscopy (NIRS) has been recently investigated for use in noninvasive brain-computer interface (BCI) technologies. Previous studies have demonstrated the ability to classify patterns of neural activation associated with different mental tasks (e.g., mental arithmetic) using NIRS signals. Though these studies represent an important step towards the realization of an NIRS-BCI, there is a paucity of literature regarding the consistency of these responses, and the ability to classify them on a single-trial basis, over multiple sessions. This is important when moving out of an experimental context toward a practical system, where performance must be maintained over longer periods. When considering response consistency across sessions, two questions arise: 1) can the hemodynamic response to the activation task be distinguished from a baseline (or other task) condition, consistently across sessions, and if so, 2) are the spatiotemporal characteristics of the response which best distinguish it from the baseline (or other task) condition consistent across sessions. The answers will have implications for the viability of an NIRS-BCI system, and the design strategies (especially in terms of classifier training protocols) adopted. In this study, we investigated the consistency of classification of a mental arithmetic task and a no-control condition over five experimental sessions. Mixed model linear regression on intrasession classification accuracies indicate that the task and baseline states remain differentiable across multiple sessions, with no significant decrease in accuracy (p = 0.67). Intersession analysis, however, revealed inconsistencies in spatiotemporal response characteristics. Based on these results, we investigated several different practical classifier training protocols, including scenarios in which the training and test data come from 1) different sessions, 2) the same session, and 3) a combination of both. Results indicate that when selecting optimal classifier training protocols for NIRS-BCI, a compromise between accuracy and convenience (e.g., in terms of duration/frequency of training data collection) must be considered.

  5. Effects of Video Modeling on Treatment Integrity of Behavioral Interventions

    ERIC Educational Resources Information Center

    DiGennaro-Reed, Florence D.; Codding, Robin; Catania, Cynthia N.; Maguire, Helena

    2010-01-01

    We examined the effects of individualized video modeling on the accurate implementation of behavioral interventions using a multiple baseline design across 3 teachers. During video modeling, treatment integrity improved above baseline levels; however, teacher performance remained variable. The addition of verbal performance feedback increased…

  6. Neurocognitive predictors of financial capacity in traumatic brain injury.

    PubMed

    Martin, Roy C; Triebel, Kristen; Dreer, Laura E; Novack, Thomas A; Turner, Crystal; Marson, Daniel C

    2012-01-01

    To develop cognitive models of financial capacity (FC) in patients with traumatic brain injury (TBI). Longitudinal design. Inpatient brain injury rehabilitation unit. Twenty healthy controls, and 24 adults with moderate-to-severe TBI were assessed at baseline (30 days postinjury) and 6 months postinjury. The FC instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were employed to develop cognitive models of FCI performance in the TBI group, at baseline and 6-month time follow-up. Three cognitive predictor models of FC were developed. At baseline, measures of mental arithmetic/working memory and immediate verbal memory predicted baseline FCI performance (R = 0.72). At 6-month follow-up, measures of executive function and mental arithmetic/working memory predicted 6-month FCI performance (R = 0.79), and a third model found that these 2 measures at baseline predicted 6-month FCI performance (R = 0.71). Multiple cognitive functions are associated with initial impairment and partial recovery of FC in moderate-to-severe TBI patients. In particular, arithmetic, working memory, and executive function skills appear critical to recovery of FC in TBI. The study results represent an initial step toward developing a neurocognitive model of FC in patients with TBI.

  7. DETECTION OF FAST RADIO TRANSIENTS WITH MULTIPLE STATIONS: A CASE STUDY USING THE VERY LONG BASELINE ARRAY

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

    Thompson, David R.; Wagstaff, Kiri L.; Majid, Walid A.

    2011-07-10

    Recent investigations reveal an important new class of transient radio phenomena that occur on submillisecond timescales. Often, transient surveys' data volumes are too large to archive exhaustively. Instead, an online automatic system must excise impulsive interference and detect candidate events in real time. This work presents a case study using data from multiple geographically distributed stations to perform simultaneous interference excision and transient detection. We present several algorithms that incorporate dedispersed data from multiple sites, and report experiments with a commensal real-time transient detection system on the Very Long Baseline Array. We test the system using observations of pulsar B0329+54.more » The multiple-station algorithms enhanced sensitivity for detection of individual pulses. These strategies could improve detection performance for a future generation of geographically distributed arrays such as the Australian Square Kilometre Array Pathfinder and the Square Kilometre Array.« less

  8. Multiple Uses of a Word Study Technique

    ERIC Educational Resources Information Center

    Joseph, Laurice M.; Orlins, Andrew

    2005-01-01

    This paper presents two case studies that illustrate the multiple uses of word sorts, a word study phonics technique. Case study children were Sara, a second grader, who had difficulty with reading basic words and John, a third grader, who had difficulty with spelling basic words. Multiple baseline designs were employed to study the effects of…

  9. Single-stage evaluation of highly-loaded high-Mach-number compressor stages 5. Data and performance of baseline, corner-blow wall suction and combined corner blow wall suction stator

    NASA Technical Reports Server (NTRS)

    Nikkanen, J. P.; Brooky, J. P.

    1972-01-01

    A single-stage compressor with a rotor tip speed of 1600 ft/sec and a 0.5 hub tip ratio was used to investigate the effects of several stator endwall treatment methods on stage range and performance. These endwall treatment methods consisted of stator corner-blow, annular wall suction upstream of stator leading edge, and combined corner-blow and annular wall suction. The overall stage performance with corner blow was essentially the same as the baseline performance. The performance for the annular wall suction and the combined corner-blow and wall suction showed a reduction in peak efficiency of 2.5 percentage points compared to the baseline data.

  10. Erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) combined responders to tadalafil after 12 weeks of treatment.

    PubMed

    Roehrborn, Claus G; Egan, Kathryn B; Miner, Martin M; Ni, Xiao; Wong, David G; Rosen, Raymond C

    2016-07-01

    To analyse the proportion of men taking tadalafil 5 mg once daily who experience a combined improvement in symptoms of both erectile dysfunction (ED) and lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH). The data from men aged ≥45 years randomized to tadalafil 5 mg once daily or placebo enrolled in one of four randomized, placebo-controlled LUTS/BPH clinical trials were analysed (N = 927). A novel classification of 'combined responders' to ED and LUTS/BPH treatment was defined, based on published criteria for men who showed improvement in both International Index of Erectile Function - Erectile Function domain (IIEF-EF) score and total International Prostate Symptom Score (IPSS). Descriptive analyses assessed the covariate distribution by responder status. Unadjusted and adjusted logistic regressions provided odds ratios with 95% confidence intervals comparing combined responders with all others (partial and non-responders). Among men randomized to tadalafil 5 mg, 40.5% were combined responders (n = 189). Among placebo randomized men, 18.3% were combined responders (n = 84). Combined responders, in the total population, had the highest baseline IPSS and lowest baseline IIEF-EF scores, corresponding to the highest level of dysfunction. The majority of men were aged ≤65 years, white, non-obese, non-smokers, and regular alcohol consumers. Only treatment, baseline IPSS, baseline IIEF-EF, obesity and psychoactive medication use were significantly associated with responder status (P ≤ 0.05). Tadalafil-treated men had 2.8 times significantly increased adjusted odds of being combined responders vs non-responders (P < 0.001). For each unit decrease in baseline IIEF-EF or alcoholic drink consumption per week there was a 4% significant increase in the adjusted odds of being a combined responder to tadalafil therapy. This novel measure of combined response is useful in differentiating patients with clinically relevant symptom improvement for both ED and LUTS/BPH after treatment with tadalafil 5 mg once daily vs placebo. This combined responder measure may be useful in future assessment of treatment benefits across patient groups after various types of treatment intervention (e.g. surgical vs pharmacotherapy vs non-pharmacological intervention). © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  11. Interrater Agreement on the Visual Analysis of Individual Tiers and Functional Relations in Multiple Baseline Designs.

    PubMed

    Wolfe, Katie; Seaman, Michael A; Drasgow, Erik

    2016-11-01

    Previous research on visual analysis has reported low levels of interrater agreement. However, many of these studies have methodological limitations (e.g., use of AB designs, undefined judgment task) that may have negatively influenced agreement. Our primary purpose was to evaluate whether agreement would be higher than previously reported if we addressed these weaknesses. Our secondary purposes were to investigate agreement at the tier level (i.e., the AB comparison) and at the functional relation level in multiple baseline designs and to examine the relationship between raters' decisions at each of these levels. We asked experts (N = 52) to make judgments about changes in the dependent variable in individual tiers and about the presence of an overall functional relation in 31 multiple baseline graphs. Our results indicate that interrater agreement was just at or just below minimally adequate levels for both types of decisions and that agreement at the individual tier level often resulted in agreement about the overall functional relation. We report additional findings and discuss implications for practice and future research. © The Author(s) 2016.

  12. Relationship of carbohydrate molecular spectroscopic features in combined feeds to carbohydrate utilization and availability in ruminants

    NASA Astrophysics Data System (ADS)

    Zhang, Xuewei; Yu, Peiqiang

    To date, there is no study on the relationship between carbohydrate (CHO) molecular structures and nutrient availability of combined feeds in ruminants. The objective of this study was to use molecular spectroscopy to reveal the relationship between CHO molecular spectral profiles (in terms of functional groups (biomolecular, biopolymer) spectral peak area and height intensity) and CHO chemical profiles, CHO subfractions, energy values, and CHO rumen degradation kinetics of combined feeds of hulless barley with pure wheat dried distillers grains with solubles (DDGS) at five different combination ratios (hulless barley to pure wheat DDGS: 100:0, 75:25, 50:50, 25:75, 0:100). The molecular spectroscopic parameters assessed included: lignin biopolymer molecular spectra profile (peak area and height, region and baseline: ca. 1539-1504 cm-1); structural carbohydrate (STCHO, peaks area region and baseline: ca. 1485-1186 cm-1) mainly associated with hemi- and cellulosic compounds; cellulosic materials peak area (centered at ca. 1240 cm-1 with region and baseline: ca. 1272-1186 cm-1); total carbohydrate (CHO, peaks area region and baseline: ca. 1186-946 cm-1). The results showed that the functional groups (biomolecular, biopolymer) in the combined feeds are sensitive to the changes of carbohydrate chemical and nutrient profiles. The changes of the CHO molecular spectroscopic features in the combined feeds were highly correlated with CHO chemical profiles, CHO subfractions, in situ CHO rumen degradation kinetics and fermentable organic matter supply. Further study is needed to investigate possibility of using CHO molecular spectral features as a predictor to estimate nutrient availability in combined feeds for animals and quantify their relationship.

  13. 75 FR 45620 - Combined Notice of Filings #2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ..., LLC. Description: FPL Energy Oliver Wind I, LLC submits tariff filing per 35.12: Oliver I Baseline... Energy South Dakota Wind, LLC submits tariff filing per 35.12: South Dakota Baseline Filing, to be..., Inc. Description: FPL Energy Stateline II, Inc. submits tariff filing per 35.12: Stateline II Baseline...

  14. Multibaseline interferometric SAR at millimeterwaves test of an algorithm on real data and a synthetic scene

    NASA Astrophysics Data System (ADS)

    Essen, Helmut; Brehm, Thorsten; Boehmsdorff, Stephan

    2007-10-01

    Interferometric Synthetic Aperture Radar has the capability to provide the user with the 3-D-Information of land surfaces. To gather data with high height estimation accuracy it is necessary to use a wide interferometric baseline or a high radar frequency. However the problem of resolving the phase ambiguity at smaller wavelengths is more critical than at longer wavelengths, as the unambiguous height interval is inversely proportional to the radar wavelength. To solve this shortcoming, a multiple baseline approach can be used with a number of neighbouring horns and an increasing baselength going from narrow to wide. The narrowest, corresponding to adjacent horns, is then assumed to be unambiguous in phase. This initial interferogram is used as a starting point for the algorithm, which in the next step, unwraps the interferogram with the next wider baseline using the coarse height information to solve the phase ambiguities. This process is repeated consecutively until the interferogram with highest precision is unwrapped. On the expense of this multi-channel-approach the algorithm is simple and robust, and even the amount of processing time is reduced considerably, compared to traditional methods. The multiple baseline approach is especially adequate for millimeterwave radars as antenna horns with relatively small aperture can be used, while a sufficient 3-dB beamwidth is maintained. The paper describes the multiple baseline algorithm and shows the results of tests on real data and a synthetic area. Possibilities and limitations of this approach are discussed. Examples of digital elevation maps derived from measured data at millimeterwaves are shown.

  15. Training Behavior Modifiers: Videotape Self-Monitoring Versus Remote Auditory Prompting. Draft.

    ERIC Educational Resources Information Center

    Cone, John D.; And Others

    The separate and comparative effectiveness of two procedures, remote auditory prompting (RAP) and videotape self-monitoring (VSM), for training 14 adult aides to use behavior modification with institutionalized retarded children were examined. A two-group, multiple baseline design with baseline, training, and followup phases was employed with…

  16. The Effects of Reinforcer Pairing and Fading on Preschoolers' Snack Selections

    ERIC Educational Resources Information Center

    Solberg, Katherine M.; Hanley, Gregory P.; Layer, Stacy A.; Ingvarsson, Einar T.

    2007-01-01

    The effects of reinforcement pairing and fading on preschoolers' snack selections were evaluated in a multiple baseline design. Baseline preferences for snack options were assessed via repeated paired-item preference assessments. Edible, social, and activity-based reinforcers were then exclusively paired with a less preferred snack option. Once…

  17. The Treatment Efficacy of Multiple Opposition Phonological Approach via Telepractice for Two Children with Severe Phonological Disorders in Rural Areas of West Texas in the USA

    ERIC Educational Resources Information Center

    Lee, Sue Ann S.

    2018-01-01

    The goals of the present study were to (1) examine the effects of the multiple opposition phonological approach on improving phoneme production accuracy in children with severe phonological disorders and (2) explore whether the multiple opposition approach is feasible for the telepractice service delivery model. A multiple-baseline,…

  18. Drug Use and Multiple Sex Partners among Homeless Ex-Offenders: Secondary Findings from an Experimental Study

    PubMed Central

    Nyamathi, Adeline M.; Zhang, Sheldon; Wall, Sarah; Hall, Elizabeth A.; Salem, Benissa E.; Farabee, David; Faucette, Mark; Yadav, Kartik

    2016-01-01

    Background Transitioning into society after release from incarceration presents real challenges for male offenders; in California, up to 60% return to prison within three years following release. The risk for ongoing drug use and having sex with multiple sex partners is a significant challenge for ex-offenders preparing to enter the community. Objectives The aims are to describe drug use and sexual behavior (sex with multiple partners) prior to incarceration and six and 12 months following study enrollment using data obtained as part of a randomized controlled trial (RCT). Methods This is a planned secondary analysis of data obtained as part of an RCT designed to study the effects of intensive peer coaching and nurse case management, intensive peer coaching, and brief nurse counseling on hepatitis A and B vaccination adherence compared to a usual care control treatment that also included brief peer coaching and brief nurse counseling. Self-report data from subjects enrolled at one residential drug treatment facility in Los Angeles were captured at three time points: baseline, and six- and 12-month follow up. Results Findings showed substantive and significant reductions in drug use and engaging in sex with multiple partners six months following enrollment into the study compared to the baseline data, but results did not differ by study condition. At 12-month follow up, drug use and sex with multiple partners increased, but remained less than at baseline levels. Discussion Sustaining reductions in drug use and engaging in sex with multiple partners remains a challenge following incarceration. PMID:27124254

  19. Treatment of multiple adjacent Miller Class I and II gingival recessions with collagen matrix and the modified coronally advanced tunnel technique.

    PubMed

    Molnár, Bálint; Aroca, Sofia; Keglevich, Tibor; Gera, István; Windisch, Péter; Stavropoulos, Andreas; Sculean, Anton

    2013-01-01

    To clinically evaluate the treatment of Miller Class I and II multiple adjacent gingival recessions using the modified coronally advanced tunnel technique combined with a newly developed bioresorbable collagen matrix of porcine origin. Eight healthy patients exhibiting at least three multiple Miller Class I and II multiple adjacent gingival recessions (a total of 42 recessions) were consecutively treated by means of the modified coronally advanced tunnel technique and collagen matrix. The following clinical parameters were assessed at baseline and 12 months postoperatively: full mouth plaque score (FMPS), full mouth bleeding score (FMBS), probing depth (PD), recession depth (RD), recession width (RW), keratinized tissue thickness (KTT), and keratinized tissue width (KTW). The primary outcome variable was complete root coverage. Neither allergic reactions nor soft tissue irritations or matrix exfoliations occurred. Postoperative pain and discomfort were reported to be low, and patient acceptance was generally high. At 12 months, complete root coverage was obtained in 2 out of the 8 patients and 30 of the 42 recessions (71%). Within their limits, the present results indicate that treatment of Miller Class I and II multiple adjacent gingival recessions by means of the modified coronally advanced tunnel technique and collagen matrix may result in statistically and clinically significant complete root coverage. Further studies are warranted to evaluate the performance of collagen matrix compared with connective tissue grafts and other soft tissue grafts.

  20. Test-Retest Reliability of Measures Commonly Used to Measure Striatal Dysfunction across Multiple Testing Sessions: A Longitudinal Study.

    PubMed

    Palmer, Clare E; Langbehn, Douglas; Tabrizi, Sarah J; Papoutsi, Marina

    2017-01-01

    Cognitive impairment is common amongst many neurodegenerative movement disorders such as Huntington's disease (HD) and Parkinson's disease (PD) across multiple domains. There are many tasks available to assess different aspects of this dysfunction, however, it is imperative that these show high test-retest reliability if they are to be used to track disease progression or response to treatment in patient populations. Moreover, in order to ensure effects of practice across testing sessions are not misconstrued as clinical improvement in clinical trials, tasks which are particularly vulnerable to practice effects need to be highlighted. In this study we evaluated test-retest reliability in mean performance across three testing sessions of four tasks that are commonly used to measure cognitive dysfunction associated with striatal impairment: a combined Simon Stop-Signal Task; a modified emotion recognition task; a circle tracing task; and the trail making task. Practice effects were seen between sessions 1 and 2 across all tasks for the majority of dependent variables, particularly reaction time variables; some, but not all, diminished in the third session. Good test-retest reliability across all sessions was seen for the emotion recognition, circle tracing, and trail making test. The Simon interference effect and stop-signal reaction time (SSRT) from the combined-Simon-Stop-Signal task showed moderate test-retest reliability, however, the combined SSRT interference effect showed poor test-retest reliability. Our results emphasize the need to use control groups when tracking clinical progression or use pre-baseline training on tasks susceptible to practice effects.

  1. Chronic periodontitis with multiple risk factor syndrome: a case report.

    PubMed

    Shimoe, Masayuki; Yamamoto, Tadashi; Iwamoto, Yoshihiro; Shiomi, Nobuyuki; Maeda, Hiroshi; Nishimura, Fusanori; Takashiba, Shogo

    2011-07-01

    Multiple risk factor syndrome is a clustering of cardiovascular risk factors, such as diabetes, dyslipidemia, hypertension, and obesity associated epidemiologically with insulin resistance. This report describes the clinical course of a patient suffering from severe periodontitis with multiple risk factor syndrome, and discusses the association between periodontal infection and systemic health. The patient had a history of type 2 diabetes, dyslipidemia, and hypertension for over 10 years. At baseline, her hemoglobin A1 c was 8.1%. However, she had no diabetic complications except periodontitis. The IgG antibody titers against Porphyromonas gingivalis FDC 381 and SU63 were elevated above the mean of healthy subjects +2 standard deviations. Intensive periodontal treatment, including periodontal surgery, was performed to reduce periodontal infection and bacteremia. Her systemic and periodontal conditions were evaluated longitudinally for 10 years. Following periodontal treatment, antibody titers against Porphyromonas gingivalis and hemoglobin A1c values were significantly improved. The other clinical data and medication for her systemic condition also remained stable during supportive periodontal therapy. However, she developed myocardial infarction, and showed continuous deterioration of hemoglobin A1 c level and periodontitis. The long-term clustering of risk factors, such as diabetes, dyslipidemia, hypertension, and periodontitis, are associated with the development of myocardial infarction. Treatment of systemic conditions in combination with comprehensive periodontal treatment is important in management of patients with multiple risk factor syndrome.

  2. Physiological correlates of neurobehavioral disinhibition that relate to drug use and risky sexual behavior in adolescents with prenatal substance exposure.

    PubMed

    Conradt, Elisabeth; Lagasse, Linda L; Shankaran, Seetha; Bada, Henrietta; Bauer, Charles R; Whitaker, Toni M; Hammond, Jane A; Lester, Barry M

    2014-01-01

    Physiological correlates of behavioral and emotional problems, substance use onset and initiation of risky sexual behavior have not been studied in adolescents with prenatal drug exposure. We studied the concordance between baseline respiratory sinus arrhythmia (RSA) at age 3 and baseline cortisol levels at age 11. We hypothesized that children who showed concordance between RSA and cortisol would have lower neurobehavioral disinhibition scores which would in turn predict age of substance use onset and first sexual intercourse. The sample included 860 children aged 16 years participating in the Maternal Lifestyle Study, a multisite longitudinal study of children with prenatal exposure to cocaine and other substances. Structural equation modeling was used to test pathways between prenatal substance exposure, early adversity, baseline RSA, baseline cortisol, neurobehavioral disinhibition, drug use, and sexual behavior outcomes. Concordance was studied by examining separate male and female models in which there were statistically significant interactions between baseline RSA and cortisol. Prenatal substance exposure was operationalized as the number of substances to which the child was exposed. An adversity score was computed based on caregiver postnatal substance use, depression and psychological distress, number of caregiver changes, socioeconomic and poverty status, quality of the home environment, and child history of protective service involvement, abuse and neglect. RSA and cortisol were measured during a baseline period prior to the beginning of a task. Neurobehavioral disinhibition, based on composite scores of behavioral dysregulation and executive dysfunction, substance use and sexual behavior were derived from questionnaires and cognitive tests administered to the child. Findings were sex specific. In females, those with discordance between RSA and cortisol (high RSA and low cortisol or low RSA and high cortisol) had the most executive dysfunction which, in turn, predicted earlier initiation of alcohol by age 16. Among boys, there also existed a significant baseline RSA by baseline cortisol interaction. Boys with low baseline RSA and high baseline cortisol had the highest levels of behavioral dysregulation. This increase in behavioral dysregulation was in turn related to initiation of alcohol use by age 16 and lower age of first sexual intercourse. We found sex-specific pathways to the initiation of alcohol use and risky sexual behavior through the combined activity of parasympathetic and neuroendocrine functioning. The study of multiple physiological systems may suggest new pathways to the study of age of onset of substance use and engagement in risky sexual behavior in adolescents. © 2014 S. Karger AG, Basel.

  3. Physiological Correlates of Neurobehavioral Disinhibition that Relate to Drug Use and Risky Sexual Behavior in Adolescents with Prenatal Substance Exposure

    PubMed Central

    Conradt, Elisabeth; Lagasse, Linda L.; Shankaran, Seetha; Bada, Henrietta; Bauer, Charles R.; Whitaker, Toni M.; Hammond, Jane A.; Lester, Barry M.

    2015-01-01

    Physiological correlates of behavioral and emotional problems, substance use onset and initiation of risky sexual behavior have not been studied in adolescents with prenatal drug exposure. We studied the concordance between baseline respiratory sinus arrhythmia (RSA) at age 3 and baseline Cortisol levels at age 11. We hypothesized that children who showed concordance between RSA and Cortisol would have lower neurobehavioral disinhibition scores which would in turn predict age of substance use onset and first sexual intercourse. The sample included 860 children aged 16 years participating in the Maternal Lifestyle Study, a multisite longitudinal study of children with prenatal exposure to cocaine and other substances. Structural equation modeling was used to test pathways between prenatal substance exposure, early adversity, baseline RSA, baseline Cortisol, neurobehavioral disinhibition, drug use, and sexual behavior outcomes. Concordance was studied by examining separate male and female models in which there were statistically significant interactions between baseline RSA and Cortisol. Prenatal substance exposure was operationalized as the number of substances to which the child was exposed. An adversity score was computed based on caregiver postnatal substance use, depression and psychological distress, number of caregiver changes, socioeconomic and poverty status, quality of the home environment, and child history of protective service involvement, abuse and neglect. RSA and Cortisol were measured during a baseline period prior to the beginning of a task. Neurobehavioral disinhibition, based on composite scores of behavioral dysregulation and executive dysfunction, substance use and sexual behavior were derived from questionnaires and cognitive tests administered to the child. Findings were sex specific. In females, those with discordance between RSA and Cortisol (high RSA and low Cortisol or low RSA and high Cortisol) had the most executive dysfunction which, in turn, predicted earlier initiation of alcohol by age 16. Among boys, there also existed a significant baseline RSA by baseline Cortisol interaction. Boys with low baseline RSA and high baseline Cortisol had the highest levels of behavioral dysregulation. This increase in behavioral dysregulation was in turn related to initiation of alcohol use by age 16 and lower age of first sexual intercourse. We found sex-specific pathways to the initiation of alcohol use and risky sexual behavior through the combined activity of parasympathetic and neuroendocrine functioning. The study of multiple physiological systems may suggest new pathways to the study of age of onset of substance use and engagement in risky sexual behavior in adolescents. PMID:25033835

  4. Feasibility and potential effectiveness of a non-pharmacological multidisciplinary care programme for persons with generalised osteoarthritis: a randomised, multiple-baseline single-case study

    PubMed Central

    Kwakkenbos, Linda; Rietveld, Leonie; den Broeder, Alfons A; de Bie, Rob A; van den Ende, Cornelia H M

    2012-01-01

    Objectives To evaluate the feasibility and potential effectiveness of a 12-week, non-pharmacological multidisciplinary intervention in patients with generalised osteoarthritis (GOA). Design A randomised, concurrent, multiple-baseline single-case design. During the baseline period, the intervention period and the postintervention period, all participants completed several health outcomes twice a week on Visual Analogue Scales. Setting Rheumatology outpatient department of a specialised hospital in the Netherlands. Participants 1 man and four women (aged 51–76 years) diagnosed with GOA. Primary outcome measures To assess feasibility, the authors assessed the number of dropouts and adverse events, adherence rates and patients' satisfaction. Secondary outcome measures To assess the potential effectiveness, the authors assessed pain and self-efficacy using visual data inspection and randomisation tests. Results The intervention was feasible in terms of adverse events (none) and adherence rate but not in terms of participants' satisfaction with the intervention. Visual inspection of the data and randomisation testing demonstrated no effects on pain (p=0.93) or self-efficacy (p=0.85). Conclusions The results of the present study indicate that the proposed intervention for patients with GOA was insufficiently feasible and effective. The data obtained through this multiple-baseline study have highlighted several areas in which the therapy programme can be optimised. PMID:22815466

  5. Patient-Customized Drug Combination Prediction and Testing for T-cell Prolymphocytic Leukemia Patients.

    PubMed

    He, Liye; Tang, Jing; Andersson, Emma I; Timonen, Sanna; Koschmieder, Steffen; Wennerberg, Krister; Mustjoki, Satu; Aittokallio, Tero

    2018-05-01

    The molecular pathways that drive cancer progression and treatment resistance are highly redundant and variable between individual patients with the same cancer type. To tackle this complex rewiring of pathway cross-talk, personalized combination treatments targeting multiple cancer growth and survival pathways are required. Here we implemented a computational-experimental drug combination prediction and testing (DCPT) platform for efficient in silico prioritization and ex vivo testing in patient-derived samples to identify customized synergistic combinations for individual cancer patients. DCPT used drug-target interaction networks to traverse the massive combinatorial search spaces among 218 compounds (a total of 23,653 pairwise combinations) and identified cancer-selective synergies by using differential single-compound sensitivity profiles between patient cells and healthy controls, hence reducing the likelihood of toxic combination effects. A polypharmacology-based machine learning modeling and network visualization made use of baseline genomic and molecular profiles to guide patient-specific combination testing and clinical translation phases. Using T-cell prolymphocytic leukemia (T-PLL) as a first case study, we show how the DCPT platform successfully predicted distinct synergistic combinations for each of the three T-PLL patients, each presenting with different resistance patterns and synergy mechanisms. In total, 10 of 24 (42%) of selective combination predictions were experimentally confirmed to show synergy in patient-derived samples ex vivo The identified selective synergies among approved drugs, including tacrolimus and temsirolimus combined with BCL-2 inhibitor venetoclax, may offer novel drug repurposing opportunities for treating T-PLL. Significance: An integrated use of functional drug screening combined with genomic and molecular profiling enables patient-customized prediction and testing of drug combination synergies for T-PLL patients. Cancer Res; 78(9); 2407-18. ©2018 AACR . ©2018 American Association for Cancer Research.

  6. A Multi-Method Examination of Negative Behaviors during Couples Interactions and Problem Drinking Trajectories

    PubMed Central

    Fairbairn, Catharine E.; Cranford, James A.

    2016-01-01

    Models of alcohol use disorder (AUD) are increasingly conceptualizing social and relationship factors as being critical to the understanding of problem drinking. Close relationships involving conflict have been a particular research focus, and partners’ expressions of negative emotion are theorized to impact drinking among those with AUD. While it has long been presumed that behaviors during couples interactions influence drinking—and this assumption has informed many modern treatments for AUD—this hypothesis has not been directly tested. We bring multiple methods to bear on this question, combining laboratory based behavioral-observation with a longitudinal design. Forty-eight individuals with AUD (probands), together with their partners, completed a laboratory-based conflict interaction. Their behavior was coded with the Rapid Marital Interaction Coding System. Longitudinal follow-ups of drinking behaviors were completed at 6 and 12 months. Results showed that, above and beyond the proband’s own behaviors, partner negative behaviors moderated probands’ drinking trajectories, with drinkers whose partners displayed higher levels of hostility at baseline reporting slower declines in frequency of a) drinking, b) heavy episodic drinking, and c) alcohol problems over time and higher levels of drinking, heavy episodic drinking, and alcohol problems at follow-up. Results emphasize the importance of considering close relationships in the study of AUD and further indicate the utility of combining multiple methods in alcohol research. PMID:27362489

  7. Effects of Tai Chi on Cognition and Fall Risk in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial.

    PubMed

    Sungkarat, Somporn; Boripuntakul, Sirinun; Chattipakorn, Nipon; Watcharasaksilp, Kanokwan; Lord, Stephen R

    2017-04-01

    To examine whether combined center- and home-based Tai Chi training can improve cognitive ability and reduce physiological fall risk in older adults with amnestic mild cognitive impairment (a-MCI). Randomized controlled trial. Chiang Mai, Thailand. Adults aged 60 and older who met Petersen's criteria for multiple-domain a-MCI (N = 66). Three weeks center-based and 12 weeks home-based Tai Chi (50 minutes per session, 3 times per week). Cognitive tests, including Logical Memory (LM) delayed recall, Block Design, Digit Span forward and backward, and Trail-Making Test Part B-A (TMT B-A), and fall risk index using the Physiological Profile Assessment (PPA). At the end of the trial, performance on LM, Block Design, and TMT B-A were significantly better for the Tai Chi group than the control group after adjusting for baseline test performance. The Tai Chi group also had significantly better composite PPA score and PPA parameter scores: knee extension strength, reaction time, postural sway, and lower limb proprioception. Combined center- and home-based Tai Chi training three times per week for 15 weeks significantly improved cognitive function and moderately reduced physiological fall risk in older adults with multiple-domain a-MCI. Tai Chi may be particularly beneficial to older adults with this condition. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  8. Cerebrospinal fluid ATP metabolites in multiple sclerosis.

    PubMed

    Lazzarino, G; Amorini, A M; Eikelenboom, M J; Killestein, J; Belli, A; Di Pietro, V; Tavazzi, B; Barkhof, F; Polman, C H; Uitdehaag, B M J; Petzold, A

    2010-05-01

    Increased axonal energy demand and mitochondrial failure have been suggested as possible causes for axonal degeneration and disability in multiple sclerosis. Our objective was to test whether ATP depletion precedes clinical, imaging and biomarker evidence for axonal degeneration in multiple sclerosis. The method consisted of a longitudinal study which included 21 patients with multiple sclerosis. High performance liquid chromatography was used to quantify biomarkers of the ATP metabolism (oxypurines and purines) from the cerebrospinal fluid at baseline. The Expanded Disability Status Scale, MRI brain imaging measures for brain atrophy (ventricular and parenchymal fractions), and cerebrospinal fluid biomarkers for axonal damage (phosphorylated and hyperphosphorylated neurofilaments) were quantified at baseline and 3-year follow-up. Central ATP depletion (sum of ATP metabolites >19.7 micromol/litre) was followed by more severe progression of disability if compared to normal ATP metabolites (median 1.5 versus 0, p< 0.05). Baseline ATP metabolite levels correlated with change of Expanded Disability Status Scale in the pooled cohort (r= 0.66, p= 0.001) and subgroups (relapsing-remitting patients: r= 0.79, p< 0.05 and secondary progressive/primary progressive patients: r= 0.69, p< 0.01). There was no relationship between central ATP metabolites and either biomarker or MRI evidence for axonal degeneration. The data suggests that an increased energy demand in multiple sclerosis may cause a quantifiable degree of central ATP depletion. We speculate that the observed clinical disability may be related to depolarisation associated conduction block.

  9. Longitudinal association of hypertension and diabetes mellitus with cognitive functioning in a general 70-year-old population: the SONIC study.

    PubMed

    Ryuno, Hirochika; Kamide, Kei; Gondo, Yasuyuki; Kabayama, Mai; Oguro, Ryosuke; Nakama, Chikako; Yokoyama, Serina; Nagasawa, Motonori; Maeda-Hirao, Satomi; Imaizumi, Yuki; Takeya, Miyuki; Yamamoto, Hiroko; Takeda, Masao; Takami, Yoichi; Itoh, Norihisa; Takeya, Yasushi; Yamamoto, Koichi; Sugimoto, Ken; Nakagawa, Takeshi; Yasumoto, Saori; Ikebe, Kazunori; Inagaki, Hiroki; Masui, Yukie; Takayama, Michiyo; Arai, Yasumichi; Ishizaki, Tatsuro; Takahashi, Ryutaro; Rakugi, Hiromi

    2017-07-01

    Both hypertension and diabetes in middle-aged individuals have been suggested to be predictive indicators of cognitive decline. However, the association of hypertension, diabetes and their combination with cognitive functioning is still controversial in older people. The purpose of this study was to investigate the association between cognitive decline and hypertension, diabetes, and their combination in 70-year-old people based on a 3-year longitudinal analysis. Four hundred and fifty-four people aged 70 (±1) years who participated in the Japanese longitudinal cohort study of Septuagenarians, Octogenarians and Nonagenarians Investigation with Centenarians (SONIC) were recruited randomly from a general population and were monitored for 3 years. The data, including most of the demographics, cognitive functioning measured by the Montreal Cognitive Assessment Japanese version (MoCA-J), blood pressure, blood chemistry and other medical histories, were collected at baseline and during the follow-up. The prevalence of hypertension noted in the follow-up survey was significantly higher than than noted at baseline. The mean MoCA-J score at follow-up was not significantly different from the score obtained at baseline. However, the participants with diabetes, especially combined with hypertension at baseline, had significantly lower MoCA-J scores than those without lifestyle-related diseases. The combination of hypertension and diabetes was still a significant risk factor for cognitive decline, considering the MoCA-J scores obtained during the follow-up after adjustments at baseline, relative to sex, body mass index, dyslipidemia, smoking, excessive alcohol intake, antihypertensive treatment and education level (β=-0.14; P<0.01). Our findings indicate that diabetes and the combination of hypertension and diabetes are clear risk factors for future cognitive decline in elderly individuals who are 70 years of age.

  10. NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CODING: BASELINE QUESTIONNAIRE (HOUSEHOLD) (UA-D-7.0)

    EPA Science Inventory

    The purpose of this SOP is to define the coding strategy for the Baseline Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the "Border" study. Household and individual data were combined in a single Baseline Questionnaire data file. Key...

  11. Regular use of nonsteroidal anti-inflammatory drugs and cognitive function in aging women.

    PubMed

    Kang, Jae Hee; Grodstein, Francine

    2003-05-27

    To examine the relationship of nonsteroidal anti-inflammatory drug (NSAID) use and cognitive decline in young-old women. The authors prospectively studied 16,128 Nurses' Health Study participants, aged 70 to 81 years at baseline, who provided information on NSAID use and potential confounders in biennial questionnaires from 1976 through 1998. From 1995 through 2001, we administered, by telephone, six tests of cognitive function, including the Telephone Interview of Cognitive Status (TICS). Second interviews were begun 2 years later and completed on 13,255 women to date. The authors used multiple logistic regression to estimate relative risks (RR) of low baseline scores (defined as the bottom 10%) and substantial decline (worst 10%). Compared to never users, the RR was 0.75 (95% CI 0.59, 0.96) for a low baseline TICS score with current aspirin use of 15+ years duration, and 0.79 (95% CI 0.62, 1.02) for current use of NSAID (primarily ibuprofen) lasting 8+ years. Results for aspirin users were weaker on other tests, but long-term ibuprofen users had a RR of 0.75 (95% CI 0.56, 1.00) for a low baseline global score (combination of all six tests). The RR for substantial global cognitive decline was 0.93 (95% CI 0.68, 1.26) with long-term aspirin use, and 0.77 (95% CI 0.57, 1.05) with long-term ibuprofen use. In these young-old women, current, long-term NSAID users, especially of nonaspirin agents, showed reduced odds of low cognitive function and possibly lower rates of substantial cognitive decline over 2 years. Continued follow-up will help determine if associations differ at older ages.

  12. Strategic Key Word Instruction: Increasing Fluency in Connected Expository Text

    ERIC Educational Resources Information Center

    Coulter, Gail; Lambert, Michael C.

    2015-01-01

    The effects of preteaching key words on fluency in connected text were examined with three third-grade general education participants. Researchers used a multiple base-line design (i.e., Baseline and Wordlist Intervention) and found that preteaching increased fluency in connected text written above the participant's instructional level of reading…

  13. Improving the Interview Skills of College Students Using Behavioral Skills Training

    ERIC Educational Resources Information Center

    Stocco, Corey S.; Thompson, Rachel H.; Hart, John M.; Soriano, Heidi L.

    2017-01-01

    Obtaining a job as a college graduate is partly dependent on interview performance. We used a multiple baseline design across skills to evaluate the effects of behavioral skills training with self-evaluation for five college students. Training effects were evaluated using simulated interviews as baseline and posttraining assessments. All…

  14. Effects of a Driver Enforcement Program on Yielding to Pedestrians

    ERIC Educational Resources Information Center

    Van Houten, Ron; Malenfant, J. E. Louis

    2004-01-01

    A driver-yielding enforcement program that included decoy pedestrians, feedback flyers, written and verbal warnings, and saturation enforcement for a 2-week period was evaluated in the city of Miami Beach using a multiple baseline design. During baseline, data were collected at crosswalks along two major corridors. Treatment was introduced first…

  15. Effects of the TWA Strategy on Expository Reading Comprehension of Students with Autism

    ERIC Educational Resources Information Center

    Howorth, Sarah; Lopata, Christopher; Thomeer, Marcus; Rodgers, Jonathan

    2016-01-01

    High-functioning students with autism spectrum disorder (ASD) have been shown to have significant reading comprehension difficulty. This multiple baseline study examined the effect of the think before reading, think while reading, and think after reading (TWA) strategy on expository text comprehension of four boys with ASD. Following baseline,…

  16. Baseline features and differences in 48 week clinical outcomes in patients with gastroparesis and type 1 vs type 2 diabetes.

    PubMed

    Koch, K L; Hasler, W L; Yates, K P; Parkman, H P; Pasricha, P J; Calles-Escandon, J; Snape, W J; Abell, T L; McCallum, R W; Nguyen, L A; Sarosiek, I; Farrugia, G; Tonascia, J; Lee, L; Miriel, L; Hamilton, F

    2016-07-01

    In studies of diabetic gastroparesis, patients with type 1 and type 2 diabetes mellitus (T1DM, T2DM) are often combined for analyses. We compared gastroparesis severity, healthcare utilization, psychological function, and quality of life in T1DM vs T2DM gastroparesis patients. Questionnaire, laboratory, and scintigraphy data from patients with gastroparesis and T1DM and T2DM from seven centers of the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium Registry were compared at enrollment and after 48 weeks. Multiple regression models assessed baseline and follow-up differences between diabetes subtypes. At baseline, T1DM patients (N = 78) had slower gastric emptying, more hospitalizations, more gastric stimulator implantations, higher hemoglobin A1c (HbA1c), and more anxiety vs T2DM patients (N = 59). Independent discriminators of patients with T1DM vs T2DM included worse gastroesophageal reflux disease, less bloating, more peripheral neuropathy, and fewer comorbidities (p ≤ 0.05). On follow-up, gastrointestinal (GI) symptom scores decreased only in T2DM (p < 0.05), but not in T1DM patients who reported greater prokinetic, proton pump inhibitor, anxiolytic, and gastric stimulator usage over 48 weeks (p ≤ 0.03). Gastrointestinal symptoms at baseline and 48 weeks with both subtypes were not associated with HbA1c, peripheral neuropathy, psychological factors, or quality of life. Baseline symptoms were similar in T1DM and T2DM patients, even though T1DM patients had worse gastric emptying delays and higher HbA1c suggesting other factors mediate symptom severity. Symptom scores at 48 weeks decreased in T2DM, but not T1DM patients, despite increased medical and surgical treatment utilization by T1DM patients. Defining causes of different outcomes in diabetic gastroparesis warrants further investigation. © 2016 John Wiley & Sons Ltd.

  17. What is different about workers' compensation patients? Socioeconomic predictors of baseline disability status among patients with lumbar radiculopathy.

    PubMed

    Atlas, Steven J; Tosteson, Tor D; Hanscom, Brett; Blood, Emily A; Pransky, Glenn S; Abdu, William A; Andersson, Gunnar B; Weinstein, James N

    2007-08-15

    Combined analysis of 2 prospective clinical studies. To identify socioeconomic characteristics associated with workers' compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Few studies have compared socioeconomic differences between those receiving or not receiving workers' compensation with the same underlying clinical conditions. Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers' compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers' compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers' compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers' compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers' compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers' compensation. Clinical trials involving conditions commonly seen in patients with workers' compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers' compensation. Identifying the independent effects of workers' compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status.

  18. Far-Field Acoustic Characteristics of Multiple Blade-Vane Configurations for a High Tip Speed Fan

    NASA Technical Reports Server (NTRS)

    Woodward, Richard P.; Gazzaniga, John A.; Hughes, Christopher

    2004-01-01

    The acoustic characteristics of a model high-speed fan stage were measured in the NASA Glenn 9- by 15-Foot Low Speed Wind Tunnel at takeoff and approach flight conditions. The fan was designed for a corrected rotor tip speed of 442 m/s (1450 ft/s), and had a powered core, or booster stage, giving the model a nominal bypass ratio of 5. A simulated engine pylon and nozzle bifurcation was contained within the bypass duct. The fan stage consisted of all combinations of 3 possible rotors, and 3 stator vane sets. The 3 rotors were (1) wide chord, (2) forward swept, and (3) shrouded. The 3 stator sets were (1) baseline, moderately swept, (2) swept and leaned, and (3) swept integral vane/frame which incorporated some of the swept and leaned features as well as eliminated the downstream support structure. The baseline configuration is considered to be the wide chord rotor with the radial vane stator. A flyover Effective Perceived Noise Level (EPNL) code was used to generate relative EPNL values for the various configurations. The swept and leaned stator showed a 3 EPNdB reduction at lower fan speeds relative to the baseline stator; while the swept integral vane/frame stator showed lowest noise levels at high fan speeds. The baseline, wide chord rotor was typically the quietest of the three rotors. A tone removal study was performed to assess the acoustic benefits of removing the fundamental rotor interaction tone and its harmonics. Reprocessing the acoustic results with the bypass tone removed had the most impact on reducing fan noise at transonic rotor speeds. Removal of the bypass rotor interaction tones (BPF and nBPF) showed up to a 6 EPNdB noise reduction at transonic rotor speeds relative to noise levels for the baseline (wide chord rotor and radial stator; all tones present) configuration.

  19. BASELINE FEATURES AND DIFFERENCES IN 48 WEEK CLINICAL OUTCOMES IN PATIENTS WITH GASTROPARESIS AND TYPE 1 VERSUS TYPE 2 DIABETES

    PubMed Central

    Koch, Kenneth L.; Hasler, William L.; Yates, Katherine P.; Parkman, Henry P.; Pasricha, Pankaj J.; Calles-Escandon, Jorge; Snape, William J.; Abell, Thomas L.; McCallum, Richard W.; Nguyen, Linda A.; Sarosiek, Irene; Farrugia, Gianrico; Tonascia, James; Lee, Linda; Miriel, Laura; Hamilton, Frank

    2016-01-01

    Background In studies of diabetic gastroparesis, patients with type 1 and type 2 diabetes (T1DM, T2DM) are often combined for analyses. We compared gastroparesis severity, healthcare utilization, psychological function, and quality of life in T1DM versus T2DM gastroparesis patients. Methods Questionnaire, laboratory, and scintigraphy data from patients with gastroparesis and T1DM and T2DM from seven centers of the NIDDK Gastroparesis Clinical Research Consortium (GpCRC) Registry were compared at enrollment and after 48 weeks. Multiple regression models assessed baseline and follow-up differences between diabetes subtypes. Key Results At baseline, T1DM patients (N=78) had slower gastric emptying, more hospitalizations, more gastric stimulator implantations, higher hemoglobin A1c (HbA1c), and more anxiety versus T2DM patients (N=59). Independent discriminators of patients with T1DM versus T2DM included worse GERD, less bloating, more peripheral neuropathy, and fewer comorbidities (P≤0.05). On follow-up, gastrointestinal (GI) symptom scores decreased only in T2DM (P<0.05), but not in T1DM patients who reported greater prokinetic, proton pump inhibitor, anxiolytic, and gastric stimulator usage over 48 weeks (P≤0.03). GI symptoms at baseline and 48 weeks with both subtypes were not associated with HbA1c, peripheral neuropathy, psychological factors, or quality of life. Conclusions & Inferences Baseline symptoms were similar in T1DM and T2DM patients, even though T1DM patients had worse gastric emptying delays and higher HbA1c suggesting other factors mediate symptom severity. Symptom scores at 48 weeks decreased in T2DM but not T1DM patients, despite increased medical and surgical treatment utilization by T1DM patients. Defining causes of different outcomes in diabetic gastroparesis warrants further investigation. PMID:26946489

  20. Evaluation of attention training and metacognitive facilitation to improve reading comprehension in aphasia.

    PubMed

    Lee, Jaime B; Moore Sohlberg, McKay

    2013-05-01

    This pilot study investigated the impact of direct attention training combined with metacognitive facilitation on reading comprehension in individuals with aphasia. A single-subject, multiple baseline design was employed across 4 participants to evaluate potential changes in reading comprehension resulting from an 8-week intervention using Attention Process Training-3 (APT-3). The primary outcome measure was a maze reading task. Pre- and posttesting included attention and reading comprehension measures. Visual inspection of graphed performance data across conditions was used as the primary method of analysis. Treatment effect sizes were calculated for changes in reading comprehension probes from baseline to maintenance phases. Two of the study's 4 participants demonstrated improvements in maze reading, with corresponding effect sizes that were small in magnitude according to benchmarks for aphasia treatment research. All 4 participants made improvements on select standardized measures of attention. Interventions that include a metacognitive component with direct attention training may elicit improvements in participants' attention and allocation of resources. Maze passage reading is a repeated measure that appears sensitive to treatment-related changes in reading comprehension. Issues for future research related to measurement, candidacy, and clinical delivery are discussed.

  1. E-learning optimization: the relative and combined effects of mental practice and modeling on enhanced podcast-based learning-a randomized controlled trial.

    PubMed

    Alam, Fahad; Boet, Sylvain; Piquette, Dominique; Lai, Anita; Perkes, Christopher P; LeBlanc, Vicki R

    2016-10-01

    Enhanced podcasts increase learning, but evidence is lacking on how they should be designed to optimize their effectiveness. This study assessed the impact two learning instructional design methods (mental practice and modeling), either on their own or in combination, for teaching complex cognitive medical content when incorporated into enhanced podcasts. Sixty-three medical students were randomised to one of four versions of an airway management enhanced podcast: (1) control: narrated presentation; (2) modeling: narration with video demonstration of skills; (3) mental practice: narrated presentation with guided mental practice; (4) combined: modeling and mental practice. One week later, students managed a manikin-based simulated airway crisis. Knowledge acquisition was assessed by baseline and retention multiple-choice quizzes. Two blinded raters assessed all videos obtained from simulated crises to measure the students' skills using a key-elements scale, critical error checklist, and the Ottawa global rating scale (GRS). Baseline knowledge was not different between all four groups (p = 0.65). One week later, knowledge retention was significantly higher for (1) both the mental practice and modeling group than the control group (p = 0.01; p = 0.01, respectively) and (2) the combined mental practice and modeling group compared to all other groups (all ps = 0.01). Regarding skills acquisition, the control group significantly under-performed in comparison to all other groups on the key-events scale (all ps ≤ 0.05), the critical error checklist (all ps ≤ 0.05), and the Ottawa GRS (all ps ≤ 0.05). The combination of mental practice and modeling led to greater improvement on the key events checklist (p = 0.01) compared to either strategy alone. However, the combination of the two strategies did not result in any further learning gains on the two other measures of clinical performance (all ps > 0.05). The effectiveness of enhanced podcasts for knowledge retention and clinical skill acquisition is increased with either mental practice or modeling. The combination of mental practice and modeling had synergistic effects on knowledge retention, but conveyed less clear advantages in its application through clinical skills.

  2. Positioning performance improvements with European multiple-frequency satellite navigation - Galileo

    NASA Astrophysics Data System (ADS)

    Ji, Shengyue

    2008-10-01

    The rapid development of Global Positioning System has demonstrated the advantages of satellite based navigation systems. In near future, there will be a number of Global Navigation Satellite System (GNSS) available, i.e. modernized GPS, Galileo, restored GLONASS, BeiDou and many other regional GNSS augmentation systems. Undoubtedly, the new GNSS systems will significantly improve navigation performance over current GPS, with a better satellite coverage and multiple satellite signal bands. In this dissertation, the positioning performance improvement of new GNSS has been investigated based on both theoretical analysis and numerical study. First of all, the navigation performance of new GNSS systems has been analyzed, particularly for urban applications. The study has demonstrated that Receiver Autonomous Integrity Monitoring (RAIM) performance can be significantly improved with multiple satellite constellations, although the position accuracy improvement is limited. Based on a three-dimensional urban building model in Hong Kong streets, it is found that positioning availability is still very low in high-rising urban areas, even with three GNSS systems. On the other hand, the discontinuity of navigation solutions is significantly reduced with the combined constellations. Therefore, it is possible to use cheap DR systems to bridge the gaps of GNSS positioning, with high accuracy. Secondly, the ambiguity resolution performance has been investigated with Galileo multiple frequency band signals. The ambiguity resolution performance of three different algorithms is compared, including CAR, ILS and improved CAR methods (a new method proposed in this study). For short baselines, with four frequency Galileo data, it is highly possible to achieve reliable single epoch ambiguity resolution, when the carrier phase noise level is reasonably low (i.e. less than 6mm). For long baselines (up to 800 km), the integer ambiguity can be determined within 1 min on average. Ambiguity validation is crucial for any ambiguity resolution algorithm using searching method. This study has proposed to use both Ellipsoidal Integer Aperture (EIA) estimator and R-ratio test for ambiguity validation. Using real GPS data and simulated Galileo data, it has been demonstrated that the new method performs better than the use of EIA or the R-ratio test alone, with much less ambiguity mis-fixed rate.

  3. Initial combination therapy with vildagliptin plus metformin in drug-naïve patients with T2DM: a 24-week real-life study from Asia.

