Comparison of conventional therapies for dentin hypersensitivity versus medical hypnosis.

PubMed

Eitner, Stephan; Bittner, Christian; Wichmann, Manfred; Nickenig, Hans-Joachim; Sokol, Biljana

2010-10-01

This study compared the efficacy of conventional treatments for dentin hypersensitivity (DHS) and hypnotherapy. During a 1-month period at an urban practice in a service area of approximately 22,000 inhabitants, all patients were examined. A total of 102 individuals were included in the evaluation. Values of 186 teeth were analyzed. The comparison of the different treatment methods (desensitizer, fluoridation, and hypnotherapy) did not show significant differences in success rates. However, a noticeable difference was observed in terms of onset and duration of effect. For both desensitizer and hypnotherapy treatments, onset of effect was very rapid. Compared to the other methods studied, hypnotherapy effects had the longest duration. In conclusion, hypnotherapy was as effective as other methods in the treatment of DHS.

A comparison of treatment effectiveness between the CAD/CAM method and the manual method for managing adolescent idiopathic scoliosis.

PubMed

Wong, M S; Cheng, J C Y; Lo, K H

2005-04-01

The treatment effectiveness of the CAD/CAM method and the manual method in managing adolescent idiopathic scoliosis (AIS) was compared. Forty subjects were recruited with twenty subjects for each method. The clinical parameters namely Cobb's angle and apical vertebral rotation were evaluated at the pre-brace and the immediate in-brace visits. The results demonstrated that orthotic treatments rendered by the CAD/CAM method and the conventional manual method were effective in providing initial control of Cobb's angle. Significant decreases (p < 0.05) were found between the pre-brace and immediate in-brace visits for both methods. The mean reductions of Cobb's angle were 12.8 degrees (41.9%) for the CAD/CAM method and 9.8 degrees (32.1%) for the manual method. An initial control of the apical vertebral rotation was not shown in this study. In the comparison between the CAD/CAM method and the manual method, no significant difference was found in the control of Cobb's angle and apical vertebral rotation. The current study demonstrated that the CAD/CAM method can provide similar result in the initial stage of treatment as compared with the manual method.

Physical therapy methods in the treatment and rehabilitation of cancer patients

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

Kucherova, T. Ya., E-mail: nii@oncology.tomsk.ru; Choinzonov, E. L., E-mail: nii@oncology.tomsk.ru; Tuzikov, S. A., E-mail: TuzikovSA@oncology.tomsk.ru

The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.

Physical therapy methods in the treatment and rehabilitation of cancer patients

NASA Astrophysics Data System (ADS)

Kucherova, T. Ya.; Velikaya, V. V.; Gribova, O. V.; Startseva, Zh. A.; Choinzonov, E. L.; Tuzikov, S. A.; Vusik, M. V.; Doroshenko, A. V.

2016-08-01

The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.

Current gamma knife treatment for ophthalmic branch of primary trigeminal neuralgia

PubMed Central

Shan, Guo-Yong; Liang, Hao-Fang; Zhang, Jian-Hua

2011-01-01

AIM To probe into problems existing in gamma knife treatment of ophthalmic branch of primary trigeminal neuralgia (TN), and propose a safe and effective solution to the problem. METHODS Through sorting the literature reporting gamma knife treatment of refractory TN in recent years, this article analyzed the advantages and problems of gamma knife treatment of primary TN, and proposed reasonable assessment for existing problems and the possible solution. RESULTS Gamma knife treatment of TN has drawn increasing attention of clinicians due to its unique non-invasion, safety and effectiveness, but there are three related issues to be considered. The first one is the uncertainty of the optimal dose (70-90GY); the second one is the difference in radiotherapy target selection (using a single isocenter or two isocenters); and the third one is the big difference of recurrent pains (specific treatment methods need to be summarized and improved). CONCLUSION For patients with refractory TN, gamma knife treatment can be selected when the medical treatment fails or drug side effects emerge. The analysis of a large number of TN patients receiving gamma knife treatment has shown that this is a safe and effective treatment method. PMID:22553625

The use of propensity score methods with survival or time-to-event outcomes: reporting measures of effect similar to those used in randomized experiments.