    PubMed

    Chawla, Manoj; Kim, Tae Ho; Mirasol, Roberto C; Faruque, Pathan; Cooke, Kathryn; Hours-Zesiger, Peggy; Shete, Abhijit

    2018-06-12

    To assess the effectiveness and safety of vildagliptin/metformin initial combination therapy in drug-naïve patients with type 2 diabetes mellitus (T2DM). INITIAL was a 24-week prospective, observational study in T2DM patients with glycated hemoglobin (HbA1c) ≥ 7.5%, and prescribed vildagliptin/metformin as initial combination therapy. The primary endpoint was change in HbA1c from baseline to week 24. Key secondary endpoints were HbA1c change from baseline to week 12, proportion of patients achieving HbA1c ≤7.0%, change in body weight at 12 and 24 weeks, change in HbA1c by sub-groups (baseline HbA1c, age, body mass index [BMI], dosage strength, co-morbidities) from baseline to week 24, and safety. A total of 532 patients were enrolled. The mean age, HbA1c, and BMI were 49.6 ± 11.27 years, 9.3 ± 1.57%, and 26.7 ± 4.50 kg/m 2 , respectively. Cardiovascular risk factors present at baseline were dyslipidemia (30.1%), hypertension (29.7%), and obesity (20.9%). The mean reductions in HbA1c from baseline to week 12 (-1.6 ± 1.59%) and 24 (-1.9 ± 1.70%) were statistically significant (p < .001). At 24 weeks, 39.6% of patients achieved HbA1c ≤ 7.0%, and the mean body weight reduction was -1.1 ± 2.62 kg. HbA1c reductions were consistently seen from baseline to weeks 12 and 24 in the various sub-groups. Overall, 48 (9.0%) patients reported adverse events, including one hypoglycemic episode. There were no serious adverse events or deaths. Overall, in a relatively young drug-naïve T2DM Asian study population with high baseline HbA1c and often associated with cardiovascular risk factors, vildagliptin/metformin combination therapy was associated with significant and clinically relevant HbA1c reduction from baseline. This effect was seen at week 12, was maintained over 24 weeks, and was accompanied by good tolerability.

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

    Chen, Dong; Heidelberger, Philip; Sugawara, Yutaka

    An apparatus and method for extending the scalability and improving the partitionability of networks that contain all-to-all links for transporting packet traffic from a source endpoint to a destination endpoint with low per-endpoint (per-server) cost and a small number of hops. An all-to-all wiring in the baseline topology is decomposed into smaller all-to-all components in which each smaller all-to-all connection is replaced with star topology by using global switches. Stacking multiple copies of the star topology baseline network creates a multi-planed switching topology for transporting packet traffic. Point-to-point unified stacking method using global switch wiring methods connects multiple planes ofmore » a baseline topology by using the global switches to create a large network size with a low number of hops, i.e., low network latency. Grouped unified stacking method increases the scalability (network size) of a stacked topology.« less

  5. Structured Instruction With Modified Storybooks to Teach Morphosyntax and Vocabulary to Preschoolers Who are Deaf/Hard of Hearing.

    PubMed

    Richels, Corrin G; Schwartz, Kathryn S; Bobzien, Jonna L; Raver, Sharon A

    2016-10-01

    Children who are deaf/hard of hearing (D/HH) are at risk for diminished morphosyntactical and vocabulary development. The purpose of this study was to examine the effects of repeated reading combined with structured instruction. Targets were a morphosyntactical form and novel vocabulary words. Participants were 3 preschoolers who are D/HH who were receiving instruction with an oral approach. Data from a multiple baseline design indicated that all children acquired the targeted skills and demonstrated high levels of generalization of these skills to untrained context. Implications for teaching young children who are D/HH using repeated storybook reading are discussed. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Constraining proposed combinations of ice history and Earth rheology using VLBI determined baseline length rates in North America

    NASA Technical Reports Server (NTRS)

    Mitrovica, J. X.; Davis, J. L.; Shapiro, I. I.

    1993-01-01

    We predict the present-day rates of change of the lengths of 19 North American baselines due to the glacial isostatic adjustment process. Contrary to previously published research, we find that the three dimensional motion of each of the sites defining a baseline, rather than only the radial motions of these sites, needs to be considered to obtain an accurate estimate of the rate of change of the baseline length. Predictions are generated using a suite of Earth models and late Pleistocene ice histories, these include specific combinations of the two which have been proposed in the literature as satisfying a variety of rebound related geophysical observations from the North American region. A number of these published models are shown to predict rates which differ significantly from the VLBI observations.

  7. Clinical time series prediction: towards a hierarchical dynamical system framework

    PubMed Central

    Liu, Zitao; Hauskrecht, Milos

    2014-01-01

    Objective Developing machine learning and data mining algorithms for building temporal models of clinical time series is important for understanding of the patient condition, the dynamics of a disease, effect of various patient management interventions and clinical decision making. In this work, we propose and develop a novel hierarchical framework for modeling clinical time series data of varied length and with irregularly sampled observations. Materials and methods Our hierarchical dynamical system framework for modeling clinical time series combines advantages of the two temporal modeling approaches: the linear dynamical system and the Gaussian process. We model the irregularly sampled clinical time series by using multiple Gaussian process sequences in the lower level of our hierarchical framework and capture the transitions between Gaussian processes by utilizing the linear dynamical system. The experiments are conducted on the complete blood count (CBC) panel data of 1000 post-surgical cardiac patients during their hospitalization. Our framework is evaluated and compared to multiple baseline approaches in terms of the mean absolute prediction error and the absolute percentage error. Results We tested our framework by first learning the time series model from data for the patient in the training set, and then applying the model in order to predict future time series values on the patients in the test set. We show that our model outperforms multiple existing models in terms of its predictive accuracy. Our method achieved a 3.13% average prediction accuracy improvement on ten CBC lab time series when it was compared against the best performing baseline. A 5.25% average accuracy improvement was observed when only short-term predictions were considered. Conclusion A new hierarchical dynamical system framework that lets us model irregularly sampled time series data is a promising new direction for modeling clinical time series and for improving their predictive performance. PMID:25534671

  8. Constructing Benchmark Databases and Protocols for Medical Image Analysis: Diabetic Retinopathy

    PubMed Central

    Kauppi, Tomi; Kämäräinen, Joni-Kristian; Kalesnykiene, Valentina; Sorri, Iiris; Uusitalo, Hannu; Kälviäinen, Heikki

    2013-01-01

    We address the performance evaluation practices for developing medical image analysis methods, in particular, how to establish and share databases of medical images with verified ground truth and solid evaluation protocols. Such databases support the development of better algorithms, execution of profound method comparisons, and, consequently, technology transfer from research laboratories to clinical practice. For this purpose, we propose a framework consisting of reusable methods and tools for the laborious task of constructing a benchmark database. We provide a software tool for medical image annotation helping to collect class label, spatial span, and expert's confidence on lesions and a method to appropriately combine the manual segmentations from multiple experts. The tool and all necessary functionality for method evaluation are provided as public software packages. As a case study, we utilized the framework and tools to establish the DiaRetDB1 V2.1 database for benchmarking diabetic retinopathy detection algorithms. The database contains a set of retinal images, ground truth based on information from multiple experts, and a baseline algorithm for the detection of retinopathy lesions. PMID:23956787

  9. ULTIMATE: a deployable multiple integral field unit for Subaru

    NASA Astrophysics Data System (ADS)

    Ellis, S. C.; Zhelem, Ross; Brown, David; Staszak, Nicholas F.; Lidman, Chris; Nataf, David M.; Casey, Andrew R.; Xavier, Pascal; Sheinis, Andrew; Gillingham, Peter; Tims, Julia; Lawrence, Jon; Bryant, Julia; Sharp, Rob

    2016-08-01

    ULTIMATE is an instrument concept under development at the AAO, for the Subaru Telescope, which will have the unique combination of ground layer adaptive optics feeding multiple deployable integral field units. This will allow ULTIMATE to probe unexplored parameter space, enabling science cases such as the evolution of galaxies at z 0:5 to 1.5, and the dark matter content of the inner part of our Galaxy. ULTIMATE will use Starbugs to position between 7 and 13 IFUs over a 14 × 8 arcmin field-of-view, pro- vided by a new wide-field corrector. All Starbugs can be positioned simultaneously, to an accuracy of better than 5 milli-arcsec within the typical slew-time of the telescope, allowing for very efficient re-configuration between observations. The IFUs will feed either the near-infrared nuMOIRCS or the visible/ near-infrared PFS spectrographs, or both. Future possible upgrades include the possibility of purpose built spectrographs and incorporating OH suppression using fibre Bragg gratings. We describe the science case and resulting design requirements, the baseline instrument concept, and the expected performance of the instrument.

  10. Cytotoxic CD4+ T Cells Drive Multiple Sclerosis Progression.

    PubMed

    Peeters, Liesbet M; Vanheusden, Marjan; Somers, Veerle; Van Wijmeersch, Bart; Stinissen, Piet; Broux, Bieke; Hellings, Niels

    2017-01-01

    Multiple sclerosis (MS) is the leading cause of chronic neurological disability in young adults. The clinical disease course of MS varies greatly between individuals, with some patients progressing much more rapidly than others, making prognosis almost impossible. We previously discovered that cytotoxic CD4+ T cells (CD4+ CTL), identified by the loss of CD28, are able to migrate to sites of inflammation and that they contribute to tissue damage. Furthermore, in an animal model for MS, we showed that these cells are correlated with inflammation, demyelination, and disability. Therefore, we hypothesize that CD4+ CTL drive progression of MS and have prognostic value. To support this hypothesis, we investigated whether CD4+ CTL are correlated with worse clinical outcome and evaluated the prognostic value of these cells in MS. To this end, the percentage of CD4+CD28null T cells was measured in the blood of 176 patients with relapsing-remitting MS (=baseline). Multimodal evoked potentials (EP) combining information on motoric, visual, and somatosensoric EP, as well as Kurtzke expanded disability status scale (EDSS) were used as outcome measurements at baseline and after 3 and 5 years. The baseline CD4+CD28null T cell percentage is associated with EP ( P  = 0.003, R 2  = 0.28), indicating a link between these cells and disease severity. In addition, the baseline CD4+CD28null T cell percentage has a prognostic value since it is associated with EP after 3 years ( P  = 0.005, R 2  = 0.29) and with EP and EDSS after 5 years ( P  = 0.008, R 2  = 0.42 and P  = 0.003, R 2  = 0.27). To the best of our knowledge, this study provides the first direct link between the presence of CD4+ CTL and MS disease severity, as well as its prognostic value. Therefore, we further elaborate on two important research perspectives: 1° investigating strategies to block or reverse pathways in the formation of these cells resulting in new treatments that slow down MS disease progression, 2° including immunophenotyping in prediction modeling studies to aim for personalized medicine.

  11. U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR CODING: BASELINE QUESTIONNAIRE (HOUSEHOLD) (UA-D-7.0)

    EPA Science Inventory

    The purpose of this SOP is to define the coding strategy for the Baseline Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the Border study. Household and individual data were combined in a single Baseline Questionnaire data file. Keywo...

  12. Long-term natalizumab treatment is associated with sustained improvements in quality of life in patients with multiple sclerosis.

    PubMed

    Foley, John F; Nair, Kavita V; Vollmer, Timothy; Stephenson, Judith J; Niecko, Timothy; Agarwal, Sonalee S; Watson, Crystal

    2017-01-01

    Multiple sclerosis (MS) patients experience lower health-related quality of life (HRQoL) than the general population. In clinical trials, natalizumab significantly improved HRQoL and reduced relapse rates and disability progression in patients with relapsing MS. In a 1-year analysis of patients included in the current study, HRQoL improvement occurred within 3 months of natalizumab initiation and continued for 1 year thereafter. However, natalizumab's long-term efficacy in improving HRQoL has not been studied. In this longitudinal, observational, single-arm US study, HRQoL and treatment satisfaction were evaluated in MS patients receiving intravenous natalizumab 300 mg every 4 weeks in clinical settings. Patients completed surveys at baseline and every 6 months for 3 years and reported the following measures: Short Form-12 Version 2 (SF-12v2), Multiple Sclerosis Impact Scale (MSIS-29), and Treatment Satisfaction Questionnaire for Medication. In this study, 120 patients completed ≥3 years of natalizumab treatment. Significant HRQoL improvements were evident from baseline to year 3 by increases in SF-12v2 Physical Component Summary (PCS) and Mental Component Summary scores ( P <0.01) and decreases in MSIS-29 physical and psychological scores ( P <0.0001). Patients with less physical disability (baseline Disease Steps [DS] 0-2) had significant improvement from baseline to year 3 in SF-12v2 PCS ( P <0.05) and MSIS-29 physical scores ( P <0.05). Physical HRQoL outcomes in patients with baseline DS 3-6 remained stable over 3 years. Treatment satisfaction increased significantly from baseline to year 1 ( P <0.0001) and was maintained in the following 2 years. Patients reported physical and psychological HRQoL improvements over 3 years of natalizumab treatment, supporting the long-term efficacy of natalizumab in real-world settings. Lower baseline disease activity and earlier treatment were related to better outcomes, indicating the importance of starting natalizumab early in the disease course. Treatment satisfaction increased after natalizumab initiation and remained high over 3 years of treatment.

  13. Assisting persons with multiple disabilities to move through simple occupational activities with automatic prompting.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Oliva, Doretta; Campodonico, Francesca; Groeneweg, Jop

    2008-01-01

    The present study assessed the possibility of assisting four persons with multiple disabilities to move through and perform simple occupational activities arranged within a room with the help of automatic prompting. The study involved two multiple probe designs across participants. The first multiple probe concerned the two participants with blindness or minimal vision and deafness, who received air blowing as a prompt. The second multiple probe concerned the two participants with blindness and typical hearing who received a voice calling as a prompt. Initially, all participants had baseline sessions. Then intervention started with the first participant of each dyad. When their performance was consolidated, new baseline and intervention occurred with the second participant of each dyad. Finally, all four participants were exposed to a second intervention phase, in which the number of activities per session doubled (i.e., from 8 to 16). Data showed that all four participants: (a) learned to move across and perform the activities available with the help of automatic prompting and (b) remained highly successful through the second intervention phase when the sessions were extended. Implications of the findings are discussed.

  14. Cardiovascular (CV) Risk after Initiation of Abatacept versus TNF Inhibitors in Rheumatoid Arthritis Patients with and without Baseline CV Disease.

    PubMed

    Jin, Yinzhu; Kang, Eun Ha; Brill, Gregory; Desai, Rishi J; Kim, Seoyoung C

    2018-05-15

    To evaluate the cardiovascular safety of abatacept (ABA) versus tumor necrosis factor inhibitors (TNFi) in rheumatoid arthritis (RA) patients with and without underlying cardiovascular disease (CVD). We identified RA patients with and without baseline CVD who initiated ABA or TNFi by using data from 2 large US insurance claims databases: Medicare (2008-2013) and Truven MarketScan (2006-2015). After stratifying by baseline CVD, ABA initiators were 1:1 propensity score (PS) matched to TNFi initiators to control for > 60 baseline covariates. Cox proportional hazards regression estimated the HR and 95% CI for a composite endpoint of CVD including myocardial infarction, stroke/transient ischemic stroke, or coronary revascularization in the PS-matched cohorts. HR from 2 databases were combined through an inverse variance-weighted fixed-effects model. We included 6102 PS-matched pairs of ABA and TNFi initiators from Medicare and 6934 pairs from MarketScan. Of these, 35.3% in Medicare and 14.0% in MarketScan had baseline CVD. HR (95% CI) for composite CVD in the overall ABA group versus TNFi was 0.67 (0.55-0.81) in Medicare and 1.08 (0.83-1.41) in MarketScan with the combined HR of 0.79 (0.67-0.92). Among patients with baseline CVD, the HR (95% CI) was 0.71 (0.55-0.92) in Medicare and 1.02 (0.68-1.51) in MarketScan, with the combined HR of 0.79 (0.64-0.98). In this large cohort of publicly or privately insured patients with RA in the United States, ABA was associated with a 20% reduced risk of CVD versus TNFi. While this observational study is subject to potential residual confounding, our results were consistent in patients with baseline CVD.

  15. The effectiveness of music as a mnemonic device on recognition memory for people with multiple sclerosis.

    PubMed

    Moore, Kimberly Sena; Peterson, David A; O'Shea, Geoffrey; McIntosh, Gerald C; Thaut, Michael H

    2008-01-01

    Research shows that people with multiple sclerosis exhibit learning and memory difficulties and that music can be used successfully as a mnemonic device to aid in learning and memory. However, there is currently no research investigating the effectiveness of music mnemonics as a compensatory learning strategy for people with multiple sclerosis. Participants with clinically definitive multiple sclerosis (N = 38) were given a verbal learning and memory test. Results from a recognition memory task were analyzed that compared learning through music (n = 20) versus learning through speech (n = 18). Preliminary baseline neuropsychological data were collected that measured executive functioning skills, learning and memory abilities, sustained attention, and level of disability. An independent samples t test showed no significant difference between groups on baseline neuropsychological functioning or on recognition task measures. Correlation analyses suggest that music mnemonics may facilitate learning for people who are less impaired by the disease. Implications for future research are discussed.

  16. Dynamic Bus Travel Time Prediction Models on Road with Multiple Bus Routes

    PubMed Central

    Bai, Cong; Peng, Zhong-Ren; Lu, Qing-Chang; Sun, Jian

    2015-01-01

    Accurate and real-time travel time information for buses can help passengers better plan their trips and minimize waiting times. A dynamic travel time prediction model for buses addressing the cases on road with multiple bus routes is proposed in this paper, based on support vector machines (SVMs) and Kalman filtering-based algorithm. In the proposed model, the well-trained SVM model predicts the baseline bus travel times from the historical bus trip data; the Kalman filtering-based dynamic algorithm can adjust bus travel times with the latest bus operation information and the estimated baseline travel times. The performance of the proposed dynamic model is validated with the real-world data on road with multiple bus routes in Shenzhen, China. The results show that the proposed dynamic model is feasible and applicable for bus travel time prediction and has the best prediction performance among all the five models proposed in the study in terms of prediction accuracy on road with multiple bus routes. PMID:26294903

  17. Dynamic Bus Travel Time Prediction Models on Road with Multiple Bus Routes.

    PubMed

    Bai, Cong; Peng, Zhong-Ren; Lu, Qing-Chang; Sun, Jian

    2015-01-01

    Accurate and real-time travel time information for buses can help passengers better plan their trips and minimize waiting times. A dynamic travel time prediction model for buses addressing the cases on road with multiple bus routes is proposed in this paper, based on support vector machines (SVMs) and Kalman filtering-based algorithm. In the proposed model, the well-trained SVM model predicts the baseline bus travel times from the historical bus trip data; the Kalman filtering-based dynamic algorithm can adjust bus travel times with the latest bus operation information and the estimated baseline travel times. The performance of the proposed dynamic model is validated with the real-world data on road with multiple bus routes in Shenzhen, China. The results show that the proposed dynamic model is feasible and applicable for bus travel time prediction and has the best prediction performance among all the five models proposed in the study in terms of prediction accuracy on road with multiple bus routes.

  18. Combining Video, Audio and Lexical Indicators of Affect in Spontaneous Conversation via Particle Filtering

    PubMed Central

    Savran, Arman; Cao, Houwei; Shah, Miraj; Nenkova, Ani; Verma, Ragini

    2013-01-01

    We present experiments on fusing facial video, audio and lexical indicators for affect estimation during dyadic conversations. We use temporal statistics of texture descriptors extracted from facial video, a combination of various acoustic features, and lexical features to create regression based affect estimators for each modality. The single modality regressors are then combined using particle filtering, by treating these independent regression outputs as measurements of the affect states in a Bayesian filtering framework, where previous observations provide prediction about the current state by means of learned affect dynamics. Tested on the Audio-visual Emotion Recognition Challenge dataset, our single modality estimators achieve substantially higher scores than the official baseline method for every dimension of affect. Our filtering-based multi-modality fusion achieves correlation performance of 0.344 (baseline: 0.136) and 0.280 (baseline: 0.096) for the fully continuous and word level sub challenges, respectively. PMID:25300451

  19. Combining Video, Audio and Lexical Indicators of Affect in Spontaneous Conversation via Particle Filtering.

    PubMed

    Savran, Arman; Cao, Houwei; Shah, Miraj; Nenkova, Ani; Verma, Ragini

    2012-01-01

    We present experiments on fusing facial video, audio and lexical indicators for affect estimation during dyadic conversations. We use temporal statistics of texture descriptors extracted from facial video, a combination of various acoustic features, and lexical features to create regression based affect estimators for each modality. The single modality regressors are then combined using particle filtering, by treating these independent regression outputs as measurements of the affect states in a Bayesian filtering framework, where previous observations provide prediction about the current state by means of learned affect dynamics. Tested on the Audio-visual Emotion Recognition Challenge dataset, our single modality estimators achieve substantially higher scores than the official baseline method for every dimension of affect. Our filtering-based multi-modality fusion achieves correlation performance of 0.344 (baseline: 0.136) and 0.280 (baseline: 0.096) for the fully continuous and word level sub challenges, respectively.

  20. Persons with Alzheimer's Disease Make Phone Calls Independently Using a Computer-Aided Telephone System

    ERIC Educational Resources Information Center

    Perilli, Viviana; Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Cassano, Germana; Cordiano, Noemi; Pinto, Katia; Minervini, Mauro G.; Oliva, Doretta

    2012-01-01

    This study assessed whether four patients with a diagnosis of Alzheimer's disease could make independent phone calls via a computer-aided telephone system. The study was carried out according to a non-concurrent multiple baseline design across participants. All participants started with baseline during which the telephone system was not available,…

  1. Effects of Structured Teaching on the Behavior of Young Children with Disabilities

    ERIC Educational Resources Information Center

    Bennett, Katherine; Reichow, Brian; Wolery, Mark

    2011-01-01

    The effects of structured work systems based on the principles of structured teaching were evaluated with 3 preschool-aged children with developmental disabilities (2 children had autism). A withdrawal design was used with 2 participants, and a multiple baseline across stimuli was used with the other. During baseline, children were given 3 tasks…

  2. The Effects of Graphic Feedback, Goal-Setting, and Manager Praise on Customer Service Behaviors

    ERIC Educational Resources Information Center

    Loewy, Shannon; Bailey, Jon

    2007-01-01

    The current study used a multiple baseline design to investigate the effects of graphic feedback, goal setting, and manager praise on customer service behaviors in a large retail setting. Direct observation of customer greeting, eye contact, and smiling was used to collect data. After baseline data were collected feedback graphs were posted twice…

  3. Using Portable Video Modeling Technology to Increase the Compliment Behaviors of Children with Autism during Athletic Group Play

    ERIC Educational Resources Information Center

    Macpherson, Kevin; Charlop, Marjorie H.; Miltenberger, Catherine A.

    2015-01-01

    A multiple baseline design across participants was used to examine the effects of a portable video modeling intervention delivered in the natural environment on the verbal compliments and compliment gestures demonstrated by five children with autism. Participants were observed playing kickball with peers and adults. In baseline, participants…

  4. Teaching Children with Autism to Discriminate the Reinforced and Nonreinforced Responses of Others: Implications for Observational Learning

    ERIC Educational Resources Information Center

    DeQuinzio, Jaime Ann; Taylor, Bridget A.

    2015-01-01

    We taught 4 participants with autism to discriminate between the reinforced and nonreinforced responses of an adult model and evaluated the effectiveness of this intervention using a multiple baseline design. During baseline, participants were simply exposed to adult models' correct and incorrect responses and the respective consequences of each.…

  5. Improved Topographic Mapping Through Multi-Baseline SAR Interferometry with MAP Estimation

    NASA Astrophysics Data System (ADS)

    Dong, Yuting; Jiang, Houjun; Zhang, Lu; Liao, Mingsheng; Shi, Xuguo

    2015-05-01

    There is an inherent contradiction between the sensitivity of height measurement and the accuracy of phase unwrapping for SAR interferometry (InSAR) over rough terrain. This contradiction can be resolved by multi-baseline InSAR analysis, which exploits multiple phase observations with different normal baselines to improve phase unwrapping accuracy, or even avoid phase unwrapping. In this paper we propose a maximum a posteriori (MAP) estimation method assisted by SRTM DEM data for multi-baseline InSAR topographic mapping. Based on our method, a data processing flow is established and applied in processing multi-baseline ALOS/PALSAR dataset. The accuracy of resultant DEMs is evaluated by using a standard Chinese national DEM of scale 1:10,000 as reference. The results show that multi-baseline InSAR can improve DEM accuracy compared with single-baseline case. It is noteworthy that phase unwrapping is avoided and the quality of multi-baseline InSAR DEM can meet the DTED-2 standard.

  6. Sources of Variability in Physical Activity Among Inactive People with Multiple Sclerosis.

    PubMed

    Uszynski, Marcin K; Herring, Matthew P; Casey, Blathin; Hayes, Sara; Gallagher, Stephen; Motl, Robert W; Coote, Susan

    2018-04-01

    Evidence supports that physical activity (PA) improves symptoms of multiple sclerosis (MS). Although application of principles from Social Cognitive Theory (SCT) may facilitate positive changes in PA behaviour among people with multiple sclerosis (pwMS), the constructs often explain limited variance in PA. This study investigated the extent to which MS symptoms, including fatigue, depression, and walking limitations combined with the SCT constructs, explained more variance in PA than SCT constructs alone among pwMS. Baseline data, including objectively assessed PA, exercise self-efficacy, goal setting, outcome expectations, 6-min walk test, fatigue and depression, from 65 participants of the Step It Up randomized controlled trial completed in Ireland (2016), were included. Multiple regression models quantified variance explained in PA and independent associations of (1) SCT constructs, (2) symptoms and (3) SCT constructs and symptoms. Model 1 included exercise self-efficacy, exercise goal setting and multidimensional outcomes expectations for exercise and explained ~14% of the variance in PA (R 2 =0.144, p < 0.05). Model 2 included walking limitations, fatigue and depression and explained 20% of the variance in PA (R 2 =0.196, p < 0.01). Model 3 combined models 1 and 2 and explained variance increased to ~29% (R 2 =0.288; p<0.01). In Model 3, exercise self-efficacy (β=0.30, p < 0.05), walking limitations (β=0.32, p < 0.01), fatigue (β = -0.41, p < 0.01) and depression (β = 0.34, p < 0.05) were significantly and independently associated with PA. Findings suggest that relevant MS symptoms improved by PA, including fatigue, depression and walking limitations, and SCT constructs together explained more variance in PA than SCT constructs alone, providing support for targeting both SCT constructs and these symptoms in the multifactorial promotion of PA among pwMS.

  7. Verteporfin photodynamic therapy combined with intravitreal bevacizumab for neovascular age-related macular degeneration.

    PubMed

    Kaiser, Peter K; Boyer, David S; Garcia, Raul; Hao, Yong; Hughes, Mark S; Jabbour, N M; Kaiser, Peter K; Mieler, William; Slakter, Jason S; Samuel, Michael; Tolentino, Michael J; Roth, Daniel; Sheidow, Thomas; Strong, H Andrew

    2009-04-01

    To assess outcomes for patients with choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) treated with verteporfin photodynamic therapy (PDT) and bevacizumab. Retrospective, case series database study (registry). We included 1196 patients with CNV due to AMD who received > or =1 combination treatment of 1.25 mg intravitreal bevacizumab within 14 days of verteporfin PDT. Retrospective analysis of baseline data with ongoing follow-up. Physicians from 45 clinical centers entered patient data at baseline and follow-up examinations, including subsequent treatments, into a secure, Web-accessed database. Snellen visual acuity (VA) was converted to logarithm of the minimum angle of resolution (logMAR) for statistical analyses. Change from baseline in VA and retreatment rates of any therapy after the initial combination treatment. Of 1196 patients, 1073 patients had > or =6 months of follow-up. For these 1073 patients, mean baseline VA was 0.967 logMAR (approximate Snellen 20/185) and 56.3% of patients (604/1073) were treatment naïve. After their baseline combination treatment, patients received a mean of 0.6 additional verteporfin PDT retreatments and 2.0 bevacizumab retreatments over a mean follow-up period of 15.0 months. By 12 months, 82% of patients (578/701) had stable or improved vision (loss of <3 lines or a gain in VA), 36% (255/701) improved by > or =3 lines, and 17% (121/701) improved by > or =6 lines. By 12 months, patients gained approximately 1.2 lines (6 letters) of VA from baseline. Patients who were treatment naïve gained significantly more VA by month 12 (+8.4 letters) compared with those who had been previously treated (+2.4 letters; P<0.01). Most serious adverse events (26/30) were judged by investigators as not related to any study treatment, although 3 ocular events were judged related to bevacizumab alone, and 1 ocular event was judged related to both bevacizumab and PDT. Combination therapy with PDT and bevacizumab led to vision benefit for most patients, particularly those who were treatment naïve at baseline. The number of retreatments was lower than published reports with either treatment delivered as monotherapy. Randomized clinical trials are underway to confirm these findings.

  8. One session treatment for pediatric blood-injection-injury phobia: A controlled multiple baseline trial.

    PubMed

    Oar, Ella L; Farrell, Lara J; Waters, Allison M; Conlon, Elizabeth G; Ollendick, Thomas H

    2015-10-01

    The present study evaluated the effectiveness of a modified One Session Treatment (OST), which included an e-therapy homework maintenance program over 4 weeks for Blood-Injection-Injury (BII) phobia in children and adolescents. Using a single case, non-concurrent multiple-baseline design, 24 children and adolescents (8-18 years; 7 males, 17 females) with a primary diagnosis of BII phobia were randomly assigned to a one, two or three week baseline prior to receiving OST. Primary outcome measures included diagnostic severity, diagnostic status, and child and parent fear ratings. Secondary outcome measures included avoidance during behavioural avoidance tasks (BAT), global functioning and self and parent reported anxiety, fear and depression. Efficacy was assessed at post-treatment, 1-month, and 3-month follow-up. BII symptoms and diagnostic severity remained relatively stable during the baseline periods and then significantly improved following implementation of the intervention. Treatment response was supported by changes across multiple measures, including child, parent and independent clinician ratings. At post-treatment 8 of the 24 (33.33%) children were BII diagnosis free. Treatment gains improved at follow-ups with 14 (58.33%) children diagnosis free at 1-month follow-up and 15 (62.5%) diagnosis free at 3-month follow-up. Preliminary findings support the effectiveness of a modified OST approach for BII phobic youth with treatment outcomes improving over follow-up intervals. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Colour vision impairment is associated with disease severity in multiple sclerosis.

    PubMed

    Martínez-Lapiscina, Elena H; Ortiz-Pérez, Santiago; Fraga-Pumar, Elena; Martínez-Heras, Eloy; Gabilondo, Iñigo; Llufriu, Sara; Bullich, Santiago; Figueras, Marc; Saiz, Albert; Sánchez-Dalmau, Bernardo; Villoslada, Pablo

    2014-08-01

    Colour vision assessment correlates with damage of the visual pathway and might be informative of overall brain damage in multiple sclerosis (MS). The objective of this paper is to investigate the association between impaired colour vision and disease severity. We performed neurological and ophthalmic examinations, as well as magnetic resonance imaging (MRI) and optical coherence tomography (OCT) analyses, on 108 MS patients, both at baseline and after a follow-up of one year. Colour vision was evaluated by Hardy, Rand and Rittler plates. Dyschromatopsia was defined if colour vision was impaired in either eye, except for participants with optic neuritis (ON), for whom only the unaffected eye was considered. We used general linear models adjusted for sex, age, disease duration and MS treatment for comparing presence of dyschromatopsia and disease severity. Impaired colour vision in non-ON eyes was detected in 21 out of 108 patients at baseline. At baseline, patients with dyschromatopsia had lower Multiple Sclerosis Functional Composite (MSFC) scores and Brief Repeatable Battery-Neuropsychology executive function scores than those participants with normal colour vision. In addition, these patients had thinner retinal nerve fiber layer (RNFL), and smaller macular volume, normalized brain volume and normalized gray matter volume (NGMV) at baseline. Moreover, participants with incident dyschromatopsia after one-year follow-up had a greater disability measured by the Expanded Disability Status Scale and MSFC-20 and a greater decrease in NGMV than participants with normal colour vision. Colour vision impairment is associated with greater MS severity. © The Author(s) 2013.

  10. Family Matters: Examining Child Abuse and Neglect as Family Dysfunction for Minority Youth Living in Extreme Poverty.

    PubMed

    Spano, Richard; David, Michael A; Jeffries, Sara R; Bolland, John M

    2017-12-01

    Two competing models of child abuse and neglect (scapegoat vs. family dysfunction) are used to illustrate how the specification of victims ("index" victim vs. all children in household) from incidents of child abuse and neglect can be used to improve estimates of maltreatment for at-risk minority youth. Child Protection Services records were searched in 2005 for 366 "index" victims who were surveyed for 5 consecutive years (from 1998 to 2002) for the Mobile Youth Survey as well as other siblings in the household. The findings indicate that the baseline estimate of any maltreatment, sexual abuse, physical abuse, and neglect increased by 68%, 26%, 33%, and 74%, respectively, after adjusting for incidents that involved multiple victims (i.e., maltreatment as family dysfunction). In addition, the baseline estimate of more severe (indicated) incidents of physical abuse and neglect increased by 67% and 64%, respectively, after accounting for incidents that involved multiple victims, but there were no incidents of more severe (indicated) sexual abuse that involved multiple victims. Similarly, baseline estimates of age of onset (or chronicity) of maltreatment during childhood and adolescence increased by 62% and 26%, respectively. Baseline estimates for youth with 3 or more years of maltreatment and youth with 3 or more incidents of maltreatment both increased by about 71%. The implications of these findings for policy and practice as well as areas for future research are also discussed.

  11. Psychosocial Intervention for Young Children With Chronic Tics

    ClinicalTrials.gov

    2018-06-18

    Tourette's Syndrome; Tourette's Disorder; Tourette's Disease; Tourette Disorder; Tourette Disease; Tic Disorder, Combined Vocal and Multiple Motor; Multiple Motor and Vocal Tic Disorder, Combined; Gilles de La Tourette's Disease; Gilles de la Tourette Syndrome; Gilles De La Tourette's Syndrome; Combined Vocal and Multiple Motor Tic Disorder; Combined Multiple Motor and Vocal Tic Disorder; Chronic Motor and Vocal Tic Disorder

  12. Intoxicated Speech Detection: A Fusion Framework with Speaker-Normalized Hierarchical Functionals and GMM Supervectors

    PubMed Central

    Bone, Daniel; Li, Ming; Black, Matthew P.; Narayanan, Shrikanth S.

    2013-01-01

    Segmental and suprasegmental speech signal modulations offer information about paralinguistic content such as affect, age and gender, pathology, and speaker state. Speaker state encompasses medium-term, temporary physiological phenomena influenced by internal or external biochemical actions (e.g., sleepiness, alcohol intoxication). Perceptual and computational research indicates that detecting speaker state from speech is a challenging task. In this paper, we present a system constructed with multiple representations of prosodic and spectral features that provided the best result at the Intoxication Subchallenge of Interspeech 2011 on the Alcohol Language Corpus. We discuss the details of each classifier and show that fusion improves performance. We additionally address the question of how best to construct a speaker state detection system in terms of robust and practical marginalization of associated variability such as through modeling speakers, utterance type, gender, and utterance length. As is the case in human perception, speaker normalization provides significant improvements to our system. We show that a held-out set of baseline (sober) data can be used to achieve comparable gains to other speaker normalization techniques. Our fused frame-level statistic-functional systems, fused GMM systems, and final combined system achieve unweighted average recalls (UARs) of 69.7%, 65.1%, and 68.8%, respectively, on the test set. More consistent numbers compared to development set results occur with matched-prompt training, where the UARs are 70.4%, 66.2%, and 71.4%, respectively. The combined system improves over the Challenge baseline by 5.5% absolute (8.4% relative), also improving upon our previously best result. PMID:24376305

  13. Effectiveness of massage therapy as co-adjuvant treatment to exercise in osteoarthritis of the knee: a randomized control trial.

    PubMed

    Cortés Godoy, Virginia; Gallego Izquierdo, Tomás; Lázaro Navas, Irene; Pecos Martín, Daniel

    2014-01-01

    The effectiveness of exercise therapy in the treatment of osteoarthritis of the knee (KOA) is widely evidenced. The current study aims to compare the effectiveness of massage therapy as a co-adjuvant treatment for KOA. A blind, randomized controlled trial design was used. Eighteen women were randomly allocated to two different groups. Group A was treated with massage therapy and an exercise program, and Group B was treated with the exercise program alone. The intervention lasted for 6 weeks. Outcomes were assessed using a verbal analogue scale (VAS), the WOMAC index, and the Get-Up and Go test. Baseline, post-treatment, and 1- and 3- month follow-up data were collected. Values were considered statistically significant at a p < 0.05. The Mann-Whitney U test was applied in order to find out the differences between groups, and to verify the existence of such differences, the Friedman Test for repeated measures complemented with multiple comparisons tests was carried out. In both groups, significant differences were found in the three variables between the baseline measurement and three months after treatment, with the exception of the WOMAC variable in group B (p=0.064) No significant differences were found between both groups in the WOMAC index (p=0.508) and VAS (p=0.964) variables and the Get-Up and Go test (p=0.691). Combining exercise-based therapy with massage therapy may lead to clinical improvement in patients with KOA. The use of massage therapy combined with exercise as a treatment for gonarthrosis does not seem to have any beneficial effects.

  14. Models of Sector Flows Under Local, Regional and Airport Weather Constraints

    NASA Technical Reports Server (NTRS)

    Kulkarni, Deepak

    2017-01-01

    Recently, the ATM community has made important progress in collaborative trajectory management through the introduction of a new FAA traffic management initiative called a Collaborative Trajectory Options Program (CTOP). FAA can use CTOPs to manage air traffic under multiple constraints (manifested as flow constrained areas or FCAs) in the system, and it allows flight operators to indicate their preferences for routing and delay options. CTOPs also permits better management of the overall trajectory of flights by considering both routing and departure delay options simultaneously. However, adoption of CTOPs in airspace has been hampered by many factors that include challenges in how to identify constrained areas and how to set rates for the FCAs. Decision support tools providing assistance would be particularly helpful in effective use of CTOPs. Such DSTs tools would need models of demand and capacity in the presence of multiple constraints. This study examines different approaches to using historical data to create and validate models of maximum flows in sectors and other airspace regions in the presence of multiple constraints. A challenge in creating an empirical model of flows under multiple constraints is a lack of sufficient historical data that captures diverse situations involving combinations of multiple constraints especially those with severe weather. The approach taken here to deal with this is two-fold. First, we create a generalized sector model encompassing multiple sectors rather than individual sectors in order to increase the amount of data used for creating the model by an order of magnitude. Secondly, we decompose the problem so that the amount of data needed is reduced. This involves creating a baseline demand model plus a separate weather constrained flow reduction model and then composing these into a single integrated model. A nominal demand model is a flow model (gdem) in the presence of clear local weather. This defines the flow as a function of weather constraints in neighboring regions, airport constraints and weather in locations that can cause re-routes to the location of interest. A weather constrained flow reduction model (fwx-red) is a model of reduction in baseline counts as a function of local weather. Because the number of independent variables associated with each of the two decomposed models is smaller than that with a single model, need for amount of data is reduced. Finally, a composite model that combines these two can be represented as fwx-red (gdem(e), l) where e represents non-local constraints and l represents local weather. The approaches studied to developing these models are divided into three categories: (1) Point estimation models (2) Empirical models (3) Theoretical models. Errors in predictions of these different types of models have been estimated. In situations when there is abundant data, point estimation models tend to be very accurate. In contrast, empirical models do better than theoretical models when there is some data available. The biggest benefit of theoretical models is their general applicability in wider range situations once the degree of accuracy of these has been established.

  15. Models of Sector Aircraft Counts in the Presence of Local, Regional and Airport Constraints

    NASA Technical Reports Server (NTRS)

    Kulkarni, Deepak

    2017-01-01

    Recently, the ATM community has made important progress in collaborative trajectory management through the introduction of a new FAA traffic management initiative called a Collaborative Trajectory Options Program (CTOP). FAA can use CTOPs to manage air traffic under multiple constraints (manifested as flow constrained areas or FCAs) in the system, and it allows flight operators to indicate their preferences for routing and delay options. CTOPs also permits better management of the overall trajectory of flights by considering both routing and departure delay options simultaneously. However, adoption of CTOPs in airspace has been hampered by many factors that include challenges in how to identify constrained areas and how to set rates for the FCAs. Decision support tools providing assistance would be particularly helpful in effective use of CTOPs. Such DSTs tools would need models of demand and capacity in the presence of multiple constraints. This study examines different approaches to using historical data to create and validate models of maximum flows in sectors and other airspace regions in the presence of multiple constraints. A challenge in creating an empirical model of flows under multiple constraints is a lack of sufficient historical data that captures diverse situations involving combinations of multiple constraints especially those with severe weather. The approach taken here to deal with this is two-fold. First, we create a generalized sector model encompassing multiple sectors rather than individual sectors in order to increase the amount of data used for creating the model by an order of magnitude. Secondly, we decompose the problem so that the amount of data needed is reduced. This involves creating a baseline demand model plus a separate weather constrained flow reduction model and then composing these into a single integrated model. A nominal demand model is a flow model (gdem) in the presence of clear local weather. This defines the flow as a function of weather constraints in neighboring regions, airport constraints and weather in locations that can cause re-routes to the location of interest. A weather constrained flow reduction model (fwx-red) is a model of reduction in baseline counts as a function of local weather. Because the number of independent variables associated with each of the two decomposed models is smaller than that with a single model, need for amount of data is reduced. Finally, a composite model that combines these two can be represented as fwx-red (gdem(e), l) where e represents non-local constraints and l represents local weather. The approaches studied to developing these models are divided into three categories: (1) Point estimation models (2) Empirical models (3) Theoretical models. Errors in predictions of these different types of models have been estimated. In situations when there is abundant data, point estimation models tend to be very accurate. In contrast, empirical models do better than theoretical models when there is some data available. The biggest benefit of theoretical models is their general applicability in wider range situations once the degree of accuracy of these has been established.

  16. In vivo serial MRI-based models and statistical methods to quantify sensitivity and specificity of mechanical predictors for carotid plaque rupture: location and beyond.

    PubMed

    Wu, Zheyang; Yang, Chun; Tang, Dalin

    2011-06-01

    It has been hypothesized that mechanical risk factors may be used to predict future atherosclerotic plaque rupture. Truly predictive methods for plaque rupture and methods to identify the best predictor(s) from all the candidates are lacking in the literature. A novel combination of computational and statistical models based on serial magnetic resonance imaging (MRI) was introduced to quantify sensitivity and specificity of mechanical predictors to identify the best candidate for plaque rupture site prediction. Serial in vivo MRI data of carotid plaque from one patient was acquired with follow-up scan showing ulceration. 3D computational fluid-structure interaction (FSI) models using both baseline and follow-up data were constructed and plaque wall stress (PWS) and strain (PWSn) and flow maximum shear stress (FSS) were extracted from all 600 matched nodal points (100 points per matched slice, baseline matching follow-up) on the lumen surface for analysis. Each of the 600 points was marked "ulcer" or "nonulcer" using follow-up scan. Predictive statistical models for each of the seven combinations of PWS, PWSn, and FSS were trained using the follow-up data and applied to the baseline data to assess their sensitivity and specificity using the 600 data points for ulcer predictions. Sensitivity of prediction is defined as the proportion of the true positive outcomes that are predicted to be positive. Specificity of prediction is defined as the proportion of the true negative outcomes that are correctly predicted to be negative. Using probability 0.3 as a threshold to infer ulcer occurrence at the prediction stage, the combination of PWS and PWSn provided the best predictive accuracy with (sensitivity, specificity) = (0.97, 0.958). Sensitivity and specificity given by PWS, PWSn, and FSS individually were (0.788, 0.968), (0.515, 0.968), and (0.758, 0.928), respectively. The proposed computational-statistical process provides a novel method and a framework to assess the sensitivity and specificity of various risk indicators and offers the potential to identify the optimized predictor for plaque rupture using serial MRI with follow-up scan showing ulceration as the gold standard for method validation. While serial MRI data with actual rupture are hard to acquire, this single-case study suggests that combination of multiple predictors may provide potential improvement to existing plaque assessment schemes. With large-scale patient studies, this predictive modeling process may provide more solid ground for rupture predictor selection strategies and methods for image-based plaque vulnerability assessment.

  17. Evaluation of the Effect of Fingolimod Treatment on Microglial Activation Using Serial PET Imaging in Multiple Sclerosis.

    PubMed

    Sucksdorff, Marcus; Rissanen, Eero; Tuisku, Jouni; Nuutinen, Salla; Paavilainen, Teemu; Rokka, Johanna; Rinne, Juha; Airas, Laura

    2017-10-01

    Traditionally, multiple sclerosis (MS) has been considered a white matter disease with focal inflammatory lesions. It is, however, becoming clear that significant pathology, such as microglial activation, also takes place outside the plaque areas, that is, in areas of normal-appearing white matter (NAWM) and gray matter (GM). Microglial activation can be detected in vivo using 18-kDa translocator protein (TSPO)-binding radioligands and PET. It is unknown whether fingolimod affects microglial activation in MS. The aim of this study was to investigate whether serial PET can be used to evaluate the effect of fingolimod treatment on microglial activation. Methods: Ten relapsing-remitting MS patients were studied using the TSPO radioligand 11 C-( R )-PK11195. Imaging was performed at baseline and after 8 and 24 wk of fingolimod treatment. Eight healthy individuals were imaged for comparison. Microglial activation was evaluated as distribution volume ratio of 11 C-( R )-PK11195. Results: The patients had MS for an average of 7.9 ± 4.3 y (mean ± SD), their total relapses averaged 4 ± 2.4, and their Expanded Disability Status Scale was 2.7 ± 0.5. The patients were switched to fingolimod because of safety reasons or therapy escalation. The mean washout period before the initiation of fingolimod was 2.3 ± 1.1 mo. The patients were clinically stable on fingolimod. At baseline, microglial activation was significantly higher in the combined NAWM and GM areas of MS patients than in healthy controls ( P = 0.021). 11 C-( R )-PK11195 binding was reduced (-12.31%) within the combined T2 lesion area after 6 mo of fingolimod treatment ( P = 0.040) but not in the areas of NAWM or GM. Conclusion: Fingolimod treatment reduced microglial/macrophage activation at the site of focal inflammatory lesions, presumably by preventing leukocyte trafficking from the periphery. It did not affect the widespread, diffuse microglial activation in the NAWM and GM. The study opens new vistas for designing future therapeutic studies in MS that use the evaluation of microglial activation as an imaging outcome measure. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  18. Constraining proposed combinations of ice history and earth rheology using VLBI determined baseline length rates in North America

    NASA Technical Reports Server (NTRS)

    Mitrovica, J. X.; Davis, J. L.; Shapiro, I. I.

    1993-01-01

    We predict the present-day rates of change of the lengths of 19 North American baselines due to the glacial isostatic adjustment process. Contrary to previously published research, we find that the three-dimensional motion of each of the sites defining a baseline, rather than only the radial motions of these sites, needs to be considered to obtain an accurate estimate of the rate of change of the baseline length. Predictions are generated using a suite of Earth models and late Pleistocene ice histories; these include specific combinations of the two which have been proposed in the literature as satisfying a variety of rebound related geophysical observations from the North American region. A number of these published models are shown to predict rates which differ significantly from the Very Long Base Interferometry (VLBI) observations.

  19. Comparison of iron chelation effects of deferoxamine, deferasirox, and combination of deferoxamine and deferiprone on liver and cardiac T2* MRI in thalassemia maior.

    PubMed

    Ansari, Shahla; Azarkeivan, Azita; Miri-Aliabad, Ghasem; Yousefian, Saeed; Rostami, Tahereh

    2017-01-01

    Cardiac complications due to iron overload are the most common cause of death in patients with thalassemia major. The aim of this study was to compare iron chelation effects of deferoxamine, deferasirox, and combination of deferoxamine and deferiprone on cardiac and liver iron load measured by T2* MRI. In this study, 108 patients with thalassemia major aged over 10 years who had iron overload in cardiac T2* MRI were studied in terms of iron chelators efficacy on the reduction of myocardial siderosis. The first group received deferoxamine, the second group only deferasirox, and the third group, a combination of deferoxamine and deferiprone. Myocardial iron was measured at baseline and 12 months later through T2* MRI technique. The three groups were similar in terms of age, gender, ferritin level, and mean myocardial T2* at baseline. In the deferoxamine group, myocardial T2* was increased from 12.0±4.1 ms at baseline to 13.5±8.4 ms at 12 months (p=0.10). Significant improvement was observed in myocardial T2* of the deferasirox group (p<0.001). In the combined treatment group, myocardial T2* was significantly increased (p<0.001). These differences among the three groups were not significant at the 12 months. A significant improvement was observed in liver T2* at 12 months compared to baseline in the deferasirox and the combination group. In comparison to deferoxamine monotherapy, combination therapy and deferasirox monotherapy have a significant impact on reducing iron overload and improvement of myocardial and liver T2* MRI.

  20. Glycolic Acid Peels/Azelaic Acid 20% Cream Combination and Low Potency Triple Combination Lead to Similar Reduction in Melasma Severity in Ethnic Skin: Results of a Randomized Controlled Study

    PubMed Central

    Mahajan, Rahul; Kanwar, Amrinder Jit; Parsad, Davinder; Kumaran, Muthu Sendhil; Sharma, Reena

    2015-01-01

    Background: Numerous therapeutic options have been tried in the management of melasma. Aims and Objectives: This prospective randomized study was planned to assess the efficacy of low potency triple combination (TC) cream (TC-hydroquinone 2%/tretinoin 0.05%/fluocinolone 0.01%) versus glycolic acid (GA) peels/azelaic acid (AA) 20% cream (GA/AA) combination in melasma. Materials and Methods: Forty patients with melasma were recruited into this study and randomized into two groups. Group A consisting 20 patients received TC cream once a day for night time application for 3 months. Group B comprising of 20 patients received GA/AA 20% cream combination for 3 months. The disease severity was monitored with digital photography, melasma area and severity index (MASI) score, which was calculated at baseline, 6 weeks and 12 weeks, and visual analog scale (VAS) score, which was calculated at baseline and 12 weeks. Results: Of 40 patients, 38 were completed the study. A significant reduction in MASI and VAS was recorded after 6 weeks and 12 weeks of treatment in both groups A and B (P = 0.001). However, there was no significant difference in the mean MASI scores between the two groups at baseline, 6 weeks and 12 weeks. Similarly, there was no difference in the mean VAS scores between the two groups at baseline and 12 weeks. Four patients in group A and 3 in group B experienced adverse effects such as irritation, dryness, and photosensitivity. Conclusion: Both low potency TC cream and GA/AA 20% cream combination are effective in treating melasma among Indian patients. PMID:25814702

  1. Glycolic Acid peels/azelaic Acid 20% cream combination and low potency triple combination lead to similar reduction in melasma severity in ethnic skin: results of a randomized controlled study.

    PubMed

    Mahajan, Rahul; Kanwar, Amrinder Jit; Parsad, Davinder; Kumaran, Muthu Sendhil; Sharma, Reena

    2015-01-01

    Numerous therapeutic options have been tried in the management of melasma. This prospective randomized study was planned to assess the efficacy of low potency triple combination (TC) cream (TC-hydroquinone 2%/tretinoin 0.05%/fluocinolone 0.01%) versus glycolic acid (GA) peels/azelaic acid (AA) 20% cream (GA/AA) combination in melasma. Forty patients with melasma were recruited into this study and randomized into two groups. Group A consisting 20 patients received TC cream once a day for night time application for 3 months. Group B comprising of 20 patients received GA/AA 20% cream combination for 3 months. The disease severity was monitored with digital photography, melasma area and severity index (MASI) score, which was calculated at baseline, 6 weeks and 12 weeks, and visual analog scale (VAS) score, which was calculated at baseline and 12 weeks. Of 40 patients, 38 were completed the study. A significant reduction in MASI and VAS was recorded after 6 weeks and 12 weeks of treatment in both groups A and B (P = 0.001). However, there was no significant difference in the mean MASI scores between the two groups at baseline, 6 weeks and 12 weeks. Similarly, there was no difference in the mean VAS scores between the two groups at baseline and 12 weeks. Four patients in group A and 3 in group B experienced adverse effects such as irritation, dryness, and photosensitivity. Both low potency TC cream and GA/AA 20% cream combination are effective in treating melasma among Indian patients.

  2. Impact of Multiple Complex Plaques on Short-and Long-Term Clinical in Patients Presenting with ST-Segment Elevation Myocardial Infarction (From the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction [HORIZONS-AMI] Trial)

    PubMed Central

    Keeley, Ellen C.; Mehran, Roxana; Brener, Sorin J.; Witzenbichler, Bernhard; Guagliumi, Giulio; Dudek, Dariusz; Kornowski, Ran; Dressler, Ovidiu; Fahy, Martin; Xu, Ke; Grines, Cindy L.; Stone, Gregg W.

    2014-01-01

    It is not known whether the extent and severity of non-culprit coronary lesions correlate with outcomes in patients with STEMI referred for primary PCI. We sought to quantify complex plaques in ST-segment elevation myocardial infarction (STEMI) patients referred for primary percutaneous coronary intervention (PCI) and to determine their effect on short- and long-term clinical outcomes by examining the core laboratory database for plaque analysis from the HORIZONS-AMI study. Baseline demographic, angiographic, and procedural details were compared between patients with single vs. multiple complex plaques undergoing single vessel PCI. Multivariable analysis was performed for predictors of long-term major adverse cardiac events (MACE), a combined end point of death, reinfarction, ischemic target vessel revascularization, or stroke, and for death alone. Single vessel PCI was performed in 3,137 patients (87%): 2,174 (69%) had multiple complex plaques and 963 (31%) had a single complex plaque. Compared to those with a single complex plaque, patients with multiple complex plaques were older (p<0.0001) and had more comorbidities. The presence of multiple complex plaques was an independent predictor of 3-year MACE (hazard ratio [HR]: 1.58; 95% confidence interval [CI]: 1.26–1.98, p<0.0001), and death alone (HR: 1.68; 95% CI: 1.05–2.70, p=0.03). In conclusion, multiple complex plaques are present in the majority of STEMI patients undergoing primary PCI and their presence is an independent predictor of short- and long-term MACE, including death. (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction [HORIZONS-AMI]; NCT00433966) PMID:24703369

  3. A Theoretical and Empirical Integrated Method to Select the Optimal Combined Signals for Geometry-Free and Geometry-Based Three-Carrier Ambiguity Resolution.

    PubMed

    Zhao, Dongsheng; Roberts, Gethin Wyn; Lau, Lawrence; Hancock, Craig M; Bai, Ruibin

    2016-11-16

    Twelve GPS Block IIF satellites, out of the current constellation, can transmit on three-frequency signals (L1, L2, L5). Taking advantages of these signals, Three-Carrier Ambiguity Resolution (TCAR) is expected to bring much benefit for ambiguity resolution. One of the research areas is to find the optimal combined signals for a better ambiguity resolution in geometry-free (GF) and geometry-based (GB) mode. However, the existing researches select the signals through either pure theoretical analysis or testing with simulated data, which might be biased as the real observation condition could be different from theoretical prediction or simulation. In this paper, we propose a theoretical and empirical integrated method, which first selects the possible optimal combined signals in theory and then refines these signals with real triple-frequency GPS data, observed at eleven baselines of different lengths. An interpolation technique is also adopted in order to show changes of the AR performance with the increase in baseline length. The results show that the AR success rate can be improved by 3% in GF mode and 8% in GB mode at certain intervals of the baseline length. Therefore, the TCAR can perform better by adopting the combined signals proposed in this paper when the baseline meets the length condition.

  4. A Theoretical and Empirical Integrated Method to Select the Optimal Combined Signals for Geometry-Free and Geometry-Based Three-Carrier Ambiguity Resolution

    PubMed Central

    Zhao, Dongsheng; Roberts, Gethin Wyn; Lau, Lawrence; Hancock, Craig M.; Bai, Ruibin

    2016-01-01

    Twelve GPS Block IIF satellites, out of the current constellation, can transmit on three-frequency signals (L1, L2, L5). Taking advantages of these signals, Three-Carrier Ambiguity Resolution (TCAR) is expected to bring much benefit for ambiguity resolution. One of the research areas is to find the optimal combined signals for a better ambiguity resolution in geometry-free (GF) and geometry-based (GB) mode. However, the existing researches select the signals through either pure theoretical analysis or testing with simulated data, which might be biased as the real observation condition could be different from theoretical prediction or simulation. In this paper, we propose a theoretical and empirical integrated method, which first selects the possible optimal combined signals in theory and then refines these signals with real triple-frequency GPS data, observed at eleven baselines of different lengths. An interpolation technique is also adopted in order to show changes of the AR performance with the increase in baseline length. The results show that the AR success rate can be improved by 3% in GF mode and 8% in GB mode at certain intervals of the baseline length. Therefore, the TCAR can perform better by adopting the combined signals proposed in this paper when the baseline meets the length condition. PMID:27854324

  5. Advances in Digital Calibration Techniques Enabling Real-Time Beamforming SweepSAR Architectures

    NASA Technical Reports Server (NTRS)

    Hoffman, James P.; Perkovic, Dragana; Ghaemi, Hirad; Horst, Stephen; Shaffer, Scott; Veilleux, Louise

    2013-01-01

    Real-time digital beamforming, combined with lightweight, large aperture reflectors, enable SweepSAR architectures, which promise significant increases in instrument capability for solid earth and biomass remote sensing. These new instrument concepts require new methods for calibrating the multiple channels, which are combined on-board, in real-time. The benefit of this effort is that it enables a new class of lightweight radar architecture, Digital Beamforming with SweepSAR, providing significantly larger swath coverage than conventional SAR architectures for reduced mass and cost. This paper will review the on-going development of the digital calibration architecture for digital beamforming radar instrument, such as the proposed Earth Radar Mission's DESDynI (Deformation, Ecosystem Structure, and Dynamics of Ice) instrument. This proposed instrument's baseline design employs SweepSAR digital beamforming and requires digital calibration. We will review the overall concepts and status of the system architecture, algorithm development, and the digital calibration testbed currently being developed. We will present results from a preliminary hardware demonstration. We will also discuss the challenges and opportunities specific to this novel architecture.

  6. Effect of metformin combined with lifestyle modification versus lifestyle modification alone on proinflammatory-oxidative status in drug-naïve pre-diabetic and diabetic patients: A randomized controlled study.

    PubMed

    Bulatova, Nailya; Kasabri, Violet; Qotineh, Amenah; Al-Athami, Taiba; Yousef, Al-Motassem; AbuRuz, Salah; Momani, Munther; Zayed, Aymen

    2018-05-01

    Targeting biomarkers of oxidative-proinflammatory stress may result in improvement of modifiable metabolic syndrome, pre-diabetes and diabetes risk factors and subsequent risk reduction. 64 newly diagnosed antihyperglycemic treatment-naïve prediabetic and type 2 diabetes mellitus (T2DM) patients were randomly assigned using block design to either metformin combined with therapeutic lifestyle changes (TLC) or TLC alone. Body mass index (BMI), waist circumference, blood pressure, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), fasting lipid profile, plasma oxidative status and tumor necrosis factor (TNF)-α were measured at baseline, after 3 months and after 6 months from baseline. Except for HbA1c, baseline values did not differ significantly between the two groups. The post 3-months relative reductions in BMI (P=0.014) and HbA1c (P=0.037) in metformin combined with TLC intervention were significantly greater than those in TLC alone group. TNFα plasma levels were decreased significantly vs. baseline by metformin combined with TLC intervention (-22.90±46.76%, P=0.01). Conversely, TLC alone basically worsened proinflammatory status (42.40±40.82 %), P<0.001. Metformin with TLC treatment effected a therapeutic decrement of the oxidative stress (-15.44±35.32%, P=0.029 vs. baseline) unlike TLC alone (61.49±122.66%, P=0.01 vs. baseline). Both interventions' effects were sustained in the 6-month follow up periods. In both intervention groups, the relative changes in plasma TNFα were significantly correlated (P<0.01) with systolic blood pressure and the relative changes in oxidative stress were markedly correlated (P<0.05) with total cholesterol. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  7. An Analysis Method for Superconducting Resonator Parameter Extraction with Complex Baseline Removal

    NASA Technical Reports Server (NTRS)

    Cataldo, Giuseppe

    2014-01-01

    A new semi-empirical model is proposed for extracting the quality (Q) factors of arrays of superconducting microwave kinetic inductance detectors (MKIDs). The determination of the total internal and coupling Q factors enables the computation of the loss in the superconducting transmission lines. The method used allows the simultaneous analysis of multiple interacting discrete resonators with the presence of a complex spectral baseline arising from reflections in the system. The baseline removal allows an unbiased estimate of the device response as measured in a cryogenic instrumentation setting.

  8. Teaching Students with Cognitive Impairment Chained Mathematical Task of Decimal Subtraction Using Simultaneous Prompting

    ERIC Educational Resources Information Center

    Rao, Shaila; Kane, Martha T.

    2009-01-01

    This study assessed effectiveness of simultaneous prompting procedure in teaching two middle school students with cognitive impairment decimal subtraction using regrouping. A multiple baseline, multiple probe design replicated across subjects successfully taught two students with cognitive impairment at middle school level decimal subtraction…

  9. Mastering the Multiplication Facts

    ERIC Educational Resources Information Center

    D'Ettorre, Jenna

    2009-01-01

    The purpose of this paper is to share the results of a six-week research project (after baseline data was collected) that focused on three different strategies (flashcards, interactive games, and music) and their effectiveness in helping fifth grade students memorize the basic multiplication facts. Many teachers face a serious problem when their…

  10. Modulation of brain activity by multiple lexical and word form variables in visual word recognition: A parametric fMRI study.

    PubMed

    Hauk, Olaf; Davis, Matthew H; Pulvermüller, Friedemann

    2008-09-01

    Psycholinguistic research has documented a range of variables that influence visual word recognition performance. Many of these variables are highly intercorrelated. Most previous studies have used factorial designs, which do not exploit the full range of values available for continuous variables, and are prone to skewed stimulus selection as well as to effects of the baseline (e.g. when contrasting words with pseudowords). In our study, we used a parametric approach to study the effects of several psycholinguistic variables on brain activation. We focussed on the variable word frequency, which has been used in numerous previous behavioural, electrophysiological and neuroimaging studies, in order to investigate the neuronal network underlying visual word processing. Furthermore, we investigated the variable orthographic typicality as well as a combined variable for word length and orthographic neighbourhood size (N), for which neuroimaging results are still either scarce or inconsistent. Data were analysed using multiple linear regression analysis of event-related fMRI data acquired from 21 subjects in a silent reading paradigm. The frequency variable correlated negatively with activation in left fusiform gyrus, bilateral inferior frontal gyri and bilateral insulae, indicating that word frequency can affect multiple aspects of word processing. N correlated positively with brain activity in left and right middle temporal gyri as well as right inferior frontal gyrus. Thus, our analysis revealed multiple distinct brain areas involved in visual word processing within one data set.

  11. Cigarette smoking and military deployment: a prospective evaluation.

    PubMed

    Smith, Besa; Ryan, Margaret A K; Wingard, Deborah L; Patterson, Thomas L; Slymen, Donald J; Macera, Caroline A

    2008-12-01

    The stress of military deployment may compound occupational stress experienced in the military and manifest in maladaptive coping behaviors such as cigarette smoking. The current study describes new smoking among never-smokers, smoking recidivism among past smokers, and change in daily smoking among smokers in relation to military deployment. The Millennium Cohort is a 21-year longitudinal study. The current analysis utilized participants (N=48,304) who submitted baseline data (July 2001-June 2003) before the current conflicts in Iraq and Afghanistan and follow-up data (June 2004-January 2006) on health measures. New smoking was identified among baseline never-smokers, smoking recidivism among baseline past smokers, and increased or decreased daily smoking among baseline smokers. Analyses were conducted March 2007-April 2007. Among never-smokers, smoking initiation was identified in 1.3% of nondeployers and 2.3% of deployers. Among past smokers, smoking resumption occurred in 28.7% of nondeployers and 39.4% of those who deployed. Smoking increased 44% among nondeployers and 57% among deployers. Those who deployed and reported combat exposures were at 1.6 times greater odds of initiating smoking among baseline never-smokers (95% CI=1.2, 2.3) and at 1.3 times greater odds of resuming smoking among baseline past smokers when compared to those who did not report combat exposures. Other deployment factors independently associated with postdeployment smoking recidivism included deploying for >9 months and deploying multiple times. Among those who smoked at baseline, deployment was not associated with changes in daily amount smoked. Military deployment is associated with smoking initiation and, more strongly, with smoking recidivism, particularly among those with prolonged deployments, multiple deployments, or combat exposures. Prevention programs should focus on the prevention of smoking relapse during or after deployment.

  12. A Computer-Aided Telephone System to Enable Five Persons with Alzheimer's Disease to Make Phone Calls Independently

    ERIC Educational Resources Information Center

    Perilli, Viviana; Lancioni, Giulio E.; Laporta, Dominga; Paparella, Adele; Caffo, Alessandro O.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Oliva, Doretta

    2013-01-01

    This study extended the assessment of a computer-aided telephone system to enable five patients with a diagnosis of Alzheimer's disease to make phone calls independently. The patients were divided into two groups and exposed to intervention according to a non-concurrent multiple baseline design across groups. All patients started with baseline in…

  13. Effects of PECS Phase III Application Training on Independent Mands in Young Children with Autism

    ERIC Educational Resources Information Center

    Love, Jessica June

    2013-01-01

    The purpose of this study was to examine the effects of PECS phase III application training on independent mands in young children with autism. Participants were five children with autism ranging from ages 2 to 4 years old. A multiple baseline across participants was used to evaluate acquisition of independent correct mands across baseline and…

  14. An Evaluation of the Effectiveness of Exposure and Response Prevention on Repetitive Behaviors Associated with Tourette's Syndrome

    ERIC Educational Resources Information Center

    Wetterneck, Chad T.; Woods, Douglas W.

    2006-01-01

    Exposure and response prevention (ERP) was evaluated as treatment for three repetitive behaviors in an 11-year-old boy using a multiple baseline across behaviors design. The repetitive behaviors and associated self-reported distress were eliminated. At 3-month follow-up, the frequency for two of the three behaviors returned to baseline levels.…

  15. Access to General Education Curriculum: The Effect of Preteaching Key Words Upon Fluency and Accuracy in Expository Text

    ERIC Educational Resources Information Center

    Coulter, Gail A.; Lambert, Michael C.

    2015-01-01

    The effects of preteaching key words on accuracy and fluency in connected text were examined with three fifth-grade participants identified with learning disability and reading two grade levels below their same age peers. Researchers incorporated a multiple baseline design (i.e., Baseline and Wordlist Intervention) and found that preteaching…

  16. Impact of a Comprehensive Safety Program on Bicycle Helmet Use among Middle-School Children

    ERIC Educational Resources Information Center

    Van Houten, Ron; Van Houten, Joy; Malenfant, J. E. Louis

    2007-01-01

    A bicycle helmet program was evaluated in three middle schools using a multiple baseline across schools design. Two of the three schools had histories of enforcement of helmet use. During baseline many students riding their bikes to and from school did not wear their helmets or wore them incorrectly. A program that consisted of peer data…

  17. Is insulin the preferred treatment for HbA1c >9%?

    PubMed

    Bloomgarden, Zachary

    2017-09-01

    The algorithms and guidelines of the American Association of Clinical Endocrinologists and the American Diabetes Association recommend that insulin administration be strongly considered for people with type 2 diabetes (T2D) with HbA1c levels exceeding 9.0% and 10%, respectively. Although the caveat is given in both sets of recommendations that this is particularly appropriate when patients are "symptomatic," referring to urinary frequency with increased thirst and appetite, weight loss, and ketosis, the clinical definition of such presentations may be ill-defined, and it is noteworthy that both documents consider insulin to offer particular benefit under such circumstances. However, with multiple options for glycemic treatment, it is of interest to reconsider this argument for insulin use. It should be recalled that in the UK Prospective Diabetes Study, diet alone was associated with a reduction in HbA1c from 9% to 7%. Drug-naïve people with T2D do often show surprisingly strong reductions in HbA1c with metformin-based dual-agent oral treatment approaches; a recent report showed that even with baseline HbA1c >11%, the combination of metformin with a sulfonylurea, pioglitazone, or sitagliptin was associated with reduction in HbA1c from 11.6% to 6.0%. A 32-week study of the combination of rosiglitazone with metformin in patients with mean baseline HbA1c 8.9% showed a mean HbA1c reduction of 2.3%, and an open-label cohort with baseline HbA1c 11.8% had a reduction in HbA1c to 7.8%. With metformin plus sitagliptin, a mean placebo-adjusted HbA1c reduction of 2.1% from a baseline of 8.8% was reported, with those patients with baseline HbA1c >9% having a 2.6% reduction in HbA1c, and an open-label cohort with baseline HbA1c 11.2% having a 2.9% reduction in HbA1c. Similar 2% HbA1c reductions from baseline levels of 9.1% were seen with metformin in initial combination with the sodium-glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin. Although such dual oral agent approaches are more effective than monotherapy, with a combination regimen the HbA1c reduction will not be directly additive, because the expected reduction decreases at lower baseline HbA1c levels. As an example of this, administration of canagliflozin 300 mg daily to patients with baseline HbA1c >9% reduced levels from 9.6% by 1.8%, whereas at a baseline HbA1c of 10% either canagliflozin 300 mg or metformin 2 g/day reduced HbA1c by 2%; the addition of both agents led to an HbA1c reduction by somewhat less than 3%, which appears concordant with a reduction by the second agent from approximately 8% (10% to 2%). Similar less-than-additive effects of the addition of exenatide QW to dapagliflozin have been reported, with HbA1c reduction from a baseline of 10.0%-10.1% of 1.9% and 1.6% with the individual agents, respectively, and a reduction of 2.2% with their combination. However, one may consider these approaches inferior to the expected HbA1c reduction with insulin, suggesting that insulin should, indeed, be the preferred treatment for people with T2D and HbA1c >9%. Rather, studies comparing basal insulin directly with glucagon-like peptide-1 (GLP-1) receptor agonists (RA) suggest that the latter agents may offer superior benefit. The Diabetes Therapy Utilization: Researching Changes in HBA1C, Weight, and Other Factors Through Intervention with Exenatide Once Weekly (DURATION)-3 and Liraglutide Effect and Action in Diabetes (LEAD)-5 studies compared exenatide QW and liraglutide, respectively, with insulin glargine. Those study participants in the highest quartile of baseline HbA1c had levels ≥9.0% and ≥8.9%, with the GLP-1RA leading to 0.3% and 0.2% greater reductions in HbA1c, respectively, than insulin glargine. Another study comparing T2D patients receiving oral agents given liraglutide with those given insulin glargine showed that those in the highest baseline HbA1c quartile (mean 10.6%) had an HbA1c reduction of 3.1% with either agent. In the exenatide QW study, the reduction in HbA1c with this agent exceeded that with insulin glargine for those groups of study participants with HbA1c 9.0%-9.4%, 9.5%-9.9%, 10.0%-10.4%, 10.5%-10.9%, and even ≥11.0%. Similar superiority of the HbA1c-lowering effect of exenatide QW compared with that of insulin glargine was reported in a study with baseline HbA1c 8.5%. An individual-patient meta-analysis of six studies of another weekly GLP-1RA, namely dulaglutide, showed that at a baseline HbA1c of 10% the expected HbA1c reduction would be nearly 2.5%, and a study directly comparing dulaglutide with insulin glargine also showed a superior HbA1c-lowering effect of the former. Another advantage of the GLP-1RAs is their association with weight loss, rather than the weight gain associated with insulin treatment. An interesting potential combination is that of a GLP-1RA with a thiazolidinedione. In a study comparing the addition of exenatide QW and pioglitazone with the addition of basal-bolus insulin in 101 people receiving sulfonylureas and metformin with baseline HbA1c >10%, HbA1c fell from >11% by >4% compared with <4%, respectively, and the GLP-1RA plus thiazolidinedione treatment was associated with less weight gain and hypoglycemia. What can we conclude? Should HbA1c 11% be the new "use insulin" point? Insulin is an important part of our armamentarium for T2D, and is certainly needed for many patients, but with current therapeutic approaches including metformin, incretin-based treatments, SGLT2 inhibitors, and, possibly, thiazolidinediones, we can reconsider its use in many instances. Although there is no doubt that insulin is necessary for truly uncontrolled diabetes, we may wish to better define its correct indications. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  18. Damages detection in cylindrical metallic specimens by means of statistical baseline models and updated daily temperature profiles

    NASA Astrophysics Data System (ADS)

    Villamizar-Mejia, Rodolfo; Mujica-Delgado, Luis-Eduardo; Ruiz-Ordóñez, Magda-Liliana; Camacho-Navarro, Jhonatan; Moreno-Beltrán, Gustavo

    2017-05-01

    In previous works, damage detection of metallic specimens exposed to temperature changes has been achieved by using a statistical baseline model based on Principal Component Analysis (PCA), piezodiagnostics principle and taking into account temperature effect by augmenting the baseline model or by using several baseline models according to the current temperature. In this paper a new approach is presented, where damage detection is based in a new index that combine Q and T2 statistical indices with current temperature measurements. Experimental tests were achieved in a carbon-steel pipe of 1m length and 1.5 inches diameter, instrumented with piezodevices acting as actuators or sensors. A PCA baseline model was obtained to a temperature of 21º and then T2 and Q statistical indices were obtained for a 24h temperature profile. Also, mass adding at different points of pipe between sensor and actuator was used as damage. By using the combined index the temperature contribution can be separated and a better differentiation of damages respect to undamaged cases can be graphically obtained.

  19. Therapeutic Horseback Riding Outcomes of Parent-Identified Goals for Children with Autism Spectrum Disorder: An ABA′ Multiple Case Design Examining Dosing and Generalization to the Home and Community

    PubMed Central

    Baird, Joanne M.; Kim, Young Joo; Rajora, Kuwar B.; D’Silva, Delma; Podolinsky, Lin; Mazefsky, Carla; Minshew, Nancy

    2014-01-01

    We examined whether different doses of therapeutic riding influenced parent-nominated target behaviors of children with autism spectrum disorder (ASD) (a) during the session (b) at home, and (c) in the community. We used a single subject multiple Baseline, multiple case design, with dosing of 1, 3, and 5 times/week. Three boys with ASD, 6–8 years of age participated, and counts of target behaviors were collected in each setting and phase of the study. Compared to Baseline, 70 % of the target behaviors were better during Intervention and improvement was retained in 63 % of the behaviors during Withdrawal. Increased doses of therapeutic riding were significant for magnitude of change, and the effect of the therapeutic riding sessions generalized to home and community. PMID:24091469

  20. 5α-Reductase inhibitor is less effective in men with small prostate volume and low serum prostatic specific antigen level.

    PubMed

    Lin, Victor C; Liao, Chun-Hou; Wang, Chung-Cheng; Kuo, Hann-Chorng

    2015-09-01

    Large total prostate volumes (TPVs) or high serum prostate-specific antigen (PSA) levels indicate high-risk clinical progression of benign prostatic hyperplasia. This prospective study investigated the treatment outcome of combined 5α-reductase inhibitor and α-blocker in patients with and without large TPVs or high PSA levels. Men aged ≥ 45 years with International Prostate Symptom scores (IPSS) ≥ 8, TPV ≥ 20 mL, and maximum flow rate ≤ 15 mL/s received a combination therapy (dutasteride plus doxaben) for 2 years. Patients with baseline PSA ≥ 4 ng/mL underwent prostatic biopsy for excluding malignancy. The changes in the parameters from baseline to 24 months after combination therapy were compared in those with and without TPV ≥ 40 mL or PSA levels ≥ 1.5 ng/mL. A total of 285 patients (mean age 72 ± 9 years) completed the study. Combination therapy resulted in significant continuous improvement in IPSS, quality of life index, maximum flow rate, and postvoid residual (all p < 0.0001) regardless of baseline TPV or PSA levels. However, only patients with baseline TPV ≥ 40 mL had significant improvements in IPSS-storage subscore, voided volume, reduction in TPV, transitional zone index, and PSA levels. In addition, patients with baseline TPV < 40 mL and PSA < 1.5 ng/mL had neither a reduction in TPV nor a decrease in serum PSA level. A high TPV indicates more outlet resistance, whereas elevated serum PSA level reflects glandular proliferation. Thus, patients with TPV<40 mL and low PSA levels has less benefit from 5α-reductase inhibitor therapy. The therapeutic effect of combined treatment may arise mainly from the α-blocker in these patients. Copyright © 2013. Published by Elsevier B.V.

  1. Unsupervised Ensemble Anomaly Detection Using Time-Periodic Packet Sampling

    NASA Astrophysics Data System (ADS)

    Uchida, Masato; Nawata, Shuichi; Gu, Yu; Tsuru, Masato; Oie, Yuji

    We propose an anomaly detection method for finding patterns in network traffic that do not conform to legitimate (i.e., normal) behavior. The proposed method trains a baseline model describing the normal behavior of network traffic without using manually labeled traffic data. The trained baseline model is used as the basis for comparison with the audit network traffic. This anomaly detection works in an unsupervised manner through the use of time-periodic packet sampling, which is used in a manner that differs from its intended purpose — the lossy nature of packet sampling is used to extract normal packets from the unlabeled original traffic data. Evaluation using actual traffic traces showed that the proposed method has false positive and false negative rates in the detection of anomalies regarding TCP SYN packets comparable to those of a conventional method that uses manually labeled traffic data to train the baseline model. Performance variation due to the probabilistic nature of sampled traffic data is mitigated by using ensemble anomaly detection that collectively exploits multiple baseline models in parallel. Alarm sensitivity is adjusted for the intended use by using maximum- and minimum-based anomaly detection that effectively take advantage of the performance variations among the multiple baseline models. Testing using actual traffic traces showed that the proposed anomaly detection method performs as well as one using manually labeled traffic data and better than one using randomly sampled (unlabeled) traffic data.

  2. Aspiring to Spectral Ignorance in Earth Observation

    NASA Astrophysics Data System (ADS)

    Oliver, S. A.

    2016-12-01

    Enabling robust, defensible and integrated decision making in the Era of Big Earth Data requires the fusion of data from multiple and diverse sensor platforms and networks. While the application of standardised global grid systems provides a common spatial analytics framework that facilitates the computationally efficient and statistically valid integration and analysis of these various data sources across multiple scales, there remains the challenge of sensor equivalency; particularly when combining data from different earth observation satellite sensors (e.g. combining Landsat and Sentinel-2 observations). To realise the vision of a sensor ignorant analytics platform for earth observation we require automation of spectral matching across the available sensors. Ultimately, the aim is to remove the requirement for the user to possess any sensor knowledge in order to undertake analysis. This paper introduces the concept of spectral equivalence and proposes a methodology through which equivalent bands may be sourced from a set of potential target sensors through application of equivalence metrics and thresholds. A number of parameters can be used to determine whether a pair of spectra are equivalent for the purposes of analysis. A baseline set of thresholds for these parameters and how to apply them systematically to enable relation of spectral bands amongst numerous different sensors is proposed. The base unit for comparison in this work is the relative spectral response. From this input, determination of a what may constitute equivalence can be related by a user, based on their own conceptualisation of equivalence.

  3. MRI outcomes with cladribine tablets for multiple sclerosis in the CLARITY study.

    PubMed

    Comi, Giancarlo; Cook, Stuart D; Giovannoni, Gavin; Rammohan, Kottil; Rieckmann, Peter; Sørensen, Per Soelberg; Vermersch, Patrick; Hamlett, Anthony C; Viglietta, Vissia; Greenberg, Steven J

    2013-04-01

    We herein provide a comprehensive assessment of magnetic resonance imaging (MRI) outcomes from CLARITY, a 96-week, double-blind study demonstrating significant clinical and MRI improvements in patients with relapsing-remitting multiple sclerosis (RRMS) treated with cladribine tablets. Patients with RRMS were randomized 1:1:1 to annual short-course therapy with cladribine tablets cumulative dose 3.5 or 5.25 mg/kg or placebo. MRI endpoints included mean number of T1 gadolinium-enhancing (Gd+), active T2 and combined unique (CU) lesions/patient/scan. MRI-measured disease activity was significantly reduced in both cladribine tablets groups versus placebo. The proportion of patients with no active lesions at study end was: T1 Gd+ lesions: 86.8 and 91.0 versus 48.3 % (p < 0.001); active T2 lesions: 61.7 and 62.5 versus 28.4 % (p < 0.001); CU lesions: 59.6 and 60.7 versus 26.1 % (p < 0.001). Clinically meaningful and significant reductions in active lesion counts and increases in proportions of active lesion-free patients were achieved consistently in cladribine tablet groups when data were stratified by baseline disease characteristics. For example, the percentage of patients who remained lesion-free over the study was significantly greater in cladribine tablet groups than in the placebo group for all lesion types regardless of relapse category at baseline (p < 0.001 for all analyses of patients with ≤1 or 2 relapses; p ≤ 0.022 for analyses of patients with ≥3 relapses). MRI-measured disease activity was greatly reduced by both doses of cladribine tablets, with consistent effect across clinically relevant patient populations. These findings add to our scientific understanding of the neurological impact of this therapeutic modality in patients with RRMS.

  4. Increasing drought in Jordan: Climate change and cascading Syrian land-use impacts on reducing transboundary flow.

    PubMed

    Rajsekhar, Deepthi; Gorelick, Steven M

    2017-08-01

    In countries where severe drought is an anticipated effect of climate change and in those that heavily depend on upstream nations for fresh water, the effect of drier conditions and consequent changes in the transboundary streamflow regime induced by anthropogenic interventions and disasters leads to uncertainty in regional water security. As a case in point, we analyze Jordan's surface water resources and agricultural water demand through 2100, considering the combined impacts of climate change and land-use change driven by the Syrian conflict. We use bias-corrected regional climate simulations as input to high-resolution hydrologic models to assess three drought types: meteorological (rainfall decrease), agricultural (soil moisture deficit), and hydrologic (streamflow decline) under future scenarios. The historical baseline period (1981-2010) is compared to the future (2011-2100), divided into three 30-year periods. Comparing the baseline period to 2070-2100, average temperature increases by 4.5°C, rainfall decreases by 30%, and multiple drought-type occurrences increase from ~8 in 30 years to ~25 in 30 years. There is a significant increase in the contemporaneous occurrence of multiple drought types along with an 80% increase in simultaneous warm and dry events. Watershed simulations of future transboundary Yarmouk-Jordan River flow from Syria show that Jordan would receive 51 to 75% less Yarmouk water compared to historical flow. Recovery of Syrian irrigated agriculture to pre-conflict conditions would produce twice the decline in transboundary flow as that due to climate change. In Jordan, the confluence of limited water supply, future drought, and transboundary hydrologic impacts of land use severely challenges achieving freshwater sustainability.

  5. Increasing drought in Jordan: Climate change and cascading Syrian land-use impacts on reducing transboundary flow

    PubMed Central

    Rajsekhar, Deepthi; Gorelick, Steven M.

    2017-01-01

    In countries where severe drought is an anticipated effect of climate change and in those that heavily depend on upstream nations for fresh water, the effect of drier conditions and consequent changes in the transboundary streamflow regime induced by anthropogenic interventions and disasters leads to uncertainty in regional water security. As a case in point, we analyze Jordan’s surface water resources and agricultural water demand through 2100, considering the combined impacts of climate change and land-use change driven by the Syrian conflict. We use bias-corrected regional climate simulations as input to high-resolution hydrologic models to assess three drought types: meteorological (rainfall decrease), agricultural (soil moisture deficit), and hydrologic (streamflow decline) under future scenarios. The historical baseline period (1981–2010) is compared to the future (2011–2100), divided into three 30-year periods. Comparing the baseline period to 2070–2100, average temperature increases by 4.5°C, rainfall decreases by 30%, and multiple drought-type occurrences increase from ~8 in 30 years to ~25 in 30 years. There is a significant increase in the contemporaneous occurrence of multiple drought types along with an 80% increase in simultaneous warm and dry events. Watershed simulations of future transboundary Yarmouk-Jordan River flow from Syria show that Jordan would receive 51 to 75% less Yarmouk water compared to historical flow. Recovery of Syrian irrigated agriculture to pre-conflict conditions would produce twice the decline in transboundary flow as that due to climate change. In Jordan, the confluence of limited water supply, future drought, and transboundary hydrologic impacts of land use severely challenges achieving freshwater sustainability. PMID:28875164

  6. Factors associated with clinically significant increased walking time in multiple sclerosis: results of a survival analysis of short-term follow-up data from a clinical database.

    PubMed

    Miller, Deborah M; Thompson, Nicolas R; Cohen, Jeffrey A; Fox, Robert J; Hartman, Jen; Schwetz, Kathleen; Conway, Devon S; Rudick, Richard A

    2015-04-01

    Because multiple sclerosis (MS) is variable and unpredictable, if symptom worsening could be predicted, patients may feel better prepared to manage changes in function. The objective of this paper is to study the prediction of walking impairment in MS. We retrieved data for all MS patients at our center (2008-2009), including baseline and follow-up timed 25-foot walk (T25FW) times. We assessed the incidence of ≥20% worsening in T25FW by developing two survival models: (1) disease course and (2) Multiple Sclerosis Performance Scales (MSPS) score. The outcome was days until ≥20% worsening in T25FW. Covariates were disease subtype, years since diagnosis, Patient Health Questionnaire-9 (PHQ-9) score, and demographics. Data were interval censored; missing data were handled with multiple imputation. Of 1544 patients, 309 (20%) experienced ≥20% worsening T25FW. For disease course, time to worsening was significantly shorter for secondary progressive vs. relapsing-remitting disease (p < 0.001). For MSPS, patients with lower baseline MSPS scores progressed more slowly (p = 0.001). In both models, sex, baseline T25W, and time since diagnosis were significantly associated with worsening. In the disease course model, PHQ 9 score may be related to worsening (p = 0.07). These findings suggest factors associated with worsening in T25FW and a potential approach to establishing indicators associated with clinically significant change. © The Author(s), 2014.

  7. Gender classification under extended operating conditions

    NASA Astrophysics Data System (ADS)

    Rude, Howard N.; Rizki, Mateen

    2014-06-01

    Gender classification is a critical component of a robust image security system. Many techniques exist to perform gender classification using facial features. In contrast, this paper explores gender classification using body features extracted from clothed subjects. Several of the most effective types of features for gender classification identified in literature were implemented and applied to the newly developed Seasonal Weather And Gender (SWAG) dataset. SWAG contains video clips of approximately 2000 samples of human subjects captured over a period of several months. The subjects are wearing casual business attire and outer garments appropriate for the specific weather conditions observed in the Midwest. The results from a series of experiments are presented that compare the classification accuracy of systems that incorporate various types and combinations of features applied to multiple looks at subjects at different image resolutions to determine a baseline performance for gender classification.

  8. A phase IV, open-label study evaluating the use of triple-combination therapy with minocycline HCl extended-release tablets, a topical antibiotic/retinoid preparation and benzoyl peroxide in patients with moderate to severe acne vulgaris.

    PubMed

    Zaenglein, Andrea L; Shamban, Ava; Webster, Guy; Del Rosso, James; Dover, Jeffrey S; Swinyer, Leonard; Stein, Linda; Lin, Xiaoming; Draelos, Zoe; Gold, Michael; Thiboutot, Diane

    2013-06-01

    Moderate to severe acne vulgaris is often treated with a combination of an oral antibiotic, topical antibiotic/retinoid, and benzoyl peroxide (BP), but data are limited on the efficacy of this and other combination regimens that incorporate both oral and topical therapies.
    Patients were required to be aged 12-30 years with moderate to severe acne (grades 3-4 acne on the Investigator's Global Assessment [IGA]) and deemed potential candidates for treatment with isotretinoin. Enrolled patients were given triple-combination therapy, defined in this study as oral minocycline HCl extended release 1 mg/kg QD, 6% BP foaming cloths used QD, and clindamycin phosphate 1.2%/tretinoin 0.025% gel applied QD, and were evaluated at baseline and weeks 2, 4, 8, and 12.
    A total of 97 patients were enrolled in the study. At week 12, 89% of patients had at least a one-grade improvement from baseline IGA and 96% had at least a one-grade improvement from baseline Global Aesthetic Improvement Scale score. Mean ± SD in- flammatory, non-inflammatory, and total lesion counts decreased from baseline by 61.8% ± 38.3%, 48.8% ± 34.5%, and 56.5% ± 29.9%, respectively. The percentage of patients evaluated as candidates for isotretinoin by independent photographic review was 77% (69/90) at baseline and only 16% (14/90) at week 12. Treatment-related adverse events (AEs) occurred in eight of 97 (8%) patients. Triplecombination therapy was not associated with any serious AEs or AEs leading to discontinuation.
    Triple-combination therapy was well tolerated and substantially reduced facial acne lesion counts, with 84% of patients judged to no longer be candidates for isotretinoin therapy by study end. These data support the clinical observation that a triple-combination regimen incorporating oral minocycline (dosed by patient weight), BP foaming cloths 6% QD, and clindamycin phosphate 1.2%/ tretinoin 0.025% gel QD can substantially improve moderate to severe acne vulgaris.

  9. Phenome-driven disease genetics prediction toward drug discovery

    PubMed Central

    Chen, Yang; Li, Li; Zhang, Guo-Qiang; Xu, Rong

    2015-01-01

    Motivation: Discerning genetic contributions to diseases not only enhances our understanding of disease mechanisms, but also leads to translational opportunities for drug discovery. Recent computational approaches incorporate disease phenotypic similarities to improve the prediction power of disease gene discovery. However, most current studies used only one data source of human disease phenotype. We present an innovative and generic strategy for combining multiple different data sources of human disease phenotype and predicting disease-associated genes from integrated phenotypic and genomic data. Results: To demonstrate our approach, we explored a new phenotype database from biomedical ontologies and constructed Disease Manifestation Network (DMN). We combined DMN with mimMiner, which was a widely used phenotype database in disease gene prediction studies. Our approach achieved significantly improved performance over a baseline method, which used only one phenotype data source. In the leave-one-out cross-validation and de novo gene prediction analysis, our approach achieved the area under the curves of 90.7% and 90.3%, which are significantly higher than 84.2% (P < e−4) and 81.3% (P < e−12) for the baseline approach. We further demonstrated that our predicted genes have the translational potential in drug discovery. We used Crohn’s disease as an example and ranked the candidate drugs based on the rank of drug targets. Our gene prediction approach prioritized druggable genes that are likely to be associated with Crohn’s disease pathogenesis, and our rank of candidate drugs successfully prioritized the Food and Drug Administration-approved drugs for Crohn’s disease. We also found literature evidence to support a number of drugs among the top 200 candidates. In summary, we demonstrated that a novel strategy combining unique disease phenotype data with system approaches can lead to rapid drug discovery. Availability and implementation: nlp.case.edu/public/data/DMN Contact: rxx@case.edu PMID:26072493

  10. Impact of low vision care on reading performance in children with multiple disabilities and visual impairment

    PubMed Central

    Ramani, Krishna Kumar; Police, Shailaja Reddy; Jacob, Namita

    2014-01-01

    Background: Lack of evidence in literature to show low vision care enhances the reading performance in children with Multiple Disabilities and Visual Impairment (MDVI). Aim: To evaluate the effectiveness of Low Vision Care intervention on the reading performance of children with MDVI. Materials and Methods: Three subjects who were diagnosed to have cerebral palsy and visual impairment, studying in a special school were recruited for the study. All of them underwent detailed eye examination and low vision care evaluation at a tertiary eye care hospital. A single subject multiple baseline (study) design was adopted and the study period was 16 weeks. The reading performance (reading speed, reading accuracy, reading fluency) was evaluated during the baseline phase and the intervention phase. The median of all the reading parameters for each week was noted. The trend of the reading performance was graphically represented in both the phases. Results: Reading speed increased by 37 Word per minute, 37 Letters per minute and 5 letters per minute for the subject 1, 2 and 3 respectively after the intervention. Reading accuracy was 84%, 91% and 86.4% at the end of the baseline period and 98.7%, 98.4% and 99% at the end of 16 weeks for subject 1, 2 and 3 respectively. Average reading fluency score was 8.3, 7.1 and 5.5 in the baseline period and 10.2, 10.2 and 8.7 in the intervention period. Conclusion: This study shows evidence of noticeable improvement in reading performance of children with MDVI using a novel study design. PMID:23619499

  11. Longitudinal performance of plasma neurofilament light and tau in professional fighters: The Professional Fighters Brain Health Study.

    PubMed

    Bernick, Charles; Zetterberg, Henrik; Shan, Guogen; Banks, Sarah; Blennow, Kaj

    2018-04-02

    The objective of this study is to evaluate longitudinal change in plasma neurofilament light (NF-L) and tau levels in relationship to clinical and radiological measures in professional fighters. Participants (active and retired professional fighters and control group) underwent annual blood sampling, 3 Tesla MRI brain imaging, computerized cognitive testing, and assessment of exposure to head trauma. Plasma tau and NF-L concentrations were measured using Simoa assays. Multiple linear regression models were used to compare the difference across groups in regard to baseline measurements, while mixed linear models was used for the longitudinal data with multiple measurements for each participant. Plasma samples were available on 471 participants. Baseline NF-L measures differed across groups (F_3,393=6.99, p=0.0001), with the active boxers having the highest levels. Higher NF-L levels at baseline were correlated with lower baseline MRI regional volumes and lower cognitive scores. The number of sparring rounds completed by the active fighters was correlated with NF-L (95% CI 0.0116-0.4053, p=0.0381), but not tau, levels. Among 126 subjects having multiple yearly samples, there was a significant difference in average yearly percentage change in tau across groups (F_3,83=3.87, p=0.0121).). We conclude that plasma NF-L and tau behave differently in a group of active and retired fighters; NF-L better reflects acute exposure whereas the role of plasma tau levels in signifying chronic change in brain structure over time requires further study.

  12. Impact of low vision care on reading performance in children with multiple disabilities and visual impairment.

    PubMed

    Ramani, Krishna Kumar; Police, Shailaja Reddy; Jacob, Namita

    2014-02-01

    Lack of evidence in literature to show low vision care enhances the reading performance in children with Multiple Disabilities and Visual Impairment (MDVI). To evaluate the effectiveness of Low Vision Care intervention on the reading performance of children with MDVI. Three subjects who were diagnosed to have cerebral palsy and visual impairment, studying in a special school were recruited for the study. All of them underwent detailed eye examination and low vision care evaluation at a tertiary eye care hospital. A single subject multiple baseline (study) design was adopted and the study period was 16 weeks. The reading performance (reading speed, reading accuracy, reading fluency) was evaluated during the baseline phase and the intervention phase. The median of all the reading parameters for each week was noted. The trend of the reading performance was graphically represented in both the phases. Reading speed increased by 37 Word per minute, 37 Letters per minute and 5 letters per minute for the subject 1, 2 and 3 respectively after the intervention. Reading accuracy was 84%, 91% and 86.4% at the end of the baseline period and 98.7%, 98.4% and 99% at the end of 16 weeks for subject 1, 2 and 3 respectively. Average reading fluency score was 8.3, 7.1 and 5.5 in the baseline period and 10.2, 10.2 and 8.7 in the intervention period. This study shows evidence of noticeable improvement in reading performance of children with MDVI using a novel study design.

  13. Multiple sclerosis and employment: Associations of psychological factors and work instability.

    PubMed

    Wicks, Charlotte Rose; Ward, Karl; Stroud, Amanda; Tennant, Alan; Ford, Helen L

    2016-10-12

    People with multiple sclerosis often stop working earlier than expected. Psychological factors may have an impact on job retention. Investigation may inform interventions to help people stay in work. To investigate the associations between psychological factors and work instability in people with multiple sclerosis. A multi-method, 2-phased study. Focus groups were held to identify key themes. Questionnaire packs using validated scales of the key themes were completed at baseline and at 8-month follow-up. Four key psychological themes emerged. Out of 208 study subjects 57.2% reported medium/high risk of job loss, with marginal changes at 8 months. Some psychological variables fluctuated significantly, e.g. depression fell from 24.6% to 14.5%. Work instability and anxiety and depression were strongly correlated (χ2 p < 0.001). Those with probable depression at baseline had 7.1 times increased odds of medium/high work instability, and baseline depression levels also predicted later work instability (Hosmer-Lemeshow test 0.899; Nagelkerke R Square 0.579). Psychological factors fluctuated over the 8-month follow-up period. Some psychological variables, including anxiety and depression, were significantly associated with, and predictive of, work instability. Longitudinal analysis should further identify how these psychological attributes impact on work instability and potential job loss in the longer term.

  14. New graduate students' baseline knowledge of the responsible conduct of research.

    PubMed

    Heitman, Elizabeth; Olsen, Cara H; Anestidou, Lida; Bulger, Ruth Ellen

    2007-09-01

    To assess (1) new biomedical science graduate students' baseline knowledge of core concepts and standards in responsible conduct of research (RCR), (2) differences in graduate students' baseline knowledge overall and across the Office of Research Integrity's nine core areas, and (3) demographic and educational factors in these differences. A 30-question, computer-scored multiple-choice test on core concepts and standards of RCR was developed following content analysis of 20 United States-published RCR texts, and combined with demographic questions on undergraduate experience with RCR developed from graduate student focus groups. Four hundred two new graduate students at three health science universities were recruited for Scantron and online testing before beginning RCR instruction. Two hundred fifty-one of 402 eligible trainees (62%) at three universities completed the test; scores ranged from 26.7% to 83.3%, with a mean of 59.5%. Only seven (3%) participants scored 80% or above. Students who received their undergraduate education outside the United States scored significantly lower (mean 52.0%) than those with U.S. bachelor's degrees (mean 60.5%, P < .001). Participants with prior graduate biomedical or health professions education scored marginally higher than new students, but both groups' mean scores were well below 80%. The mean score of 16 participants who reported previous graduate-level RCR instruction was 67.7%. Participants' specific knowledge varied, but overall scores were universally low. New graduate biomedical sciences students have inadequate and inconsistent knowledge of RCR, irrespective of their prior education or experience. Incoming trainees with previous graduate RCR education may also have gaps in core knowledge.

  15. Behavioral Impulsivity Does Not Predict Naturalistic Alcohol Consumption or Treatment Outcomes

    PubMed Central

    Mullen, Jillian; Mathias, Charles W.; Karns, Tara E.; Liang, Yuanyuan; Hill-Kapturczak, Nathalie; Roache, John D.; Lamb, Richard J.; Dougherty, Donald M.

    2016-01-01

    Objective The purpose of this study was to determine if behavioral impulsivity under multiple conditions (baseline, after alcohol consumption or after serotonin depletion) predicted naturalistic alcohol use or treatment outcomes from a moderation-based contingency management intervention. Method The current data analysis pulls information from three phases of a large study: 1) Phase 1 examined baseline and the effects of alcohol use and serotonin depletion on three types of behavioral impulsivity: response initiation (IMT task), response inhibition (GoStop task), and delay discounting (SKIP task); 2) Phase 2 involved 28 days of naturalistic drinking; and 3) Phase 3 involved 3 months of contingency management. During phases 2 and 3 alcohol use was measured objectively using transdermal alcohol monitors. The results of each individual phase has been previously published showing that at a group level the effects of alcohol consumption on impulsivity were dependent on the component of impulsivity being measured and the dose of alcohol consumed but serotonin depletion had no effect on impulsivity, and that a moderation-based contingency management intervention reduced heavy drinking. Results The current analysis combining data from those who completed all three phases (n = 67) showed that impulsivity measured at baseline, after alcohol consumption, or after serotonin depletion did not predict naturalistic drinking or treatment outcomes from a moderation-based CM treatment. Conclusions Contingency management interventions may prove to be an effective intervention for impulsive individuals, however, normal variations in measured impulsivity do not seem to relate to normal variations in drinking pattern or response to moderation-based contingency management. PMID:27746702

  16. A moderately precise dynamical age for the Homunculus of Eta Carinae based on 13 years of HST imaging

    NASA Astrophysics Data System (ADS)

    Smith, Nathan

    2017-11-01

    The Hubble Space Telescope archive contains a large collection of images of η Carinae, and this paper analyses those most suitable for measuring its expanding Homunculus Nebula. Multiple intensity tracings through the Homunculus reveal the fractional increase in the overall size of the nebula; this avoids registration uncertainty, mitigates brightness fluctuations, and is independent of previous methods. Combining a 13 yr baseline of Wide Field Planetary Camera 2 images in the F631N filter, with a 4 yr baseline of Advanced Camera for Surveys/High Resolution Channel images in the F550M filter, yields an ejection date (assuming linear motion) of 1847.1 (±0.8 yr). This result improves the precision, but is in excellent agreement with the previous study by Morse et al., that used a shorter time baseline and a different analysis method. This more precise date is inconsistent with ejection during a periastron passage of the eccentric binary. Ejection occurred well into the main plateau of the Great Eruption, and not during the brief peaks in 1843 and 1838. The age uncertainty is dominated by a real spread in ages of various knots, and by some irregular brightness fluctuations. Several knots appear to have been ejected decades before or after the mean date, implying a complicated history of mass-loss episodes outside the main bright phase of the eruption. The extended history of mass ejection may have been largely erased by the passage of a shock through clumpy ejecta, as most material was swept into a thin shell with nearly uniform apparent age.

  17. Relationship between mild cognitive impairment and falls in older people with and without Parkinson's disease: 1-Year Prospective Cohort Study.

    PubMed

    Camicioli, Richard; Majumdar, Sumit R

    2010-05-01

    We conducted a 12-month longitudinal cohort study of 102 older people without dementia (52 Parkinson's Disease [PD]; 50 age- and sex-matched controls) to determine (1) if mild cognitive impairment predicts falls in older people with or without PD and (2) how baseline falls, a history of freezing and Hoehn and Yahr stage affected the association between cognitive impairment and multiple falls in PD patients. Cognitive impairment was defined as the sum of impairments on the caregiver-rated Clinical Dementia Rating Scale (CCDRSum>0). Overall the mean age (SD) was 71.5 (4.7) years, 42% were women, 26% had fallen and 14% had cognitive impairment at baseline. Thirty-one percent (15/52) of PD patients vs 12% (6/50) of controls fell more than once during 12-month follow-up, p=0.04. When combined in a 2-predictor model for the entire cohort, the adjusted odds ratios [aOR] for falling were significantly increased for cognitive impairment at baseline (aOR: 4.8, 95% CI: 1.3-18.2) and prior falls (aOR: 7.4, 95% CI: 2.4-22.3). The overall accuracy of the model was 82%, with low sensitivity of 19% but high specificity of 99%. In the PD subgroup, the overall accuracy of the same prediction model was 79%, with much better sensitivity of 73% but a lower specificity of 81%. We conclude that mild cognitive impairment might contribute to falls risk beyond conventional risk factors in older people with and without PD. Copyright 2010 Elsevier B.V. All rights reserved.

  18. Parametric performance analysis of steam-injected gas turbine with a thermionic-energy-converter-lined combustor

    NASA Technical Reports Server (NTRS)

    Choo, Y. K.; Burns, R. K.

    1982-01-01

    The performance of steam-injected gas turbines having combustors lined with thermionic energy converters (STIG/TEC systems) was analyzed and compared with that of two baseline systems; a steam-injected gas turbine (without a TEC-lined combustor) and a conventional combined gas turbine/steam turbine cycle. Common gas turbine parameters were assumed for all of the systems. Two configurations of the STIG/TEC system were investigated. In both cases, steam produced in an exhaust-heat-recovery boiler cools the TEC collectors. It is then injected into the gas combustion stream and expanded through the gas turbine. The STIG/TEC system combines the advantage of gas turbine steam injection with the conversion of high-temperature combustion heat by TEC's. The addition of TEC's to the baseline steam-injected gas turbine improves both its efficiency and specific power. Depending on system configuration and design parameters, the STIG/TEC system can also achieve higher efficiency and specific power than the baseline combined cycle.

  19. Multivariate qualitative analysis of banned additives in food safety using surface enhanced Raman scattering spectroscopy

    NASA Astrophysics Data System (ADS)

    He, Shixuan; Xie, Wanyi; Zhang, Wei; Zhang, Liqun; Wang, Yunxia; Liu, Xiaoling; Liu, Yulong; Du, Chunlei

    2015-02-01

    A novel strategy which combines iteratively cubic spline fitting baseline correction method with discriminant partial least squares qualitative analysis is employed to analyze the surface enhanced Raman scattering (SERS) spectroscopy of banned food additives, such as Sudan I dye and Rhodamine B in food, Malachite green residues in aquaculture fish. Multivariate qualitative analysis methods, using the combination of spectra preprocessing iteratively cubic spline fitting (ICSF) baseline correction with principal component analysis (PCA) and discriminant partial least squares (DPLS) classification respectively, are applied to investigate the effectiveness of SERS spectroscopy for predicting the class assignments of unknown banned food additives. PCA cannot be used to predict the class assignments of unknown samples. However, the DPLS classification can discriminate the class assignment of unknown banned additives using the information of differences in relative intensities. The results demonstrate that SERS spectroscopy combined with ICSF baseline correction method and exploratory analysis methodology DPLS classification can be potentially used for distinguishing the banned food additives in field of food safety.