PubMed

Austin, Peter C

2014-03-30

Propensity score methods are increasingly being used to estimate causal treatment effects in observational studies. In medical and epidemiological studies, outcomes are frequently time-to-event in nature. Propensity-score methods are often applied incorrectly when estimating the effect of treatment on time-to-event outcomes. This article describes how two different propensity score methods (matching and inverse probability of treatment weighting) can be used to estimate the measures of effect that are frequently reported in randomized controlled trials: (i) marginal survival curves, which describe survival in the population if all subjects were treated or if all subjects were untreated; and (ii) marginal hazard ratios. The use of these propensity score methods allows one to replicate the measures of effect that are commonly reported in randomized controlled trials with time-to-event outcomes: both absolute and relative reductions in the probability of an event occurring can be determined. We also provide guidance on variable selection for the propensity score model, highlight methods for assessing the balance of baseline covariates between treated and untreated subjects, and describe the implementation of a sensitivity analysis to assess the effect of unmeasured confounding variables on the estimated treatment effect when outcomes are time-to-event in nature. The methods in the paper are illustrated by estimating the effect of discharge statin prescribing on the risk of death in a sample of patients hospitalized with acute myocardial infarction. In this tutorial article, we describe and illustrate all the steps necessary to conduct a comprehensive analysis of the effect of treatment on time-to-event outcomes. © 2013 The authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

TREATMENT SWITCHING: STATISTICAL AND DECISION-MAKING CHALLENGES AND APPROACHES.

PubMed

Latimer, Nicholas R; Henshall, Chris; Siebert, Uwe; Bell, Helen

2016-01-01

Treatment switching refers to the situation in a randomized controlled trial where patients switch from their randomly assigned treatment onto an alternative. Often, switching is from the control group onto the experimental treatment. In this instance, a standard intention-to-treat analysis does not identify the true comparative effectiveness of the treatments under investigation. We aim to describe statistical methods for adjusting for treatment switching in a comprehensible way for nonstatisticians, and to summarize views on these methods expressed by stakeholders at the 2014 Adelaide International Workshop on Treatment Switching in Clinical Trials. We describe three statistical methods used to adjust for treatment switching: marginal structural models, two-stage adjustment, and rank preserving structural failure time models. We draw upon discussion heard at the Adelaide International Workshop to explore the views of stakeholders on the acceptability of these methods. Stakeholders noted that adjustment methods are based on assumptions, the validity of which may often be questionable. There was disagreement on the acceptability of adjustment methods, but consensus that when these are used, they should be justified rigorously. The utility of adjustment methods depends upon the decision being made and the processes used by the decision-maker. Treatment switching makes estimating the true comparative effect of a new treatment challenging. However, many decision-makers have reservations with adjustment methods. These, and how they affect the utility of adjustment methods, require further exploration. Further technical work is required to develop adjustment methods to meet real world needs, to enhance their acceptability to decision-makers.

Estimating Causal Effects of Education Interventions Using a Two-Rating Regression Discontinuity Design: Lessons from a Simulation Study and an Application

ERIC Educational Resources Information Center

Porter, Kristin E.; Reardon, Sean F.; Unlu, Fatih; Bloom, Howard S.; Cimpian, Joseph R.

2017-01-01

A valuable extension of the single-rating regression discontinuity design (RDD) is a multiple-rating RDD (MRRDD). To date, four main methods have been used to estimate average treatment effects at the multiple treatment frontiers of an MRRDD: the "surface" method, the "frontier" method, the "binding-score" method, and…

Infrared coagulation: a new treatment for hemorrhoids

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

Leicester, R.J.; Nicholls, R.J.; Mann, C.V.

Many methods, which have effectively reduced the number of patients requiring hospital admission, have been described for the outpatient treatment of hemorrhoids. However, complications have been reported, and the methods are often associated with unpleasant side effects. In 1977 Neiger et al. described a new method that used infrared coagulation, which produced minimal side effects. The authors have conducted a prospective, randomized trial to evaluate infrared coagulation compared with more traditional methods of treatment. The authors' results show that it may be more effective than injection sclerotherapy in treating non-prolapsing hemorrhoids and that it compares favorably with rubber band ligationmore » in most prolapsing hemorrhoids. No complications occurred, and significantly fewer patients experienced pain after infrared coagulation (P . less than 0.001).« less

Mediation and moderation of treatment effects in randomised controlled trials of complex interventions.