  20. Investigation of Changes in Extreme Temperature and Humidity Over China Through a Dynamical Downscaling Approach

    NASA Astrophysics Data System (ADS)

    Zhu, Jinxin; Huang, Gordon; Wang, Xiuquan; Cheng, Guanhui

    2017-11-01

    Impacts of climate change relating to public health are often determined by multiple climate variables. The health-related metrics combining high-temperature and relative humidity are most concerned. Temperatures, relative humidity and relationship among them are investigated here for a comprehensive assessment of climate change impacts over China. A projection of combined temperatures and humidity through the PRECIS model is addressed. The PRECIS model's skill in reproducing the historical climate over China was first gauged through validating its historical simulation with the observation data set in terms of the two contributing variables. With good results of validation, a plausible range of combined temperatures and relative humidity were generated under RCPs. The results suggested that the annual mean temperature of China will increase up to 6°C at the end of 21st century. Opposite to the significantly change in the temperature, the maximum magnitude of changes in relative humidity is only 8% from the value in the baseline period. The dew point temperature is projected to be 14.9°C (within the comfortable interval) over the whole nation under high radiative forcing scenario at the end of this century. Therefore, the combination effects of high temperatures and relative humidity are substantially smaller than generally anticipated for China. Even though the impact-relevant metric like the dew point temperature is not projected as bad as the generally anticipated, we found that the frequency of high-temperature extremes increases up to 40% and the duration increases up to 150% in China. China is still expected to have more number of extremely hot days, more frequent high-temperature extremes, and longer duration of warm spell than before. Regionally, South China has the smallest changes in the mean, maximum and minimum temperatures while the largest increases in all five high-temperature indices. Consequently, the climate over South China for two future periods will be changing more drastically than the baseline period. Extra cautions need to be given to South China in the future.

  1. A Long-Term Leisure Program for Individuals with Intellectual Disability in Residential Care Settings: Research to Practice

    ERIC Educational Resources Information Center

    Fox, Robert A.; Burke, Amie M.; Fung, Michael P.

    2013-01-01

    We studied the effectiveness of an individually-tailored leisure program implemented by direct care staff in a residential program for 28 adults with severe to profound intellectual disability using a multiple baseline design across two homes over a 1.5 year baseline and treatment period followed by another nearly 1.5 year maintenance phase. The…

  2. Fair Play Game: A Group Contingency Strategy to Increase Students' Active Behaviours in Physical Education

    ERIC Educational Resources Information Center

    Vidoni, Carla; Lee, Chang-Hung; Azevedo, L. B.

    2014-01-01

    A dependent group contingency strategy called Fair Play Game was applied to promote increase in number of steps during physical education classes for sixth-grade students. Results from a multiple baseline design across three classes showed that the mean number of steps for baseline vs. intervention were: Class 1: 43 vs. 64 steps/minute; Class 2:…

  3. Using Optical Interferometry for GEO Satellites Imaging: An Update

    DTIC Science & Technology

    2016-05-27

    of a geostationary satellite using the Navy Precision Optical Inter- ferometer (NPOI) during the glint season of March 2015. We succeeded in detecting...night. These baseline lengths correspond to a resolution of ∼4 m at geostationary altitude. This is the first multiple-baseline interferometric...detection of a satellite. Keywords: geostationary satellites, optical interferometry, imaging, telescope arrays 1. INTRODUCTION Developing the ability to

  4. The Effects of a Self-Monitoring Package on Homework Completion and Accuracy of Students with Disabilities in an Inclusive General Education Classroom

    ERIC Educational Resources Information Center

    Falkenberg, Carol Ann; Barbetta, Patricia M.

    2013-01-01

    This study used a multiple baseline design across subjects to investigate the effects of a self-monitoring package on the math and spelling homework completion and accuracy rates of four fourth-grade students (two boys and two girls) with disabilities in an inclusive general education classroom. Throughout baseline and intervention, participants…

  5. Stress, Behavior, and Children and Youth Who Are Deafblind

    ERIC Educational Resources Information Center

    Nelson, Catherine; Greenfield, Robin G.; Hyte, Holly A.; Shaffer, Jason P.

    2013-01-01

    Children and youth who are deafblind with multiple disabilities have several identified risk factors for experiencing toxic levels of stress, and such stress is known to impair physical, mental, and emotional health. This single-case multiple baseline study examined the frequency and duration of behaviors thought to indicate stress, the duration…

  6. Teaching Children with Language-Learning Disabilities to Plan and Revise Compare-Contrast Texts

    ERIC Educational Resources Information Center

    Shen, Mei; Troia, Gary A.

    2018-01-01

    This study used a multiple-probe, multiple-baseline single-case design to investigate the efficacy of planning, and then revising strategy instruction using self-regulated strategy development on the compare-contrast writing performance of three late elementary students with language-learning disabilities. After receiving the planning instruction,…

  7. Avoiding the Major Causes of Death: Does Childhood Misfortune Reduce the Likelihood of Being Disease Free in Later Life?

    PubMed

    Williams, Monica M; Kemp, Blakelee R; Ferraro, Kenneth F; Mustillo, Sarah A

    2018-04-03

    Although previous research reveals the detrimental effects of early misfortune on the development of chronic diseases in later life, few studies have investigated its effects on remaining disease free. This study draws on cumulative inequality theory to investigate whether experiencing childhood misfortune reduces the likelihood of remaining disease free over time. This study utilizes five waves of data from the Health and Retirement Study to test whether five domains of childhood misfortune predict being disease free at baseline (2004) and developing disease over time (2004-2012). Respondents reporting risky parental behaviors during childhood were less likely to be disease free at baseline and had an increased risk of disease onset over time, the latter driven by having a guardian who smoked in combination with more pack-years smoked in adulthood. Furthermore, we find that adult resources, i.e. wealth, help to mitigate the noxious effects of other misfortunes, notably poor socioeconomic conditions. Consistent with cumulative inequality theory, these findings reveal that experiencing multiple types of misfortune during childhood decreases the likelihood of remaining disease free in later life, but engaging in health behaviors, such as physical activity, can help to ameliorate some of the noxious effects of early misfortune.

  8. Kinship foster care among African American youth: Interaction effects at multiple contextual levels

    PubMed Central

    Rufa, Anne K.; Fowler, Patrick J.

    2016-01-01

    This study investigated the effects of kinship foster care on mental health outcomes among African American youth. Longitudinal data were used from a nationally representative sample of children and adolescents who were the subject of child protective services investigation from 1999 to 2000 (n=5,501). The secondary analyses focused on African American youth (n=225) placed into foster care. In structured interviews, current caregivers reported on youth internalizing and externalizing behaviors immediately following placement into out-of-home care and 18-months later. Path analysis tested a theoretical model that compared placements with kin to other formal out-of-home arrangements in context of setting characteristics, including aspects of caregiver and neighborhood disorder. Results suggested significant increases in internalizing symptoms over time for youth with more baseline mental health problems, as well as those placed in more distressed neighborhoods. Increased externalizing symptoms occurred among youth with greater baseline behavior problems, those placed in more problematic neighborhoods, and youth who experienced a placement change between assessments. Additionally, a combination of placement characteristics predicted increases in externalizing problems; youth placed in kinship foster care with older caregivers in poorer health exhibited greater increases in externalizing problems. Findings highlighted important contextual considerations for out-of-home placement among African American youth. PMID:26924865

  9. An Investigation of High-Cycle Fatigue Models for Metallic Structures Exhibiting Snap-Through Response

    NASA Technical Reports Server (NTRS)

    Przekop, Adam; Rizzi, Stephen A.; Sweitzer, Karl A.

    2007-01-01

    A study is undertaken to develop a methodology for determining the suitability of various high-cycle fatigue models for metallic structures subjected to combined thermal-acoustic loadings. Two features of this problem differentiate it from the fatigue of structures subject to acoustic loading alone. Potentially large mean stresses associated with the thermally pre- and post-buckled states require models capable of handling those conditions. Snap-through motion between multiple post-buckled equilibrium positions introduces very high alternating stress. The thermal-acoustic time history response of a clamped aluminum beam structure with geometric and material nonlinearities is determined via numerical simulation. A cumulative damage model is employed using a rainflow cycle counting scheme and fatigue estimates are made for 2024-T3 aluminum using various non-zero mean fatigue models, including Walker, Morrow, Morrow with true fracture strength, and MMPDS. A baseline zero-mean model is additionally considered. It is shown that for this material, the Walker model produces the most conservative fatigue estimates when the stress response has a tensile mean introduced by geometric nonlinearity, but remains in the linear elastic range. However, when the loading level is sufficiently high to produce plasticity, the response becomes more fully reversed and the baseline, Morrow, and Morrow with true fracture strength models produce the most conservative fatigue estimates.

  10. A malaria transmission-directed model of mosquito life cycle and ecology

    PubMed Central

    2011-01-01

    Background Malaria is a major public health issue in much of the world, and the mosquito vectors which drive transmission are key targets for interventions. Mathematical models for planning malaria eradication benefit from detailed representations of local mosquito populations, their natural dynamics and their response to campaign pressures. Methods A new model is presented for mosquito population dynamics, effects of weather, and impacts of multiple simultaneous interventions. This model is then embedded in a large-scale individual-based simulation and results for local elimination of malaria are discussed. Mosquito population behaviours, such as anthropophily and indoor feeding, are included to study their effect upon the efficacy of vector control-based elimination campaigns. Results Results for vector control tools, such as bed nets, indoor spraying, larval control and space spraying, both alone and in combination, are displayed for a single-location simulation with vector species and seasonality characteristic of central Tanzania, varying baseline transmission intensity and vector bionomics. The sensitivities to habitat type, anthropophily, indoor feeding, and baseline transmission intensity are explored. Conclusions The ability to model a spectrum of local vector species with different ecologies and behaviours allows local customization of packages of interventions and exploration of the effect of proposed new tools. PMID:21999664

  11. CD4 cell responses to combination antiretroviral therapy in patients starting therapy at high CD4 cell counts.

    PubMed

    Wright, Stephen T; Carr, Andrew; Woolley, Ian; Giles, Michelle; Hoy, Jennifer; Cooper, David A; Law, Matthew G

    2011-09-01

    To examine CD4 cell responses to combination antiretroviral therapy (cART) in patients enrolled in the Australian HIV Observational Database who commenced cART at CD4 cell counts >350 cells per microliter. CD4 cell counts were modelled using random effects, repeated measurement models in 432 HIV-infected adults from Australian HIV Observational Database who commenced their first cART regimen and had a baseline CD4 count >350 cells per microliter. Using published AIDS and/or death incidence rates combined with the data summarized by time and predicted CD4 cell count, we calculated the expected reduction in risk of an event for different starting baseline CD4 strata. Mean CD4 counts increased above 500 cells per microliter in all baseline CD4 strata by 12 months (means of 596, 717, and 881 cells/μL in baseline CD4 strata 351-500, 501-650, and >650 cells/μL, respectively) and after 72 months since initiating cART, mean CD4 cell counts (by increasing baseline CD4 strata) were 689, 746, 742 cells per microliter. The expected reduction in risk of mortality for baseline CD4 counts >650 cells per microliter relative to 351-500 cells per microliter was approximately 8%, an absolute risk reduction 0.33 per 1000 treated patient-years. Patients starting cART at high CD4 cell counts (>650 cells/μL) tend to maintain this immunological level over 6 years of follow-up. Patients starting from 351 to 500 CD4 cells per microliter achieve levels of >650 cells per microliter after approximately 3 years of cART. Initiating cART with a baseline CD4 count 501-650 or >650 cells per microliter relative to 351-500 cells per microliter indicated a minimal reduction in risk of AIDS incidence and/or death.

  12. The Healthy Hearts and Kidneys (HHK) study: Design of a 2×2 RCT of technology-supported self-monitoring and social cognitive theory-based counseling to engage overweight people with diabetes and chronic kidney disease in multiple lifestyle changes.

    PubMed

    Sevick, Mary Ann; Woolf, Kathleen; Mattoo, Aditya; Katz, Stuart D; Li, Huilin; St-Jules, David E; Jagannathan, Ram; Hu, Lu; Pompeii, Mary Lou; Ganguzza, Lisa; Li, Zhi; Sierra, Alex; Williams, Stephen K; Goldfarb, David S

    2018-01-01

    Patients with complex chronic diseases usually must make multiple lifestyle changes to limit and manage their conditions. Numerous studies have shown that education alone is insufficient for engaging people in lifestyle behavior change, and that theory-based behavioral approaches also are necessary. However, even the most motivated individual may have difficulty with making lifestyle changes because of the information complexity associated with multiple behavior changes. The goal of the current Healthy Hearts and Kidneys study was to evaluate, different mobile health (mHealth)-delivered intervention approaches for engaging individuals with type 2 diabetes (T2D) and concurrent chronic kidney disease (CKD) in behavior changes. Participants were randomized to 1 of 4 groups, receiving: (1) a behavioral counseling, (2) technology-based self-monitoring to reduce information complexity, (3) combined behavioral counseling and technology-based self-monitoring, or (4) baseline advice. We will determine the impact of randomization assignment on weight loss success and 24-hour urinary excretion of sodium and phosphorus. With this report we describe the study design, methods, and approaches used to assure information security for this ongoing clinical trial. Clinical Trials.gov Identifier: NCT02276742. Copyright © 2017. Published by Elsevier Inc.

  13. Evaluation of a shared-work program for reducing assistance provided to supported workers with severe multiple disabilities.

    PubMed

    Parsons, Marsha B; Reid, Dennis H; Green, Carolyn W; Browning, Leah B; Hensley, Mary B

    2002-01-01

    Concern has been expressed recently regarding the need to enhance the performance of individuals with highly significant disabilities in community-based, supported jobs. We evaluated a shared-work program for reducing job coach assistance provided to three workers with severe multiple disabilities in a publishing company. Following systematic observations of the assistance provided as each worker worked on entire job tasks, steps comprising the tasks were then re-assigned across workers. The re-assignment involved assigning each worker only those task steps for which the respective worker received the least amount of assistance (e.g., re-assigning steps that a worker could not complete due to physical disabilities), and ensuring the entire tasks were still completed by combining steps performed by all three workers. The shared-work program was accompanied by reductions in job coach assistance provided to each worker. Work productivity of the supported workers initially decreased but then increased to a level equivalent to the higher ranges of baseline productivity. These results suggested that the shared-work program appears to represent a viable means of enhancing supported work performance of people with severe multiple disabilities in some types of community jobs. Future research needs discussed focus on evaluating shared-work approaches with other jobs, and developing additional community work models specifically for people with highly significant disabilities.

  14. Merging information from multi-model flood projections in a hierarchical Bayesian framework

    NASA Astrophysics Data System (ADS)

    Le Vine, Nataliya

    2016-04-01

    Multi-model ensembles are becoming widely accepted for flood frequency change analysis. The use of multiple models results in large uncertainty around estimates of flood magnitudes, due to both uncertainty in model selection and natural variability of river flow. The challenge is therefore to extract the most meaningful signal from the multi-model predictions, accounting for both model quality and uncertainties in individual model estimates. The study demonstrates the potential of a recently proposed hierarchical Bayesian approach to combine information from multiple models. The approach facilitates explicit treatment of shared multi-model discrepancy as well as the probabilistic nature of the flood estimates, by treating the available models as a sample from a hypothetical complete (but unobserved) set of models. The advantages of the approach are: 1) to insure an adequate 'baseline' conditions with which to compare future changes; 2) to reduce flood estimate uncertainty; 3) to maximize use of statistical information in circumstances where multiple weak predictions individually lack power, but collectively provide meaningful information; 4) to adjust multi-model consistency criteria when model biases are large; and 5) to explicitly consider the influence of the (model performance) stationarity assumption. Moreover, the analysis indicates that reducing shared model discrepancy is the key to further reduction of uncertainty in the flood frequency analysis. The findings are of value regarding how conclusions about changing exposure to flooding are drawn, and to flood frequency change attribution studies.

  15. A randomized comparative trial of a combined oral contraceptive and azelaic acid to assess their effect on sleep quality in adult female acne patients.

    PubMed

    Albuquerque, Rachel Gimenes; da Rocha, Marco Alexandre Dias; Hirotsu, Camila; Hachul, Helena; Bagatin, Edileia; Tufik, Sergio; Andersen, Monica Levy

    2015-12-01

    Several studies have reported an increase in the prevalence of adult female acne. This subtype of acne presents particular characteristics, and can be triggered by several factors such as smoking, stress, the use of oily cosmetics and even by poor sleep. Sleep quality is related to well-being and the maintenance of body homeostasis. In addition, several skin diseases present a bidirectional relationship with sleep, demonstrating an important connection between skin and the central nervous system. With this in mind, we aimed to compare the effect of two types of treatment for adult female acne (azelaic acid or a combined oral contraceptive) on sleep quality and on concentrations of stress hormones. Also, we proposed to assess the correlation of sleep and hormonal parameters with acne severity. In order to do this, 32 women underwent a clinical evaluation, completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and had their blood collected for hormone assays. These procedures were performed at baseline and after 6 months of treatment. At baseline there were no differences between the groups in terms of body mass index, age, acne severity and hormone concentrations. Results showed that both treatments demonstrated effectiveness but that women treated with azelaic acid presented a better sleep quality after the treatment compared to baseline and to the group treated with the combined oral contraceptive. The combined oral contraceptive group presented an increase in cortisol and a decrease in free testosterone concentration in relation to baseline. These data suggest that both azelaic acid and combined oral contraceptive are effective in the treatment of adult female acne but, azelaic acid seems to be a more suitable option for those women who may benefit from a better subjective sleep quality.

  16. Changes in Physiological Parameters after Combined Exercise according to the I/D Polymorphism of hUCP2 Gene in Middle-Aged Obese Females

    PubMed Central

    DUK OH, Sang

    2014-01-01

    Abstract Background The purpose of this study was to determine whether a 45 bp insertion/deletion (I/D) polymorphism in human uncoupling protein 2 (hUCP2) gene was associated with changes in several cardiovascular risk and physical fitness factors in response to combined exercise during 12 weeks in Korean middle-aged women. The changes in physiological parameters after combined exercise during 12 weeks were compared between each genotype subgroups of hUCP2 gene to clarify the inter-individual differences in exercised-induced changes according to genetic predisposition. Methods A total of 185 women aged over 40 years living in Seoul, Korea were participated in this study, and analyzed before and after 12 weeks on combined exercise including aerobic exercise and strength training for body composition, hemodynamic parameters, physical fitness and metabolic variables. A 45 bp I/D polymorphism in hUCP2 gene was genotyped by polymerase chain reaction (PCR) amplification and agarose gel electrophoresis method. Results Combined exercise program during 12 weeks indicated the significant health-promoting effects for our participants on multiple body composition, hemodynamic parameters, physical fitness factors and metabolic parameters, respectively. With respect to a 45 bp I/D polymorphism in hUCP2 gene, this polymorphism was significantly associated with baseline %body fat of our participants (P <.05). Moreover, this polymorphism was significantly associated with the changes in %body fat and serum triglyceride(TG) level after combined exercise program during 12 weeks(P <.05). Conclusion Our data suggest that a 45 bp I/D polymorphism in hUCP2 gene may at least in part contribute to the inter-individual differences on the changes in some clinical and metabolic parameters following combined exercise in middle-aged women. PMID:25909061

  17. Divided visual attention: A comparison of patients with multiple sclerosis and controls, assessed with an optokinetic nystagmus suppression task.

    PubMed

    Williams, Isla M; Schofield, Peter; Khade, Neha; Abel, Larry A

    2016-12-01

    Multiple sclerosis (MS) frequently causes impairment of cognitive function. We compared patients with MS with controls on divided visual attention tasks. The MS patients' and controls' stare optokinetic nystagmus (OKN) was recorded in response to a 24°/s full field stimulus. Suppression of the OKN response, judged by the gain, was measured during tasks dividing visual attention between the fixation target and a second stimulus, central or peripheral, static or dynamic. All participants completed the Audio Recorded Cognitive Screen. MS patients had lower gain on the baseline stare OKN. OKN suppression in divided attention tasks was the same in MS patients as in controls but in both groups was better maintained in static than in dynamic tasks. In only dynamic tasks, older age was associated with less effective OKN suppression. MS patients had lower scores on a timed attention task and on memory. There was no significant correlation between attention or memory and eye movement parameters. Attention, a complex multifaceted construct, has different neural combinations for each task. Despite impairments on some measures of attention, MS patients completed the divided visual attention tasks normally. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Robust Weighted Sum Harvested Energy Maximization for SWIPT Cognitive Radio Networks Based on Particle Swarm Optimization.

    PubMed

    Tuan, Pham Viet; Koo, Insoo

    2017-10-06

    In this paper, we consider multiuser simultaneous wireless information and power transfer (SWIPT) for cognitive radio systems where a secondary transmitter (ST) with an antenna array provides information and energy to multiple single-antenna secondary receivers (SRs) equipped with a power splitting (PS) receiving scheme when multiple primary users (PUs) exist. The main objective of the paper is to maximize weighted sum harvested energy for SRs while satisfying their minimum required signal-to-interference-plus-noise ratio (SINR), the limited transmission power at the ST, and the interference threshold of each PU. For the perfect channel state information (CSI), the optimal beamforming vectors and PS ratios are achieved by the proposed PSO-SDR in which semidefinite relaxation (SDR) and particle swarm optimization (PSO) methods are jointly combined. We prove that SDR always has a rank-1 solution, and is indeed tight. For the imperfect CSI with bounded channel vector errors, the upper bound of weighted sum harvested energy (WSHE) is also obtained through the S-Procedure. Finally, simulation results demonstrate that the proposed PSO-SDR has fast convergence and better performance as compared to the other baseline schemes.

  19. Adapting Word Embeddings from Multiple Domains to Symptom Recognition from Psychiatric Notes

    PubMed Central

    Zhang, Yaoyun; Li, Hee-Jin; Wang, Jingqi; Cohen, Trevor; Roberts, Kirk; Xu, Hua

    2018-01-01

    Mental health is increasingly recognized an important topic in healthcare. Information concerning psychiatric symptoms is critical for the timely diagnosis of mental disorders, as well as for the personalization of interventions. However, the diversity and sparsity of psychiatric symptoms make it challenging for conventional natural language processing techniques to automatically extract such information from clinical text. To address this problem, this study takes the initiative to use and adapt word embeddings from four source domains – intensive care, biomedical literature, Wikipedia and Psychiatric Forum – to recognize symptoms in the target domain of psychiatry. We investigated four different approaches including 1) only using word embeddings of the source domain, 2) directly combining data of the source and target to generate word embeddings, 3) assigning different weights to word embeddings, and 4) retraining the word embedding model of the source domain using a corpus of the target domain. To the best of our knowledge, this is the first work of adapting multiple word embeddings of external domains to improve psychiatric symptom recognition in clinical text. Experimental results showed that the last two approaches outperformed the baseline methods, indicating the effectiveness of our new strategies to leverage embeddings from other domains. PMID:29888086

  20. Developmental progression to early adult binge drinking and marijuana use from worsening versus stable trajectories of adolescent ADHD and delinquency

    PubMed Central

    Howard, Andrea L.; Molina, Brooke S. G.; Swanson, James M.; Hinshaw, Stephen P.; Belendiuk, Katherine A.; Harty, Seth C.; Arnold, L. Eugene; Abikoff, Howard B.; Hechtman, Lily; Stehli, Annamarie; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Wigal, Timothy

    2015-01-01

    Aims To examine the association between developmental trajectories of inattention, hyperactivity-impulsivity, and delinquency through childhood and adolescence (ages 8-16) and subsequent binge drinking and marijuana use in early adulthood (age 21). Design Prospective naturalistic follow-up of children with attention-deficit/hyperactivity disorder (ADHD) previously enrolled in a randomized controlled trial (RCT). Treatment-phase assessments occurred at 3, 9, and 14 months after randomization; follow-up assessments occurred at 24 months, 36 months, and 6, 8, and 12 years after randomization. Setting Secondary analysis of data from the Multimodal Treatment Study of ADHD (MTA), a multi-site RCT comparing the effects of careful medication management, intensive behavior therapy, their combination, and referral to usual community care. Participants 579 children with DSM-IV ADHD combined type, aged 7.0 and 9.9 years old at baseline (M=8.5, SD=.80). Measurements Ratings of inattention, hyperactivity-impulsivity, and delinquency were collected from multiple informants at baseline and through the 8-year follow-up. Self-reports of binge drinking and marijuana use were collected at the 12-year follow-up (M age 21). Findings Trajectories of worsening inattention symptoms and delinquency (and less apparent improvement in hyperactivity-impulsivity) were associated with higher rates of early adult binge drinking and marijuana use, compared with trajectories of stable or improving symptoms and delinquency (of 24 comparisons, 22 p-values <.05), even when symptom levels in stable trajectories were high. Conclusions Worsening inattention symptoms and delinquency during adolescence are associated with increased-levels of early adult substance use; this pattern may reflect a developmental course of vulnerability to elevated substance use in early adulthood. PMID:25664657

  1. Developmental progression to early adult binge drinking and marijuana use from worsening versus stable trajectories of adolescent attention deficit/hyperactivity disorder and delinquency.

    PubMed

    Howard, Andrea L; Molina, Brooke S G; Swanson, James M; Hinshaw, Stephen P; Belendiuk, Katherine A; Harty, Seth C; Arnold, L Eugene; Abikoff, Howard B; Hechtman, Lily; Stehli, Annamarie; Greenhill, Laurence L; Newcorn, Jeffrey H; Wigal, Timothy

    2015-05-01

    To examine the association between developmental trajectories of inattention, hyperactivity-impulsivity and delinquency through childhood and adolescence (ages 8-16 years) and subsequent binge drinking and marijuana use in early adulthood (age 21 years). Prospective naturalistic follow-up of children with attention deficit/hyperactivity disorder (ADHD) previously enrolled in a randomized controlled trial (RCT). Treatment-phase assessments occurred at 3, 9 and 14 months after randomization; follow-up assessments occurred at 24 months, 36 months, and 6, 8 and 12 years after randomization. Secondary analysis of data from the Multimodal Treatment Study of ADHD (MTA), a multi-site RCT comparing the effects of careful medication management, intensive behavior therapy, their combination, and referral to usual community care. A total of 579 children with DSM-IV ADHD combined type, aged 7.0 and 9.9 years at baseline (mean = 8.5, SD = 0.80). Ratings of inattention, hyperactivity-impulsivity and delinquency were collected from multiple informants at baseline and through the 8-year follow-up. Self-reports of binge drinking and marijuana use were collected at the 12-year follow-up (mean age 21 years). Trajectories of worsening inattention symptoms and delinquency (and less apparent improvement in hyperactivity-impulsivity) were associated with higher rates of early adult binge drinking and marijuana use, compared with trajectories of stable or improving symptoms and delinquency (of 24 comparisons, all P-values <0.05), even when symptom levels in stable trajectories were high. Worsening inattention symptoms and delinquency during adolescence are were associated with higher levels of early adult substance use; this pattern may reflect a developmental course of vulnerability to elevated substance use in early adulthood. © 2015 Society for the Study of Addiction.

  2. Intraoperative laser speckle contrast imaging with retrospective motion correction for quantitative assessment of cerebral blood flow

    PubMed Central

    Richards, Lisa M.; Towle, Erica L.; Fox, Douglas J.; Dunn, Andrew K.

    2014-01-01

    Abstract. Although multiple intraoperative cerebral blood flow (CBF) monitoring techniques are currently available, a quantitative method that allows for continuous monitoring and that can be easily integrated into the surgical workflow is still needed. Laser speckle contrast imaging (LSCI) is an optical imaging technique with a high spatiotemporal resolution that has been recently demonstrated as feasible and effective for intraoperative monitoring of CBF during neurosurgical procedures. This study demonstrates the impact of retrospective motion correction on the quantitative analysis of intraoperatively acquired LSCI images. LSCI images were acquired through a surgical microscope during brain tumor resection procedures from 10 patients under baseline conditions and after a cortical stimulation in three of those patients. The patient’s electrocardiogram (ECG) was recorded during acquisition for postprocess correction of pulsatile artifacts. Automatic image registration was retrospectively performed to correct for tissue motion artifacts, and the performance of rigid and nonrigid transformations was compared. In baseline cases, the original images had 25%±27% noise across 16 regions of interest (ROIs). ECG filtering moderately reduced the noise to 20%±21%, while image registration resulted in a further noise reduction of 15%±4%. Combined ECG filtering and image registration significantly reduced the noise to 6.2%±2.6% (p<0.05). Using the combined motion correction, accuracy and sensitivity to small changes in CBF were improved in cortical stimulation cases. There was also excellent agreement between rigid and nonrigid registration methods (15/16 ROIs with <3% difference). Results from this study demonstrate the importance of motion correction for improved visualization of CBF changes in clinical LSCI images. PMID:26157974

  3. The Additive Impact of Group and Individual Publicly Displayed Feedback: Examining Individual Response Patterns and Response Generalization in a Safe-Driving Occupational Intervention

    ERIC Educational Resources Information Center

    Ludwig, Timothy D.; Geller, E. Scott; Clarke, Steven W.

    2010-01-01

    Additive effects of publicly posting individual feedback following group goal-setting and feedback were evaluated. The turn-signal use of pizza deliverers was studied in a multiple baseline design across two pizza stores. After baseline observations, pizza deliverers voted on a group turn-signal goal and then received 4 weeks of group feedback on…

  4. EAT-UP™ Family-Centered Feeding Intervention to Promote Food Acceptance and Decrease Challenging Behaviors: A Single-Case Experimental Design Replicated across Three Families of Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Cosbey, Joanna; Muldoon, Deirdre

    2017-01-01

    This study evaluated the effectiveness of a family-centered feeding intervention, Easing Anxiety Together with Understanding and Perseverance (EAT-UP™), for promoting food acceptance of children with autism spectrum disorder at home. A concurrent multiple-baseline design was used with systematic replication across three families. Baseline was…

  5. Effect of high-dose oral multivitamins and minerals in participants not treated with statins in the randomized Trial to Assess Chelation Therapy (TACT).

    PubMed

    Issa, Omar M; Roberts, Rhonda; Mark, Daniel B; Boineau, Robin; Goertz, Christine; Rosenberg, Yves; Lewis, Eldrin F; Guarneri, Erminia; Drisko, Jeanne; Magaziner, Allan; Lee, Kerry L; Lamas, Gervasio A

    2018-01-01

    In a prespecified subgroup analysis of participants not on statin therapy at baseline in the TACT, a high-dose complex oral multivitamins and multimineral regimen was found to have a large unexpected benefit compared with placebo. The regimen tested was substantially different from any vitamin regimen tested in prior clinical trials. To explore these results, we performed detailed additional analyses of participants not on statins at enrollment in TACT. TACT was a factorial trial testing chelation treatments and a 28-component high-dose oral multivitamins and multiminerals regimen versus placebo in post-myocardial infarction (MI) patients 50 years or older. There were 460 (27%) of 1,708 TACT participants not taking statins at baseline, 224 (49%) were in the active vitamin group and 236 (51%) were in the placebo group. Patients were enrolled at 134 sites around the United States and Canada. Daily high-dose oral multivitamins and multiminerals (6 tablets, active or placebo). The primary end point of TACT was time to the first occurrence of any component of the composite end point: all-cause mortality, MI, stroke, coronary revascularization, or hospitalization for angina. The primary end point occurred in 137 nonstatin participants (30%), of which 51 (23%) of 224 were in the active group and 86 (36%) of 236 were taking placebo (hazard ratio, 0.62; 95% confidence interval, 0.44-0.87; P=.006). Results in the key TACT secondary end point, a combination of cardiovascular mortality, stroke, or recurrent MI, was consistent in favoring the active vitamin group (hazard ratio, 0.46; 95% confidence interval, 0.28-0.75; P=.002). Multiple end point analyses were consistent with these results. High-dose oral multivitamin and multimineral supplementation seem to decrease combined cardiac events in a stable, post-MI population not taking statin therapy at baseline. These unexpected findings are being retested in the ongoing TACT2. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Robot-assisted gait training in multiple sclerosis patients: a randomized trial.

    PubMed

    Schwartz, Isabella; Sajin, Anna; Moreh, Elior; Fisher, Iris; Neeb, Martin; Forest, Adina; Vaknin-Dembinsky, Adi; Karusis, Dimitrios; Meiner, Zeev

    2012-06-01

    Preservation of locomotor activity in multiple sclerosis (MS) patients is of utmost importance. Robotic-assisted body weight-supported treadmill training is a promising method to improve gait functions in neurologically impaired patients, although its effectiveness in MS patients is still unknown. To compare the effectiveness of robot-assisted gait training (RAGT) with that of conventional walking treatment (CWT) on gait and generalized functions in a group of stable MS patients. A prospective randomized controlled trial of 12 sessions of RAGT or CWT in MS patients of EDSS score 5-7. Primary outcome measures were gait parameters and the secondary outcomes were functional and quality of life parameters. All tests were performed at baseline, 3 and 6 months post-treatment by a blinded rater. Fifteen and 17 patients were randomly allocated to RAGT and CWT, respectively. Both groups were comparable at baseline in all parameters. As compared with baseline, although some gait parameters improved significantly following the treatment at each time point there was no difference between the groups. Both FIM and EDSS scores improved significantly post-treatment with no difference between the groups. At 6 months, most gait and functional parameters had returned to baseline. Robot-assisted gait training is feasible and safe and may be an effective additional therapeutic option in MS patients with severe walking disabilities.

  7. A comparison of the effects of visual deprivation and regular body weight support treadmill training on improving over-ground walking of stroke patients: a multiple baseline single subject design.

    PubMed

    Kim, Jeong-Soo; Kang, Sun-Young; Jeon, Hye-Seon

    2015-01-01

    The body-weight-support treadmill (BWST) is commonly used for gait rehabilitation, but other forms of BWST are in development, such as visual-deprivation BWST (VDBWST). In this study, we compare the effect of VDBWST training and conventional BWST training on spatiotemporal gait parameters for three individuals who had hemiparetic strokes. We used a single-subject experimental design, alternating multiple baselines across the individuals. We recruited three individuals with hemiparesis from stroke; two on the left side and one on the right. For the main outcome measures we assessed spatiotemporal gait parameters using GAITRite, including: gait velocity; cadence; step time of the affected side (STA); step time of the non-affected side (STN); step length of the affected side (SLA); step length of the non-affected side (SLN); step-time asymmetry (ST-asymmetry); and step-length asymmetry (SL-asymmetry). Gait velocity, cadence, SLA, and SLN increased from baseline after both interventions, but STA, ST-asymmetry, and SL-asymmetry decreased from the baseline after the interventions. The VDBWST was significantly more effective than the BWST for increasing gait velocity and cadence and for decreasing ST-asymmetry. VDBWST is more effective than BWST for improving gait performance during the rehabilitation for ground walking.

  8. Repeatedly measured material and behavioral factors changed the explanation of socioeconomic inequalities in all-cause mortality.

    PubMed

    Oude Groeniger, Joost; Kamphuis, Carlijn B; Mackenbach, Johan P; van Lenthe, Frank J

    2017-11-01

    We examined whether using repeatedly measured material and behavioral factors contributed differently to socioeconomic inequalities in all-cause mortality compared to one baseline measurement. Data from the Dutch prospective GLOBE cohort were linked to mortality register data (1991-2013; N = 4,851). Socioeconomic position was measured at baseline by educational level and occupation. Material factors (financial difficulties, housing tenure, health insurance) and behavioral factors (smoking, leisure time physical activity, sports participation, and body mass index) were self-reported in 1991, 1997, and 2004. Cox proportional hazards regression and bootstrap methods were used to examine the contribution of baseline-only and time-varying risk factors to socioeconomic inequalities in mortality. Men and women in the lowest educational and occupational groups were at an increased risk of dying compared to the highest groups. The contribution of material factors to socioeconomic inequalities in mortality was smaller when multiple instead of baseline-only measurements were used (25%-65% vs. 49%-93%). The contribution of behavioral factors was larger when multiple measurements were used (39%-51% vs. 19%-40%). Inclusion of time-dependent risk factors contributes to understanding socioeconomic inequalities in mortality, but careful examination of the underlying mechanisms and suitability of the model is required. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Alemtuzumab improves quality-of-life outcomes compared with subcutaneous interferon beta-1a in patients with active relapsing-remitting multiple sclerosis.

    PubMed

    Arroyo González, Rafael; Kita, Mariko; Crayton, Heidi; Havrdova, Eva; Margolin, David H; Lake, Stephen L; Giovannoni, Gavin

    2017-09-01

    Alemtuzumab was superior on clinical and magnetic resonance imaging (MRI) outcomes versus subcutaneous interferon beta-1a in phase 3 trials in patients with relapsing-remitting multiple sclerosis. To examine quality-of-life (QoL) outcomes in the alemtuzumab phase 3 trials. Patients who were treatment naive (Comparison of Alemtuzumab and Rebif ® Efficacy in Multiple Sclerosis I [CARE-MS I]) or had an inadequate response to prior therapy (CARE-MS II) received annual courses of alemtuzumab 12 mg/day at baseline (5 days) and Month 12 (3 days) or subcutaneous interferon beta-1a 44 µg three times/week. QoL was measured every 6 or 12 months using Functional Assessment of Multiple Sclerosis (FAMS), European Quality of Life-5 Dimensions (EQ-5D) and its visual analog scale (EQ-VAS), and 36-Item Short-Form Survey (SF-36). Statistically significant improvements from baseline with alemtuzumab were observed on all three QoL instruments at the earliest post-baseline assessment and sustained through Year 2. Statistically significant greater QoL improvements over subcutaneous interferon beta-1a were seen at all time points in CARE-MS II with FAMS, EQ-VAS and SF-36 physical component summary, and in CARE-MS I with FAMS. Patients treated with alemtuzumab had improvements in physical, mental, and emotional QoL regardless of treatment history. Improvements were significantly greater with alemtuzumab versus subcutaneous interferon beta-1a on both disease-specific and general measures of QoL.

  10. Prolonged-release fampridine treatment improved subject-reported impact of multiple sclerosis: Item-level analysis of the MSIS-29.

    PubMed

    Gasperini, Claudio; Hupperts, Raymond; Lycke, Jan; Short, Christine; McNeill, Manjit; Zhong, John; Mehta, Lahar R

    2016-11-15

    Prolonged-release (PR) fampridine is approved to treat walking impairment in persons with multiple sclerosis (MS); however, treatment benefits may extend beyond walking. MOBILE was a phase 2, 24-week, double-blind, placebo-controlled exploratory study to assess the impact of 10mg PR-fampridine twice daily versus placebo on several subject-assessed measures. This analysis evaluated the physical and psychological health outcomes of subjects with progressing or relapsing MS from individual items of the Multiple Sclerosis Impact Scale (MSIS-29). PR-fampridine treatment (n=68) resulted in greater improvements from baseline in the MSIS-29 physical (PHYS) and psychological (PSYCH) impact subscales, with differences of 89% and 148% in mean score reduction from baseline (n=64) at week 24 versus placebo, respectively. MSIS-29 item analysis showed that a higher percentage of PR-fampridine subjects had mean improvements in 16/20 PHYS and 6/9 PSYCH items versus placebo after 24weeks. Post hoc analysis of the 12-item Multiple Sclerosis Walking Scale (MSWS-12) improver population (≥8-point mean improvement) demonstrated differences in mean reductions from baseline of 97% and 111% in PR-fampridine MSIS-29 PHYS and PSYCH subscales versus the overall placebo group over 24weeks. A higher percentage of MSWS-12 improvers treated with PR-fampridine showed mean improvements in 20/20 PHYS and 8/9 PSYCH items versus placebo at 24weeks. In conclusion, PR-fampridine resulted in physical and psychological benefits versus placebo, sustained over 24weeks. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  11. Communication Opportunities via Special Messaging Technology for Two Post-Coma Persons with Multiple Disabilities

    ERIC Educational Resources Information Center

    Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Colonna, Fabio; Navarro, Jorge; Lanzilotti, Crocifissa; de Pace, Claudia; Megna, Marisa; Oliva, Doretta

    2011-01-01

    This study extended the assessment of a special messaging technology with two additional post-coma adults who had emerged from a minimally conscious state, but showed multiple disabilities including profound motor and communication impairments. For each participant, the study involved an ABAB design, in which the A represented baseline phases and…

  12. Improving the Writing and Knowledge of Emergent Writers: The Effects of Self-Regulated Strategy Development

    ERIC Educational Resources Information Center

    Zumbrunn, Sharon; Bruning, Roger

    2013-01-01

    The purpose of this study was to investigate the effectiveness of implementing the Self-Regulated Strategy Development (SRSD) model of instruction (Graham & Harris, 2005; Harris & Graham, 1996) on the writing skills and knowledge of six first grade students. A multiple-baseline design across participants with multiple probes (Kazdin, 2010) was…

  13. A fault-tolerant control architecture for unmanned aerial vehicles

    NASA Astrophysics Data System (ADS)

    Drozeski, Graham R.

    Research has presented several approaches to achieve varying degrees of fault-tolerance in unmanned aircraft. Approaches in reconfigurable flight control are generally divided into two categories: those which incorporate multiple non-adaptive controllers and switch between them based on the output of a fault detection and identification element, and those that employ a single adaptive controller capable of compensating for a variety of fault modes. Regardless of the approach for reconfigurable flight control, certain fault modes dictate system restructuring in order to prevent a catastrophic failure. System restructuring enables active control of actuation not employed by the nominal system to recover controllability of the aircraft. After system restructuring, continued operation requires the generation of flight paths that adhere to an altered flight envelope. The control architecture developed in this research employs a multi-tiered hierarchy to allow unmanned aircraft to generate and track safe flight paths despite the occurrence of potentially catastrophic faults. The hierarchical architecture increases the level of autonomy of the system by integrating five functionalities with the baseline system: fault detection and identification, active system restructuring, reconfigurable flight control; reconfigurable path planning, and mission adaptation. Fault detection and identification algorithms continually monitor aircraft performance and issue fault declarations. When the severity of a fault exceeds the capability of the baseline flight controller, active system restructuring expands the controllability of the aircraft using unconventional control strategies not exploited by the baseline controller. Each of the reconfigurable flight controllers and the baseline controller employ a proven adaptive neural network control strategy. A reconfigurable path planner employs an adaptive model of the vehicle to re-shape the desired flight path. Generation of the revised flight path is posed as a linear program constrained by the response of the degraded system. Finally, a mission adaptation component estimates limitations on the closed-loop performance of the aircraft and adjusts the aircraft mission accordingly. A combination of simulation and flight test results using two unmanned helicopters validates the utility of the hierarchical architecture.

  14. What Is Different About Worker’s Compensation Patients?

    PubMed Central

    Atlas, Steven J.; Tosteson, Tor D.; Hanscom, Brett; Blood, Emily A.; Pransky, Glenn S.; Abdu, William A.; Andersson, Gunnar B.; Weinstein, James N.

    2010-01-01

    Study Design Combined analysis of 2 prospective clinical studies. Objective To identify socioeconomic characteristics associated with workers’ compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Summary of Background Data Few studies have compared socioeconomic differences between those receiving or not receiving workers’ compensation with the same underlying clinical conditions. Methods Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers’ compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers’ compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Results Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers’ compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers’ compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers’ compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers’ compensation. Conclusion Clinical trials involving conditions commonly seen in patients with workers’ compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers’ compensation. Identifying the independent effects of workers’ compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status. PMID:17700451

  15. Genomic-based multiple-trait evaluation in Eucalyptus grandis using dominant DArT markers.

    PubMed

    Cappa, Eduardo P; El-Kassaby, Yousry A; Muñoz, Facundo; Garcia, Martín N; Villalba, Pamela V; Klápště, Jaroslav; Marcucci Poltri, Susana N

    2018-06-01

    We investigated the impact of combining the pedigree- and genomic-based relationship matrices in a multiple-trait individual-tree mixed model (a.k.a., multiple-trait combined approach) on the estimates of heritability and on the genomic correlations between growth and stem straightness in an open-pollinated Eucalyptus grandis population. Additionally, the added advantage of incorporating genomic information on the theoretical accuracies of parents and offspring breeding values was evaluated. Our results suggested that the use of the combined approach for estimating heritabilities and additive genetic correlations in multiple-trait evaluations is advantageous and including genomic information increases the expected accuracy of breeding values. Furthermore, the multiple-trait combined approach was proven to be superior to the single-trait combined approach in predicting breeding values, in particular for low-heritability traits. Finally, our results advocate the use of the combined approach in forest tree progeny testing trials, specifically when a multiple-trait individual-tree mixed model is considered. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Efficacy of functional microarray of microneedles combined with topical tranexamic acid for melasma

    PubMed Central

    Xu, Yang; Ma, Renyan; Juliandri, Juliandri; Wang, Xiaoyan; Xu, Bai; Wang, Daguang; Lu, Yan; Zhou, Bingrong; Luo, Dan

    2017-01-01

    Abstract To evaluate the efficacy of a functional microarray of microneedles (MNs) plus topical tranexamic acid (TA) for melasma in middle-aged women in China. Thirty female subjects with melasma were enrolled in this study. The left or right side of the face was chosen randomly to be pretreated with a functional microarray of MNs, followed by topical 0.5% TA solution once per week for 12 weeks. The other half-face was the control, treated with a sham device plus topical 0.5% TA solution. At baseline and at weeks 4, 8, and 12 of treatment, clinical (photographic) evaluations and parameters determined by Visia were recorded. At baseline and week 12, patient satisfaction scores and the biophysical parameters measured by Mexameter were also recorded. Side effects were evaluated at baseline and at the end of the 12 weeks. In total, 28 women (93.3%) completed the study. The brown spots’ scores measured by Visia were significantly lower on the combined therapy side than on the control side at 12 weeks after starting treatment; there was no significant difference between sides at 4 or 8 weeks. After 12 weeks, melanin index (MI) decreased significantly in both 2 groups, and the MI was significantly less on the combined side at week 12. Transepidermal water loss, roughness, skin hydration, skin elasticity, and erythema index showed no significant differences between 2 sides at baseline, 4, 8, and 12 weeks after treatment. Physicians’ evaluations of photographs showed better results at week 12 with combined therapy: >25% improvement was observed in the MNs plus TA side in 25 patients, and in the TA side in only 10 patients. Subjective satisfaction scores on both sides increased significantly. The participants were more satisfied with the results of the combined therapy side than the control side. No obvious adverse reactions were observed throughout the study. Combined therapy with a functional microarray of MNs and topical TA solution is a promising treatment for melasma. PMID:28489798

  17. UNIX programmer`s environment and configuration control

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

    Arnold, T.R.; Wyatt, P.W.

    1993-12-31

    A package of UNIX utilities has been developed which unities the advantages of the public domain utility ``imake`` and a configuration control system. The ``imake`` utility is portable It allows a user to make Makefiles on a wide variety of platforms without worrying about the machine-dependent idiosyncracies of the UNIX utility ``make.`` Makefiles are a labor-saving device for compiling and linking complicated programs, and ``imake`` is a labor-saving device for making Makefiles, as well as other useful software (like a program`s internal dependencies on included files). This ``Environment,`` which has been developed around ``imake,`` allows a programmer to manage amore » complicated project consisting of multiple executables which may each link with multiple user-created libraries. The configuration control aspect consists of a directory hierarchy (a baseline) which is mirrored in a developer`s workspace. The workspace includes a minimum of files copied from the baseline; it employs soft links into the baseline wherever possible. The utilities are a multi-tiered suite of Bourne shells to copy or check out sources, check them back in, import new sources (sources which are not in the baseline) and link them appropriately, create new low-level directories and link them, compare with the baseline, update Makefiles with minimal effort, and handle dependencies. The directory hierarchy utilizes a single source repository, which is mirrored in the baseline and in a workspace for a several platform architectures. The system was originally written to support C code on Sun-4`s and RS6000`s. It has now been extended to support FORTRAN as well as C on SGI and Cray YMP platforms as well as Sun-4`s and RS6000`s.« less

  18. Schema therapy as treatment for adults with autism spectrum disorder and comorbid personality disorder: Protocol of a multiple-baseline case series study testing cognitive-behavioral and experiential interventions.

    PubMed

    Vuijk, Richard; Arntz, Arnoud

    2017-03-01

    To our knowledge treatment of personality disorder (PD) comorbidity in adults with ASD is understudied and is still in its infancy. This study investigates the effectiveness of schema therapy for PD-psychopathology in adult patients with both ASD and PD. Twelve adult individuals (age > 18 years) with ASD and at least one PD are given a treatment protocol consisting of 30 weekly offered sessions. A concurrent multiple baseline design is used with baseline varying from 4 to 9 weeks, after which weekly supportive sessions varying from 1 to 6 weeks start with the study therapist. After baseline and 1 to 6 supportive sessions, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, and schema modes are explored, and information about the treatment is given. This is followed by 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions: patients are vice versa and randomly assigned to the interventions. Finally, there is a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and report weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs, and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after supportive sessions, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II is administered during screening procedure, at 5- and at 10-month follow-up. The Netherlands National Trial Register NTR5788. Registered 01 April 2016.

  19. The effect of antacid on salivary pH in patients with and without dental erosion after multiple acid challenges.

    PubMed

    Dhuhair, Sarah; Dennison, Joseph B; Yaman, Peter; Neiva, Gisele F

    2015-04-01

    To evaluate the effect of antacid swish in the salivary pH values and to monitor the pH changes in subjects with and without dental erosion after multiple acid challenge tests. 20 subjects with tooth erosion were matched in age and gender with 20 healthy controls according to specific inclusion/exclusion criteria. Baseline measures were taken of salivary pH, buffering capacity and salivary flow rate using the Saliva Check System. Subjects swished with Diet Pepsi three times at 10-minute intervals. Changes in pH were monitored using a digital pH meter at 0-, 5-, and 10- minute intervals and at every 5 minutes after the third swish until pH resumed baseline value or 45 minutes relapse. Swishing regimen was repeated on a second visit, followed by swishing with sugar-free liquid antacid (Mylanta Supreme). Recovery times were also recorded. Data was analyzed using independent t-tests, repeated measures ANOVA, and Fisher's exact test (α= 0.05). Baseline buffering capacity and flow rate were not significantly different between groups (P= 0.542; P= 0.2831, respectively). Baseline salivary pH values were similar between groups (P= 0.721). No significant differences in salivary pH values were found between erosion and non-erosion groups in response to multiple acid challenges (P= 0.695) or antacid neutralization (P= 0.861). Analysis of salivary pH recovery time revealed no significant differences between groups after acid challenges (P= 0.091) or after the use of antacid (P= 0.118). There was a highly significant difference in the survival curves of the two groups on Day 2, with the non-erosion group resolving significantly faster than the erosion group (P= 0.0086).

  20. Vision: A Six-telescope Fiber-fed Visible Light Beam Combiner for the Navy Precision Optical Interferometer

    DTIC Science & Technology

    2016-05-01

    Visible-light long baseline interferometry holds the promise of advancing a number of important applications in fundamental astronomy, including the...advance the field of visible-light interferometry requires development of instruments capable of combing light from 15 baselines (6 telescopes

  1. Protein contact prediction by integrating deep multiple sequence alignments, coevolution and machine learning.

    PubMed

    Adhikari, Badri; Hou, Jie; Cheng, Jianlin

    2018-03-01

    In this study, we report the evaluation of the residue-residue contacts predicted by our three different methods in the CASP12 experiment, focusing on studying the impact of multiple sequence alignment, residue coevolution, and machine learning on contact prediction. The first method (MULTICOM-NOVEL) uses only traditional features (sequence profile, secondary structure, and solvent accessibility) with deep learning to predict contacts and serves as a baseline. The second method (MULTICOM-CONSTRUCT) uses our new alignment algorithm to generate deep multiple sequence alignment to derive coevolution-based features, which are integrated by a neural network method to predict contacts. The third method (MULTICOM-CLUSTER) is a consensus combination of the predictions of the first two methods. We evaluated our methods on 94 CASP12 domains. On a subset of 38 free-modeling domains, our methods achieved an average precision of up to 41.7% for top L/5 long-range contact predictions. The comparison of the three methods shows that the quality and effective depth of multiple sequence alignments, coevolution-based features, and machine learning integration of coevolution-based features and traditional features drive the quality of predicted protein contacts. On the full CASP12 dataset, the coevolution-based features alone can improve the average precision from 28.4% to 41.6%, and the machine learning integration of all the features further raises the precision to 56.3%, when top L/5 predicted long-range contacts are evaluated. And the correlation between the precision of contact prediction and the logarithm of the number of effective sequences in alignments is 0.66. © 2017 Wiley Periodicals, Inc.

  2. An Examination of Fluoxetine for the Treatment of Selective Mutism Using a Nonconcurrent Multiple-Baseline Single-Case Design Across 5 Cases.

    PubMed

    Barterian, Justin A; Sanchez, Joel M; Magen, Jed; Siroky, Allison K; Mash, Brittany L; Carlson, John S

    2018-01-01

    This study examined the utility of fluoxetine in the treatment of 5 children, aged 5 to 14 years, diagnosed with selective mutism who also demonstrated symptoms of social anxiety. A nonconcurrent, randomized, multiple-baseline, single-case design with a single-blind placebo-controlled procedure was used. Parents and the study psychiatrist completed multiple methods of assessment including Direct Behavior Ratings and questionnaires. Treatment outcomes were evaluated by calculating effect sizes for each participant as an individual and for the participants as a group. Information regarding adverse effects with an emphasis on behavioral disinhibition and ratings of parental acceptance of the intervention was gathered. All 5 children experienced improvement in social anxiety, responsive speech, and spontaneous speech with medium to large effect sizes; however, children still met criteria for selective mutism at the end of the study. Adverse events were minimal, with only 2 children experiencing brief occurrences of minor behavioral disinhibition. Parents found the treatment highly acceptable.

  3. Measuring Resistance to Change at the Within-Session Level

    PubMed Central

    Tonneau, François; Ríos, Américo; Cabrera, Felipe

    2006-01-01

    Resistance to change is often studied by measuring response rate in various components of a multiple schedule. Response rate in each component is normalized (that is, divided by its baseline level) and then log-transformed. Differential resistance to change is demonstrated if the normalized, log-transformed response rate in one component decreases more slowly than in another component. A problem with normalization, however, is that it can produce artifactual results if the relation between baseline level and disruption is not multiplicative. One way to address this issue is to fit specific models of disruption to untransformed response rates and evaluate whether or not a multiplicative model accounts for the data. Here we present such a test of resistance to change, using within-session response patterns in rats as a data base for fitting models of disruption. By analyzing response rate at a within-session level, we were able to confirm a central prediction of the resistance-to-change framework while discarding normalization artifacts as a plausible explanation of our results. PMID:16903495

  4. Measuring resistance to change at the within-session level.

    PubMed

    Tonneau, François; Ríos, Américo; Cabrera, Felipe

    2006-07-01

    Resistance to change is often studied by measuring response rate in various components of a multiple schedule. Response rate in each component is normalized (that is, divided by its baseline level) and then log-transformed. Differential resistance to change is demonstrated if the normalized, log-transformed response rate in one component decreases more slowly than in another component. A problem with normalization, however, is that it can produce artifactual results if the relation between baseline level and disruption is not multiplicative. One way to address this issue is to fit specific models of disruption to untransformed response rates and evaluate whether or not a multiplicative model accounts for the data. Here we present such a test of resistance to change, using within-session response patterns in rats as a data base for fitting models of disruption. By analyzing response rate at a within-session level, we were able to confirm a central prediction of the resistance-to-change framework while discarding normalization artifacts as a plausible explanation of our results.

  5. Privacy protection in surveillance systems based on JPEG DCT baseline compression and spectral domain watermarking

    NASA Astrophysics Data System (ADS)

    Sablik, Thomas; Velten, Jörg; Kummert, Anton

    2015-03-01

    An novel system for automatic privacy protection in digital media based on spectral domain watermarking and JPEG compression is described in the present paper. In a first step private areas are detected. Therefore a detection method is presented. The implemented method uses Haar cascades to detects faces. Integral images are used to speed up calculations and the detection. Multiple detections of one face are combined. Succeeding steps comprise embedding the data into the image as part of JPEG compression using spectral domain methods and protecting the area of privacy. The embedding process is integrated into and adapted to JPEG compression. A Spread Spectrum Watermarking method is used to embed the size and position of the private areas into the cover image. Different methods for embedding regarding their robustness are compared. Moreover the performance of the method concerning tampered images is presented.

  6. The use of structural analysis to develop antecedent-based interventions for students with autism.

    PubMed

    Stichter, Janine P; Randolph, Jena K; Kay, Denise; Gage, Nicholas

    2009-06-01

    Evidence continues to maintain that the use of antecedent variables (i.e., instructional practices, and environmental characteristics) increase prosocial and adaptive behaviors of students with disabilities (e.g., Kern et al. in J Appl Behav Anal 27(1):7-19, 1994; Stichter et al. in Behav Disord 30:401-418, 2005). This study extends the literature by systematically utilizing practitioner-implemented structural analyzes within school settings to determine antecedent variables affecting the prosocial behavior of students with autism. Optimal antecedents were combined into intervention packages and assessed utilizing a multiple baseline design across settings. All three students demonstrated improvement across all three settings. Rates of engagement and social interaction were obtained from classroom peers to serve as benchmark data. Findings indicate that practitioners can implement structural analyzes and design corresponding interventions for students with ASD within educational settings.

  7. The Abcd Formula of Phase Definition in Optical Interferometry: Combined Effect of Air Dispersion and Broad Passband

    NASA Astrophysics Data System (ADS)

    Mathar, Richard J.

    Long-baseline interferometry detects fringes created by superposition of two beams of light collected by two telescopes pointing into a common direction. The external path difference is commonly compensated by adding a variable optical path length (delay) through air for one beam such that the optical path difference between the beams remains close to zero near the detector. The ABCD formula assigns a (wrapped) phase to the signals A to D of an interference pattern shifted by multiples of 90 degrees in phase. We study the interplay between a broad spectral passband of the optics and the dispersion of the air in the compensating delay, which leads to small deviations between the ABCD phase and the reduced, monochromatic group-delay representation of the wave packets. This adds dispersion to the effects that have been discussed for evacuated interferometers before (Milman 2005).

  8. Peer Mediation to Increase Communication and Interaction at Recess for Students with Autism Spectrum Disorders

    PubMed Central

    Mason, Rose; Kamps, Debra; Turcotte, Amy; Cox, Suzanne; Feldmiller, Sarah; Miller, Todd

    2015-01-01

    Recess plays an integral role in the social and emotional development of children given the time provided to engage in interactions with others and practice important social skills. Students with ASD, however, typically fail to achieve even minimal benefit from recess due to social and communication impairments as well as a tendency to withdraw. Implementation of evidence-based interventions such as peer-mediated social skills groups, are necessary to ensure recess is an advantageous learning environment for students with ASD. A multiple-baseline design across participants was used to determine if a functional relationship exists between a social skills instructional program combined with peer networks with school staff as implementers and increases in level of communicative acts for participants with ASD at recess. Results indicate all participants demonstrated an immediate increase in the number of communicative acts with the introduction of the intervention. Implications for practice are discussed. PMID:26180543

  9. Order of stimulus presentation influences children's acquisition in receptive identification tasks.

    PubMed

    Petursdottir, Anna Ingeborg; Aguilar, Gabriella

    2016-03-01

    Receptive identification is usually taught in matching-to-sample format, which entails the presentation of an auditory sample stimulus and several visual comparison stimuli in each trial. Conflicting recommendations exist regarding the order of stimulus presentation in matching-to-sample trials. The purpose of this study was to compare acquisition in receptive identification tasks under 2 conditions: when the sample was presented before the comparisons (sample first) and when the comparisons were presented before the sample (comparison first). Participants included 4 typically developing kindergarten-age boys. Stimuli, which included birds and flags, were presented on a computer screen. Acquisition in the 2 conditions was compared in an adapted alternating-treatments design combined with a multiple baseline design across stimulus sets. All participants took fewer trials to meet the mastery criterion in the sample-first condition than in the comparison-first condition. © 2015 Society for the Experimental Analysis of Behavior.

  10. Event Reconstruction Techniques in NOvA

    NASA Astrophysics Data System (ADS)

    Baird, M.; Bian, J.; Messier, M.; Niner, E.; Rocco, D.; Sachdev, K.

    2015-12-01

    The NOvA experiment is a long-baseline neutrino oscillation experiment utilizing the NuMI beam generated at Fermilab. The experiment will measure the oscillations within a muon neutrino beam in a 300 ton Near Detector located underground at Fermilab and a functionally-identical 14 kiloton Far Detector placed 810 km away. The detectors are liquid scintillator tracking calorimeters with a fine-grained cellular structure that provides a wealth of information for separating the different particle track and shower topologies. Each detector has its own challenges with the Near Detector seeing multiple overlapping neutrino interactions in each event and the Far Detector having a large background of cosmic rays due to being located on the surface. A series of pattern recognition techniques have been developed to go from event records, to spatially and temporally separating individual interactions, to vertexing and tracking, and particle identification. This combination of methods to achieve the full event reconstruction will be discussed.

  11. Using an adapted form of the picture exchange communication system to increase independent requesting in deafblind adults with learning disabilities.

    PubMed

    Bracken, Maeve; Rohrer, Nicole

    2014-02-01

    The current study assessed the effectiveness of an adapted form of the Picture Exchange Communication System (PECS) in increasing independent requesting in deafblind adults with learning disabilities. PECS cards were created to accommodate individual needs, including adaptations such as enlarging photographs and using swelled images which consisted of images created on raised line drawing paper. Training included up to Phase III of PECS and procedures ensuring generalizations across individuals and contexts were included. The effects of the intervention were evaluated using a multiple baseline design across participants. Results demonstrated an increase in independent requesting with each of the participants reaching mastery criterion. These results suggest that PECS, in combination with some minor adaptations, may be an effective communicative alternative for individuals who are deafblind and have learning impairments. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Social Skills Training for Adolescents With Intellectual Disabilities: A School-Based Evaluation.

    PubMed

    O'Handley, Roderick D; Ford, W Blake; Radley, Keith C; Helbig, Kate A; Wimberly, Joy K

    2016-07-01

    Individuals with intellectual disabilities (ID) often demonstrate impairments in social functioning, with deficits becoming more apparent during adolescence. This study evaluated the effects of the Superheroes Social Skills program, a program that combines behavioral skills training and video modeling to teach target social skills, on accurate demonstration of three target social skills in adolescents with ID. Skills taught in the present study include Expressing Wants and Needs, Conversation, and Turn Taking. Four adolescents with ID participated in a 3-week social skills intervention, with the intervention occurring twice per week. A multiple baseline across skills design was used to determine the effect of the intervention on social skill accuracy in both a training and generalization setting. All participants demonstrated substantial improvements in skill accuracy in both settings, with teacher ratings of social functioning further suggesting generalization of social skills to nontraining settings. © The Author(s) 2016.

  13. Designing Studies That Would Address the Multilayered Nature of Health Care

    PubMed Central

    Pennell, Michael; Rhoda, Dale; Hade, Erinn M.; Paskett, Electra D.

    2010-01-01

    We review design and analytic methods available for multilevel interventions in cancer research with particular attention to study design, sample size requirements, and potential to provide statistical evidence for causal inference. The most appropriate methods will depend on the stage of development of the research and whether randomization is possible. Early on, fractional factorial designs may be used to screen intervention components, particularly when randomization of individuals is possible. Quasi-experimental designs, including time-series and multiple baseline designs, can be useful once the intervention is designed because they require few sites and can provide the preliminary evidence to plan efficacy studies. In efficacy and effectiveness studies, group-randomized trials are preferred when randomization is possible and regression discontinuity designs are preferred otherwise if assignment based on a quantitative score is possible. Quasi-experimental designs may be used, especially when combined with recent developments in analytic methods to reduce bias in effect estimates. PMID:20386057

  14. Comparison of combined hormonal vaginal ring with ultralow-dose combined oral contraceptive pills in the management of heavy menstrual bleeding: A pilot study.

    PubMed

    Agarwal, N; Gupta, M; Kriplani, A; Bhatla, N; Singh, N

    2016-01-01

    The aim of this study was to compare combined hormonal vaginal ring with ultralow-dose combined oral contraceptive (COC) pills in management of heavy menstrual bleeding (HMB). Fifty patients were randomised into Group I: vaginal ring (n = 25) and group II: COC pills (n = 25). Menstrual blood loss (MBL) was assessed at baseline, 1, 3 and 6 months (while on treatment) and at 9 months (3 months after stopping therapy). There was significant reduction in baseline pictorial blood loss assessment chart (PBAC) score from 440 ± 188 (Mean ± SD) to 178 ± 95, 139 ± 117, 112 ± 84 and 120 ± 108 in group I and from 452 ± 206 to 204 ± 152, 179 ± 125, 176 ± 164 and 202 ± 167 in group II at 1, 3, 6 and 9 months, respectively (p = 0.001). Reduction in MBL was 72% and 62% at 6 months and up to 71% and 55% at 9 months in group I and group II, respectively (p = 0.001). Reduction in MBL with ring was greater at higher baseline PBAC score but lesser in patients with fibroid > 2 cm. Combined vaginal hormonal treatment for HMB is as effective as oral hormonal therapy, with minor and transient side effects and persistence of response after cessation of therapy.

  15. The combined effects of diet quality and physical activity on maintenance of muscle strength among diabetic older adults from the NuAge cohort.

    PubMed

    Rahi, Berna; Morais, José A; Dionne, Isabelle J; Gaudreau, Pierrette; Payette, Hélène; Shatenstein, Bryna

    2014-01-01

    Diabetic older adults are at a higher risk of muscle strength (MS) decline than their non-diabetic counterparts. Adequate protein and energy intakes and physical activity (PA) may preserve MS during aging. However, the role of diet quality (DQ) in MS maintenance is still unknown. This study aimed to determine the association between DQ - alone or combined with PA - and changes in MS over 3 years in diabetic participants aged 67 to 84 years at recruitment in a secondary analysis of the longitudinal observational NuAge study. Changes in handgrip, knee extensor and elbow flexor strengths were calculated as the difference between recruitment (T1) and after 3 years (T4) in 156 diabetic older adults. Baseline DQ was calculated from 3 non-consecutive 24-hour dietary recalls collected at T1 using the validated Canadian Healthy Eating Index (C-HEI). Change in PA was calculated from Physical Activity Scale for the Elderly (PASE) as PASE T4-PASE T1. Four combinations of variables were created: C-HEI<70 with PASE change either < or > median and C-HEI ≥ 70 with PASE change either < or > median. The association between these four categories and MS maintenance was evaluated using General Linear Modeling (GLM). Analyses were stratified by sex and controlled for covariates. Baseline DQ alone was not associated with MS maintenance. Baseline DQ combined with PASE change showed associations with crude and baseline adjusted handgrip strength (p=0.031, p=0.018) and crude and baseline adjusted elbow flexor change (p=0.028, p=0.017) in males only; no significant results were found for knee extensor strength in either males or females. While findings for females were inconclusive, results demonstrate that better adherence to dietary guidelines combined with a more active lifestyle may prevent MS decline among diabetic older males. Additional research is needed on a larger sample since generalization of these results is limited by the small sample size. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Baseline estimation in flame's spectra by using neural networks and robust statistics

    NASA Astrophysics Data System (ADS)

    Garces, Hugo; Arias, Luis; Rojas, Alejandro

    2014-09-01

    This work presents a baseline estimation method in flame spectra based on artificial intelligence structure as a neural network, combining robust statistics with multivariate analysis to automatically discriminate measured wavelengths belonging to continuous feature for model adaptation, surpassing restriction of measuring target baseline for training. The main contributions of this paper are: to analyze a flame spectra database computing Jolliffe statistics from Principal Components Analysis detecting wavelengths not correlated with most of the measured data corresponding to baseline; to systematically determine the optimal number of neurons in hidden layers based on Akaike's Final Prediction Error; to estimate baseline in full wavelength range sampling measured spectra; and to train an artificial intelligence structure as a Neural Network which allows to generalize the relation between measured and baseline spectra. The main application of our research is to compute total radiation with baseline information, allowing to diagnose combustion process state for optimization in early stages.

  17. Musculoskeletal pain and re-employment among unemployed job seekers: a three-year follow-up study.

    PubMed

    Nwaru, Chioma A; Nygård, Clas-Håkan; Virtanen, Pekka

    2016-07-08

    Poor health is a potential risk factor for not finding employment among unemployed individuals. We investigated the associations between localized and multiple-site musculoskeletal pain and re-employment in a three-year follow-up of unemployed job seekers. Unemployed people (n = 539) from six localities in southern Finland who participated in various active labour market policy measures at baseline in 2002/2003 were recruited into a three-year health service intervention trial. A questionnaire was used to collect data on musculoskeletal health and background characteristics at baseline and on employment status at the end of the follow-up. We conducted a complete case (n = 284) and multiple imputation analyses using logistic regression to investigate the association between baseline musculoskeletal pain and re-employment after three years. Participants with severe pain in the lower back were less likely to become re-employed. This was independent of potential confounding variables. Pain in the hands/upper extremities, neck/shoulders, lower extremities, as well as multiple site were not determinants of re-employment. Our findings lend some support to the hypothesis that poor health can potentially cause health selection into employment. There is the need to disentangle health problems in order to clearly appreciate their putative impact on employment. This will allow for more targeted interventions for the unemployed.

  18. Imaging with New Classic and Vision at the NPOI

    NASA Astrophysics Data System (ADS)

    Jorgensen, Anders

    2018-04-01

    The Navy Precision Optical Interferometer (NPOI) is unique among interferometric observatories for its ability to position telescopes in an equally-spaced array configuration. This configuration is optimal for interferometric imaging because it allows the use of bootstrapping to track fringes on long baselines with signal-to-noise ratio less than one. When combined with coherent integration techniques this can produce visibilities with acceptable SNR on baselines long enough to resolve features on the surfaces of stars. The stellar surface imaging project at NPOI combines the bootstrapping array configuration of the NPOI array, real-time fringe tracking, baseline- and wavelength bootstrapping with Earth rotation to provide dense coverage in the UV plane at a wide range of spatial frequencies. In this presentation, we provide an overview of the project and an update of the latest status and results from the project.

  19. Operational Dynamic Configuration Analysis

    NASA Technical Reports Server (NTRS)

    Lai, Chok Fung; Zelinski, Shannon

    2010-01-01

    Sectors may combine or split within areas of specialization in response to changing traffic patterns. This method of managing capacity and controller workload could be made more flexible by dynamically modifying sector boundaries. Much work has been done on methods for dynamically creating new sector boundaries [1-5]. Many assessments of dynamic configuration methods assume the current day baseline configuration remains fixed [6-7]. A challenging question is how to select a dynamic configuration baseline to assess potential benefits of proposed dynamic configuration concepts. Bloem used operational sector reconfigurations as a baseline [8]. The main difficulty is that operational reconfiguration data is noisy. Reconfigurations often occur frequently to accommodate staff training or breaks, or to complete a more complicated reconfiguration through a rapid sequence of simpler reconfigurations. Gupta quantified a few aspects of airspace boundary changes from this data [9]. Most of these metrics are unique to sector combining operations and not applicable to more flexible dynamic configuration concepts. To better understand what sort of reconfigurations are acceptable or beneficial, more configuration change metrics should be developed and their distribution in current practice should be computed. This paper proposes a method to select a simple sequence of configurations among operational configurations to serve as a dynamic configuration baseline for future dynamic configuration concept assessments. New configuration change metrics are applied to the operational data to establish current day thresholds for these metrics. These thresholds are then corroborated, refined, or dismissed based on airspace practitioner feedback. The dynamic configuration baseline selection method uses a k-means clustering algorithm to select the sequence of configurations and trigger times from a given day of operational sector combination data. The clustering algorithm selects a simplified schedule containing k configurations based on stability score of the sector combinations among the raw operational configurations. In addition, the number of the selected configurations is determined based on balance between accuracy and assessment complexity.

  20. Efficacy and safety of vildagliptin in patients with type 2 diabetes mellitus inadequately controlled with dual combination of metformin and sulphonylurea.

    PubMed

    Lukashevich, V; Del Prato, S; Araga, M; Kothny, W

    2014-05-01

    The broadly used combination of metformin and sulphonylurea (SU) often fails to bring patients to glycaemic goal. This study assessed the efficacy and safety of vildagliptin as add-on therapy to metformin plus glimepiride combination in patients with type 2 diabetes mellitus (T2DM) who had inadequate glycaemic control. A multicentre, double-blind, placebo-controlled study randomized patients to receive treatment with vildagliptin 50 mg bid (n = 158) or placebo (n = 160) for 24 weeks. After 24 weeks, the adjusted mean change in haemoglobin A1c (HbA1c) was -1.01% with vildagliptin (baseline 8.75%) and -0.25% with placebo (baseline 8.80%), with a between-treatment difference of -0.76% (p < 0.001). Significantly more patients on vildagliptin achieved the HbA1c target <7% (28.3% vs. 5.6%; p < 0.001). The difference in fasting plasma glucose reduction between vildagliptin and placebo was -1.13 mmol/l (p < 0.001). In subgroup of patients with baseline HbA1c ≤8%, vildagliptin reduced HbA1c by 0.74% from baseline 7.82% (between-treatment difference: -0.97%; p < 0.001) with significantly more patients achieving the HbA1c target <7% (38.6% vs. 13.9%; p = 0.014). Vildagliptin was well tolerated with low incidence of hypoglycaemia, slightly higher than with placebo (5.1% vs. 1.9%) and no clinically relevant weight gain. Vildagliptin significantly improved glycaemic control in patients with T2DM inadequately controlled with metformin plus glimepiride combination. The addition of vildagliptin was well tolerated with low risk of hypoglycaemia and weight gain. This makes vildagliptin an attractive treatment option for patients failing on metformin plus SU particularly in patients with baseline HbA1c ≤8%. © 2013 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  1. Efficacy and safety of vildagliptin in patients with type 2 diabetes mellitus inadequately controlled with dual combination of metformin and sulphonylurea

    PubMed Central

    Lukashevich, V; Del Prato, S; Araga, M; Kothny, W

    2014-01-01

    Aim The broadly used combination of metformin and sulphonylurea (SU) often fails to bring patients to glycaemic goal. This study assessed the efficacy and safety of vildagliptin as add-on therapy to metformin plus glimepiride combination in patients with type 2 diabetes mellitus (T2DM) who had inadequate glycaemic control. Methods A multicentre, double-blind, placebo-controlled study randomized patients to receive treatment with vildagliptin 50 mg bid (n = 158) or placebo (n = 160) for 24 weeks. Results After 24 weeks, the adjusted mean change in haemoglobin A1c (HbA1c) was −1.01% with vildagliptin (baseline 8.75%) and −0.25% with placebo (baseline 8.80%), with a between-treatment difference of −0.76% (p < 0.001). Significantly more patients on vildagliptin achieved the HbA1c target <7% (28.3% vs. 5.6%; p < 0.001). The difference in fasting plasma glucose reduction between vildagliptin and placebo was −1.13 mmol/l (p < 0.001). In subgroup of patients with baseline HbA1c ≤8%, vildagliptin reduced HbA1c by 0.74% from baseline 7.82% (between-treatment difference: –0.97%; p < 0.001) with significantly more patients achieving the HbA1c target <7% (38.6% vs. 13.9%; p = 0.014). Vildagliptin was well tolerated with low incidence of hypoglycaemia, slightly higher than with placebo (5.1% vs. 1.9%) and no clinically relevant weight gain. Conclusions Vildagliptin significantly improved glycaemic control in patients with T2DM inadequately controlled with metformin plus glimepiride combination. The addition of vildagliptin was well tolerated with low risk of hypoglycaemia and weight gain. This makes vildagliptin an attractive treatment option for patients failing on metformin plus SU particularly in patients with baseline HbA1c ≤8%. PMID:24199686

  2. Multivariate qualitative analysis of banned additives in food safety using surface enhanced Raman scattering spectroscopy.

    PubMed

    He, Shixuan; Xie, Wanyi; Zhang, Wei; Zhang, Liqun; Wang, Yunxia; Liu, Xiaoling; Liu, Yulong; Du, Chunlei

    2015-02-25

    A novel strategy which combines iteratively cubic spline fitting baseline correction method with discriminant partial least squares qualitative analysis is employed to analyze the surface enhanced Raman scattering (SERS) spectroscopy of banned food additives, such as Sudan I dye and Rhodamine B in food, Malachite green residues in aquaculture fish. Multivariate qualitative analysis methods, using the combination of spectra preprocessing iteratively cubic spline fitting (ICSF) baseline correction with principal component analysis (PCA) and discriminant partial least squares (DPLS) classification respectively, are applied to investigate the effectiveness of SERS spectroscopy for predicting the class assignments of unknown banned food additives. PCA cannot be used to predict the class assignments of unknown samples. However, the DPLS classification can discriminate the class assignment of unknown banned additives using the information of differences in relative intensities. The results demonstrate that SERS spectroscopy combined with ICSF baseline correction method and exploratory analysis methodology DPLS classification can be potentially used for distinguishing the banned food additives in field of food safety. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Estimation of aboveground biomass in Mediterranean forests by statistical modelling of ASTER fraction images

    NASA Astrophysics Data System (ADS)

    Fernández-Manso, O.; Fernández-Manso, A.; Quintano, C.

    2014-09-01

    Aboveground biomass (AGB) estimation from optical satellite data is usually based on regression models of original or synthetic bands. To overcome the poor relation between AGB and spectral bands due to mixed-pixels when a medium spatial resolution sensor is considered, we propose to base the AGB estimation on fraction images from Linear Spectral Mixture Analysis (LSMA). Our study area is a managed Mediterranean pine woodland (Pinus pinaster Ait.) in central Spain. A total of 1033 circular field plots were used to estimate AGB from Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) optical data. We applied Pearson correlation statistics and stepwise multiple regression to identify suitable predictors from the set of variables of original bands, fraction imagery, Normalized Difference Vegetation Index and Tasselled Cap components. Four linear models and one nonlinear model were tested. A linear combination of ASTER band 2 (red, 0.630-0.690 μm), band 8 (short wave infrared 5, 2.295-2.365 μm) and green vegetation fraction (from LSMA) was the best AGB predictor (Radj2=0.632, the root-mean-squared error of estimated AGB was 13.3 Mg ha-1 (or 37.7%), resulting from cross-validation), rather than other combinations of the above cited independent variables. Results indicated that using ASTER fraction images in regression models improves the AGB estimation in Mediterranean pine forests. The spatial distribution of the estimated AGB, based on a multiple linear regression model, may be used as baseline information for forest managers in future studies, such as quantifying the regional carbon budget, fuel accumulation or monitoring of management practices.

  4. Parenting Skills and Emotional Availability: An RCT.

    PubMed

    Yousafzai, Aisha K; Rasheed, Muneera A; Rizvi, Arjumand; Armstrong, Robert; Bhutta, Zulfiqar A

    2015-05-01

    To investigate whether a responsive stimulation intervention delivered to caregivers of young children either alone or integrated with nutrition interventions would benefit parenting skills and emotional availability to promote children's development and growth compared with either a nutrition intervention alone or the usual standard of care. A cluster randomized factorial effectiveness trial was implemented in an impoverished community in Pakistan. The 4 trial arms were control (usual standard of care), responsive stimulation (responsive care and stimulation), enhanced nutrition (education and multiple micronutrients), and a combination of both enriched interventions. The 4 intervention packages were delivered by community health workers to 1489 mother-infant dyads in the first 2 years of life. Parenting skills and emotional availability indexed by mother-child interaction, caregiving environment, knowledge and practices pertaining to early childhood care and feeding, and maternal depressive symptoms were assessed at multiple intervals. An intention-to-treat factorial analysis was conducted. Intervention groups were comparable at baseline. Responsive stimulation significantly benefitted parenting skills with large effect sizes on mother-child interaction (Cohen's d 0.8), caregiving environment (Cohen's d 0.9-1.0), and knowledge and practices (Cohen's d 0.7-1.1) compared with small-modest significant effects as a result of nutrition intervention on mother-child interaction and caregiving environment only (Cohen's d 0.4 and 0.2, respectively). The combined intervention had a small significant effect on decreasing maternal depressive symptoms over time (Cohen's d 0-0.2). A responsive stimulation intervention can promote positive caregiving behaviors among impoverished families. Additional research is needed on interventions to reduce maternal depressive symptoms. Copyright © 2015 by the American Academy of Pediatrics.

  5. Effect of two lipid-lowering strategies on high-density lipoprotein function and some HDL-related proteins: a randomized clinical trial.

    PubMed

    Lee, Chan Joo; Choi, Seungbum; Cheon, Dong Huey; Kim, Kyeong Yeon; Cheon, Eun Jeong; Ann, Soo-Jin; Noh, Hye-Min; Park, Sungha; Kang, Seok-Min; Choi, Donghoon; Lee, Ji Eun; Lee, Sang-Hak

    2017-02-28

    The influence of lipid-lowering therapy on high-density lipoprotein (HDL) is incompletely understood. We compared the effect of two lipid-lowering strategies on HDL functions and identified some HDL-related proteins. Thirty two patients were initially screened and HDLs of 21 patients were finally analyzed. Patients were randomized to receive atorvastatin 20 mg (n = 11) or atorvastatin 5 mg/ezetimibe 10 mg combination (n = 10) for 8 weeks. The cholesterol efflux capacity and other anti-inflammatory functions were assessed based on HDLs of the participants before and after treatment. Pre-specified HDL proteins of the same HDL samples were measured. The post-treatment increase in cholesterol efflux capacities was similar between the groups (35.6% and 34.6% for mono-therapy and combination, respectively, p = 0.60). Changes in nitric oxide (NO) production, vascular cell adhesion molecule-1 (VCAM-1) expression, and reactive oxygen species (ROS) production were similar between the groups. The baseline cholesterol efflux capacity correlated positively with apolipoprotein (apo)A1 and C3, whereas apoA1 and apoC1 showed inverse associations with VCAM-1 expression. The changes in the cholesterol efflux capacity were positively correlated with multiple HDL proteins, especially apoA2. Two regimens increased the cholesterol efflux capacity of HDL comparably. Multiple HDL proteins, not limited to apoA1, showed a correlation with HDL functions. These results indicate that conventional lipid therapy may have additional effects on HDL functions with changes in HDL proteins. ClinicalTrials.gov, number NCT02942602 .

  6. A combination of supplements may reduce the risk of Alzheimer's disease in elderly Japanese with normal cognition.

    PubMed

    Bun, Shogyoku; Ikejima, Chiaki; Kida, Jiro; Yoshimura, Atsuko; Lebowitz, Adam Jon; Kakuma, Tatsuyuki; Asada, Takashi

    2015-01-01

    A number of studies have examined the effect of a single supplement against Alzheimer's disease (AD) with conflicting results. Taking into account the complex and multifactorial nature of AD pathogenesis, multiple supplements may be more effective. Physical activity is another prospect against AD. An open-label intervention study was conducted to explore a potential protective effect of multiple supplements and physical activity. Their interaction was also examined. Participants were community-dwelling volunteers aged 65 or older as of May 2001 in a rural area of Japan. Among 918 cognitively normal participants included in the analyses, 171 took capsules daily for three years that contained n-3 polyunsaturated fatty acid, Ginkgo biloba leaf dry extracts, and lycopene. Two hundred and forty one participants joined the two-year exercise intervention that included a community center-based and a home-based exercise program. One-hundred and forty eight participated in both interventions. A standardized neuropsychological battery was administered at baseline in 2001, the first follow-up in 2004-2005, and the second in 2008-2009. The primary outcome was AD diagnosis at follow-ups. A complementary log-log model was used for survival analysis. A total of 76 participants were diagnosed with AD during follow-up periods. Higher adherence to supplementation intervention was associated with lower AD incidence in both unadjusted and adjusted models. Exercise intervention was also associated with lower AD incidence in the unadjusted model, but not in the adjusted model. We hypothesized that the combination of supplements acted in a complementary and synergistic fashion to bring significant effects against AD occurrence.

  7. Prescribing Patterns in a Psychiatrically Referred Sample of Youth With Autism Spectrum Disorder.

    PubMed

    Shekunov, Julia; Wozniak, Janet; Conroy, Kristina; Pinsky, Elizabeth; Fitzgerald, Maura; de Leon, Melissa F; Belser, Abigail; Biederman, Joseph; Joshi, Gagan

    The aim of this study was to examine the pattern of psychopharmacologic interventions in a psychiatrically referred sample of youth with autism spectrum disorder (ASD). This retrospective chart review aimed at collecting demographic and clinical information, including data on DSM-IV-TR criteria-based psychiatric disorders and related current medication treatment and response. Data were collected in December 2011. Clinicians identified the target disorder for each medication and any adverse events. Level of psychopathology and therapeutic response was assessed by the clinician-rated Clinical Global Impressions scale (CGI). Psychiatrically referred youth with ASD (n = 54) suffered from multiple psychopathologies (mean = 2.3) and had a marked level of morbidity (range of baseline CGI-Severity of Illness mean scores, 4.3-5.6). The most prevalent psychopathology was ADHD (83%), anxiety disorders (67%), bipolar spectrum disorder (43%), and mood disorder not otherwise specified (44%). The majority (80%) of the subjects received combination therapy (mean ± SD number of psychotropic medications = 3 ± 1.5). Forty percent of the participants responded on all treatment target symptoms (CGI-Improvement scale score ≤ 2), and an additional 10% experienced response versus nonresponse on a relatively greater number of target symptoms. Half of the subjects reported an adverse event, most commonly weight gain (28%) and sedation (12%), both from antipsychotic medication use. Psychiatrically referred youth with ASD suffer from multiple highly impairing psychiatric disorders that require combination pharmacotherapy. These findings highlight the need for further research to guide clinical decision-making and treatment. © Copyright 2017 Physicians Postgraduate Press, Inc.

  8. Phentermine and topiramate for the management of obesity: a review

    PubMed Central

    Cosentino, Gina; Conrad, Ariane O; Uwaifo, Gabriel I

    2013-01-01

    Obesity is now a major public health concern worldwide with increasing prevalence and a growing list of comorbidities and complications. The morbidity, mortality and reduced productivity associated with obesity and its complications result in a major burden to health care costs. Obesity is a complex chronic medical syndrome often with multiple different etiologic factors in individual patients. The long term successful management of obesity remains particularly challenging and invariably requires a multifaceted approach including lifestyle and behavioral modification, increased physical activity, and adjunctive pharmacotherapy. Bariatric surgery remains a last resort though at present it has the best results for achieving sustained robust weight loss. Obesity pharmacotherapy has been very limited in its role for long term obesity management because of the past history of several failed agents as well as the fact that presently available agents are few, and generally utilized as monotherapy. The recent FDA approval of the fixed drug combination of phentermine and extended release topiramate (topiramate-ER) (trade name Qsymia™) marks the first FDA approved combination pharmacotherapeutic agent for obesity since the Phen-Fen combination of the 1990s. This review details the history and clinical trial basis for the use of both phentermine and topiramate in obesity therapeutics as well as the results of clinical trials of their combination for obesity treatment in humans. The initial clinical approval trials offer evidence that this fixed drug combination offers synergistic potential for effective, robust and sustained weight loss with mean weight loss of at least 10% of baseline achieved and sustained for up to 2 years in over 50% of subjects treated. It is anticipated that this agent will be the first in a new trend of multi-agent combination therapy for the chronic adjunctive management of obesity. PMID:23630412

  9. Cost-effectiveness of ranibizumab in the treatment of visual impairment due to diabetic macular edema.

    PubMed

    Haig, Jennifer; Barbeau, Martin; Ferreira, Alberto

    2016-07-01

    Objective Ranibizumab, an anti-vascular endothelial growth factor designed for ocular use, has been deemed cost-effective in multiple indications by several Health Technology Assessment bodies. This study assessed the cost-effectiveness of ranibizumab monotherapy or combination therapy (ranibizumab plus laser photocoagulation) compared with laser monotherapy for the treatment of visual impairment due to diabetic macular edema (DME). Methods A Markov model was developed in which patients moved between health states defined by best-corrected visual acuity (BCVA) intervals and an absorbing 'death' state. The population of interest was patients with DME due to type 1 or type 2 diabetes mellitus. Baseline characteristics were based on those of participants in the RESTORE study. Main outputs were costs (in 2013 CA$) and health outcomes (in quality-adjusted life-years [QALYs]) and the incremental cost-effectiveness ratio (ICER) was calculated. This cost-utility analysis was conducted from healthcare system and societal perspectives in Quebec. Results From a healthcare system perspective, the ICERs for ranibizumab monotherapy and combination therapy vs laser monotherapy were CA$24 494 and CA$36 414 per QALY gained, respectively. The incremental costs per year without legal blindness for ranibizumab monotherapy and combination therapy vs laser monotherapy were CA$15 822 and CA$20 616, respectively. Based on the generally accepted Canadian ICER threshold of CA$50 000 per QALY gained, ranibizumab monotherapy and combination therapy were found to be cost-effective compared with laser monotherapy. From a societal perspective, ranibizumab monotherapy and combination therapy provided greater benefits at lower costs than laser monotherapy (ranibizumab therapy dominated laser therapy). Conclusions Ranibizumab monotherapy and combination therapy resulted in increased quality-adjusted survival and time without legal blindness and lower costs from a societal perspective compared with laser monotherapy.

  10. The Effects of Self-Regulated Strategy Development on the Writing of Expository Essays for Adults with Written Expression Difficulties: Preparing for the GED

    ERIC Educational Resources Information Center

    Berry, Ann Bassett; Mason, Linda H.

    2012-01-01

    A multiple-probe, multiple-baseline, across-subjects design was used to examine the writing performance of four low-achieving adult students with and without disabilities enrolled in general equivalency diploma (GED) preparatory classes. Students' writing was evaluated before instruction and after self-regulated strategy development (SRSD)…

  11. Allowing Students to Administer Their Own Interventions: An Application of the Self-Administered Folding-In Technique

    ERIC Educational Resources Information Center

    Hulac, David M.; Wickerd, Garry; Vining, Odell

    2013-01-01

    This study sought to determine the efficacy of a self-administered folding-in technique to help fourth grade students at-risk for math difficulties improve their fluency with multiplication facts. The investigators used a multiple baseline across participants design during a two-phase intervention. While 4 of the 5 students made progress during…

  12. System and Method for Detecting Unauthorized Device Access by Comparing Multiple Independent Spatial-Time Data Sets from Other Devices

    NASA Technical Reports Server (NTRS)

    Westmeyer, Paul A. (Inventor); Wertenberg, Russell F. (Inventor); Krage, Frederick J. (Inventor); Riegel, Jack F. (Inventor)

    2017-01-01

    An authentication procedure utilizes multiple independent sources of data to determine whether usage of a device, such as a desktop computer, is authorized. When a comparison indicates an anomaly from the base-line usage data, the system, provides a notice that access of the first device is not authorized.

  13. Use of Multiple Imputation Method to Improve Estimation of Missing Baseline Serum Creatinine in Acute Kidney Injury Research

    PubMed Central

    Peterson, Josh F.; Eden, Svetlana K.; Moons, Karel G.; Ikizler, T. Alp; Matheny, Michael E.

    2013-01-01

    Summary Background and objectives Baseline creatinine (BCr) is frequently missing in AKI studies. Common surrogate estimates can misclassify AKI and adversely affect the study of related outcomes. This study examined whether multiple imputation improved accuracy of estimating missing BCr beyond current recommendations to apply assumed estimated GFR (eGFR) of 75 ml/min per 1.73 m2 (eGFR 75). Design, setting, participants, & measurements From 41,114 unique adult admissions (13,003 with and 28,111 without BCr data) at Vanderbilt University Hospital between 2006 and 2008, a propensity score model was developed to predict likelihood of missing BCr. Propensity scoring identified 6502 patients with highest likelihood of missing BCr among 13,003 patients with known BCr to simulate a “missing” data scenario while preserving actual reference BCr. Within this cohort (n=6502), the ability of various multiple-imputation approaches to estimate BCr and classify AKI were compared with that of eGFR 75. Results All multiple-imputation methods except the basic one more closely approximated actual BCr than did eGFR 75. Total AKI misclassification was lower with multiple imputation (full multiple imputation + serum creatinine) (9.0%) than with eGFR 75 (12.3%; P<0.001). Improvements in misclassification were greater in patients with impaired kidney function (full multiple imputation + serum creatinine) (15.3%) versus eGFR 75 (40.5%; P<0.001). Multiple imputation improved specificity and positive predictive value for detecting AKI at the expense of modestly decreasing sensitivity relative to eGFR 75. Conclusions Multiple imputation can improve accuracy in estimating missing BCr and reduce misclassification of AKI beyond currently proposed methods. PMID:23037980

  14. Physical Exercise Combined with Whole-Body Cryotherapy in Evaluating the Level of Lipid Peroxidation Products and Other Oxidant Stress Indicators in Kayakers

    PubMed Central

    Sutkowy, Paweł; Augustyńska, Beata; Woźniak, Alina; Rakowski, Andrzej

    2014-01-01

    The influence of exercise combined with whole-body cryotherapy (WBC) on the oxidant/antioxidant balance in healthy men was assessed. The study included 16 kayakers of the Polish National Team, aged 22.7 ± 2.6, subjected to WBC (−120°C–−145°C; 3 min) twice a day for the first 10 days of a 19-day physical training cycle: pre exercise morning stimulation and post exercise afternoon recovery. Blood samples were taken on Day 0 (baseline) and on Days 5, 11 and 19. The serum concentration of malondialdehyde (MDA), conjugated dienes (CD), thiobarbituric acid reactive substances (TBARS), protein carbonyls, vitamin E, urea, cortisol, and testosterone were determined, along with the glutathione peroxidase (GPx) activity, the total antioxidant capacity (TAC), and morphological blood parameters. On 5th day of exercise/WBC, the baseline GPx activity decreased by 15.1% (P < 0.05), while on 19th day, it increased by 19.7% (P < 0.05) versus Day 5. On Day 19 TBARS concentration decreased versus baseline and Day 5 (by 15.9% and 17.4%, resp.; P < 0.01). On 19 Day urea concentration also decreased versus 11 Day; however, on 5th and 11th days the level was higher versus baseline. Combining exercise during longer training cycles with WBC may be advantageous. PMID:24864189

  15. Physical exercise combined with whole-body cryotherapy in evaluating the level of lipid peroxidation products and other oxidant stress indicators in kayakers.

    PubMed

    Sutkowy, Paweł; Augustyńska, Beata; Woźniak, Alina; Rakowski, Andrzej

    2014-01-01

    The influence of exercise combined with whole-body cryotherapy (WBC) on the oxidant/antioxidant balance in healthy men was assessed. The study included 16 kayakers of the Polish National Team, aged 22.7 ± 2.6, subjected to WBC (-120°C--145°C; 3 min) twice a day for the first 10 days of a 19-day physical training cycle: pre exercise morning stimulation and post exercise afternoon recovery. Blood samples were taken on Day 0 (baseline) and on Days 5, 11 and 19. The serum concentration of malondialdehyde (MDA), conjugated dienes (CD), thiobarbituric acid reactive substances (TBARS), protein carbonyls, vitamin E, urea, cortisol, and testosterone were determined, along with the glutathione peroxidase (GPx) activity, the total antioxidant capacity (TAC), and morphological blood parameters. On 5th day of exercise/WBC, the baseline GPx activity decreased by 15.1% (P < 0.05), while on 19th day, it increased by 19.7% (P < 0.05) versus Day 5. On Day 19 TBARS concentration decreased versus baseline and Day 5 (by 15.9% and 17.4%, resp.; P < 0.01). On 19 Day urea concentration also decreased versus 11 Day; however, on 5th and 11th days the level was higher versus baseline. Combining exercise during longer training cycles with WBC may be advantageous.

  16. 75 FR 42434 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-21

    ..., LLC, Foote Creek II, LLC, Foote Creek IV, LLC, Ridge Crest Wind Partners, LLC, Oak Creek Wind Power... submits tariff filing per 35.12: Baseline Cost-Based Rates Tariff of Florida Power Corporation to be...: Baseline Cost-Based Rates Tariff of Carolina Power and Light Company to be effective 7/13/2010. Filed Date...

  17. Measuring the sterile neutrino CP phase at DUNE and T2HK

    NASA Astrophysics Data System (ADS)

    Choubey, Sandhya; Dutta, Debajyoti; Pramanik, Dipyaman

    2018-04-01

    The CP phases associated with the sterile neutrino cannot be measured in the dedicated short-baseline experiments being built to test the sterile neutrino hypothesis. On the other hand, these phases can be measured in long-baseline experiments, even though the main goal of these experiments is not to test or measure sterile neutrino parameters. In particular, the sterile neutrino phase δ _{24} affects the charged-current electron appearance data in long-baseline experiment. In this paper we show how well the sterile neutrino phase δ _{24} can be measured by the next-generation long-baseline experiments DUNE, T2HK (and T2HKK). We also show the expected precision with which this sterile phase can be measured by combining the DUNE data with data from T2HK or T2HKK. The T2HK experiment is seen to be able to measure the sterile phase δ _{24} to a reasonable precision. We also present the sensitivity of these experiments to the sterile mixing angles, both by themselves, as well as when DUNE is combined with T2HK or T2HKK.

  18. Modeling and Assessment of Precise Time Transfer by Using BeiDou Navigation Satellite System Triple-Frequency Signals.

    PubMed

    Tu, Rui; Zhang, Pengfei; Zhang, Rui; Liu, Jinhai; Lu, Xiaochun

    2018-03-29

    This study proposes two models for precise time transfer using the BeiDou Navigation Satellite System triple-frequency signals: ionosphere-free (IF) combined precise point positioning (PPP) model with two dual-frequency combinations (IF-PPP1) and ionosphere-free combined PPP model with a single triple-frequency combination (IF-PPP2). A dataset with a short baseline (with a common external time frequency) and a long baseline are used for performance assessments. The results show that IF-PPP1 and IF-PPP2 models can both be used for precise time transfer using BeiDou Navigation Satellite System (BDS) triple-frequency signals, and the accuracy and stability of time transfer is the same in both cases, except for a constant system bias caused by the hardware delay of different frequencies, which can be removed by the parameter estimation and prediction with long time datasets or by a priori calibration.

  19. Tafamidis delays disease progression in patients with early stage transthyretin familial amyloid polyneuropathy: additional supportive analyses from the pivotal trial.

    PubMed

    Keohane, Denis; Schwartz, Jeffrey; Gundapaneni, Balarama; Stewart, Michelle; Amass, Leslie

    2017-03-01

    Tafamidis, a non-NSAID highly specific transthyretin stabilizer, delayed neurologic disease progression as measured by Neuropathy Impairment Score-Lower Limbs (NIS-LL) in an 18-month, double-blind, placebo-controlled randomized trial in 128 patients with early-stage transthyretin V30M familial amyloid polyneuropathy (ATTRV30M-FAP). The current post hoc analyses aimed to further evaluate the effects of tafamidis in delaying ATTRV30M-FAP progression in this trial. Pre-specified, repeated-measures analysis of change from baseline in NIS-LL in this trial (ClinicalTrials.gov NCT00409175) was repeated with addition of baseline as covariate and multiple imputation analysis for missing data by treatment group. Change in NIS-LL plus three small-fiber nerve tests (NIS-LL + Σ3) and NIS-LL plus seven nerve tests (NIS-LL + Σ7) were assessed without baseline as covariate. Treatment outcomes over the NIS-LL, Σ3, Σ7, modified body mass index and Norfolk Quality of Life-Diabetic Neuropathy Total Quality of Life Score were also examined using multivariate analysis techniques. Neuropathy progression based on NIS-LL change from baseline to Month 18 remained significantly reduced for tafamidis versus placebo in the baseline-adjusted and multiple imputation analyses. NIS-LL + Σ3 and NIS-LL + Σ7 captured significant treatment group differences. Multivariate analyses provided strong statistical evidence for a superior tafamidis treatment effect. These supportive analyses confirm that tafamidis delays neurologic progression in early-stage ATTRV30M-FAP. NCT00409175.

  20. Predictors for Employment Status in People With Multiple Sclerosis: A 10-Year Longitudinal Observational Study.

    PubMed

    Forslin, Mia; Fink, Katharina; Hammar, Ulf; von Koch, Lena; Johansson, Sverker

    2018-01-31

    To identify predictors for employment status after 10 years in a cohort of people with multiple sclerosis (MS), with the aim to increase knowledge concerning factors present at an early stage that are important for working life and work-life balance. A 10-year longitudinal observational cohort study. University hospital. A consecutive sample of people with MS (N=154) of working age were included at baseline, of which a total of 116 people participated in the 10-year follow-up; 27 people declined participation and 11 were deceased. Not applicable. Baseline data on personal factors and functioning were used as independent variables. Employment status 10 years after baseline, categorized as full-time work, part-time work, and no work, was used as the dependent variable. A generalized ordinal logistic regression was used to analyze the predictive value of the independent variables. Predictors for full- or part-time work after 10 years were young age (P=.002), low perceived physical impact of MS (P=.02), fatigue (P=.03), full-time work (P=.001), and high frequency of social/lifestyle activities (P=.001) at baseline. Low perceived physical impact of MS (P=.02) at baseline also predicted full-time work after 10 years. This study underlines the complexity of working life for people with MS, and indicates that it may be valuable to give more attention to the balance between working and private life, both in clinical practice and future research, to achieve a sustainable working life over time. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Deadlines at work and sleep quality. Cross-sectional and longitudinal findings among Danish knowledge workers.

    PubMed

    Rugulies, Reiner; Martin, Marie H T; Garde, Anne Helene; Persson, Roger; Albertsen, Karen

    2012-03-01

    Exposure to deadlines at work is increasing in several countries and may affect health. We aimed to investigate cross-sectional and longitudinal associations between frequency of difficult deadlines at work and sleep quality. Study participants were knowledge workers, drawn from a representative sample of Danish employees who responded to a baseline questionnaire in 2006 (n = 363) and a follow-up questionnaire in 2007 (n = 302). Frequency of difficult deadlines was measured by self-report and categorized into low, intermediate, and high. Sleep quality was measured with a Total Sleep Quality Score and two indexes (Awakening Index and Disturbed Sleep Index) derived from the Karolinska Sleep Questionnaire. Analyses on the association between frequency of deadlines and sleep quality scores were conducted with multiple linear regression models, adjusted for potential confounders. In addition, we used multiple logistic regression models to analyze whether frequency of deadlines at baseline predicted caseness of sleep problems at follow-up among participants free of sleep problems at baseline. Frequent deadlines were cross-sectionally and longitudinally associated with poorer sleep quality on all three sleep quality measures. Associations in the longitudinal analyses were greatly attenuated when we adjusted for baseline sleep quality. The logistic regression analyses showed that frequent deadlines at baseline were associated with elevated odds ratios for caseness of sleep problems at follow-up, however, confidence intervals were wide in these analyses. Frequent deadlines at work were associated with poorer sleep quality among Danish knowledge workers. We recommend investigating the relation between deadlines and health endpoints in large-scale epidemiologic studies. Copyright © 2011 Wiley Periodicals, Inc.

  2. Impact of Age and Polytherapy on Fingolimod Induced Bradycardia: a Preclinical Study.

    PubMed

    Ritter, Christian; Svačina, Martin K R; Bobylev, Ilja; Joshi, Abhijeet; Schneider, Toni; Lehmann, Helmar C

    2017-03-01

    Fingolimod is a an oral disease modifying drug for relapsing remitting multiple sclerosis (MS) preventing egress of B and T cells from lymph nodes. Relevant first dose adverse events include bradycardia and atrioventricular conduction slowing. Cardiac side effects of fingolimod and combinational pharmacotherapy including duloxetine and tolterodine were monitored in mice of different age using implantable ECG telemetric systems. Cardiac tissue was assessed for S1P-receptor subtype (1 and 3), and for GIRK1 expression. Fingolimod led to a significant heart rate reduction within 60 min, which returned to baseline values within 24 h. In older mice bradycardia was more pronounced compared to younger mice. Atrioventricular conduction was not affected. Older mice showed a higher S1PR3 expression in a naïve state and receptor expression was reduced after fingolimod administration. Combination with duloxetine or tolterodine alleviated fingolimod induced heart rate decrease. Our data provide preclinical evidence that negative chronotropic effects of fingolimod might be age dependent, possibly due to an altered expression and internalization of cardiac S1PR3 in older animals. This data could be relevant for future clinical monitoring and patient selection in the aging MS population. Combinational therapies of fingolimod and duloxetine or tolterodine are well tolerated and safe without an increased risk for pronounced bradycardia or arrhythmia.

  3. Effect of aquatic exercise training on fatigue and health-related quality of life in patients with multiple sclerosis.

    PubMed

    Kargarfard, Mehdi; Etemadifar, Masoud; Baker, Peter; Mehrabi, Maryam; Hayatbakhsh, Reza

    2012-10-01

    To examine the effectiveness of aquatic exercise training on fatigue and health-related quality of life (HRQOL) in women with multiple sclerosis (MS). Randomized controlled trial, 4-week and 8-week follow-up. Referral center of a multiple sclerosis society. Women (N=32) diagnosed with relapsing-remitting MS (mean age ± SD, 32.6±8.0y) were recruited into this study. After undergoing baseline testing by a neurologist, participants were randomly assigned to either an intervention (aquatic exercise) or a control group. The intervention consisted of 8 weeks supervised aquatic exercise in a swimming pool (3 times a week, each session lasting 60min). At baseline, 4 weeks, and 8 weeks, fatigue and HRQOL were assessed by a blind assessor using the Modified Fatigue Impact Scale and the Multiple Sclerosis Quality of Life-54 questionnaire, respectively. A mixed-model approach to repeated-measures analysis of variance was used to detect within- and between-subject effects. Findings are based on 21 patients (10 from the exercise group and 11 from the control group) who had data available on outcomes. There was no significant difference between the 2 groups at the baseline. Patients in the aquatic exercise group showed significant improvements in fatigue and subscores of HRQOL after 4 and 8 weeks compared with the control group. Results obtained from the intention-to-treat analysis were consistent with those of per-protocol analysis. The findings suggest that aquatic exercise training can effectively improve fatigue and HRQOL of patients with MS and should be considered in the management of this relatively common public health problem. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Pharmacodynamic Effects of Single and Multiple Doses of Empagliflozin in Patients With Type 2 Diabetes.

    PubMed

    Heise, Tim; Jordan, Jens; Wanner, Christoph; Heer, Martina; Macha, Sreeraj; Mattheus, Michaela; Lund, Søren S; Woerle, Hans J; Broedl, Uli C

    2016-10-01

    Our aim was to investigate the effects of the sodium glucose cotransporter 2 inhibitor empagliflozin on urinary and serum glucose and electrolytes, urinary volume, osmolality, and the renin-angiotensin system in patients with type 2 diabetes. In an open-label study, 22 patients receiving metformin (median age 56 years; range 40-65 years) received empagliflozin 25 mg once daily for 5 days. Food, fluid, and sodium intake were standardized for 3 days before and during treatment. Twenty patients completed treatment. After single and multiple doses of empagliflozin, mean (SE) changes from baseline in 24-hour urinary glucose excretion were 463.3 (57.3) mmol/d and 599.5 (60.0) mmol/d, respectively (83.5 [10.3] g/d and 108.0 [10.8] g/d, respectively) (both P < 0.001), and in fasting serum glucose concentration were -1.8 (0.4) mmol/L and -1.1 (0.3) mmol/L, respectively (both P < 0.001). After a single dose, mean (SE) change from baseline in urine sodium excretion was 45.3 (9.6) mmol/d (P < 0.001), and in urine volume was 341.0 (140.5) g/d (P = 0.025), but there were no changes compared with baseline in either parameter after multiple doses. There were no changes in plasma renin or serum aldosterone with single or multiple doses of empagliflozin. There was a nonsignificant reduction in weight after a single dose of empagliflozin and a mean (SE) change of -1.4 (0.5) kg after multiple doses (P = 0.020). Empagliflozin 25 mg increased urinary glucose excretion and decreased serum glucose and weight with transient natriuresis and increases in urine volume, without significant changes in the renin-angiotensin system. Clinicaltrials.gov Identifier: NCT01276288. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  5. Health-related quality of life impact in a randomised phase III study of the combination of dabrafenib and trametinib versus dabrafenib monotherapy in patients with BRAF V600 metastatic melanoma.

    PubMed

    Schadendorf, Dirk; Amonkar, Mayur M; Stroyakovskiy, Daniil; Levchenko, Evgeny; Gogas, Helen; de Braud, Filippo; Grob, Jean-Jacques; Bondarenko, Igor; Garbe, Claus; Lebbe, Celeste; Larkin, James; Chiarion-Sileni, Vanna; Millward, Michael; Arance, Ana; Mandalà, Mario; Flaherty, Keith T; Nathan, Paul; Ribas, Antoni; Robert, Caroline; Casey, Michelle; DeMarini, Douglas J; Irani, Jhangir G; Aktan, Gursel; Long, Georgina V

    2015-05-01

    To present the impact of treatments on health-related quality of life (HRQoL) from the double-blind, randomised phase III COMBI-d study that investigated the combination of dabrafenib and trametinib versus dabrafenib monotherapy in patients with BRAF V600E/K-mutant metastatic melanoma. COMBI-d showed significantly prolonged progression-free survival for the combination. HRQoL was evaluated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30, a generic cancer questionnaire (completed at baseline, during study treatment, at progression and post progression) assessing various dimensions (global health/QoL, functional status, and symptom impact). A mixed-model, repeated-measures analyses of covariance evaluated differences between arms. Questionnaire completion rates were >95% at baseline, >85% to week 40 and >70% at disease progression. Baseline scores across both arms were comparable for all dimensions. Global health dimension scores were significantly better at weeks 8, 16 and 24 for patients receiving the combination during treatment and at progression. The majority of functional dimension scores (physical, social, role, emotional and cognitive functioning) trended in favour of the combination. Pain scores were significantly improved and clinically meaningful (6-13 point difference) for patients receiving the combination for all follow-up assessments versus those receiving dabrafenib monotherapy. For other symptom dimensions (nausea and vomiting, diarrhoea, dyspnoea, and constipation), scores trended in favour of dabrafenib monotherapy. This analysis demonstrates that the combination of dabrafenib and trametinib provides better preservation of HRQoL and pain improvements versus dabrafenib monotherapy while also delaying progression. (Clinicaltrials.gov registration number: NCT01584648). Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Effects of video modeling on treatment integrity of behavioral interventions.

    PubMed

    Digennaro-Reed, Florence D; Codding, Robin; Catania, Cynthia N; Maguire, Helena

    2010-01-01

    We examined the effects of individualized video modeling on the accurate implementation of behavioral interventions using a multiple baseline design across 3 teachers. During video modeling, treatment integrity improved above baseline levels; however, teacher performance remained variable. The addition of verbal performance feedback increased treatment integrity to 100% for all participants, and performance was maintained 1 week later. Teachers found video modeling to be more socially acceptable with performance feedback than alone, but rated both positively.

  7. The Noise of a Forward Swept Fan

    NASA Technical Reports Server (NTRS)

    Dittmar, James H.; Elliott, David M.; Fite, E. Brian

    2003-01-01

    A forward swept fan, designated the Quiet High Speed Fan (QHSF), was tested in the NASA Glenn 9-by 15-foot Low Speed Wind Tunnel to investigate its noise reduction relative to a baseline fan of the same aerodynamic performance. The objective of the Quiet High Speed Fan was a 6 decibel reduction in the Effective Perceived Noise relative to the baseline fan at the takeoff condition. The intent of the Quiet High Speed Fan design was to provide both a multiple pure tone noise reduction from the forward sweep of the fan rotor and a rotor-stator interaction blade passing tone noise reduction from a leaned stator. The tunnel noise data indicted that the Quiet High Speed Fan was quieter than the baseline fan for a significant portion of the operating line and was 6 dB quieter near the takeoff condition. Although reductions in the multiple pure tones were observed, the vast majority of the EPNdB reduction was a result of the reduction in the blade passing tone and its harmonics. The baseline fan's blade passing tone was dominated by the rotor-strut interaction mechanism. The observed blade passing tone reduction could be the result of either the redesign of the Quiet High Speed Fan Rotor or the redesigned stator. The exact cause of this rotor-strut noise reduction, whether from the rotor or stator redesign, was not discernable from this experiment.

  8. Using Robust Standard Errors to Combine Multiple Regression Estimates with Meta-Analysis

    ERIC Educational Resources Information Center

    Williams, Ryan T.

    2012-01-01

    Combining multiple regression estimates with meta-analysis has continued to be a difficult task. A variety of methods have been proposed and used to combine multiple regression slope estimates with meta-analysis, however, most of these methods have serious methodological and practical limitations. The purpose of this study was to explore the use…

  9. Comparison of the effects of combined nicotine replacement therapy vs. cigarette smoking in males.

    PubMed

    Haustein, Knut-Olaf; Krause, Jörn; Haustein, Heidi; Rasmussen, Thomas; Cort, Nicholas

    2003-04-01

    This open study assessed the effects of nicotine replacement therapy (NRT) on the normalizing of exhaled carbon monoxide (CO), transcutaneous partial oxygen tension (tcpO(2)), plasma cotinine and thiocyanate levels, and cardiovascular risk markers in abstinent subjects compared with untreated smokers after 4, 8, 12, and 26 weeks. The trial enrolled 197 subjects in two parallel groups: 164 subjects who received NRT (patch plus gum) for 12 weeks and 33 untreated smokers (controls). At 26 weeks, 123/164 participants in the treatment group had completed the study; 51/123 (41.5%) sustained abstinence from smoking, whereas 72/123 (58.5%) had relapsed. Changes in cotinine (abstainers: 291.6 ng/ml at baseline vs. 27.3 ng/ml at week 26; p<.0001) and thiocyanate levels (abstainers: 10.4 ng/ml at baseline vs. 6.2 ng/ml at week 26; p<.0001) and expired CO (abstainers: 30.4 ppm at baseline vs. 4.2 ppm at week 26; p<.0001) accurately reflected the changes in smoking and/or NRT use in both abstainers and relapsers. After they stopping smoking, tcpO(2) significantly improved in abstainers (34.9 mmHg at baseline vs. 50.4 mmHg at week 26; p<0.0001). Inverse correlations between the number of daily cigarettes and plasma cotinine, thiocyanate, and exhaled CO levels were observed in both relapsers and smokers. A clinically significant increase in HDL cholesterol (39.0 vs. 44.7 mg/dl; p<.0001) occurred in the abstainers between baseline and study end. Use of combination NRT to achieve abstinence resulted in marked improvements in biochemical parameters in abstainers and partial improvements in relapsers. The safety of combination NRT was confirmed by the absence of overdose-related adverse events.

  10. Coffee and Green Tea Consumption and Subsequent Risk of Malignant Lymphoma and Multiple Myeloma in Japan: The Japan Public Health Center-based Prospective Study.

    PubMed

    Ugai, Tomotaka; Matsuo, Keitaro; Sawada, Norie; Iwasaki, Motoki; Yamaji, Taiki; Shimazu, Taichi; Sasazuki, Shizuka; Inoue, Manami; Kanda, Yoshinobu; Tsugane, Shoichiro

    2017-08-01

    Background: The aim of this study was to investigate the association of coffee and green tea consumption and the risk of malignant lymphoma and multiple myeloma in a large-scale population-based cohort study in Japan. Methods: In this analysis, a total of 95,807 Japanese subjects (45,937 men and 49,870 women; ages 40-69 years at baseline) of the Japan Public Health Center-based Prospective Study who completed a questionnaire about their coffee and green tea consumption were followed up until December 31, 2012, for an average of 18 years. HRs and 95% confidence intervals were estimated using a Cox regression model adjusted for potential confounders as a measure of association between the risk of malignant lymphoma and multiple myeloma associated with coffee and green tea consumption at baseline. Results: During the follow-up period, a total of 411 malignant lymphoma cases and 138 multiple myeloma cases were identified. Overall, our findings showed no significant association between coffee or green tea consumption and the risk of malignant lymphoma or multiple myeloma for both sexes. Conclusions: In this study, we observed no significant association between coffee or green tea consumption and the risk of malignant lymphoma or multiple myeloma. Impact: Our results do not support an association between coffee or green tea consumption and the risk of malignant lymphoma or multiple myeloma. Cancer Epidemiol Biomarkers Prev; 26(8); 1352-6. ©2017 AACR . ©2017 American Association for Cancer Research.

  11. Observing APOD with the AuScope VLBI Array

    PubMed Central

    Sun, Jing; Cao, Jianfeng

    2018-01-01

    The possibility to observe satellites with the geodetic Very Long Baseline Interferometry (VLBI) technique is vividly discussed in the geodetic community, particularly with regard to future co-location satellite missions. The Chinese APOD-A nano satellite can be considered as a first prototype—suitable for practical observation tests—combining the techniques Satellite Laser Ranging (SLR), Global Navigation Satellite Systems (GNSS) and VLBI on a single platform in a Low Earth Orbit (LEO). Unfortunately, it has hardly been observed by VLBI, so major studies towards actual frame ties could not be performed. The main reason for the lack of observations was that VLBI observations of satellites are non-standard, and suitable observing strategies were not in place for this mission. This work now presents the first serious attempt to observe the satellite with a VLBI network over multiple passes. We introduce a series of experiments with the AuScope geodetic VLBI array which were carried out in November 2016, and describe all steps integrated in the established process chain: the experiment design and observation planning, the antenna tracking and control scheme, correlation and derivation of baseline-delays, and the data analysis yielding delay residuals on the level of 10 ns. The developed procedure chain can now serve as reference for future experiments, hopefully enabling the global VLBI network to be prepared for the next co-location satellite mission. PMID:29772732

  12. Observing APOD with the AuScope VLBI Array.

    PubMed

    Hellerschmied, Andreas; McCallum, Lucia; McCallum, Jamie; Sun, Jing; Böhm, Johannes; Cao, Jianfeng

    2018-05-16

    The possibility to observe satellites with the geodetic Very Long Baseline Interferometry (VLBI) technique is vividly discussed in the geodetic community, particularly with regard to future co-location satellite missions. The Chinese APOD-A nano satellite can be considered as a first prototype-suitable for practical observation tests-combining the techniques Satellite Laser Ranging (SLR), Global Navigation Satellite Systems (GNSS) and VLBI on a single platform in a Low Earth Orbit (LEO). Unfortunately, it has hardly been observed by VLBI, so major studies towards actual frame ties could not be performed. The main reason for the lack of observations was that VLBI observations of satellites are non-standard, and suitable observing strategies were not in place for this mission. This work now presents the first serious attempt to observe the satellite with a VLBI network over multiple passes. We introduce a series of experiments with the AuScope geodetic VLBI array which were carried out in November 2016, and describe all steps integrated in the established process chain: the experiment design and observation planning, the antenna tracking and control scheme, correlation and derivation of baseline-delays, and the data analysis yielding delay residuals on the level of 10 ns. The developed procedure chain can now serve as reference for future experiments, hopefully enabling the global VLBI network to be prepared for the next co-location satellite mission.

  13. The Effectiveness of Vowel Production Training with Real-Time Spectrographic Displays for Children with Profound Hearing Impairment.

    NASA Astrophysics Data System (ADS)

    Ertmer, David Joseph

    1994-01-01

    The effectiveness of vowel production training which incorporated direct instruction in combination with spectrographic models and feedback was assessed for two children who exhibited profound hearing impairment. A multiple-baseline design across behaviors, with replication across subjects was implemented to determine if vowel production accuracy improved following the introduction of treatment. Listener judgments of vowel correctness were obtained during the baseline, training, and follow-up phases of the study. Data were analyzed through visual inspection of changes in levels of accuracy, changes in trends of accuracy, and changes in variability of accuracy within and across phases. One subject showed significant improvement of all three trained vowel targets; the second subject for the first trained target only (Kolmogorov-Smirnov Two Sample Test). Performance trends during training sessions suggest that continued treatment would have resulted in further improvement for both subjects. Vowel duration, fundamental frequency, and the frequency locations of the first and second formants were measured before and after training. Acoustic analysis revealed highly individualized changes in the frequency locations of F1 and F2. Vowels which received the most training were maintained at higher levels than those which were introduced later in training, Some generalization of practiced vowel targets to untrained words was observed in both subjects. A bias towards judging productions as "correct" was observed for both subjects during self-evaluation tasks using spectrographic feedback.

  14. Design and baseline characteristics from the KAN-QUIT disease management intervention for rural smokers in primary care.

    PubMed

    Cox, Lisa Sanderson; Cupertino, Ana-Paula; Mussulman, Laura M; Nazir, Niaman; Greiner, K Allen; Mahnken, Jonathan D; Ahluwalia, Jasjit S; Ellerbeck, Edward F

    2008-08-01

    To describe the design, implementation, baseline data, and feasibility of establishing a disease management program for smoking cessation in rural primary care. The study is a randomized clinical trial evaluating a disease management program for smoking cessation. The intervention combined pharmacotherapy, telephone counseling, and physician feedback, and repeated intervention over two years. The program began in 2004 and was implemented in 50 primary care clinics across the State of Kansas. Of eligible patients, 73% were interested in study participation. 750 enrolled participants were predominantly Caucasian, female, employed, and averaged 47.2 years of age (SD=13.1). In addition to smoking, 427 (57%) had at least one additional major risk factor for cardiovascular disease (diabetes, hypertension, high cholesterol, heart disease or stroke). Participants smoked on average 23.7 (SD=10.4) cigarettes per day, were contemplating (61%) or preparing to quit (30%), were highly motivated and confident of their ability to quit smoking, and reported seeing their physicians multiple times in the past twelve months (Median=3.50; Mean=5.48; SD=6.58). Initial findings demonstrate the willingness of patients to enroll in a two-year disease management program to address nicotine dependence, even among patients not ready to make a quit attempt. These findings support the feasibility of identifying and enrolling rural smokers within the primary care setting.

  15. Optimal acquisition and modeling parameters for accurate assessment of low Ktrans blood-brain barrier permeability using dynamic contrast-enhanced MRI.

    PubMed

    Barnes, Samuel R; Ng, Thomas S C; Montagne, Axel; Law, Meng; Zlokovic, Berislav V; Jacobs, Russell E

    2016-05-01

    To determine optimal parameters for acquisition and processing of dynamic contrast-enhanced MRI (DCE-MRI) to detect small changes in near normal low blood-brain barrier (BBB) permeability. Using a contrast-to-noise ratio metric (K-CNR) for Ktrans precision and accuracy, the effects of kinetic model selection, scan duration, temporal resolution, signal drift, and length of baseline on the estimation of low permeability values was evaluated with simulations. The Patlak model was shown to give the highest K-CNR at low Ktrans . The Ktrans transition point, above which other models yielded superior results, was highly dependent on scan duration and tissue extravascular extracellular volume fraction (ve ). The highest K-CNR for low Ktrans was obtained when Patlak model analysis was combined with long scan times (10-30 min), modest temporal resolution (<60 s/image), and long baseline scans (1-4 min). Signal drift as low as 3% was shown to affect the accuracy of Ktrans estimation with Patlak analysis. DCE acquisition and modeling parameters are interdependent and should be optimized together for the tissue being imaged. Appropriately optimized protocols can detect even the subtlest changes in BBB integrity and may be used to probe the earliest changes in neurodegenerative diseases such as Alzheimer's disease and multiple sclerosis. © 2015 Wiley Periodicals, Inc.

  16. Randomized controlled trial of a nonpharmacologic cholesterol reduction program at the worksite.

    PubMed

    Bruno, R; Arnold, C; Jacobson, L; Winick, M; Wynder, E

    1983-07-01

    Under experimental clinical conditions diet modification has been shown to reduce serum cholesterol levels. This paper reports such a positive response to a nonpharmacologic, behavioral education program at the worksite. Employees at the New York Telephone Company corporate headquarters were assigned randomly to treatment and control groups. Treatment consisted of an 8-week group cholesterol reduction program conducted during employee lunch hours. It comprised a multiple-treatment approach--food behavior change techniques combined with nutrition education, physical activity planning, and self-management skills. The treatment group showed substantial change compared with the control group at the program's completion. Those treated displayed a significant 6.4% reduction in total serum cholesterol (266 mg% average at baseline) as compared with control subjects with a corresponding decrease in high-density lipoprotein levels. A significant increase in nutrition knowledge and moderate weight loss were also documented for this group. The magnitudes of a participant's baseline serum cholesterol level and his/her reduction in percentage of ideal body weight were positively and independently correlated with percentage changes in serum cholesterol levels. Over the same period, decreases in high-density lipoprotein levels and no changes in serum cholesterol, weight, and nutrition knowledge were observed for the control group. Overall, participants in the treatment program successfully reduced the coronary heart disease risk factors of elevated cholesterol and weight. Directions for future study are suggested.

  17. Design and Baseline Characteristics from the KAN-QUIT Disease Management Intervention for Rural Smokers in Primary Care

    PubMed Central

    Cox, Lisa Sanderson; Cupertino, Ana-Paula; Mussulman, Laura M.; Nazir, Niaman; Greiner, K. Allen; Mahnken, Jonathan D.; Ahluwalia, Jasjit S.; Ellerbeck, Edward F.

    2008-01-01

    Objective To describe the design, implementation, baseline data, and feasibility of establishing a disease management program for smoking cessation in rural primary care. Method The study is a randomized clinical trial evaluating a disease management program for smoking cessation. The intervention combined pharmacotherapy, telephone counseling, and physician feedback, and repeated intervention over two years. The program began in 2004 and was implemented in 50 primary care clinics across the State of Kansas. Results Of eligible patients, 73% were interested in study participation. 750 enrolled participants were predominantly Caucasian, female, employed, and averaged 47.2 years of age (SD=13.1). In addition to smoking, 427 (57%) had at least one additional major risk factor for cardiovascular disease (diabetes, hypertension, high cholesterol, heart disease or stroke). Participants smoked on average 23.7 (SD=10.4) cigarettes per day, were contemplating (61%) or preparing to quit (30%), were highly motivated and confident of their ability to quit smoking, and reported seeing their physicians multiple times in the past twelve months (Median=3.50; Mean=5.48; SD=6.58). Conclusion Initial findings demonstrate the willingness of patients to enroll in a two-year disease management program to address nicotine dependence, even among patients not ready to make a quit attempt. These findings support the feasibility of identifying and enrolling rural smokers within the primary care setting. PMID:18544464

  18. Estimation of reliability of predictions and model applicability domain evaluation in the analysis of acute toxicity (LD50).

    PubMed

    Sazonovas, A; Japertas, P; Didziapetris, R

    2010-01-01

    This study presents a new type of acute toxicity (LD(50)) prediction that enables automated assessment of the reliability of predictions (which is synonymous with the assessment of the Model Applicability Domain as defined by the Organization for Economic Cooperation and Development). Analysis involved nearly 75,000 compounds from six animal systems (acute rat toxicity after oral and intraperitoneal administration; acute mouse toxicity after oral, intraperitoneal, intravenous, and subcutaneous administration). Fragmental Partial Least Squares (PLS) with 100 bootstraps yielded baseline predictions that were automatically corrected for non-linear effects in local chemical spaces--a combination called Global, Adjusted Locally According to Similarity (GALAS) modelling methodology. Each prediction obtained in this manner is provided with a reliability index value that depends on both compound's similarity to the training set (that accounts for similar trends in LD(50) variations within multiple bootstraps) and consistency of experimental results with regard to the baseline model in the local chemical environment. The actual performance of the Reliability Index (RI) was proven by its good (and uniform) correlations with Root Mean Square Error (RMSE) in all validation sets, thus providing quantitative assessment of the Model Applicability Domain. The obtained models can be used for compound screening in the early stages of drug development and prioritization for experimental in vitro testing or later in vivo animal acute toxicity studies.

  19. The problem of isotopic baseline: Reconstructing the diet and trophic position of fossil animals

    NASA Astrophysics Data System (ADS)

    Casey, Michelle M.; Post, David M.

    2011-05-01

    Stable isotope methods are powerful, frequently used tools which allow diet and trophic position reconstruction of organisms and the tracking of energy sources through ecosystems. The majority of ecosystems have multiple food sources which have distinct carbon and nitrogen isotopic signatures despite occupying a single trophic level. This difference in the starting isotopic composition of primary producers sets up an isotopic baseline that needs to be accounted for when calculating diet or trophic position using stable isotopic methods. This is particularly important when comparing animals from different regions or different times. Failure to do so can cause erroneous estimations of diet or trophic level, especially for organisms with mixed diets. The isotopic baseline is known to vary seasonally and in concert with a host of physical and chemical variables such as mean annual rainfall, soil maturity, and soil pH in terrestrial settings and lake size, depth, and distance from shore in aquatic settings. In the fossil record, the presence of shallowing upward suites of rock, or parasequences, will have a considerable impact on the isotopic baseline as basin size, depth and distance from shore change simultaneously with stratigraphic depth. For this reason, each stratigraphic level is likely to need an independent estimation of baseline even within a single outcrop. Very little is known about the scope of millennial or decadal variation in isotopic baseline. Without multi-year data on the nature of isotopic baseline variation, the impacts of time averaging on our ability to resolve trophic relationships in the fossil record will remain unclear. The use of a time averaged baseline will increase the amount of error surrounding diet and trophic position reconstructions. Where signal to noise ratios are low, due to low end member disparity (e.g., aquatic systems), or where the observed isotopic shift is small (≤ 1‰) the error introduced by time averaging may severely inhibit the scope of one's interpretations and limit the types of questions one can reliably answer. In situations with strong signal strength, resulting from high amounts of end member disparity (e.g., terrestrial settings), this additional error maybe surmountable. Baseline variation that is adequately characterized can be dealt with by applying multiple end-member mixing models.

  20. Re-Assessing Green Building Performance: A Post Occupancy Evaluation of 22 GSA Buildings

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

    Fowler, Kimberly M.; Rauch, Emily M.; Henderson, Jordan W.

    2010-06-01

    2nd report on the performance of GSA's sustainably designed buildings. The purpose of this study was to provide an overview of measured whole building performance as it compares to GSA and industry baselines. The PNNL research team found the data analysis illuminated strengths and weaknesses of individual buildings as well as the portfolio of buildings. This section includes summary data, observations that cross multiple performance metrics, discussion of lessons learned from this research, and opportunities for future research. The summary of annual data for each of the performance metrics is provided in Table 25. The data represent 1 year ofmore » measurements and are not associated with any specific design features or strategies. Where available, multiple years of data were examined and there were minimal significant differences between the years. Individually focused post occupancy evaluation (POEs) would allow for more detailed analysis of the buildings. Examining building performance over multiple years could potentially offer a useful diagnostic tool for identifying building operations that are in need of operational changes. Investigating what the connection is between the building performance and the design intent would offer potential design guidance and possible insight into building operation strategies. The 'aggregate operating cost' metric used in this study represents the costs that were available for developing a comparative industry baseline for office buildings. The costs include water utilities, energy utilities, general maintenance, grounds maintenance, waste and recycling, and janitorial costs. Three of the buildings that cost more than the baseline in Figure 45 have higher maintenance costs than the baseline, and one has higher energy costs. Given the volume of data collected and analyzed for this study, the inevitable request is for a simple answer with respect to sustainably designed building performance. As previously stated, compiling the individual building values into single metrics is not statistically valid given the small number of buildings, but it has been done to provide a cursory view of this portfolio of sustainably designed buildings. For all metrics except recycling cost per rentable square foot and CBE survey response rate, the averaged building performance was better than the baseline for the GSA buildings in this study.« less

  1. Improvement in work place and household productivity for patients with early rheumatoid arthritis treated with adalimumab plus methotrexate: work outcomes and their correlations with clinical and radiographic measures from a randomized controlled trial companion study.

    PubMed

    van Vollenhoven, Ronald F; Cifaldi, Mary A; Ray, Saurabh; Chen, Naijun; Weisman, Michael H

    2010-02-01

    To evaluate household and work place outcomes for patients with rheumatoid arthritis (RA) who were homemakers or employed workers, respectively, and who were treated with adalimumab plus methotrexate versus methotrexate monotherapy. We also determined baseline predictors of household and work place outcomes. Data were from a health economic companion study to PREMIER, a 2-year, randomized controlled trial of methotrexate-naive patients with early RA (<3 years) who received treatment with adalimumab plus methotrexate, adalimumab, or methotrexate. Absenteeism (number of days missed or unfit to work), presenteeism (self-judgment of the effects of RA on job or household performance), and employment status were collected from self-reports at baseline and varying time points during the study. Household and work place outcomes were generally similar for homemakers and employed workers. Over 2 years, patients who received combination therapy missed approximately half as many days as patients who received methotrexate (17.4 versus 36.9 days for employed workers; 7.9 versus 18.6 days for homemakers). Presenteeism was lower (reflecting better productivity) for combination therapy than methotrexate monotherapy. The likelihood of gaining/retaining employment over 2 years was greater for combination therapy than methotrexate monotherapy (odds ratio 1.530, 95% confidence interval 1.038-2.255; P = 0.0318). Baseline radiographic progression was an independent predictor for retaining/gaining employment at 2 years. Compared with methotrexate monotherapy, combination therapy was associated with more positive work outcomes: less absenteeism, less presenteeism, and greater likelihood of gaining/retaining employment. Radiographic progression at baseline was predictive of the ability to retain or gain employment.

  2. Body Mass Index and Physical Activity at Different Ages and Risk of Multiple Myeloma in the NIH-AARP Diet and Health Study

    PubMed Central

    Hofmann, Jonathan N.; Moore, Steven C.; Lim, Unhee; Park, Yikyung; Baris, Dalsu; Hollenbeck, Albert R.; Matthews, Charles E.; Gibson, Todd M.; Hartge, Patricia; Purdue, Mark P.

    2013-01-01

    Several studies have reported an increased risk of multiple myeloma associated with excess body weight. We investigated the risk of multiple myeloma in relation to separate measures of adiposity and energy balance at different ages in the National Institutes of Health-AARP Diet and Health Study, a large prospective cohort study in the United States. Participants completed a baseline questionnaire (1995–1996; n = 485,049), and a subset of participants completed a second questionnaire (1996–1997; n = 305,618) in which we solicited more detailed exposure information. Hazard ratios and 95% confidence intervals were estimated for the risk of multiple myeloma (overall, n = 813; subset, n = 489) in relation to several measures of obesity and leisure time physical activity. Multiple myeloma risk was associated with increasing body mass index (BMI) at cohort entry (per 5-kg/m2 increase, hazard ratio (HR) = 1.10, 95% confidence interval (CI): 1.00, 1.22); similar associations were observed for BMI at age 50 years (HR = 1.14, 95% CI: 1.02, 1.28), age 35 years (HR = 1.20, 95% CI: 1.05, 1.36), and age 18 years (HR = 1.13, 95% CI: 0.98, 1.32) without adjustment for baseline BMI. Risk of multiple myeloma was not associated with physical activity level at any age. These findings support the hypothesis that excess body weight, both in early adulthood and later in life, is a risk factor for multiple myeloma and suggest that maintaining a healthy body weight throughout life may reduce multiple myeloma risk. PMID:23543160

  3. Improving Ambiguity Resolution for Medium Baselines Using Combined GPS and BDS Dual/Triple-Frequency Observations.

    PubMed

    Gao, Wang; Gao, Chengfa; Pan, Shuguo; Wang, Denghui; Deng, Jiadong

    2015-10-30

    The regional constellation of the BeiDou navigation satellite system (BDS) has been providing continuous positioning, navigation and timing services since 27 December 2012, covering China and the surrounding area. Real-time kinematic (RTK) positioning with combined BDS and GPS observations is feasible. Besides, all satellites of BDS can transmit triple-frequency signals. Using the advantages of multi-pseudorange and carrier observations from multi-systems and multi-frequencies is expected to be of much benefit for ambiguity resolution (AR). We propose an integrated AR strategy for medium baselines by using the combined GPS and BDS dual/triple-frequency observations. In the method, firstly the extra-wide-lane (EWL) ambiguities of triple-frequency system, i.e., BDS, are determined first. Then the dual-frequency WL ambiguities of BDS and GPS were resolved with the geometry-based model by using the BDS ambiguity-fixed EWL observations. After that, basic (i.e., L1/L2 or B1/B2) ambiguities of BDS and GPS are estimated together with the so-called ionosphere-constrained model, where the ambiguity-fixed WL observations are added to enhance the model strength. During both of the WL and basic AR, a partial ambiguity fixing (PAF) strategy is adopted to weaken the negative influence of new-rising or low-elevation satellites. Experiments were conducted and presented, in which the GPS/BDS dual/triple-frequency data were collected in Nanjing and Zhengzhou of China, with the baseline distance varying from about 28.6 to 51.9 km. The results indicate that, compared to the single triple-frequency BDS system, the combined system can significantly enhance the AR model strength, and thus improve AR performance for medium baselines with a 75.7% reduction of initialization time on average. Besides, more accurate and stable positioning results can also be derived by using the combined GPS/BDS system.

  4. Improving Ambiguity Resolution for Medium Baselines Using Combined GPS and BDS Dual/Triple-Frequency Observations

    PubMed Central

    Gao, Wang; Gao, Chengfa; Pan, Shuguo; Wang, Denghui; Deng, Jiadong

    2015-01-01

    The regional constellation of the BeiDou navigation satellite system (BDS) has been providing continuous positioning, navigation and timing services since 27 December 2012, covering China and the surrounding area. Real-time kinematic (RTK) positioning with combined BDS and GPS observations is feasible. Besides, all satellites of BDS can transmit triple-frequency signals. Using the advantages of multi-pseudorange and carrier observations from multi-systems and multi-frequencies is expected to be of much benefit for ambiguity resolution (AR). We propose an integrated AR strategy for medium baselines by using the combined GPS and BDS dual/triple-frequency observations. In the method, firstly the extra-wide-lane (EWL) ambiguities of triple-frequency system, i.e., BDS, are determined first. Then the dual-frequency WL ambiguities of BDS and GPS were resolved with the geometry-based model by using the BDS ambiguity-fixed EWL observations. After that, basic (i.e., L1/L2 or B1/B2) ambiguities of BDS and GPS are estimated together with the so-called ionosphere-constrained model, where the ambiguity-fixed WL observations are added to enhance the model strength. During both of the WL and basic AR, a partial ambiguity fixing (PAF) strategy is adopted to weaken the negative influence of new-rising or low-elevation satellites. Experiments were conducted and presented, in which the GPS/BDS dual/triple-frequency data were collected in Nanjing and Zhengzhou of China, with the baseline distance varying from about 28.6 to 51.9 km. The results indicate that, compared to the single triple-frequency BDS system, the combined system can significantly enhance the AR model strength, and thus improve AR performance for medium baselines with a 75.7% reduction of initialization time on average. Besides, more accurate and stable positioning results can also be derived by using the combined GPS/BDS system. PMID:26528977

  5. Multiple approaches to associations of physical activity and adherence to the Mediterranean diet with all-cause mortality in older adults: the PREvención con DIeta MEDiterránea study.

    PubMed

    Cárdenas-Fuentes, Gabriela; Subirana, Isaac; Martinez-Gonzalez, Miguel A; Salas-Salvadó, Jordi; Corella, Dolores; Estruch, Ramon; Fíto, Montserrat; Muñoz-Bravo, Carlos; Fiol, Miguel; Lapetra, José; Aros, Fernando; Serra-Majem, Luis; Tur, Josep A; Pinto, Xavier; Ros, Emilio; Coltell, Oscar; Díaz-López, Andres; Ruiz-Canela, Miguel; Schröder, Helmut

    2018-04-25

    Although evidence indicates that both physical activity and adherence to the Mediterranean diet (MedDiet) reduce the risk of all-cause mortality, a little is known about optimal intensities of physical activity and their combined effect with MedDiet in older adults. We assessed the separate and combined associations of leisure-time physical activity (LTPA) and MedDiet adherence with all-cause mortality. We prospectively studied 7356 older adults (67 ± 6.2 years) at high vascular risk from the PREvención con DIeta MEDiterránea study. At baseline and yearly thereafter, adherence to the MedDiet and LTPA were measured using validated questionnaires. After 6.8 years of follow-up, we documented 498 deaths. Adherence to the MedDiet and total, light, and moderate-to-vigorous LTPA were inversely associated with all-cause mortality (p < 0.01 for all) in multiple adjusted Cox regression models. The adjusted hazard of all-cause mortality was 73% lower (hazard ratio 0.27, 95% confidence interval 0.19-0.38, p < 0.001) for the combined category of highest adherence to the MedDiet (3rd tertile) and highest total LTPA (3rd tertile) compared to lowest adherence to the MedDiet (1st tertile) and lowest total LTPA (1st tertile). Reductions in mortality risk did not meaningfully differ between total, light intensity, and moderate-to-vigorous LTPA. We found that higher levels of LTPA, regardless of intensity (total, light and moderate-to-vigorous), and greater adherence to the MedDiet were associated separately and jointly with lower all-cause mortality. The finding that light LTPA was inversely associated with mortality is relevant because this level of intensity is a feasible option for older adults.

  6. Combined treatment with corticosteroids and moclobemide favors normalization of hypothalamo-pituitary-adrenal axis dysregulation in relapsing-remitting multiple sclerosis: a randomized, double blind trial.

    PubMed

    Then Bergh, F; Kümpfel, T; Grasser, A; Rupprecht, R; Holsboer, F; Trenkwalder, C

    2001-04-01

    Hyperresponsiveness of the hypothalamo-pituitary-adrenal (HPA) axis in multiple sclerosis (MS), an autoimmune inflammatory disease of the central nervous system, is presumably due to diminished corticosteroid receptor function. It probably influences the immune response, but its clinical significance is not clear. Similar HPA dysregulation occurs in depression and is reversible with successful antidepressant treatment. We conducted a double blind, placebo-controlled trial to evaluate the neuroendocrine effect of cotreatment with the antidepressant moclobemide as an adjunct to oral corticosteroids in MS. Twenty-one patients with definite relapsing-remitting MS (11 females, aged 33.9 +/- 2.0 yr; Expanded Disability Status Scale score of neurological impairment, 2.0--6.5) in acute relapse were treated with placebo (n = 13) or 300 mg moclobemide (reversible monoamine oxidase A inhibitor; n = 8) for 75 days. All received oral fluocortolone from day 7 on, and the dose was tapered until day 29. Effects were evaluated using the combined dexamethasone-CRH test and clinically on days 1, 30, and 75. At baseline, the HPA axis was mildly activated, comparably for treatment groups [area under the curve for cortisol (AUC-Cort), 213.8 +/- 76.8 arbitrary units in the moclobemide group vs. 225.8 +/- 65.1 in the steroid alone group; mean +/- SEM]. In a group of healthy controls with comparable demographic characteristics, the AUC-Cort was 107.4 +/- 14.1. Moclobemide cotreatment resulted in normalization of the HPA axis response, whereas the HPA system hyperresponse was maintained with steroids alone (AUC-Cort on day 30, 85.9 +/- 22.8 vs.177.1 +/- 68.5; on day 75, 111.0 +/- 46.0 vs. 199.2 +/- 64.6). The change in Expanded Disability Status Scale was comparable for both groups. Although corticosteroids alone had no effect on the HPA response using the dexamethasone-CRH test, treatment with moclobemide combined with corticosteroids favors normalization of the HPA response in relapsing-remitting MS.

  7. Heart rate and heart rate variability in panic, social anxiety, obsessive-compulsive, and generalized anxiety disorders at baseline and in response to relaxation and hyperventilation.

    PubMed

    Pittig, Andre; Arch, Joanna J; Lam, Chi W R; Craske, Michelle G

    2013-01-01

    It remains unclear if diminished high frequency heart rate variability (HF-HRV) can be found across anxiety disorders. HF-HRV and heart rate (HR) were examined in panic (PD), generalized anxiety (GAD), social anxiety (SAD), and obsessive-compulsive disorder (OCD) relative to healthy controls at baseline and during anxiety stressors. All disorders evidenced diminished baseline HF-HRV relative to controls. Baseline HRV differences were maintained throughout relaxation. For hyperventilation, PD and GAD demonstrated greater HR than controls. Psychotropic medication did not account for HF-HRV differences except in OCD. Age and sex evidenced multiple main effects. Findings suggest that low baseline HF-HRV represents a common index for inhibitory deficits across PD, GAD, and SAD, which is consistent with the notion of autonomic inflexibility in anxiety disorders. Elevated HR responses to hyperventilation, however, are specific to PD and GAD. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Phase retrieval based wavefront sensing experimental implementation and wavefront sensing accuracy calibration

    NASA Astrophysics Data System (ADS)

    Mao, Heng; Wang, Xiao; Zhao, Dazun

    2009-05-01

    As a wavefront sensing (WFS) tool, Baseline algorithm, which is classified as the iterative-transform algorithm of phase retrieval, estimates the phase distribution at pupil from some known PSFs at defocus planes. By using multiple phase diversities and appropriate phase unwrapping methods, this algorithm can accomplish reliable unique solution and high dynamic phase measurement. In the paper, a Baseline algorithm based wavefront sensing experiment with modification of phase unwrapping has been implemented, and corresponding Graphical User Interfaces (GUI) software has also been given. The adaptability and repeatability of Baseline algorithm have been validated in experiments. Moreover, referring to the ZYGO interferometric results, the WFS accuracy of this algorithm has been exactly calibrated.

  9. 'MetaTaal': enhancing complex syntax in children with specific language impairment--a metalinguistic and multimodal approach.

    PubMed

    Zwitserlood, Rob; Wijnen, Frank; van Weerdenburg, Marjolijn; Verhoeven, Ludo

    2015-01-01

    Currently, most research on the effective treatment of morphosyntax in children with specific language impairment (SLI) pertains to younger children. In the last two decades, several studies have provided evidence that intervention for older school-age children with SLI can be effective. These metalinguistic intervention approaches teach grammatical rules explicitly and use shapes and colours as two-dimensional visual support. Reading or writing activities form a substantial part of these interventions. However, some children with SLI are poor readers and might benefit more from an approach that is less dependent on literacy skills. To examine the effectiveness of a combined metalinguistic and multimodal approach in older school-age children with SLI. The intervention was adapted to suit poor readers and targeted the improvement of relative clause production, because relative clauses still pose difficulties for older children with SLI. Participants were 12 monolingual Dutch children with SLI (mean age 11;2). All children visited a special school for children with speech and language disorders in the Netherlands. A quasi-experimental multiple-baseline design was chosen to evaluate the effectiveness of the intervention. A set of tasks was constructed to test relative clause production and comprehension. Two balanced versions were alternated in order to suppress a possible learning effect from multiple presentations of the tasks. After 3 monthly baseline measurements, the children received individual treatment with a protocolled intervention programme twice a week during 5 weeks. The tests were repeated directly post-therapy and at a retention measurement 3 months later. During the intervention programme, the speech therapist delivering the treatment remained blind to the test results. No significant changes were found during the baseline measurements. However, measurement directly post-therapy showed that 5 h of intervention produced significant improvement on the relative clause production tasks, but not on the relative clause comprehension task. The gains were also maintained 3 months later. The motor and tactile/kinesthetic dimensions of the 'MetaTaal' metalinguistic intervention approach are a valuable addition to the existing metalinguistic approaches. This study supports the evidence that grammatical skills in older school-age children with SLI can be remediated with direct intervention using a metalinguistic approach. The current tendency to diminish direct intervention for older children with SLI should be reconsidered. © 2015 Royal College of Speech and Language Therapists.

  10. Combined mining: discovering informative knowledge in complex data.

    PubMed

    Cao, Longbing; Zhang, Huaifeng; Zhao, Yanchang; Luo, Dan; Zhang, Chengqi

    2011-06-01

    Enterprise data mining applications often involve complex data such as multiple large heterogeneous data sources, user preferences, and business impact. In such situations, a single method or one-step mining is often limited in discovering informative knowledge. It would also be very time and space consuming, if not impossible, to join relevant large data sources for mining patterns consisting of multiple aspects of information. It is crucial to develop effective approaches for mining patterns combining necessary information from multiple relevant business lines, catering for real business settings and decision-making actions rather than just providing a single line of patterns. The recent years have seen increasing efforts on mining more informative patterns, e.g., integrating frequent pattern mining with classifications to generate frequent pattern-based classifiers. Rather than presenting a specific algorithm, this paper builds on our existing works and proposes combined mining as a general approach to mining for informative patterns combining components from either multiple data sets or multiple features or by multiple methods on demand. We summarize general frameworks, paradigms, and basic processes for multifeature combined mining, multisource combined mining, and multimethod combined mining. Novel types of combined patterns, such as incremental cluster patterns, can result from such frameworks, which cannot be directly produced by the existing methods. A set of real-world case studies has been conducted to test the frameworks, with some of them briefed in this paper. They identify combined patterns for informing government debt prevention and improving government service objectives, which show the flexibility and instantiation capability of combined mining in discovering informative knowledge in complex data.

  11. A social-ecological database to advance research on infrastructure development impacts in the Brazilian Amazon.

    PubMed

    Tucker Lima, Joanna M; Valle, Denis; Moretto, Evandro Mateus; Pulice, Sergio Mantovani Paiva; Zuca, Nadia Lucia; Roquetti, Daniel Rondinelli; Beduschi, Liviam Elizabeth Cordeiro; Praia, Amanda Salles; Okamoto, Claudia Parucce Franco; da Silva Carvalhaes, Vinicius Leite; Branco, Evandro Albiach; Barbezani, Bruna; Labandera, Emily; Timpe, Kelsie; Kaplan, David

    2016-08-30

    Recognized as one of the world's most vital natural and cultural resources, the Amazon faces a wide variety of threats from natural resource and infrastructure development. Within this context, rigorous scientific study of the region's complex social-ecological system is critical to inform and direct decision-making toward more sustainable environmental and social outcomes. Given the Amazon's tightly linked social and ecological components and the scope of potential development impacts, effective study of this system requires an easily accessible resource that provides a broad and reliable data baseline. This paper brings together multiple datasets from diverse disciplines (including human health, socio-economics, environment, hydrology, and energy) to provide investigators with a variety of baseline data to explore the multiple long-term effects of infrastructure development in the Brazilian Amazon.

  12. A social-ecological database to advance research on infrastructure development impacts in the Brazilian Amazon

    PubMed Central

    Tucker Lima, Joanna M.; Valle, Denis; Moretto, Evandro Mateus; Pulice, Sergio Mantovani Paiva; Zuca, Nadia Lucia; Roquetti, Daniel Rondinelli; Beduschi, Liviam Elizabeth Cordeiro; Praia, Amanda Salles; Okamoto, Claudia Parucce Franco; da Silva Carvalhaes, Vinicius Leite; Branco, Evandro Albiach; Barbezani, Bruna; Labandera, Emily; Timpe, Kelsie; Kaplan, David

    2016-01-01

    Recognized as one of the world’s most vital natural and cultural resources, the Amazon faces a wide variety of threats from natural resource and infrastructure development. Within this context, rigorous scientific study of the region’s complex social-ecological system is critical to inform and direct decision-making toward more sustainable environmental and social outcomes. Given the Amazon’s tightly linked social and ecological components and the scope of potential development impacts, effective study of this system requires an easily accessible resource that provides a broad and reliable data baseline. This paper brings together multiple datasets from diverse disciplines (including human health, socio-economics, environment, hydrology, and energy) to provide investigators with a variety of baseline data to explore the multiple long-term effects of infrastructure development in the Brazilian Amazon. PMID:27575915

  13. Assessing the predictive value of a neuropsychological model on concurrent function in acute stroke recovery and rehabilitation.

    PubMed

    Leitner, Damian; Miller, Harry; Libben, Maya

    2018-06-25

    Few studies have examined the relationship between cognition and function for acute stroke inpatients utilizing comprehensive methods. This study aimed to assess the relationship of a neuropsychological model, above and beyond a baseline model, with concurrent functional status across multiple domains in the early weeks of stroke recovery and rehabilitation. Seventy-four acute stroke patients were administered a comprehensive neuropsychological assessment. Functional domains of ability, adjustment, and participation were assessed using the Mayo-Portland Adaptability Inventory - 4 (MPAI-4). Hierarchical linear regression was used to assess a neuropsychological model comprised of cognitive tests scores on domains of executive function, memory, and visuospatial-constructional skills (VSC), after accounting for a baseline model comprised of common demographic and stroke variants used to predict outcome. The neuropsychological model was significantly associated, above and beyond the baseline model, with MPAI-4 Ability, Participation, and Total scores (all p-values < .05). The strength of association varied across functional domains. Analyzing tests of executive function, the Color Trails Test-Part 2 predicted MPAI-4 Participation (β = -.46, p = .001), and Total score (β = -.32, p = .02). Neuropsychological assessment contributes independently to the determination of multiple domains of functional function, above and beyond common medical variants of stroke, in the early weeks of recovery and rehabilitation. Multiple tests of executive function are recommended to develop a greater appreciation of a patient's concurrent functional abilities.

  14. An MBSE Approach to Space Suit Development

    NASA Technical Reports Server (NTRS)

    Cordova, Lauren; Kovich, Christine; Sargusingh, Miriam

    2012-01-01

    The EVA/Space Suit Development Office (ESSD) Systems Engineering and Integration (SE&I) team has utilized MBSE in multiple programs. After developing operational and architectural models, the MBSE framework was expanded to link the requirements space to the system models through functional analysis and interfaces definitions. By documenting all the connections within the technical baseline, ESSD experienced significant efficiency improvements in analysis and identification of change impacts. One of the biggest challenges presented to the MBSE structure was a program transition and restructuring effort, which was completed successfully in 4 months culminating in the approval of a new EVA Technical Baseline. During this time three requirements sets spanning multiple DRMs were streamlined into one NASA-owned Systems Requirement Document (SRD) that successfully identified requirements relevant to the current hardware development effort while remaining extensible to support future hardware developments. A capability-based hierarchy was established to provide a more flexible framework for future space suit development that can support multiple programs with minimal rework of basic EVA/Space Suit requirements. This MBSE approach was most recently applied for generation of an EMU Demonstrator technical baseline being developed for an ISS DTO. The relatively quick turnaround of operational concepts, architecture definition, and requirements for this new suit development has allowed us to test and evolve the MBSE process and framework in an extremely different setting while still offering extensibility and traceability throughout ESSD projects. The ESSD MBSE framework continues to be evolved in order to support integration of all products associated with the SE&I engine.

  15. Factors influencing changes in health related quality of life of caregivers of persons with multiple chronic conditions.

    PubMed

    Duggleby, Wendy; Williams, Allison; Ghosh, Sunita; Moquin, Heather; Ploeg, Jenny; Markle-Reid, Maureen; Peacock, Shelley

    2016-05-27

    The majority of care for older adults with multiple chronic conditions (MCC) is provided by family (including friends) caregivers. Although caregivers have reported positive benefits to caregiving they also experience decreases in their physical and mental health. As there is a critical need for supportive interventions for this population, it is important to know what influences the health of family caregivers of persons with MCC. This research examined relationships among the changes from baseline to 6 months in health related quality of life (SF12v2) of family caregivers caring for older adults with multiple chronic conditions and the following factors: a) demographic variables, b) gender identity [Bem Sex Role Inventory (BSRI)] c) changes in general self-efficacy [General Self Efficacy Scale (GSES) (baseline to 6 months) and d)) changes in caregiver burden [Zarit Burden Inventory (ZBI)] baseline to 6 months. Specific hypothesis were based on a conceptual framework generated from a literature review. This is a secondary analysis of a study of 194 family caregivers who were recruited from two Canadian provinces Alberta and Ontario. Data were collected in-person, by telephone, by Skype or by mail at two time periods spaced 6 months apart. The sample size for this secondary analysis was n = 185, as 9 participants had dropped out of the study at 6 months. Changes in the scores between the two time periods were calculated for SF12v2 physical component score (PCS) and mental component score (MCS) and the other main variables. Generalized Linear Modeling was then used to determine factors associated with changes in HRQL. Participants who had significantly positive increases in their MCS (baseline to 6 months) reported lower burden (ZBI, p < 0.001), and higher general self-efficacy (GSES, p < 0.001) and Masculine BSRI (p = 0.025). There were no significant associations among variables and changes in PCS (baseline to 6 months). Our findings suggest that a masculine gender identity (which incorporates assertive and instrumental approaches to caregiving), and confidence in the ability to deal with difficult situations was positively related to improvement in mental health for caregivers of persons with MCC. Decreases in perceptions of burden in this populations was also associated with improvements in mental health. Further research is needed to explore ways to support caregivers of older persons with multiple chronic conditions living at home.

  16. Midportion achilles tendon microcirculation after intermittent combined cryotherapy and compression compared with cryotherapy alone: a randomized trial.

    PubMed

    Knobloch, Karsten; Grasemann, Ruth; Spies, Marcus; Vogt, Peter M

    2008-11-01

    The effect of combined cryotherapy/compression versus cryotherapy alone on the Achilles tendon is undetermined. Standardized combined cryotherapy/compression changes in midportion Achilles tendon microcirculation are superior to those with cryotherapy during intermittent application. Controlled laboratory study. Sixty volunteers were randomized for either combined cryotherapy/compression (Cryo/Cuff, DJO Inc, Vista, California: n = 30; 32 +/- 11 years) or cryotherapy alone (KoldBlue, TLP Industries, Kent, United Kingdom: n = 30; 33 +/- 12 years) with intermittent 3 x 10-minute application. Midportion Achilles tendon microcirculation was determined (O2C, LEA Medizintechnik, Giessen, Germany). Both Cryo/Cuff and KoldBlue significantly reduced superficial and deep capillary tendon blood flow within the first minute of application (43 +/- 46 arbitrary units [AU] vs 10 +/- 19 AU and 42 +/- 46 AU vs 12 +/- 10 AU; P = .0001) without a significant difference throughout all 3 applications. However, during recovery, superficial and deep capillary blood flow was reestablished significantly faster using Cryo/Cuff (P = .023). Tendon oxygen saturation was reduced in both groups significantly (3 minutes Cryo/Cuff: 36% +/- 20% vs 16% +/- 15%; KoldBlue: 42% +/- 19% vs 28% +/- 20%; P < .05) with significantly stronger effects using Cryo/Cuff (P = .014). Cryo/Cuff led to significantly higher tendon oxygenation (Cryo/Cuff: 62% +/- 28% vs baseline 36% +/- 20%; P = .0001) in superficial and deep tissue (Cryo/Cuff: 73% +/- 14% vs baseline 65% +/- 17%; P = .0001) compared with KoldBlue during all recoveries. Postcapillary venous filling pressures were significantly reduced in both groups during application; however, Cryo/Cuff led to significantly, but marginally, lower pressures (Cryo/Cuff: 41 +/- 7 AU vs baseline 51 +/- 13 AU; P = .0001 and KoldBlue: 46 +/- 7 AU vs baseline 56 +/- 11 AU; P = .026 for Cryo/Cuff vs KoldBlue). Increased tendon oxygenation is achieved as tendon preconditioning by combined cryotherapy and compression with significantly increased tendon oxygen saturation during recovery in contrast to cryotherapy alone. Both regimens lead to a significant amelioration of tendinous venous outflow. Combined cryotherapy and compression is superior to cryotherapy alone regarding the Achilles tendon microcirculation. Further studies in tendinopathy and tendon rehabilitation are warranted to elucidate its value regarding functional issues.

  17. Efficacy of functional microarray of microneedles combined with topical tranexamic acid for melasma: A randomized, self-controlled, split-face study.

    PubMed

    Xu, Yang; Ma, Renyan; Juliandri, Juliandri; Wang, Xiaoyan; Xu, Bai; Wang, Daguang; Lu, Yan; Zhou, Bingrong; Luo, Dan

    2017-05-01

    To evaluate the efficacy of a functional microarray of microneedles (MNs) plus topical tranexamic acid (TA) for melasma in middle-aged women in China.Thirty female subjects with melasma were enrolled in this study. The left or right side of the face was chosen randomly to be pretreated with a functional microarray of MNs, followed by topical 0.5% TA solution once per week for 12 weeks. The other half-face was the control, treated with a sham device plus topical 0.5% TA solution. At baseline and at weeks 4, 8, and 12 of treatment, clinical (photographic) evaluations and parameters determined by Visia were recorded. At baseline and week 12, patient satisfaction scores and the biophysical parameters measured by Mexameter were also recorded. Side effects were evaluated at baseline and at the end of the 12 weeks.In total, 28 women (93.3%) completed the study. The brown spots' scores measured by Visia were significantly lower on the combined therapy side than on the control side at 12 weeks after starting treatment; there was no significant difference between sides at 4 or 8 weeks. After 12 weeks, melanin index (MI) decreased significantly in both 2 groups, and the MI was significantly less on the combined side at week 12. Transepidermal water loss, roughness, skin hydration, skin elasticity, and erythema index showed no significant differences between 2 sides at baseline, 4, 8, and 12 weeks after treatment. Physicians' evaluations of photographs showed better results at week 12 with combined therapy: >25% improvement was observed in the MNs plus TA side in 25 patients, and in the TA side in only 10 patients. Subjective satisfaction scores on both sides increased significantly. The participants were more satisfied with the results of the combined therapy side than the control side. No obvious adverse reactions were observed throughout the study.Combined therapy with a functional microarray of MNs and topical TA solution is a promising treatment for melasma.

  18. Improved MIMO radar GMTI via cyclic-shift transmission of orthogonal frequency division signals

    NASA Astrophysics Data System (ADS)

    Li, Fuyou; He, Feng; Dong, Zhen; Wu, Manqing

    2018-05-01

    Minimum detectable velocity (MDV) and maximum detectable velocity are both important in ground moving target indication (GMTI) systems. Smaller MDV can be achieved by longer baseline via multiple-input multiple-output (MIMO) radar. Maximum detectable velocity is decided by blind velocities associated with carrier frequencies, and blind velocities can be mitigated by orthogonal frequency division signals. However, the scattering echoes from different carrier frequencies are independent, which is not good for improving MDV performance. An improved cyclic-shift transmission is applied in MIMO GMTI system in this paper. MDV performance is improved due to the longer baseline, and maximum detectable velocity performance is improved due to the mitigation of blind velocities via multiple carrier frequencies. The signal model for this mode is established, the principle of mitigating blind velocities with orthogonal frequency division signals is presented; the performance of different MIMO GMTI waveforms is analysed; and the performance of different array configurations is analysed. Simulation results by space-time-frequency adaptive processing proves that our proposed method is a valid way to improve GMTI performance.

  19. Technology Performance Level (TPL) Scoring Tool

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

    Weber, Jochem; Roberts, Jesse D.; Costello, Ronan

    2016-09-01

    Three different ways of combining scores are used in the revised formulation. These are arithmetic mean, geometric mean and multiplication with normalisation. Arithmetic mean is used when combining scores that measure similar attributes, e.g. used for combining costs. The arithmetic mean has the property that it is similar to a logical OR, e.g. when combining costs it does not matter what the individual costs are only what the combined cost is. Geometric mean and Multiplication are used when combining scores that measure disparate attributes. Multiplication is similar to a logical AND, it is used to combine ‘must haves.’ As amore » result, this method is more punitive than the geometric mean; to get a good score in the combined result it is necessary to have a good score in ALL of the inputs. e.g. the different types of survivability are ‘must haves.’ On balance, the revised TPL is probably less punitive than the previous spreadsheet, multiplication is used sparingly as a method of combining scores. This is in line with the feedback of the Wave Energy Prize judges.« less

  20. Effects of the lercanidipine-enalapril combination vs. the corresponding monotherapies on home blood pressure in hypertension: evidence from a large database.

    PubMed

    Mancia, Giuseppe; Omboni, Stefano; Chazova, Irina; Coca, Antonio; Girerd, Xavier; Haller, Hermann; Parati, Gianfranco; Pauletto, Paolo; Pupek-Musialik, Danuta; Svyshchenko, Yevgeniya

    2016-01-01

    To compare a combination of a dihydropyridine calcium-channel blocker with an angiotensin converting enzyme inhibitor vs. monotherapy with one or the other drug and placebo for their effects on home blood pressure (HBP). After a 2-week placebo wash-out, patients with an elevated office blood pressure (BP) (diastolic 100-109 and systolic <180 mmHg) and HBP (diastolic ≥85 mmHg) were randomized double-blind to a 10-week treatment with placebo, lercanidipine, 10 or 20 mg daily, enalapril, 10 or 20 mg daily, or the four possible combinations. In addition to office BP, HBP was self-measured via a validated semiautomatic device twice in the morning and twice in the evening during the 7 days before randomization and at the end of treatment. Baseline and treatment HBP values were separately averaged for each day, morning, evening or the whole monitoring period, excluding the first day. Day-by-day HBP variability was defined as the SD or the variation coefficient of the daily BP averages. Eight hundred and fifty-four patients with valid HBP recordings at baseline and at the end of treatment were analyzed (intention-to-treat population). From the baseline value (147.0±11.6 mmHg) systolic/diastolic HBP showed a small reduction (average baseline-adjusted change: -1.8/-1.6 mmHg) with placebo, a more marked significant fall with monotherapies (-8.8/-5.9 mmHg, P < 0.001/<0.001 vs. placebo) and even more with combination treatment (11.6/-7.6 mmHg, P < 0.001/ < 0.001 vs. placebo and P < 0.01/ < 0.05 vs. monotherapy). A similar pattern was observed for each of the days of the BP self-monitoring period as well as for either morning or evening values, although the difference between mono and combination treatment appeared to be consistently significant for the morning values only. Day-by-day systolic BP-SD was unaffected by placebo and slightly reduced by drug treatments, with no, however, significant changes in SBP-variation coefficient. Baseline and end of treatment HBP values showed a limited correlation with office BP values, this being particularly the case for treatment-induced changes (correlation coefficients: 0.37 for systolic and 0.45 for diastolic BP). This large HBP database shows that the lercanidipine-enalapril combination lowers HBP more effectively than the corresponding monotherapies and placebo, and that this greater effect is consistent between days. ClinicalTrials.gov identifier: NCT01093807.

  1. The RECONS Hunt for Intriguing Binaries in the Solar Neighborhood

    NASA Astrophysics Data System (ADS)

    Bean, J. L.; Henry, T. J.; Jao, W. C.; Subasavage, J. P.

    2001-12-01

    As part of an effort to characterize the Sun's neighbors, photometric research was carried out on two samples of low-mass stars known or suspected to lie within 25 parsecs of the Sun. Quality filtered optical photometric data (UBVRI) from published research were merged with recently released infrared data (JHK) from the Two Micron All Sky Survey (2MASS) to create comprehensive long baseline V-I or V-K colors for more than 1400 stars. These were then combined with parallaxes from the NStars Database to create color-absolute magnitude diagrams. The results of this research include increasing the breadth of the NStars Database by adding photometric data for over 1400 stars, and identifying intriguing multiple systems (close spectroscopic binaries, BY Dra types, RS CVn systems) as well as white dwarfs and evolved stars in the solar neighborhood. More than two dozen objects have been identified as probable new multiple systems from their positions above the main sequence. Additional investigations for these intriguing systems are planned, including observations made with the GSU CHARA Array to resolve very close binary systems. This research is a continuation of the work done by RECONS (Research Consortium on Nearby Stars) based at Georgia Sate U., Johns Hopkins U., and U. Virginia, and NASA's Nearby Stars Project (NStars).

  2. Effectiveness of CO2 laser with subcision in patients with acne scars.

    PubMed

    Anupama, Y G; Wahab, Afthab Jameela

    2016-11-01

    Post-acne facial scarring has always been a challenge to treat. It requires multiple therapeutic modalities as single modality is not hundred percent effective. Therefore, we have combined CO 2 laser resurfacing with subcision in patients with acne scars for better results. The aim is to study the effectiveness and side effects of CO 2 laser with subcision in patients with atrophic acne scars. Fifty patients were selected for the study. Baseline grading was done with Goodman and Baron grading system. Twenty-five patients were randomly selected for subcision followed by CO 2 laser and the remaining patients were selected for CO 2 laser alone. The treatment was done for four sessions at 4-week interval. Clinical photographs were obtained for evaluation. CO 2 laser with subcision showed excellent response in grade-2 and -3 acne scars. Statistically there is a significant difference between CO 2 laser following subcision and CO 2 laser alone at 5% level (p < 0.05). Both procedures were well tolerated with minimal side effects. The highly versatile CO 2 laser is useful for treating acne scars. Subcision prior to the CO 2 laser procedure showed better improvement when compared to CO 2 laser alone. Thus, in acne scars, multiple therapeutic modalities achieve better results.

  3. Wide-bandwidth high-resolution search for extraterrestrial intelligence

    NASA Technical Reports Server (NTRS)

    Horowitz, Paul

    1995-01-01

    Research was accomplished during the third year of the grant on: BETA architecture, an FFT array, a feature extractor, the Pentium array and workstation, and a radio astronomy spectrometer. The BETA (this SETI project) system architecture has been evolving generally in the direction of greater robustness against terrestrial interference. The new design adds a powerful state-memory feature, multiple simultaneous thresholds, and the ability to integrate multiple spectra in a flexible state-machine architecture. The FFT array is reported with regards to its hardware verification, array production, and control. The feature extractor is responsible for maintaining a moving baseline, recognizing large spectral peaks, following the progress of previously identified interesting spectral regions, and blocking signals from regions previously identified as containing interference. The Pentium array consists of 21 Pentium-based PC motherboards, each with 16 MByte of RAM and an Ethernet interface. Each motherboard receives and processes the data from a feature extractor/correlator board set, passing on the results of a first analysis to the central Unix workstation (through which each is also booted). The radio astronomy spectrometer is a technological spinoff from SETI work. It is proposed to be a combined spectrometer and power-accumulator, for use at Arecibo Observatory to search for neutral hydrogen emission from condensations of neutral hydrogen at high redshift (z = 5).

  4. The CombiRx trial of combined therapy with interferon and glatiramer cetate in relapsing remitting MS: Design and baseline characteristics

    PubMed Central

    Lindsey, JW; Scott, TF; Lynch, SG; Cofield, SS; Nelson, F; Conwit, R; Gustafson, T; Cutter, GR; Wolinsky, JS; Lublin, FD

    2012-01-01

    Background Interferon-β1a (IFNB) and glatiramer acetate (GA) are distinct therapies which are both partially effective for relapsing MS. It is not known if combining the two treatments would be more effective. Objective To review the rationale, design, and baseline characteristics of the CombiRx study of combined treatment with IFNB and GA. Methods The key inclusion criteria included a diagnosis of relapsing MS, at least 2 episodes of MS activity in the previous 3 years, expanded disability status scale of 0 to 5.5, and no prior treatment with either IFNB or GA. Subjects were randomized to IFNB+GA, IFNB monotherapy, or GA monotherapy in a 2:1:1 ratio. Results From 2005 to 2009, we enrolled 1008 subjects. The participants were 72.4% female and 87.6% Caucasian with a mean age of 37.7 years. The median duration of symptoms was 2 years at entry into the study, and the mean EDSS was 2.1. On the baseline MRI, the mean total lesion load was 12.2 ml, and 40% of the participants had enhancing lesions. Conclusion We have recruited a population of patients with clinical and MRI characteristics typical for early MS. The study results will aid in deciding on the optimum early treatment. This trial should serve as a model for future studies of combination therapy. PMID:22754793

  5. 75 FR 53292 - Combined Notice of Filings No. 1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ...-000. Applicants: UniSource Energy Development Company. Description: UniSource Energy Development Company submits tariff filing per 35.12: Baseline Filing for UniSource Energy Development Company MBR... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings No. 1 August...

  6. 75 FR 53289 - Combined Notice of Filings No. 1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ...-000. Applicants: Covanta Plymouth Renewable Energy Limited Partnership Description: Covanta Plymouth Renewable Energy Limited Partnership submits tariff filing per 35.12: Covanta Plymouth MBR Baseline eTariff... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings No. 1 August...

  7. 75 FR 52522 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-26

    ..., LLC. Description: Carthage Energy, LLC submits tariff filing per 35.12: Carthage Energy Baseline e... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 August 18...: Bethlehem Renewable Energy, LLC; Delmarva Power & Light Company; Potomac Electric Power Company; Energy...

  8. 78 FR 34362 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-07

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 Take notice that the Commission received the following electric rate filings: Docket Numbers: ER13-1541-001. Applicants: Campo Verde Solar, LLC. Description: Amendment to Application and Initial Baseline Tariff Filing...

  9. Comparison of Tone Mode Measurements for a Forward Swept and Baseline Rotor Fan

    NASA Technical Reports Server (NTRS)

    Heidelberg, Laurence J.

    2003-01-01

    A forward swept fan, designated the Quite High Speed Fan (QHSF), was tested in the NASA Glenn 9- by 15-foot Low Speed Wind Tunnel to investigate its noise reduction relative to a baseline fan of the same aerodynamic performance. The design objective of the QHSF was a 6 dB reduction in Effective Perceived Noise Level relative to the baseline fan at the takeoff condition. The design noise reduction was to be a result of lower levels of multiple pure tone noise due to the forward swept rotor, and lower rotor/stator interaction tone noise from a leaned stator. Although the design 6 dB reduction was observed in far-field measurements, the induct mode measurements revealed the reasons for goals. All of the noise reduction was from the blade passing tone and its harmonics and most of this was unexpectedly from rotor/strut interaction modes. The reason for large differences in rotor/strut noise sources could not be determined with certainty. The reductions in the multiple pure tone noise for the forward swept rotor were not observed. this reduction were not the ones related to the design

  10. Workplace bullying and mental distress - a prospective study of Norwegian employees.

    PubMed

    Finne, Live Bakke; Knardahl, Stein; Lau, Bjørn

    2011-07-01

    Using a prospective design, the objective of this study was to determine the relationship between workplace bullying and mental distress. Altogether, 1971 Norwegian employees, recruited from 20 organizations, answered questions regarding workplace bullying and mental distress at both baseline and follow-up. Baseline data were gathered between 2004-2006, and follow-up data were gathered between 2006-2009. The time-lag between baseline and follow-up was approximately two years for all the respondents in all the organizations. The factors measured in the study were individual characteristics, mental distress measured with the Hopkins Symptom Checklist (HSCL-10), self-reported workplace bullying measured with a single item from the General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic) and job demands and job control assessed by QPSNordic. A multiple linear regression analysis adjusted for mental distress, sex, age, job demands and job control at baseline [β=0.05, 95% confidence interval (95% CI) 0.03-0.17] and a repeated measures ANOVA adjusted for sex and age [F(3,1965)=38.37; partial η (2)=0.06] showed that workplace bullying predicted mental distress. Furthermore, a multiple binary logistic regression analysis adjusted for bullying, sex, age, job demands and job control at baseline [odds ratio (OR) 2.30, 95% CI 1.43-3.69] showed that mental distress was a predictor of bullying. We found support for the notion that self-reported workplace bullying is a predictor of mental distress two years later. Bullying had an independent effect on mental distress after adjusting for job demands and job control. Mental distress was also found to be a predictor of bullying, indicating that the reverse relationship is also important.

  11. EEG Changes across Multiple Nights of Sleep Restriction and Recovery in Adolescents: The Need for Sleep Study.

    PubMed

    Ong, Ju Lynn; Lo, June C; Gooley, Joshua J; Chee, Michael W L

    2016-06-01

    To investigate sleep EEG changes in adolescents across 7 nights of sleep restriction to 5 h time in bed [TIB]) and 3 recovery nights of 9 h TIB. A parallel-group design, quasi-laboratory study was conducted in a boarding school. Fifty-five healthy adolescents (25 males, age = 15-19 y) who reported habitual TIBs of approximately 6 h on week nights (group average) but extended their sleep on weekends were randomly assigned to Sleep Restriction (SR) or Control groups. Participants underwent a 2-week protocol comprising 3 baseline nights (TIB = 9 h), 7 nights of sleep opportunity manipulation (TIB = 5 h for the SR and 9 h for the Control group), and 3 nights of recovery sleep (TIB = 9 h). Polysomnography was obtained on two baseline, three manipulation, and two recovery nights. Across the sleep restriction nights, total SWS duration was preserved relative to the 9 h baseline sleep opportunity, while other sleep stages were reduced. Considering only the first 5 h of sleep opportunity, SR participants had reduced N1 duration and wake after sleep onset (WASO), and increased total sleep time (TST), rapid eye movement (REM) sleep, and slow wave sleep (SWS) relative to baseline. Total REM sleep, N2, and TST duration remained above baseline levels by the third recovery sleep episode. In spite of preservation of SWS duration over multiple nights of sleep restriction, adolescents accustomed to curtailing nocturnal sleep on school day nights evidence residual effects on sleep macro-structure, even after three nights of recovery sleep. Older teenagers may not be as resilient to successive nights of sleep restriction as is commonly believed. © 2016 Associated Professional Sleep Societies, LLC.

  12. Cardiac repolarization during fingolimod treatment in patients with relapsing-remitting multiple sclerosis.

    PubMed

    Laiho, Aapo; Laitinen, Tiina M; Hartikainen, Päivi; Hartikainen, Juha E K; Laitinen, Tomi P; Simula, Sakari

    2018-02-01

    Fingolimod is a sphingosine-1-phosphate receptor modulator for the treatment of relapsing-remitting multiple sclerosis (RRMS). Despite an established effect on heart rate, the effect of fingolimod on cardiac repolarization is not completely known. Twenty-seven patients with RRMS underwent 24-hr ambulatory ECG before fingolimod (baseline), at the day of fingolimod initiation (1D) and after three-month treatment (3M). The mean values of RR-interval as well as QT-interval corrected by Bazzet's (QTcBaz) and Fridericia's (QTcFri) formula were compared between baseline, 1D, and 3M over 24-hr period as well as at daytime and nighttime. QTcBaz over 24-hr was shorter at 1D (414 ± 20 ms, p  < .001) and at 3M (414 ± 20 ms, p  < .001) than at baseline (418 ± 20 ms). In contrast, QTcFri over 24-hr was longer at 1D (410 ± 19 ms, p  < .001) but similar at 3M (406 ± 19 ms, p  = .355) compared to baseline (407 ± 19 ms). Daytime QTcBaz was shorter at 1D ( p  < .001) and at 3M ( p  = .007), whereas daytime QTcFri was longer at 1D ( p  < .05) but similar at 3M ( p  = ns) compared to baseline. During the night, changes were observed neither in QTcBaz nor in QTcFri between baseline, 1D, and 3M. Changes in cardiac repolarization after fingolimod initiation were mild and occurred at daytime. Ambiguously, QTcBaz demonstrated shortening, whereas QTcFri showed prolongation in cardiac repolarization after fingolimod initiation. The formula applied for QT-interval correction needs to be taken carefully into account as evaluating pharmacovigilance issues related to fingolimod.

  13. Brain atrophy and lesion load measures over 1 year relate to clinical status after 6 years in patients with clinically isolated syndromes.

    PubMed

    Di Filippo, M; Anderson, V M; Altmann, D R; Swanton, J K; Plant, G T; Thompson, A J; Miller, D H

    2010-02-01

    Conventional MRI lesion measures modestly predict long term disability in some clinically isolated syndrome (CIS) studies. Brain atrophy suggests neuroaxonal loss in multiple sclerosis (MS) with the potential to reflect disease progression to a greater extent than lesion measures. To investigate whether brain atrophy and lesion load, during the first year in patients presenting with CIS, independently predict clinical outcome (development of MS and disability at 6 years). 99 patients presenting with CIS were included in the study. T1 gadolinium enhanced and T2 weighted brain MRI was acquired at baseline and approximately 1 year later. Percentage brain atrophy rate between baseline and follow-up scans was analysed using SIENA. Mean annual brain atrophy rates were -0.38% for all patients, -0.50% in patients who had developed MS at 6 years and -0.26% in those who had not. Brain atrophy rate (p = 0.005) and baseline T2 lesion load (p<0.001) were independent predictors of clinically definite MS. While brain atrophy rate was a predictor of Expanded Disability Status Scale (EDSS) score in a univariate analysis, only 1 year T2 lesion load change (p = 0.007) and baseline gadolinium enhancing lesion number (p = 0.03) were independent predictors of EDSS score at the 6 year follow-up. T1 lesion load was the only MRI parameter which predicted Multiple Sclerosis Functional Composite score at the 6 year follow-up. The findings confirm that brain atrophy occurs during the earliest phases of MS and suggest that 1 year longitudinal measures of MRI change, if considered together with baseline MRI variables, might help to predict clinical status 6 years after the first demyelinating event in CIS patients, better than measurements such as lesion or brain volumes on baseline MRI alone.

  14. Baseline factors associated with incident HIV and STI in four microbicide trials.

    PubMed

    Feldblum, Paul J; Lie, Che-Chin; Weaver, Mark A; Van Damme, Lut; Halpern, Vera; Adeiga, Adesina; Bakare, Rashidi; Schwartz, Jill; Becker, Marissa; Solomon, Suniti

    2010-10-01

    Analyzing pooled data from 4 recent microbicide trials, we aimed to determine characteristics of participants at higher risk of HIV and sexually transmitted infections (STIs), to inform targeted recruitment, preserved study power, and potentially smaller study sizes in future trials. We evaluated the relationships between participants' characteristics and the incidence of HIV, STIs, and reproductive tract infections (RTIs). We calculated incidence rates as the number of infection events divided by the person-years of observation. We applied Cox regression models to assess the relationships between baseline demographic, reproductive and behavioral factors and incident HIV, STIs and RTIs. The pooled incidence rates for HIV, chlamydia, and gonorrhea were 2.1, 6.4 and 9.9 per 100 person-years, respectively. Proportions of participants with trichomoniasis, bacterial vaginosis (BV), and candidiasis were 0.06, 0.40, and 0.40, respectively. In final multivariable models, age and education were significantly (and inversely) associated with incident HIV; baseline chlamydia, baseline trichomoniasis, and younger age were associated with incident Chlamydia; and baseline gonorrhea infection, younger age, less education, nulliparous status, baseline chlamydia, and condom use for contraception were associated with incident gonorrhea. Three factors were associated with trichomoniasis: baseline trichomoniasis infection, baseline chlamydia, and baseline BV. Only younger age was robustly associated with multiple STI outcomes in our multivariable analyses. Although there was little evidence of associations between baseline STIs and incident HIV, they were strongly associated with incident STIs. We found no evidence that measured baseline sexual behavior factors were associated with incident HIV or STIs.

  15. Baseline Vascular Cognitive Impairment Predicts the Course of Apathetic Symptoms After Stroke: The CASPER Study.

    PubMed

    Douven, Elles; Köhler, Sebastian; Schievink, Syenna H J; van Oostenbrugge, Robert J; Staals, Julie; Verhey, Frans R J; Aalten, Pauline

    2018-03-01

    To examine the influence of vascular cognitive impairment (VCI) on the course of poststroke depression (PSD) and poststroke apathy (PSA). Included were 250 stroke patients who underwent neuropsychological and neuropsychiatric assessment 3 months after stroke (baseline) and at a 6- and 12-month follow-up after baseline. Linear mixed models tested the influence of VCI in at least one cognitive domain (any VCI) or multidomain VCI (VCI in multiple cognitive domains) at baseline and domain-specific VCI at baseline on levels of depression and apathy over time, with random effects for intercept and slope. Almost half of the patients showed any VCI at baseline, and any VCI was associated with increasing apathy levels from baseline to the 12-month follow-up. Patients with multidomain VCI had higher apathy scores at the 6- and 12-month follow-up compared with patients with VCI in a single cognitive domain. Domain-specific analyses showed that impaired executive function and slowed information processing speed went together with increasing apathy levels from baseline to 6- and 12-month follow-up. None of the cognitive variables predicted the course of depressive symptoms. Baseline VCI is associated with increasing apathy levels from baseline to the chronic stroke phase, whereas no association was found between baseline VCI and the course of depressive symptoms. Health professionals should be aware that apathy might be absent early after stroke but may evolve over time in patients with VCI. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. A One Health Framework for the Evaluation of Rabies Control Programmes: A Case Study from Colombo City, Sri Lanka

    PubMed Central

    Häsler, Barbara; Hiby, Elly; Gilbert, Will; Obeyesekere, Nalinika; Bennani, Houda; Rushton, Jonathan

    2014-01-01

    Background One Health addresses complex challenges to promote the health of all species and the environment by integrating relevant sciences at systems level. Its application to zoonotic diseases is recommended, but few coherent frameworks exist that combine approaches from multiple disciplines. Rabies requires an interdisciplinary approach for effective and efficient management. Methodology/Principal Findings A framework is proposed to assess the value of rabies interventions holistically. The economic assessment compares additional monetary and non-monetary costs and benefits of an intervention taking into account epidemiological, animal welfare, societal impact and cost data. It is complemented by an ethical assessment. The framework is applied to Colombo City, Sri Lanka, where modified dog rabies intervention measures were implemented in 2007. The two options included for analysis were the control measures in place until 2006 (“baseline scenario”) and the new comprehensive intervention measures (“intervention”) for a four-year duration. Differences in control cost; monetary human health costs after exposure; Disability-Adjusted Life Years (DALYs) lost due to human rabies deaths and the psychological burden following a bite; negative impact on animal welfare; epidemiological indicators; social acceptance of dogs; and ethical considerations were estimated using a mixed method approach including primary and secondary data. Over the four years analysed, the intervention cost US $1.03 million more than the baseline scenario in 2011 prices (adjusted for inflation) and caused a reduction in dog rabies cases; 738 DALYs averted; an increase in acceptability among non-dog owners; a perception of positive changes in society including a decrease in the number of roaming dogs; and a net reduction in the impact on animal welfare from intermediate-high to low-intermediate. Conclusions The findings illustrate the multiple outcomes relevant to stakeholders and allow greater understanding of the value of the implemented rabies control measures, thereby providing a solid foundation for informed decision-making and sustainable control. PMID:25340771

  17. Multi-epoch VLBA Imaging of 20 New TeV Blazars: Apparent Jet Speeds

    NASA Astrophysics Data System (ADS)

    Piner, B. Glenn; Edwards, Philip G.

    2018-01-01

    We present 88 multi-epoch Very Long Baseline Array (VLBA) images (most at an observing frequency of 8 GHz) of 20 TeV blazars, all of the high-frequency-peaked BL Lac (HBL) class, that have not been previously studied at multiple epochs on the parsec scale. From these 20 sources, we analyze the apparent speeds of 43 jet components that are all detected at four or more epochs. As has been found for other TeV HBLs, the apparent speeds of these components are relatively slow. About two-thirds of the components have an apparent speed that is consistent (within 2σ) with no motion, and some of these components may be stationary patterns whose apparent speed does not relate to the underlying bulk flow speed. In addition, a superluminal tail to the apparent speed distribution of the TeV HBLs is detected for the first time, with eight components in seven sources having a 2σ lower limit on the apparent speed exceeding 1c. We combine the data from these 20 sources with an additional 18 sources from the literature to analyze the complete apparent speed distribution of all 38 TeV HBLs that have been studied with very long baseline interferometry at multiple epochs. The highest 2σ apparent speed lower limit considering all sources is 3.6c. This suggests that bulk Lorentz factors of up to about 4, but probably not much higher, exist in the parsec-scale radio-emitting regions of these sources, consistent with estimates obtained in the radio by other means such as brightness temperatures. This can be reconciled with the high Lorentz factors estimated from the high-energy data if the jet has velocity structures consisting of different emission regions with different Lorentz factors. In particular, we analyze the current apparent speed data for the TeV HBLs in the context of a model with a fast central spine and a slower outer layer.

  18. Unbounded boundaries and shifting baselines: Estuaries and coastal seas in a rapidly changing world

    NASA Astrophysics Data System (ADS)

    Little, S.; Spencer, K. L.; Schuttelaars, H. M.; Millward, G. E.; Elliott, M.

    2017-11-01

    This Special Issue of Estuarine, Coastal and Shelf Science presents contributions from ECSA 55; an international symposium organised by the Estuarine and Coastal Sciences Association (ECSA) and Elsevier on the broad theme of estuaries and coastal seas in times of intense change. The objectives of the SI are to synthesise, hypothesise and illustrate the impacts of global change on estuaries and coastal seas through learning lessons from the past, discussing the current and forecasting for the future. It is highlighted here that establishing impacts and assigning cause to the many pressures of global change is and will continue to be a formidable challenge in estuaries and coastal seas, due in part to: (1) their complexity and unbounded nature; (2) difficulties distinguishing between human-induced changes and natural variations and; (3) multiple pressures and effects. The contributing authors have explored a number of these issues over a range of disciplines. The complexity and connectivity of estuaries and coastal seas have been investigated through studies of physicochemical and ecological components, whilst the human imprint on the environment has been identified through a series of predictive, contemporary, historical and palaeo approaches. The impact of human activities has been shown to occur over a range of spatial and temporal scales, requiring the development of integrated management approaches. These 30 articles provide an important contribution to our understanding and assessment of the impacts of global change. The authors highlight methods for essential management/mitigation of the consequences of global change and provide a set of directions, ideas and observations for future work. These include the need to consider: (1) the cumulative, synergistic and antagonistic effects of multiple pressures; (2) the importance of unbounded boundaries and connectivity across the aquatic continuum; (3) the value of combining cross-disciplinary palaeo, contemporary and future modelling studies and; (4) the importance of shifting baselines on ecosystem functioning and the future provision of ecosystem services.

  19. A Randomized Controlled Trial of Cognitive Behavioral Therapy (CBT) for Adjusting to Multiple Sclerosis (The saMS Trial): Does CBT Work and for Whom Does It Work?

    ERIC Educational Resources Information Center

    Moss-Morris, Rona; Dennison, Laura; Landau, Sabine; Yardley, Lucy; Silber, Eli; Chalder, Trudie

    2013-01-01

    Objective: The aims were (a) to test the effectiveness of a nurse-led cognitive behavioral therapy (CBT) program to assist adjustment in the early stages of multiple sclerosis (MS) and (b) to determine moderators of treatment including baseline distress, social support (SS), and treatment preference. Method: Ninety-four ambulatory people with MS…

  20. Influence of Recruitment Strategy on the Reach and Effect of a Web-Based Multiple Tailored Smoking Cessation Intervention among Dutch Adult Smokers

    ERIC Educational Resources Information Center

    Smit, Eline Suzanne; Hoving, Ciska; Cox, Vincent Cornelis Maria; de Vries, Hein

    2012-01-01

    This study investigated the influence of two different recruitment strategies on the reach and effect of a web-based multiple tailored smoking cessation program. From May 2009 until June 2010, Dutch adult smokers were recruited via mass media or general practices. Those who completed the baseline questionnaire were followed up during 6 weeks (two…

  1. Correlations of plasma renin activity and aldosterone concentration with ambulatory blood pressure responses to nebivolol and valsartan, alone and in combination, in hypertension.

    PubMed

    Giles, Thomas D; Bakris, George; Oparil, Suzanne; Weber, Michael A; Li, Huiling; Mallick, Madhuja; Bharucha, David B; Chen, ChunLin; Ferguson, William G

    2015-11-01

    After demonstration of the antihypertensive efficacy of the combination of the beta-blocker nebivolol and the angiotensin receptor blocker valsartan in an 8-week, randomized, placebo-controlled trial (N = 4161), we now report the effects of this treatment on the renin-angiotensin-aldosterone system in a substudy (n = 805). Plasma renin activity increased with valsartan (54%-73%) and decreased with nebivolol (51%-65%) and the combination treatment (17%-39%). Plasma aldosterone decreased with individual treatments (valsartan, 11%-22%; nebivolol, 20%-26%), with the largest reduction (35%) observed with maximum combination dose (20 mg nebivolol/320 mg valsartan). Baseline ln(plasma renin activity) correlated with the 8-week reductions in 24-hour systolic and diastolic BP following treatments with the combination (all doses combined, P = .003 and P < .001) and nebivolol (both, P < .001), but not with valsartan. Baseline ln(aldosterone) correlated with 24-hour systolic and diastolic BP reductions following combination treatment only (P < .001 and P = .005). The implications of the renin-angiotensin-aldosterone system effects of this beta blocker-angiotensin receptor blocker combination should be explored further. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  2. The role of urgency, frequency, and nocturia in defining overactive bladder adaptive behavior.

    PubMed

    Minassian, Vatche; Stewart, Walter; Hirsch, Annemarie; Kolodner, Ken; Fitzgerald, Mary; Burgio, Kathryn; Cundiff, Geoffrey; Blaivas, Jerry; Newman, Diane; Dilley, Anne

    2011-03-01

    To determine the relation between urgency alone, or in combination with frequency and nocturia, and adaptive behavior in overactive bladder (OAB) syndrome. We used survey data from the General Longitudinal Overactive Bladder Evaluation (GLOBE) of primary care patients over 40. Participants (n=2,752: 1,557 females; 1,195 males) completed the same survey at two time points, 6 months apart. Questions assessed OAB symptoms and adaptive behavior. We estimated correlation coefficients (R(2)) between urgency, frequency, and nocturia symptom scores (alone and in combination) and adaptive behavior measures at baseline and change in symptom scores and behavioral measures from baseline to 6 months. At baseline, urgency was the dominant predictor of all behavioral measures for females (R(2)=0.19-0.48) and males (R(2)=0.15-0.39). Lower R(2) values were observed for the change in measures from baseline to 6 months, but again change in urgency was the strongest predictor of change in adaptive behavior (R(2)=0.04-0.13 in females, and 0.02-0.08 in males). The correlation between symptoms and measures of adaptive behavior was almost completely explained by the urgency score. Frequency and nocturia did not substantially improve the overall correlation. The relation between measures of OAB symptoms and adaptive behavior at baseline and over time are largely explained by urgency, not by frequency and nocturia. Copyright © 2011 Wiley-Liss, Inc.

  3. Wide-Baseline Stereo-Based Obstacle Mapping for Unmanned Surface Vehicles

    PubMed Central

    Mou, Xiaozheng; Wang, Han

    2018-01-01

    This paper proposes a wide-baseline stereo-based static obstacle mapping approach for unmanned surface vehicles (USVs). The proposed approach eliminates the complicated calibration work and the bulky rig in our previous binocular stereo system, and raises the ranging ability from 500 to 1000 m with a even larger baseline obtained from the motion of USVs. Integrating a monocular camera with GPS and compass information in this proposed system, the world locations of the detected static obstacles are reconstructed while the USV is traveling, and an obstacle map is then built. To achieve more accurate and robust performance, multiple pairs of frames are leveraged to synthesize the final reconstruction results in a weighting model. Experimental results based on our own dataset demonstrate the high efficiency of our system. To the best of our knowledge, we are the first to address the task of wide-baseline stereo-based obstacle mapping in a maritime environment. PMID:29617293

  4. Black cohosh with or without St. John's wort for symptom-specific climacteric treatment--results of a large-scale, controlled, observational study.

    PubMed

    Briese, Volker; Stammwitz, Ute; Friede, Michael; Henneicke-von Zepelin, Hans-Heinrich

    2007-08-20

    To evaluate usage pattern, effectiveness and safety of Black cohosh alone or in fixed combination with St. John's wort on menopausal symptoms in general clinical practice. Prospective, controlled open-label observational study of 6141 women at 1287 outpatient gynecologists in Germany. Subjects were treated with recommended doses of study therapies, with treatment chosen by the participating physicians. Patients were followed up for 6 months, optionally 12 months. The primary effectiveness variable was Menopause Rating Scale (MRS) subscore PSYCHE at Month 3 evaluated by ANCOVA. The treatment groups were comparable at baseline, excepting the main MRS score and the PSYCHE score (monotherapy: 0.31+/-0.22; combination therapy: 0.42+/-0.23). Reductions from baseline were seen with both regimens for all variables. The changes in the primary variable remained significantly different between groups (p<0.001) when adjusted for differences at baseline with the combination therapy being superior: from 0.37 (adjusted) to 0.25 (95% CI: 0.24-0.25) and 0.23 (95% CI: 0.22-0.23) at Month 3 in the monotherapy and combination-therapy groups, respectively. The improvement by both therapies was maintained at 6 and 12 months. The rate of possibly treatment-related adverse events was 0.16%, all non-serious. The results support the effectiveness and tolerability profiles of two Black cohosh-based therapies for menopausal symptoms in general practice. They were used differentially: the monotherapy for neurovegetative symptoms, the combination for patients with more pronounced mood complaints. The fixed combination of Black cohosh and St. John's wort was superior to Black cohosh alone in alleviating climacteric mood symptoms.

  5. Use of a fixed combination of acetylsalicylic acid, acetaminophen and caffeine compared with acetaminophen alone in episodic tension-type headache: meta-analysis of four randomized, double-blind, placebo-controlled, crossover studies.

    PubMed

    Diener, Hans-Christoph; Gold, Morris; Hagen, Martina

    2014-11-19

    Most patients with episodic tension-type headache treat headache episodes with over-the-counter medication. Combination analgesics containing caffeine may be more effective and as well tolerated as monotherapy. The aim of this study was to evaluate the efficacy of the combination of acetylsalicylic acid, acetaminophen (paracetamol) and caffeine in episodic tension-type headache using recently recommended endpoints. Four randomized, controlled trials of identical design in 1,900 patients with episodic tension-type headache comparing acetylsalicylic acid, acetaminophen and caffeine vs. acetaminophen or placebo were pooled. Analysis populations were 'all headache episodes' and those with 'severe pain at baseline'. Post-hoc defined primary endpoint: headache episodes pain-free at 2 h. Secondary endpoints: headache episodes pain-free at 1 h, headache response at 2 h (mild or no pain), degree of interference with daily activities. 6,861 headache episodes were treated, including 2,215 severe headache episodes. The proportion of headache episodes pain-free at 2 h was significantly higher with the triple combination (28.5%) vs. acetaminophen (21.0%) and placebo (18.0%) (p < 0.0001), and similarly for those severe at baseline (20.2% vs. 12.1% and 10.8%; p ≤ 0.0003). A similar pattern of superiority was observed for secondary endpoints. The triple combination was generally well tolerated. The combination of acetylsalicylic acid, acetaminophen and caffeine is effective and well tolerated in episodic tension-type headache, and significantly superior to acetaminophen with regard to being pain-free at 2 h, headache response at 2 h and ability to return to daily activities, even in those with pain rated severe at baseline.

  6. Vascular effects of intravenous intralipid and dextrose infusions in obese subjects

    PubMed Central

    Gosmanov, Aidar R.; Smiley, Dawn D.; Peng, Limin; Siquiera, Joselita; Robalino, Gonzalo; Newton, Christopher; Umpierrez, Guillermo E.

    2013-01-01

    Hyperglycemia and elevated free fatty acids (FFA) are implicated in the development of endothelial dysfunction. Infusion of soy-bean oil-based lipid emulsion (Intralipid®) increases FFA levels and results in elevation of blood pressure (BP) and endothelial dysfunction in obese healthy subjects. The effects of combined hyperglycemia and high FFA on BP, endothelial function and carbohydrate metabolism are not known. Twelve obese healthy subjects received four random, 8-h IV infusions of saline, Intralipid 40 mL/h, Dextrose 10% 40 mL/h, or combined Intralipid and dextrose. Plasma levels of FFA increased by 1.03±0.34 mmol/L (p=0.009) after Intralipid, but FFAs remained unchanged during saline, dextrose, and combined Intralipid and dextrose infusion. Plasma glucose and insulin concentrations significantly increased after dextrose and combined Intralipid and dextrose (all, p<0.05) and were not different from baseline during saline and lipid infusion. Intralipid increased systolic BP by 12±9 mmHg (p<0.001) and diastolic BP by 5±6 mmHg (p=0.022), and decreased flow-mediated dilatation (FMD) from baseline by 3.2%±1.4% (p<0.001). Saline and dextrose infusion had neutral effects on BP and FMD. The co-administration of lipid and dextrose decreased FMD by 2.4%±2.1% (p=0.002) from baseline, but did not significantly increase systolic or diastolic BP. Short-term Intralipid infusion significantly increased FFA and BP; in contrast, FFA and BP were unchanged during combined infusion of Intralipid and dextrose. Combined Intralipid and dextrose infusion resulted in endothelial dysfunction similar to Intralipid alone. PMID:22483976

  7. Hypercoagulable states in patients with multiple myeloma can affect the thalidomide-associated venous thromboembolism.

    PubMed

    Talamo, Giampaolo P; Ibrahim, Sulfi; Claxton, David; Tricot, Guido J; Fink, Louis M; Zangari, Maurizio

    2009-07-01

    The therapeutic use of thalidomide in patients with multiple myeloma is often complicated by the development of venous thromboembolism. The objective of the present study was to identify hypercoagulable states associated with development of venous thromboembolism in thalidomide-treated multiple myeloma patients. We screened 49 consecutive multiple myeloma patients treated with thalidomide at baseline for hypercoagulability. With a median follow-up of 11 months, 10 of 49 multiple myeloma patients developed a thrombotic episode. Laboratory assays revealed an underlying abnormality in nine of the 10 patients; hypercoagulable screenings were normal in 36 of the 39 patients who did not develop venous thromboembolism (P < 0.0001). Our retrospective study results suggest that the multiple myeloma patients with thromboembolic complications during treatment with thalidomide have a frequent concomitant underlying thrombophilic state.

  8. The Tupange Project in Kenya: A Multifaceted Approach to Increasing Use of Long-Acting Reversible Contraceptives

    PubMed Central

    Muthamia, Michael; Owino, Kenneth; Nyachae, Paul; Kilonzo, Margaret; Kamau, Mercy; Otai, Jane; Kabue, Mark; Keyonzo, Nelson

    2016-01-01

    ABSTRACT Background: Long-acting reversible contraceptives (LARCs) are safe and highly effective, and they have higher continuation rates than short-acting methods. Because only a small percentage of sexually active women in Kenya use LARCs, the Tupange project implemented a multifaceted approach to increase uptake of LARCs, particularly among the urban poor. The project included on-site mentoring, whole-site orientation, commodity security, quality improvement, and multiple demand-promotion and service-provision strategies, in the context of wide method choice. We report on activities in Nairobi between July 2011 and December 2014, the project implementation period. Methods: We used a household longitudinal survey of women of reproductive age to measure changes in the contraceptive prevalence rate (CPR) and other family planning-related variables. At baseline in July 2010, 2,676 women were interviewed; about 50% were successfully tracked and interviewed at endline in December 2014. A baseline service delivery point (SDP) survey of 112 health facilities and 303 service providers was conducted in July 2011, and an endline SDP survey was conducted in December 2014 to measure facility-based interventions. The SDP baseline survey was conducted after the household survey, as facilities were selected based on where clients said they obtained services. Results: The project led to significant increases in use of implants and intrauterine devices (IUDs). Uptake of implants increased by 6.5 percentage points, from 2.4% at baseline to 8.9% by endline, and uptake of IUDs increased by 2.1 percentage points, from 2.2% to 4.3%. By the endline survey, 37.7% of clients using pills and injectables at baseline had switched to LARCs. Contraceptive use among the poorest and poor wealth quintiles increased by 20.5 and 21.5 percentage points, respectively, from baseline to endline. Various myths and misconceptions reported about family planning methods declined significantly between baseline and endline. Conclusion: Training, commodity security, multiple service delivery models, and demand promotion were the cornerstones of a successful approach to reach the urban poor in Nairobi with LARCs. PMID:27540124

  9. Multicenter, Randomized, Controlled Study Comparing Tafluprost/Timolol Fixed Combination with Latanoprost/Timolol Fixed Combination in Primary Open-Angle Glaucoma and Ocular Hypertension.

    PubMed

    Suzuki, Katsuyoshi; Otsuka, Naomi; Hizaki, Hiroko; Hashimoto, Masayo; Kuwayama, Yasuaki

    2018-06-05

    This was the first exploratory randomized controlled study to compare the efficacy and safety of a preserved tafluprost/timolol fixed combination (TAF/TIM) with a preserved latanoprost/timolol fixed combination (LAT/TIM). This prospective, randomized, open-label study was conducted in Japanese patients with primary open-angle glaucoma, including normal-tension glaucoma or ocular hypertension. Following a 4-week LAT/TIM run-in period, eligible patients entered a 12-week treatment period, during which they received either LAT/TIM or TAF/TIM. The efficacy endpoint was the change in intraocular pressure (IOP) from baseline to week 12 and the safety endpoints included the changes from baseline to week 12 in superficial punctate keratopathy (SPK) score, tear breakup time (TBUT), and hyperemia score, as well as adverse events (AEs). At week 6, ocular symptoms were evaluated using a questionnaire. In total, 131 patients provided informed consent. Of these, 115 completed the run-in period and were assigned to receive TAF/TIM (n = 60) or LAT/TIM (n = 55). At week 12, there were no significant differences between the TAF/TIM and LAT/TIM groups in the change from baseline in trough IOP and IOP at 4-6 h after instillation. There were no significant differences between the two groups in the change from baseline to week 12 in SPK score, TBUT, and hyperemia score. However, only in the TAF/TIM group, the total SPK score and the inferior cornea SPK score were significantly lower at week 12 compared with baseline. Eye irritation and eye pain were significantly decreased in the TAF/TIM group compared with the LAT/TIM group. Two treatment-related AEs were reported in the TAF/TIM group (3.3%) and none in the LAT/TIM group, while no serious AEs were reported in either group. TAF/TIM is as effective as LAT/TIM in terms of IOP-reducing effect, with fewer ocular symptoms. TAF/TIM was associated with a significant improvement in SPK scores. UMIN Clinical Trials Registry Identifier, UMIN000023862. Santen Pharmaceutical Co., Ltd., Osaka, Japan.

  10. Intermittent fasting during Ramadan: does it affect sleep?

    PubMed

    Bahammam, Ahmed S; Almushailhi, Khalid; Pandi-Perumal, Seithikurippu R; Sharif, Munir M

    2014-02-01

    Islamic intermittent fasting is distinct from regular voluntary or experimental fasting. We hypothesised that if a regimen of a fixed sleep-wake schedule and a fixed caloric intake is followed during intermittent fasting, the effects of fasting on sleep architecture and daytime sleepiness will be minimal. Therefore, we designed this study to objectively assess the effects of Islamic intermittent fasting on sleep architecture and daytime sleepiness. Eight healthy volunteers reported to the Sleep Disorders Centre on five occasions for polysomnography and multiple sleep latency tests: (1) during adaptation; (2) 3 weeks before Ramadan, after having performed Islamic fasting for 1 week (baseline fasting); (3) 1 week before Ramadan (non-fasting baseline); (4) 2 weeks into Ramadan (Ramadan); and (5) 2 weeks after Ramadan (non-fasting; Recovery). Daytime sleepiness was assessed using the Epworth Sleepiness Scale and the multiple sleep latency test. The participants had a mean age of 26.6 ± 4.9 years, a body mass index of 23.7 ± 3.5 kg m(-2) and an Epworth Sleepiness Scale score of 7.3 ± 2.7. There was no change in weight or the Epworth Sleepiness Scale in the four study periods. The rapid eye movement sleep percentage was significantly lower during fasting. There was no difference in sleep latency, non-rapid eye movement sleep percentage, arousal index and sleep efficiency. The multiple sleep latency test analysis revealed no difference in the sleep latency between the 'non-fasting baseline', 'baseline fasting', 'Ramadan' and 'Recovery' time points. Under conditions of a fixed sleep-wake schedule and a fixed caloric intake, Islamic intermittent fasting results in decreased rapid eye movement sleep with no impact on other sleep stages, the arousal index or daytime sleepiness. © 2013 European Sleep Research Society.

  11. Improving anxiety regulation in patients with breast cancer at the beginning of the survivorship period: a randomized clinical trial comparing the benefits of single-component and multiple-component group interventions.

    PubMed

    Merckaert, Isabelle; Lewis, Florence; Delevallez, France; Herman, Sophie; Caillier, Marie; Delvaux, Nicole; Libert, Yves; Liénard, Aurore; Nogaret, Jean-Marie; Ogez, David; Scalliet, Pierre; Slachmuylder, Jean-Louis; Van Houtte, Paul; Razavi, Darius

    2017-08-01

    To compare in a multicenter randomized controlled trial the benefits in terms of anxiety regulation of a 15-session single-component group intervention (SGI) based on support with those of a 15-session multiple-component structured manualized group intervention (MGI) combining support with cognitive-behavioral and hypnosis components. Patients with nonmetastatic breast cancer were randomly assigned at the beginning of the survivorship period to the SGI (n = 83) or MGI (n = 87). Anxiety regulation was assessed, before and after group interventions, through an anxiety regulation task designed to assess their ability to regulate anxiety psychologically (anxiety levels) and physiologically (heart rates). Questionnaires were used to assess psychological distress, everyday anxiety regulation, and fear of recurrence. Group allocation was computer generated and concealed till baseline completion. Compared with patients in the SGI group (n = 77), patients attending the MGI group (n = 82) showed significantly reduced anxiety after a self-relaxation exercise (P = .006) and after exposure to anxiety triggers (P = .013) and reduced heart rates at different time points throughout the task (P = .001 to P = .047). The MGI participants also reported better everyday anxiety regulation (P = .005), greater use of fear of recurrence-related coping strategies (P = .022), and greater reduction in fear of recurrence-related psychological distress (P = .017) compared with the SGI group. This study shows that an MGI combining support with cognitive-behavioral techniques and hypnosis is more effective than an SGI based only on support in improving anxiety regulation in patients with breast cancer. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Prediction of long-term disability in multiple sclerosis.

    PubMed

    Schlaeger, R; D'Souza, M; Schindler, C; Grize, L; Dellas, S; Radue, E W; Kappos, L; Fuhr, P

    2012-01-01

    Little is known about the predictive value of neurophysiological measures for the long-term course of multiple sclerosis (MS). To prospectively investigate whether combined visual (VEP) and motor evoked potentials (MEP) allow prediction of disability over 14 years. A total of 30 patients with relapsing-remitting and secondary progressive MS were prospectively investigated with VEPs, MEPs and the Expanded Disability Status Scale (EDSS) at entry (T0) and after 6, 12 and 24 months, and with cranial MRI scans at entry (T2-weighted and gadolinium-enhanced T1-weighted images). EDSS was again assessed at year 14 (T4). The association between evoked potential (EP), magnetic resonance (MR) data and EDSS was measured using Spearman's rank correlation. Multivariable linear regression was performed to predict EDSS(T4) as a function of z-transformed EP-latencies(T0). The model was validated using a jack-knife procedure and the potential for improving it by inclusion of additional baseline variables was examined. EDSS values(T4) correlated with the sum of z-transformed EP-latencies(T0) (rho = 0.68, p < 0.0001), but not with MR-parameters(T0). EDSS(T4) as predicted by the formula EDSS(T4) = 4.194 + 0.088 * z-score P100(T0) + 0.071 * z-score CMCT(UE, T0) correlated with the observed values (rho = 0.69, p < 0.0001). Combined EPs allow prediction of long-term disability in small groups of patients with MS. This may have implications for the choice of monitoring methods in clinical trials and for daily practice decisions.

  13. Comparison of EHR-based diagnosis documentation locations to a gold standard for risk stratification in patients with multiple chronic conditions.

    PubMed

    Martin, Shelby; Wagner, Jesse; Lupulescu-Mann, Nicoleta; Ramsey, Katrina; Cohen, Aaron; Graven, Peter; Weiskopf, Nicole G; Dorr, David A

    2017-08-02

    To measure variation among four different Electronic Health Record (EHR) system documentation locations versus 'gold standard' manual chart review for risk stratification in patients with multiple chronic illnesses. Adults seen in primary care with EHR evidence of at least one of 13 conditions were included. EHRs were manually reviewed to determine presence of active diagnoses, and risk scores were calculated using three different methodologies and five EHR documentation locations. Claims data were used to assess cost and utilization for the following year. Descriptive and diagnostic statistics were calculated for each EHR location. Criterion validity testing compared the gold standard verified diagnoses versus other EHR locations and risk scores in predicting future cost and utilization. Nine hundred patients had 2,179 probable diagnoses. About 70% of the diagnoses from the EHR were verified by gold standard. For a subset of patients having baseline and prediction year data (n=750), modeling showed that the gold standard was the best predictor of outcomes on average for a subset of patients that had these data. However, combining all data sources together had nearly equivalent performance for prediction as the gold standard. EHR data locations were inaccurate 30% of the time, leading to improvement in overall modeling from a gold standard from chart review for individual diagnoses. However, the impact on identification of the highest risk patients was minor, and combining data from different EHR locations was equivalent to gold standard performance. The reviewer's ability to identify a diagnosis as correct was influenced by a variety of factors, including completeness, temporality, and perceived accuracy of chart data.

  14. Bias, precision and statistical power of analysis of covariance in the analysis of randomized trials with baseline imbalance: a simulation study.

    PubMed

    Egbewale, Bolaji E; Lewis, Martyn; Sim, Julius

    2014-04-09

    Analysis of variance (ANOVA), change-score analysis (CSA) and analysis of covariance (ANCOVA) respond differently to baseline imbalance in randomized controlled trials. However, no empirical studies appear to have quantified the differential bias and precision of estimates derived from these methods of analysis, and their relative statistical power, in relation to combinations of levels of key trial characteristics. This simulation study therefore examined the relative bias, precision and statistical power of these three analyses using simulated trial data. 126 hypothetical trial scenarios were evaluated (126,000 datasets), each with continuous data simulated by using a combination of levels of: treatment effect; pretest-posttest correlation; direction and magnitude of baseline imbalance. The bias, precision and power of each method of analysis were calculated for each scenario. Compared to the unbiased estimates produced by ANCOVA, both ANOVA and CSA are subject to bias, in relation to pretest-posttest correlation and the direction of baseline imbalance. Additionally, ANOVA and CSA are less precise than ANCOVA, especially when pretest-posttest correlation ≥ 0.3. When groups are balanced at baseline, ANCOVA is at least as powerful as the other analyses. Apparently greater power of ANOVA and CSA at certain imbalances is achieved in respect of a biased treatment effect. Across a range of correlations between pre- and post-treatment scores and at varying levels and direction of baseline imbalance, ANCOVA remains the optimum statistical method for the analysis of continuous outcomes in RCTs, in terms of bias, precision and statistical power.

  15. Bias, precision and statistical power of analysis of covariance in the analysis of randomized trials with baseline imbalance: a simulation study

    PubMed Central

    2014-01-01

    Background Analysis of variance (ANOVA), change-score analysis (CSA) and analysis of covariance (ANCOVA) respond differently to baseline imbalance in randomized controlled trials. However, no empirical studies appear to have quantified the differential bias and precision of estimates derived from these methods of analysis, and their relative statistical power, in relation to combinations of levels of key trial characteristics. This simulation study therefore examined the relative bias, precision and statistical power of these three analyses using simulated trial data. Methods 126 hypothetical trial scenarios were evaluated (126 000 datasets), each with continuous data simulated by using a combination of levels of: treatment effect; pretest-posttest correlation; direction and magnitude of baseline imbalance. The bias, precision and power of each method of analysis were calculated for each scenario. Results Compared to the unbiased estimates produced by ANCOVA, both ANOVA and CSA are subject to bias, in relation to pretest-posttest correlation and the direction of baseline imbalance. Additionally, ANOVA and CSA are less precise than ANCOVA, especially when pretest-posttest correlation ≥ 0.3. When groups are balanced at baseline, ANCOVA is at least as powerful as the other analyses. Apparently greater power of ANOVA and CSA at certain imbalances is achieved in respect of a biased treatment effect. Conclusions Across a range of correlations between pre- and post-treatment scores and at varying levels and direction of baseline imbalance, ANCOVA remains the optimum statistical method for the analysis of continuous outcomes in RCTs, in terms of bias, precision and statistical power. PMID:24712304

  16. Impact of data assimilation on ocean current forecasts in the Angola Basin

    NASA Astrophysics Data System (ADS)

    Phillipson, Luke; Toumi, Ralf

    2017-06-01

    The ocean current predictability in the data limited Angola Basin was investigated using the Regional Ocean Modelling System (ROMS) with four-dimensional variational data assimilation. Six experiments were undertaken comprising a baseline case of the assimilation of salinity/temperature profiles and satellite sea surface temperature, with the subsequent addition of altimetry, OSCAR (satellite-derived sea surface currents), drifters, altimetry and drifters combined, and OSCAR and drifters combined. The addition of drifters significantly improves Lagrangian predictability in comparison to the baseline case as well as the addition of either altimetry or OSCAR. OSCAR assimilation only improves Lagrangian predictability as much as altimetry assimilation. On average the assimilation of either altimetry or OSCAR with drifter velocities does not significantly improve Lagrangian predictability compared to the drifter assimilation alone, even degrading predictability in some cases. When the forecast current speed is large, it is more likely that the combination improves trajectory forecasts. Conversely, when the currents are weaker, it is more likely that the combination degrades the trajectory forecast.

  17. Modeling and Assessment of Precise Time Transfer by Using BeiDou Navigation Satellite System Triple-Frequency Signals

    PubMed Central

    Zhang, Pengfei; Zhang, Rui; Liu, Jinhai; Lu, Xiaochun

    2018-01-01

    This study proposes two models for precise time transfer using the BeiDou Navigation Satellite System triple-frequency signals: ionosphere-free (IF) combined precise point positioning (PPP) model with two dual-frequency combinations (IF-PPP1) and ionosphere-free combined PPP model with a single triple-frequency combination (IF-PPP2). A dataset with a short baseline (with a common external time frequency) and a long baseline are used for performance assessments. The results show that IF-PPP1 and IF-PPP2 models can both be used for precise time transfer using BeiDou Navigation Satellite System (BDS) triple-frequency signals, and the accuracy and stability of time transfer is the same in both cases, except for a constant system bias caused by the hardware delay of different frequencies, which can be removed by the parameter estimation and prediction with long time datasets or by a priori calibration. PMID:29596330

  18. Subjective, but not Objective, Lingering Effects of Multiple Past Concussions in Adolescents

    PubMed Central

    McKay, Carly D.; Mrazik, Martin; Barlow, Karen M.; Meeuwisse, Willem H.; Emery, Carolyn A.

    2013-01-01

    Abstract The existing literature on lingering effects from concussions in children and adolescents is limited and mixed, and there are no clear answers for patients, clinicians, researchers, or policy makers. The purpose of this study was to examine whether there are lingering effects of past concussions in adolescent athletes. Participants in this study included 643 competitive Bantam and Midget hockey players (most elite 20% by division of play) between 13 and 17 years of age (mean age=15.5, SD=1.2). Concussion history at baseline assessment was retrospectively documented using a pre-season questionnaire (PSQ), which was completed at home by parents and players in advance of baseline testing. Players with English as a second language, self-reported attention or learning disorders, a concussion within 6 months of baseline, or suspected invalid test profiles were excluded from these analyses. Demographically adjusted standard scores for the five composites/domains and raw symptom ratings from the brief Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) computerized battery were analyzed. Adolescent athletes with one or two or more prior concussions did not have significantly worse neurocognitive functioning on ImPACT than did those with no previous concussions. There were significantly more symptoms reported in those with two or more prior concussions than in those with no or one prior concussion. Adolescents with multiple previous concussions had higher levels of baseline symptoms, but there were not group differences in neurocognitive functioning using this brief computerized battery. PMID:23560947

  19. Subjective, but not objective, lingering effects of multiple past concussions in adolescents.

    PubMed

    Brooks, Brian L; McKay, Carly D; Mrazik, Martin; Barlow, Karen M; Meeuwisse, Willem H; Emery, Carolyn A

    2013-09-01

    The existing literature on lingering effects from concussions in children and adolescents is limited and mixed, and there are no clear answers for patients, clinicians, researchers, or policy makers. The purpose of this study was to examine whether there are lingering effects of past concussions in adolescent athletes. Participants in this study included 643 competitive Bantam and Midget hockey players (most elite 20% by division of play) between 13 and 17 years of age (mean age=15.5, SD=1.2). Concussion history at baseline assessment was retrospectively documented using a pre-season questionnaire (PSQ), which was completed at home by parents and players in advance of baseline testing. Players with English as a second language, self-reported attention or learning disorders, a concussion within 6 months of baseline, or suspected invalid test profiles were excluded from these analyses. Demographically adjusted standard scores for the five composites/domains and raw symptom ratings from the brief Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) computerized battery were analyzed. Adolescent athletes with one or two or more prior concussions did not have significantly worse neurocognitive functioning on ImPACT than did those with no previous concussions. There were significantly more symptoms reported in those with two or more prior concussions than in those with no or one prior concussion. Adolescents with multiple previous concussions had higher levels of baseline symptoms, but there were not group differences in neurocognitive functioning using this brief computerized battery.

  20. Contingency management adapted for African-American adolescents with obesity enhances youth weight loss with caregiver participation: a multiple baseline pilot study.

    PubMed

    Hartlieb, Kathryn Brogan; Naar, Sylvie; Ledgerwood, David M; Templin, Thomas N; Ellis, Deborah A; Donohue, Bradley; Cunningham, Phillippe B

    2015-12-07

    Contingency management (CM) interventions, which use operant conditioning principles to encourage completion of target behavioral goals, may be useful for improving adherence to behavioral skills training (BST). Research-to-date has yet to explore CM for weight loss in minority adolescents. To examine the effects of CM in improving adolescent weight loss when added to BST. The study utilized an innovative experimental design that builds upon multiple baseline approaches as recommended by the National Institutes of Health. Six obese African-American youth and their primary caregivers living in Detroit, Michigan, USA. Adolescents received between 4 and 12 weeks of BST during a baseline period and subsequently received CM targeting weight loss. Youth weight. Linear mixed effects modeling was used in the analysis. CM did not directly affect adolescent weight loss above that of BST (p=0.053). However, when caregivers were involved in CM session treatment, contingency management had a positive effect on adolescent weight loss. The estimated weight loss due to CM when caregivers also attended was 0.66 kg/week (p<0.001, [95% CI; -1.96, -0.97]) relative to the baseline trajectory. This study demonstrates application of a novel experimental approach to intervention development and demonstrated the importance of parent involvement when delivering contingency management for minority youth weight loss. Lessons learned from contingency management program implementation are also discussed in order to inform practice.

  1. Social Anxiety Symptoms and Suicidal Ideation in a Clinical Sample of Early Adolescents: Examining Loneliness and Social Support as Longitudinal Mediators

    PubMed Central

    Prinstein, Mitchell J.; Simon, Valerie; Spirito, Anthony

    2014-01-01

    Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12–15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived social support were assessed via structured interviews and self-report instruments. Structural equation modeling revealed a significant direct relationship between social anxiety symptoms at baseline and suicidal ideation at 18 months post-baseline, even after controlling for baseline depressive symptoms and ideation. A second multiple mediation model revealed that baseline social anxiety had a significant indirect effect on suicidal ideation at 18 months post-baseline through loneliness at 9 months post-baseline. Social anxiety did not have a significant indirect effect on suicidal ideation through perceived social support from either parents or close friends. Findings suggest that loneliness may be particularly implicated in the relationship between social anxiety and suicidality in teens. Clinicians should assess and address feelings of loneliness when treating socially anxious adolescents. PMID:24390470

  2. Social anxiety symptoms and suicidal ideation in a clinical sample of early adolescents: examining loneliness and social support as longitudinal mediators.

    PubMed

    Gallagher, Michelle; Prinstein, Mitchell J; Simon, Valerie; Spirito, Anthony

    2014-08-01

    Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12-15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived social support were assessed via structured interviews and self-report instruments. Structural equation modeling revealed a significant direct relationship between social anxiety symptoms at baseline and suicidal ideation at 18 months post-baseline, even after controlling for baseline depressive symptoms and ideation. A second multiple mediation model revealed that baseline social anxiety had a significant indirect effect on suicidal ideation at 18 months post-baseline through loneliness at 9 months post-baseline. Social anxiety did not have a significant indirect effect on suicidal ideation through perceived social support from either parents or close friends. Findings suggest that loneliness may be particularly implicated in the relationship between social anxiety and suicidality in teens. Clinicians should assess and address feelings of loneliness when treating socially anxious adolescents.

  3. Peripheral arterial stiffness is associated with higher baseline plasma uric acid: A prospective cohort study.

    PubMed

    Ding, Xiaohan; Ye, Ping; Wang, Xiaona; Cao, Ruihua; Yang, Xu; Xiao, Wenkai; Zhang, Yun; Bai, Yongyi; Wu, Hongmei

    2017-03-01

    This prospective cohort study aimed at identifying association between uric acid (UA) and peripheral arterial stiffness. A prospective cohort longitudinal study was performed according to an average of 4.8 years' follow-up. The demographic data, anthropometric parameters, peripheral arterial stiffness (carotid-radial pulse-wave velocity, cr-PWV) and biomarker variables including UA were examined at both baseline and follow-up. Pearson's correlations were used to identify the associations between UA and peripheral arterial stiffness. Further logistic regressions were employed to determine the associations between UA and arterial stiffness. At the end of follow-up, 1447 subjects were included in the analyses. At baseline, cr-PWV ( r  = 0.200, p  < 0.001) was closely associated with UA. Furthermore, the follow-up cr-PWV ( r  = 0.145, p  < 0.001) was also strongly correlated to baseline UA in Pearson's correlation analysis. Multiple regressions also indicated the association between follow-up cr-PWV ( β  = 0.493, p  = 0.013) and baseline UA level. Logistic regressions revealed that higher baseline UA level was an independent predictor of arterial stiffness severity assessed by cr-PWV at follow-up cross-section. Peripheral arterial stiffness is closely associated with higher baseline UA level. Furthermore, a higher baseline UA level is an independent risk factor and predictor for peripheral arterial stiffness.

  4. Assessment of ocular hypotensive effect and safety 12 months after changing from an unfixed combination to a latanoprost 0.005% + timolol maleate 0.5% fixed combination.

    PubMed

    Inoue, Kenji; Okayama, Ryoko; Higa, Risako; Wakakura, Masato; Tomita, Goji

    2012-01-01

    Latanoprost 0.005% + timolol maleate 0.5% combined eyedrops were recently made available in Japan. We prospectively investigated the intraocular pressure (IOP)-lowering effect, visual preservation effect, and adverse reactions of a one-year administration of this fixed combination. The subjects included 162 eyes from 162 patients diagnosed with either primary open-angle glaucoma or ocular hypertension and using an unfixed combination of latanoprost 0.005% and timolol maleate 0.5%. The unfixed combination was discontinued and replaced with the latanoprost 0.005% + timolol maleate 0.5% fixed combination with no washout period. IOP was measured before (baseline) and 3, 6, 9, and 12 months after the change. The mean deviation value of Humphrey field analysis was compared. Adverse reactions were examined at every follow-up. No significant differences were found between mean IOP values obtained at baseline (mean ± standard deviation, 15.2 ± 3.3 mmHg) 3 months (15.1 ± 3.2 mmHg), 6 months (15.3 ± 3.1 mmHg), 9 months (15.3 ± 3.1 mmHg), and 12 months (15.1 ± 3.2 mmHg) after the change from the unfixed to the fixed combination of eyedrops (P = 0.212). In addition, no significant differences were observed between mean deviation values obtained at baseline (-9.11 ± 6.94 dB) and 12 months (-10.08 ± 7.24 dB) after the change (P = 0.114). Thirty-one patients discontinued the fixed combination within 12 months of replacement, due to an insufficient IOP decrease (20 patients, 12.3%) and adverse reactions (11 patients, 6.8%). Following replacement of two eyedrop medications (latanoprost 0.005% and timolol maleate 0.5%) by one fixed combination (latanoprost 0.005% + timolol maleate 0.5%), IOP and visual field were preserved. However, 20% of the patients discontinued the new treatment because of an insufficient IOP decrease and complaints of adverse reactions.

  5. THE EFFECT OF FEEDBACK ON THE ACCURACY OF CHECKLIST COMPLETION DURING INSTRUMENT FLIGHT TRAINING

    PubMed Central

    Rantz, William G; Dickinson, Alyce M; Sinclair, Gilbert A; Van Houten, Ron

    2009-01-01

    This study examined whether pilots completed airplane checklists more accurately when they receive postflight graphic and verbal feedback. Participants were 8 college students who are pilots with an instrument rating. The task consisted of flying a designated flight pattern using a personal computer aviation training device (PCATD). The dependent variables were the number of checklist items completed correctly. A multiple baseline design across pairs of participants with withdrawal of treatment was employed in this study. During baseline, participants were given postflight technical feedback. During intervention, participants were given postflight graphic feedback on checklist use and praise for improvements along with technical feedback. The intervention produced near perfect checklist performance, which was maintained following a return to the baseline conditions. PMID:20190914

  6. Vehicle Integrated Propulsion Research for the Study of Health Management Capabilities

    NASA Technical Reports Server (NTRS)

    Lekki, John D.; Simon, Donald L.; Hunter, Gary W.; Woike, Mary; Tokars, Roger P.

    2012-01-01

    Presentation on vehicle integrated propulsion research results and planning. This research emphasizes the testing of advanced health management sensors and diagnostics in an aircraft engine that is operated through multiple baseline and fault conditions.

  7. Evaluation of a telehealth training package to remotely train staff to conduct a preference assessment.

    PubMed

    Higgins, William J; Luczynski, Kevin C; Carroll, Regina A; Fisher, Wayne W; Mudford, Oliver C

    2017-04-01

    Recent advancements in telecommunication technologies make it possible to conduct a variety of healthcare services remotely (e.g., behavioral-analytic intervention services), thereby bridging the gap between qualified providers and consumers in isolated locations. In this study, web-based telehealth technologies were used to remotely train direct-care staff to conduct a multiple-stimulus-without-replacement preference assessment. The training package included three components: (a) a multimedia presentation; (b) descriptive feedback from previously recorded baseline sessions; and (c) scripted role-play with immediate feedback. A nonconcurrent, multiple-baseline-across-participants design was used to demonstrate experimental control. Training resulted in robust and immediate improvements, and these effects maintained during 1- to 2-month follow-up observations. In addition, participants expressed high satisfaction with the web-based materials and the overall remote-training experience. © 2017 Society for the Experimental Analysis of Behavior.

  8. Repeated readings and science: Fluency with expository passages

    NASA Astrophysics Data System (ADS)

    Kostewicz, Douglas E.

    The current study investigated the effects of repeated readings to a fluency criterion (RRFC) for seven students with disabilities using science text. The study employed a single subject design, specifically, two multiple probe multiple baselines across subjects, to evaluate the effects of the RRFC intervention. Results indicated that students met criterion (200 or more correct words per minute with 2 or fewer errors) on four consecutive passages. A majority of students displayed accelerations to correct words per minute and decelerations to incorrect words per minute on successive initial, intervention readings suggesting reading transfer. Students' reading scores during posttest and maintenance out performed pre-test and baseline readings provided additional measures of reading transfer. For a relationship to comprehension, students scored higher on oral retell measures after meeting criterion as compared to initial readings. Overall, the research findings suggested that the RRFC intervention improves science reading fluency for students with disabilities, and may also indirectly benefit comprehension.

  9. In Vivo Imaging of Cortical Inflammation and Subpial Pathology in Multiple Sclerosis by Combined PET and MRI

    DTIC Science & Technology

    2014-09-01

    and Subpial Pathology in Multiple Sclerosis by Combined PET and MRI PRINCIPAL INVESTIGATOR: Dr. Caterina Mainero...studies in multiple sclerosis (MS) suggested that cortical demyelinating lesions, which are hardly detected in vivo on conventional magnetic resonance...disease progression in many MS cases. 15. SUBJECT TERMS Multiple sclerosis ; cortex; cortical sulci; neuroinflammation; microglia; cortical

  10. Efficacy and safety of nebivolol and valsartan as fixed-dose combination in hypertension: a randomised, multicentre study.

    PubMed

    Giles, Thomas D; Weber, Michael A; Basile, Jan; Gradman, Alan H; Bharucha, David B; Chen, Wei; Pattathil, Manoj

    2014-05-31

    The fixed-dose combination of any two antihypertensive drugs from different drug classes is typically more effective in reducing blood pressure than a dose increase of component monotherapy. We assessed the efficacy and safety of a fixed-dose combination of a vasodilating β blocker (nebivolol) and an angiotensin II receptor blocker (valsartan) in adults with hypertension. We did an 8-week, phase 3, multicentre, randomised, double-blind, placebo-controlled, parallel-group trial at 401 US sites. Participants (age ≥18 years) with hypertension but with blood pressure less than 180/110 mm Hg were randomly assigned (2:2:2:2:2:2:2:1) by a 24-h interactive web response system in blocks of 15 to 4 weeks of double-blind treatment with nebivolol and valsartan fixed-dose combination (5 and 80 mg/day, 5 and 160 mg/day, or 10 and 160 mg/day), nebivolol (5 mg/day or 20 mg/day), valsartan (80 mg/day or 160 mg/day), or placebo. Doses were doubled in weeks 5-8; results are reported according to the final dose. Participants and research staff were masked to treatment allocation. The primary and key secondary endpoints were changes from baseline to week 8 in diastolic and systolic blood pressure, respectively. The primary statistical comparison was between the highest fixed-dose combination dose and the highest monotherapy doses; lower doses were then compared if this comparison was positive (Hochberg method for multiple testing). Efficacy analyses were by intention to treat. Safety assessments included monitoring of adverse events. Continuous efficacy parameters were analysed using an ANCOVA model; binary outcomes were analysed using a logistic regression model. This study is registered with ClinicalTrials.gov, NCT01508026. Between Jan 6, 2012, and March 15, 2013, 4161 patients were randomly assigned (277 to placebo and 554-555 to each active comparator group), 4118 of whom were included in the primary analysis. At week 8, the fixed-dose combination 20 and 320 mg/day group had significantly greater reductions in diastolic blood pressure from baseline than both nebivolol 40 mg/day (least-squares mean difference -1·2 mm Hg, 95% CI -2·3 to -0·1; p=0·030) and valsartan 320 mg/day (-4·4 mm Hg, -5·4 to -3·3; p<0·0001); all other comparisons were also significant, favouring the fixed-dose combinations (all p<0·0001). All systolic blood pressure comparisons were also significant (all p<0·01). At least one treatment-emergent adverse event was experienced by 30-36% of participants in each group. Nebivolol and valsartan fixed-dose combination is an effective and well-tolerated treatment option for patients with hypertension. Forest Research Institute. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Headache: an important factor associated with muscle soreness/pain at the two-year follow-up point among patients with major depressive disorder.

    PubMed

    Hung, Ching-I; Liu, Chia-Yih; Yang, Ching-Hui; Wang, Shuu-Jiun

    2016-01-01

    No study has compared the associations of headache, anxiety, and depression at baseline with muscle soreness or pain (MS/P) at baseline and at the two-year follow-up point among outpatients with major depressive disorder (MDD). This study aimed to investigate the above issue. This study enrolled 155 outpatients with MDD at baseline, and 131 attended a two-year follow-up appointment. At baseline, migraine was diagnosed based on the International Classification of Headache Disorders, 2(nd) edition. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The visual analog scale was used to evaluate the intensities of headache and MS/P in the neck, shoulder, back, upper limbs, and lower limbs. Depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale. Multiple linear regressions were used to compare the associations of these factors with MS/P. Compared with anxiety disorders, migraine was more strongly associated with MS/P in all areas at baseline and in the upper and lower limbs at follow-up. Headache intensity at baseline was the factor most strongly associated with MS/P in all areas at baseline and follow-up after controlling for depression and anxiety. Headache intensity at baseline predicted MS/P at baseline and follow-up. Migraine and headache intensity are important factors related to MS/P at baseline and follow-up among patients with MDD. Integrating depression and headache treatment might be indicated to improve MS/P.

  12. Network meta-analysis of disconnected networks: How dangerous are random baseline treatment effects?

    PubMed

    Béliveau, Audrey; Goring, Sarah; Platt, Robert W; Gustafson, Paul

    2017-12-01

    In network meta-analysis, the use of fixed baseline treatment effects (a priori independent) in a contrast-based approach is regularly preferred to the use of random baseline treatment effects (a priori dependent). That is because, often, there is not a need to model baseline treatment effects, which carry the risk of model misspecification. However, in disconnected networks, fixed baseline treatment effects do not work (unless extra assumptions are made), as there is not enough information in the data to update the prior distribution on the contrasts between disconnected treatments. In this paper, we investigate to what extent the use of random baseline treatment effects is dangerous in disconnected networks. We take 2 publicly available datasets of connected networks and disconnect them in multiple ways. We then compare the results of treatment comparisons obtained from a Bayesian contrast-based analysis of each disconnected network using random normally distributed and exchangeable baseline treatment effects to those obtained from a Bayesian contrast-based analysis of their initial connected network using fixed baseline treatment effects. For the 2 datasets considered, we found that the use of random baseline treatment effects in disconnected networks was appropriate. Because those datasets were not cherry-picked, there should be other disconnected networks that would benefit from being analyzed using random baseline treatment effects. However, there is also a risk for the normality and exchangeability assumption to be inappropriate in other datasets even though we have not observed this situation in our case study. We provide code, so other datasets can be investigated. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Baseline Patient Characteristics Predicting Outcome and Attrition in Cognitive Therapy for Social Phobia: Results from a Large Multicentre Trial.

    PubMed

    Hoyer, Juergen; Wiltink, Joerg; Hiller, Wolfgang; Miller, Robert; Salzer, Simone; Sarnowsky, Stephan; Stangier, Ulrich; Strauss, Bernhard; Willutzki, Ulrike; Leibing, Eric

    2016-01-01

    We examined the role of baseline patient characteristics as predictors of outcome (end-state functioning, response and remission) and attrition for cognitive therapy (CT) in social anxiety disorder (SAD). Beyond socio-demographic and clinical variables such as symptom severity and comorbidity status, previously neglected patient characteristics (e.g., personality, self-esteem, shame, interpersonal problems and attachment style) were analysed. Data came from the CT arm of a multicentre RCT with n = 244 patients having DSM-IV SAD. CT was conducted according to the manual by Clark and Wells. Severity of SAD was assessed at baseline and end of treatment with the Liebowitz Social Anxiety Scale (LSAS). Multiple linear regression analyses and logistic regression analyses were applied. Up to 37% of the post-treatment variance (LSAS) could be explained by all pre-treatment variables combined. Symptom severity (baseline LSAS) was consistently negatively associated with end-state functioning and remission, but not with response. Number of comorbid diagnoses was negatively associated with end-state functioning and response, but not with remission. Self-esteem was positively associated with higher end-state functioning and more shame with better response. Attrition could not be significantly predicted. The results indicate that the initial probability for treatment success mainly depends on severity of disorder and comorbid conditions while other psychological variables are of minor importance, at least on a nomothetic level. This stands in contrast with efforts to arrive at an empirical-based foundation for differential indication and argues to search for more potent moderators of therapeutic change rather on the process level. Personality, self-esteem, shame, attachment style and interpersonal problems do not or only marginally moderate the effects of interventions in CT of social phobia. Symptom severity and comorbid diagnoses might affect treatment outcome negatively. Beyond these two factors, most patients share a similar likelihood of treatment success when treated according to the manual by Clark and Wells. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  14. Subjective burden among spousal and adult-child informal caregivers of older adults: results from a longitudinal cohort study.

    PubMed

    Oldenkamp, Marloes; Hagedoorn, Mariët; Slaets, Joris; Stolk, Ronald; Wittek, Rafael; Smidt, Nynke

    2016-12-07

    Pressures on informal caregivers are likely to increase due to increasing life expectancy and health care costs, which stresses the importance of prevention of subjective burden. The present study examined the correlates of overall subjective burden and multiple burden dimensions among spousal and adult-child caregivers of Dutch older adults, both cross-sectional and longitudinal (12-months follow-up). In 2010 and 2011 baseline and follow-up data was collected in a sample of informal caregivers and care recipients in the Northern provinces of the Netherlands. Subjective burden included 7 burden dimensions and a summary score for overall subjective burden, based on the Care-Related Quality of Life Instrument (CarerQoL-7D). Objective stressors were the time investment in caregiving (hours of household care, personal care, practical care) and the health situation of the care recipient, including multimorbidity, functional limitations (Katz Index of Independence Basic Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), and cognitive functioning problems (EQ-5D + C). Correlates of subjective burden were evaluated with linear and logistic regression analyses. The sample consisted of 356 caregivers at baseline (43% spousal, 57% adult-child caregivers), and 158 caregivers at follow-up (45% spousal, 55% adult-child caregivers). At baseline and follow-up, spousal caregivers experienced a higher overall subjective burden, and reported more often mental health problems, physical health problems, and problems with combining daily activities, compared to adult-child caregivers. For spousal caregivers, a poorer health situation of the care recipient was associated with higher subjective burden, while adult-child caregivers reported higher levels of subjective burden when their time investment in caregiving was high. Subjective burden at follow-up was mainly explained by baseline subjective burden. These results indicate that for effective caregiver support, it is crucial to take the type of care relationship into account, since the level and correlates of overall subjective burden and burden dimensions varied for spousal and adult-child caregivers. In addition, reducing subjective burden will also positively impact the subjective burden over time.

  15. 75 FR 61736 - Combined Notice of Filings #2

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 2 September... Wind Power LLC. Description: Klondike Wind Power LLC submits tariff filing per 35.12: Baseline Filing.... Applicants: Klondike Wind Power II LLC. Description: Klondike Wind Power II LLC submits tariff filing per 35...

  16. 75 FR 54602 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ... Wind Energy Marketing, LLC. Description: First Wind Energy Marketing, LLC submits tariff filing per 35.12: First Wind Energy Marketing MBR Baseline to be effective 8/ 30/2010. Filed Date: 08/30/2010... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 August 31...

  17. 78 FR 57374 - Combined Notice of Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-18

    ...: Kinetica Energy Express, LLC. Description: Kinetica Energy Express, LLC submits tariff filing per 154.203: Kinetica Energy Express LLC--FERC Gas Tariff--Volume 1 A Baseline Filing to be effective 9/1/2013. Filed... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings Take notice...

  18. 78 FR 34366 - Combined Notice of Filings #1

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-07

    ... Solar, LLC. Description: Application and Initial Baseline Tariff Filing to be effective 8/1/2013. Filed... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 Take notice.... Applicants: Beech Ridge Energy LLC, Bishop Hill Energy LLC, Bishop Hill Energy III LLC, Bishop Hill...

  19. Improvements in vision‐related quality of life in blind patients implanted with the Argus II Epiretinal Prosthesis

    PubMed Central

    Duncan, Jacque L; Arditi, Aries; da Cruz, Lyndon; Dagnelie, Gislin; Dorn, Jessy D; Ho, Allen C; Olmos de Koo, Lisa C; Barale, Pierre‐Olivier; Stanga, Paulo E; Thumann, Gabriele; Wang, Yizhong; Greenberg, Robert J

    2016-01-01

    Background The purpose of this analysis is to report the change in quality of life (QoL) after treatment with the Argus II Epiretinal Prosthesis in patients with end‐stage retinitis pigmentosa. Methods The Vision and Quality of Life Index (VisQoL) was used to assess changes in QoL dimensions and overall utility score in a prospective 30‐patient single‐arm clinical study. VisQoL is a multi‐attribute instrument consisting of six dimensions (injury, life, roles, assistance, activity and friendship) that may be affected by visual impairment. Within each dimension, patients were divided into two groups based on how much their QoL was affected by their blindness at baseline (moderate/severe or minimal). Outcomes were compared within each dimension sub‐group between baseline and the combined follow‐up periods using the Friedman test. In addition, data from the six dimensions were combined into a single utility score, with baseline data compared to the combined follow‐up periods. Results Overall, 80 per cent of the patients reported difficulty in one or more dimensions pre‐implant. Composite VisQoL utility scores at follow‐up showed no statistically significant change from baseline; however, in three of the six VisQoL dimensions (injury, life and roles), patients with baseline deficits showed significant and lasting improvement after implantation with Argus II. In two of the three remaining dimensions (assistance and activity), data trended toward an improvement. In the final VisQoL dimension (friendship), none of the patients reported baseline deficits, suggesting that patients had largely adjusted to this attribute. Conclusion Patients whose vision negatively affected them with respect to three VisQoL dimensions (that is, getting injured, coping with the demands of their life and fulfilling their life roles) reported significant improvement in QoL after implantation of the Argus II retinal prosthesis. Furthermore, the benefit did not deteriorate at any point during the 36‐month follow‐up, suggesting a long‐term, durable improvement. PMID:27558213

  20. Playing piano can improve upper extremity function after stroke: case studies.

    PubMed

    Villeneuve, Myriam; Lamontagne, Anouk

    2013-01-01

    Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke.

  1. A Removal of Eye Movement and Blink Artifacts from EEG Data Using Morphological Component Analysis

    PubMed Central

    Wagatsuma, Hiroaki

    2017-01-01

    EEG signals contain a large amount of ocular artifacts with different time-frequency properties mixing together in EEGs of interest. The artifact removal has been substantially dealt with by existing decomposition methods known as PCA and ICA based on the orthogonality of signal vectors or statistical independence of signal components. We focused on the signal morphology and proposed a systematic decomposition method to identify the type of signal components on the basis of sparsity in the time-frequency domain based on Morphological Component Analysis (MCA), which provides a way of reconstruction that guarantees accuracy in reconstruction by using multiple bases in accordance with the concept of “dictionary.” MCA was applied to decompose the real EEG signal and clarified the best combination of dictionaries for this purpose. In our proposed semirealistic biological signal analysis with iEEGs recorded from the brain intracranially, those signals were successfully decomposed into original types by a linear expansion of waveforms, such as redundant transforms: UDWT, DCT, LDCT, DST, and DIRAC. Our result demonstrated that the most suitable combination for EEG data analysis was UDWT, DST, and DIRAC to represent the baseline envelope, multifrequency wave-forms, and spiking activities individually as representative types of EEG morphologies. PMID:28194221

  2. PIRATE: pediatric imaging response assessment and targeting environment

    NASA Astrophysics Data System (ADS)

    Glenn, Russell; Zhang, Yong; Krasin, Matthew; Hua, Chiaho

    2010-02-01

    By combining the strengths of various imaging modalities, the multimodality imaging approach has potential to improve tumor staging, delineation of tumor boundaries, chemo-radiotherapy regime design, and treatment response assessment in cancer management. To address the urgent needs for efficient tools to analyze large-scale clinical trial data, we have developed an integrated multimodality, functional and anatomical imaging analysis software package for target definition and therapy response assessment in pediatric radiotherapy (RT) patients. Our software provides quantitative tools for automated image segmentation, region-of-interest (ROI) histogram analysis, spatial volume-of-interest (VOI) analysis, and voxel-wise correlation across modalities. To demonstrate the clinical applicability of this software, histogram analyses were performed on baseline and follow-up 18F-fluorodeoxyglucose (18F-FDG) PET images of nine patients with rhabdomyosarcoma enrolled in an institutional clinical trial at St. Jude Children's Research Hospital. In addition, we combined 18F-FDG PET, dynamic-contrast-enhanced (DCE) MR, and anatomical MR data to visualize the heterogeneity in tumor pathophysiology with the ultimate goal of adaptive targeting of regions with high tumor burden. Our software is able to simultaneously analyze multimodality images across multiple time points, which could greatly speed up the analysis of large-scale clinical trial data and validation of potential imaging biomarkers.

  3. Playing Piano Can Improve Upper Extremity Function after Stroke: Case Studies

    PubMed Central

    Villeneuve, Myriam; Lamontagne, Anouk

    2013-01-01

    Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke. PMID:23533954

  4. A Developmental Neuroscience of Borderline Pathology: Emotion Dysregulation and Social Baseline Theory

    PubMed Central

    Hughes, Amy E.; Crowell, Sheila E.; Uyeji, Lauren; Coan, James A.

    2011-01-01

    Theoretical and empirical research has linked poor emotion regulation abilities with dysfunctional frontolimbic circuitry. Consistent with this, research on borderline personality disorder (BPD) finds that frontolimbic dysfunction is a predominant neural substrate underlying the disorder. Emotion regulation is profoundly compromised in BPD. However, BPD is also associated with broad impairment across multiple domains, including impulse control, interpersonal relationships, and cognitive functioning. To date, BPD research has focused largely on single areas of dysfunction, failing to account for overlap at either the biological or behavioral levels of analysis. We examine the literature on frontolimbic dysfunction in BPD within the context of Coan’s social baseline theory. Social baseline theory proposes that healthy human functioning is dependent upon adequate social support and that, at baseline, biological systems are adapted to operate interdependently rather than independently. The social baseline perspective is particularly useful for understanding borderline personality development because the impulsive and emotionally dysregulated behaviors common among those with BPD occur almost invariably within an interpersonal context. We discuss clinical and research implications of this work. PMID:21845379

  5. Selection and placement of best management practices used to reduce water quality degradation in Lincoln Lake watershed

    NASA Astrophysics Data System (ADS)

    Rodriguez, Hector German; Popp, Jennie; Maringanti, Chetan; Chaubey, Indrajeet

    2011-01-01

    An increased loss of agricultural nutrients is a growing concern for water quality in Arkansas. Several studies have shown that best management practices (BMPs) are effective in controlling water pollution. However, those affected with water quality issues need water management plans that take into consideration BMPs selection, placement, and affordability. This study used a nondominated sorting genetic algorithm (NSGA-II). This multiobjective algorithm selects and locates BMPs that minimize nutrients pollution cost-effectively by providing trade-off curves (optimal fronts) between pollutant reduction and total net cost increase. The usefulness of this optimization framework was evaluated in the Lincoln Lake watershed. The final NSGA-II optimization model generated a number of near-optimal solutions by selecting from 35 BMPs (combinations of pasture management, buffer zones, and poultry litter application practices). Selection and placement of BMPs were analyzed under various cost solutions. The NSGA-II provides multiple solutions that could fit the water management plan for the watershed. For instance, by implementing all the BMP combinations recommended in the lowest-cost solution, total phosphorous (TP) could be reduced by at least 76% while increasing cost by less than 2% in the entire watershed. This value represents an increase in cost of 5.49 ha-1 when compared to the baseline. Implementing all the BMP combinations proposed with the medium- and the highest-cost solutions could decrease TP drastically but will increase cost by 24,282 (7%) and $82,306 (25%), respectively.

  6. ℓ(p)-Norm multikernel learning approach for stock market price forecasting.

    PubMed

    Shao, Xigao; Wu, Kun; Liao, Bifeng

    2012-01-01

    Linear multiple kernel learning model has been used for predicting financial time series. However, ℓ(1)-norm multiple support vector regression is rarely observed to outperform trivial baselines in practical applications. To allow for robust kernel mixtures that generalize well, we adopt ℓ(p)-norm multiple kernel support vector regression (1 ≤ p < ∞) as a stock price prediction model. The optimization problem is decomposed into smaller subproblems, and the interleaved optimization strategy is employed to solve the regression model. The model is evaluated on forecasting the daily stock closing prices of Shanghai Stock Index in China. Experimental results show that our proposed model performs better than ℓ(1)-norm multiple support vector regression model.

  7. Contribution of BeiDou satellite system for long baseline GNSS measurement in Indonesia

    NASA Astrophysics Data System (ADS)

    Gumilar, I.; Bramanto, B.; Kuntjoro, W.; Abidin, H. Z.; Trihantoro, N. F.

    2018-05-01

    The demand for more precise positioning method using GNSS (Global Navigation Satellite System) in Indonesia continue to rise. The accuracy of GNSS positioning depends on the length of baseline and the distribution of observed satellites. BeiDou Navigation Satellite System (BDS) is a positioning system owned by China that operating in Asia-Pacific region, including Indonesia. This research aims to find out the contribution of BDS in increasing the accuracy of long baseline static positioning in Indonesia. The contributions are assessed by comparing the accuracy of measurement using only GPS (Global Positioning System) and measurement using the combination of GPS and BDS. The data used is 5 days of GPS and BDS measurement data for baseline with 120 km in length. The software used is open-source RTKLIB and commercial software Compass Solution. This research will explain in detail the contribution of BDS to the accuracy of position in long baseline static GNSS measurement.

  8. Multiple incentives in encouraging car pool formation on a university campus

    PubMed Central

    Jacobs, Harvey E.; Fairbanks, David; Poche, Cheryl E.; Bailey, Jon S.

    1982-01-01

    The effects of a combined token economy and reserved parking program were evaluated as a means of increasing car pooling among students on a university campus. Following a baseline period, students in two experimental parking lots were notified of the availability of reserved parking and coupons redeemable for 25 cents in merchandise for each occupant of automobiles containing two or more people. Two control lots also were monitored for a comparison of treatment effects. Results indicated variable increases in car pooling in the two experimental lots and no increase in the control lots. Removal of the 25-cent coupons from one treatment lot (reserved parking only) did not adversely affect rates of car pooling. An analysis of individual automobile occupancy rates among car poolers indicated distinct patterns of car pooling and underscored the importance of individual subject data analysis in the present situation. A cost-benefit analysis indicated that even moderately effective car pool programs can be cost-effective on both a public and personal level. PMID:16795653

  9. Block-Parallel Data Analysis with DIY2

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

    Morozov, Dmitriy; Peterka, Tom

    DIY2 is a programming model and runtime for block-parallel analytics on distributed-memory machines. Its main abstraction is block-structured data parallelism: data are decomposed into blocks; blocks are assigned to processing elements (processes or threads); computation is described as iterations over these blocks, and communication between blocks is defined by reusable patterns. By expressing computation in this general form, the DIY2 runtime is free to optimize the movement of blocks between slow and fast memories (disk and flash vs. DRAM) and to concurrently execute blocks residing in memory with multiple threads. This enables the same program to execute in-core, out-of-core, serial,more » parallel, single-threaded, multithreaded, or combinations thereof. This paper describes the implementation of the main features of the DIY2 programming model and optimizations to improve performance. DIY2 is evaluated on benchmark test cases to establish baseline performance for several common patterns and on larger complete analysis codes running on large-scale HPC machines.« less

  10. Protection characteristics of a Faraday cage compromised by lightning burnthrough.

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

    Warne, Larry Kevin; Bystrom, Edward; Jorgenson, Roy Eberhardt

    2012-01-01

    A lightning flash consists of multiple, high-amplitude but short duration return strokes. Between the return strokes is a lower amplitude, continuing current which flows for longer duration. If the walls of a Faraday cage are made of thin enough metal, the continuing current can melt a hole through the metal in a process called burnthrough. A subsequent return stroke can couple energy through this newly-formed hole. This LDRD is a study of the protection provided by a Faraday cage when it has been compromised by burnthrough. We initially repeated some previous experiments and expanded on them in terms of scopemore » and diagnostics to form a knowledge baseline of the coupling phenomena. We then used a combination of experiment, analysis and numerical modeling to study four coupling mechanisms: indirect electric field coupling, indirect magnetic field coupling, conduction through plasma and breakdown through the hole. We discovered voltages higher than those encountered in the previous set of experiments (on the order of several hundreds of volts).« less

  11. Religion and remission of depression in medical inpatients with heart failure/pulmonary disease.

    PubMed

    Koenig, Harold G

    2007-05-01

    The impact of religious involvement on time to remission of depression was examined in older medical inpatients with heart failure and/or chronic pulmonary disease (CHF/CPD). Inpatients older than 50 years with CHF/CPD were systematically diagnosed with depressive disorder using a structured psychiatric interview. Cox proportional hazards regression was used to examine the effects of religious involvement on time to remission, controlling for covariates. Of 1000 depressed patients identified at baseline, follow-up data on depression course were obtained on 87%. Patients involved in group-related religious activities experienced a shorter time to remission. Although numerous religious measures were unrelated by themselves to depression outcome, the combination of frequent religious attendance, prayer, Bible study, and high intrinsic religiosity, predicted a 53% increase in speed of remission (HR 1.53, 95% CI 1.20-1.94, p = 0.0005, n = 839) after controls. Patients highly religious by multiple indicators, particularly those involved in community religious activities, remit faster from depression.

  12. Development of advanced fuel cell system, phase 3

    NASA Technical Reports Server (NTRS)

    Handley, L. M.; Meyer, A. P.; Bell, W. F.

    1975-01-01

    A multiple task research and development program was performed to improve the weight, life, and performance characteristics of hydrogen-oxygen alkaline fuel cells for advanced power systems. Gradual wetting of the anode structure and subsequent long-term performance loss was determined to be caused by deposition of a silicon-containing material on the anode. This deposit was attributed to degradation of the asbestos matrix, and attention was therefore placed on development of a substitute matrix of potassium titanate. An 80 percent gold 20 percent platinum catalyst cathode was developed which has the same performance and stability as the standard 90 percent gold - 10 percent platinum cathode but at half the loading. A hybrid polysulfone/epoxy-glass fiber frame was developed which combines the resistance to the cell environment of pure polysulfone with the fabricating ease of epoxy-glass fiber laminate. These cell components were evaluated in various configurations of full-size cells. The ways in which the baseline engineering model system would be modified to accommodate the requirements of the space tug application are identified.

  13. Mapping Nearby Terrain in 3D by Use of a Grid of Laser Spots

    NASA Technical Reports Server (NTRS)

    Padgett, Curtis; Liebe, Carl; Chang, Johnny; Brown, Kenneth

    2007-01-01

    A proposed optoelectronic system, to be mounted aboard an exploratory robotic vehicle, would be used to generate a three-dimensional (3D) map of nearby terrain and obstacles for purposes of navigating the vehicle across the terrain and avoiding the obstacles. The difference between this system and the other systems would lie in the details of implementation. In this system, the illumination would be provided by a laser. The beam from the laser would pass through a two-dimensional diffraction grating, which would divide the beam into multiple beams propagating in different, fixed, known directions. These beams would form a grid of bright spots on the nearby terrain and obstacles. The centroid of each bright spot in the image would be computed. For each such spot, the combination of (1) the centroid, (2) the known direction of the light beam that produced the spot, and (3) the known baseline would constitute sufficient information for calculating the 3D position of the spot.

  14. 5 CFR 591.216 - How does OPM combine survey data for the DC area and for COLA areas with multiple survey areas?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... DC area and for COLA areas with multiple survey areas? 591.216 Section 591.216 Administrative... combine survey data for the DC area and for COLA areas with multiple survey areas? (a) Washington, DC... equal weights to compute an overall average by item for the DC area. (b) COLA areas with multiple survey...

  15. 5 CFR 591.216 - How does OPM combine survey data for the DC area and for COLA areas with multiple survey areas?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... DC area and for COLA areas with multiple survey areas? 591.216 Section 591.216 Administrative... combine survey data for the DC area and for COLA areas with multiple survey areas? (a) Washington, DC... equal weights to compute an overall average by item for the DC area. (b) COLA areas with multiple survey...

  16. 5 CFR 591.216 - How does OPM combine survey data for the DC area and for COLA areas with multiple survey areas?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... DC area and for COLA areas with multiple survey areas? 591.216 Section 591.216 Administrative... combine survey data for the DC area and for COLA areas with multiple survey areas? (a) Washington, DC... equal weights to compute an overall average by item for the DC area. (b) COLA areas with multiple survey...

  17. 5 CFR 591.216 - How does OPM combine survey data for the DC area and for COLA areas with multiple survey areas?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... DC area and for COLA areas with multiple survey areas? 591.216 Section 591.216 Administrative... combine survey data for the DC area and for COLA areas with multiple survey areas? (a) Washington, DC... equal weights to compute an overall average by item for the DC area. (b) COLA areas with multiple survey...

  18. 5 CFR 591.216 - How does OPM combine survey data for the DC area and for COLA areas with multiple survey areas?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... DC area and for COLA areas with multiple survey areas? 591.216 Section 591.216 Administrative... combine survey data for the DC area and for COLA areas with multiple survey areas? (a) Washington, DC... equal weights to compute an overall average by item for the DC area. (b) COLA areas with multiple survey...

  19. Design of pulse waveform for waveform division multiple access UWB wireless communication system.

    PubMed

    Yin, Zhendong; Wang, Zhirui; Liu, Xiaohui; Wu, Zhilu

    2014-01-01

    A new multiple access scheme, Waveform Division Multiple Access (WDMA) based on the orthogonal wavelet function, is presented. After studying the correlation properties of different categories of single wavelet functions, the one with the best correlation property will be chosen as the foundation for combined waveform. In the communication system, each user is assigned to different combined orthogonal waveform. Demonstrated by simulation, combined waveform is more suitable than single wavelet function to be a communication medium in WDMA system. Due to the excellent orthogonality, the bit error rate (BER) of multiuser with combined waveforms is so close to that of single user in a synchronous system. That is to say, the multiple access interference (MAI) is almost eliminated. Furthermore, even in an asynchronous system without multiuser detection after matched filters, the result is still pretty ideal and satisfactory by using the third combination mode that will be mentioned in the study.

  20. Esterified estrogens combined with methyltestosterone raise intraocular pressure in postmenopausal women.

    PubMed

    Khurana, Rahul N; LaBree, Laurie D; Scott, Garrett; Smith, Ronald E; Yiu, Samuel C

    2006-09-01

    To investigate the effect of esterified estrogens combined with methyltestosterone (EECM) (Estratest, Solvay, Pharmaceuticals, Inc, Baudette, Minnesota, USA) on intraocular pressure (IOP) in postmenopausal women. Observational case series. The IOP of 13 consecutive postmenopausal women with dry eye syndrome were recorded before and during EECM therapy (1.25 mg of esterified estrogens and 2.5 mg of methyltestosterone for several months). The mean IOP increased from a baseline of 15.0 mm Hg before treatment to 18.2 mm Hg on EECM therapy (P < .0001) after a median duration of 11.3 months (range, 0.9 to 24 months). The increase in IOP was statistically significant at the 0.05 level of significance within three months and continued over 12 months. Two patients whose pressures increased (>4 mm Hg) returned to baseline levels after EECM was discontinued. Esterified estrogens combined with methyltestosterone produce a clinically significant increase in IOP in postmenopausal women with dry eye syndrome.

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