PubMed

Emsley, Richard; Dunn, Graham; White, Ian R

2010-06-01

Complex intervention trials should be able to answer both pragmatic and explanatory questions in order to test the theories motivating the intervention and help understand the underlying nature of the clinical problem being tested. Key to this is the estimation of direct effects of treatment and indirect effects acting through intermediate variables which are measured post-randomisation. Using psychological treatment trials as an example of complex interventions, we review statistical methods which crucially evaluate both direct and indirect effects in the presence of hidden confounding between mediator and outcome. We review the historical literature on mediation and moderation of treatment effects. We introduce two methods from within the existing causal inference literature, principal stratification and structural mean models, and demonstrate how these can be applied in a mediation context before discussing approaches and assumptions necessary for attaining identifiability of key parameters of the basic causal model. Assuming that there is modification by baseline covariates of the effect of treatment (i.e. randomisation) on the mediator (i.e. covariate by treatment interactions), but no direct effect on the outcome of these treatment by covariate interactions leads to the use of instrumental variable methods. We describe how moderation can occur through post-randomisation variables, and extend the principal stratification approach to multiple group methods with explanatory models nested within the principal strata. We illustrate the new methodology with motivating examples of randomised trials from the mental health literature.

Researching Sex Bias in the Classroom.

ERIC Educational Resources Information Center

Donlan, Dan

This paper outlines five methods of research on sex bias in the classroom: one-time survey, one class/one treatment, two class/two treatment, one class/random assignment to treatment, and analysis of differentiated effect. It shows how each method could be used in attempting to measure the effect of a unit on Norma Klein's "Mom, the Wolfman and…

Ratio-of-Mediator-Probability Weighting for Causal Mediation Analysis in the Presence of Treatment-by-Mediator Interaction

ERIC Educational Resources Information Center

Hong, Guanglei; Deutsch, Jonah; Hill, Heather D.

2015-01-01

Conventional methods for mediation analysis generate biased results when the mediator-outcome relationship depends on the treatment condition. This article shows how the ratio-of-mediator-probability weighting (RMPW) method can be used to decompose total effects into natural direct and indirect effects in the presence of treatment-by-mediator…

Ratio-of-Mediator-Probability Weighting for Causal Mediation Analysis in the Presence of Treatment-by-Mediator Interaction

ERIC Educational Resources Information Center

Hong, Guanglei; Deutsch, Jonah; Hill, Heather D.

2015-01-01

Conventional methods for mediation analysis generate biased results when the mediator--outcome relationship depends on the treatment condition. This article shows how the ratio-of-mediator-probability weighting (RMPW) method can be used to decompose total effects into natural direct and indirect effects in the presence of treatment-by-mediator…

Double inverse-weighted estimation of cumulative treatment effects under nonproportional hazards and dependent censoring.

PubMed

Schaubel, Douglas E; Wei, Guanghui

2011-03-01

In medical studies of time-to-event data, nonproportional hazards and dependent censoring are very common issues when estimating the treatment effect. A traditional method for dealing with time-dependent treatment effects is to model the time-dependence parametrically. Limitations of this approach include the difficulty to verify the correctness of the specified functional form and the fact that, in the presence of a treatment effect that varies over time, investigators are usually interested in the cumulative as opposed to instantaneous treatment effect. In many applications, censoring time is not independent of event time. Therefore, we propose methods for estimating the cumulative treatment effect in the presence of nonproportional hazards and dependent censoring. Three measures are proposed, including the ratio of cumulative hazards, relative risk, and difference in restricted mean lifetime. For each measure, we propose a double inverse-weighted estimator, constructed by first using inverse probability of treatment weighting (IPTW) to balance the treatment-specific covariate distributions, then using inverse probability of censoring weighting (IPCW) to overcome the dependent censoring. The proposed estimators are shown to be consistent and asymptotically normal. We study their finite-sample properties through simulation. The proposed methods are used to compare kidney wait-list mortality by race. © 2010, The International Biometric Society.

Exploring methods for comparing the real-world effectiveness of treatments for osteoporosis: adjusted direct comparisons versus using patients as their own control.

PubMed

Karlsson, Linda; Mesterton, Johan; Tepie, Maurille Feudjo; Intorcia, Michele; Overbeek, Jetty; Ström, Oskar

2017-09-21

Using Swedish and Dutch registry data for women initiating bisphosphonates, we evaluated two methods of comparing the real-world effectiveness of osteoporosis treatments that attempt to adjust for differences in patient baseline characteristics. Each method has advantages and disadvantages; both are potential complements to clinical trial analyses. We evaluated methods of comparing the real-world effectiveness of osteoporosis treatments that attempt to adjust for both observed and unobserved confounding. Swedish and Dutch registry data for women initiating zoledronate or oral bisphosphonates (OBPs; alendronate/risedronate) were used; the primary outcome was fracture. In adjusted direct comparisons (ADCs), regression and matching techniques were used to account for baseline differences in known risk factors for fracture (e.g., age, previous fracture, comorbidities). In an own-control analysis (OCA), for each treatment, fracture incidence in the first 90 days following treatment initiation (the baseline risk period) was compared with fracture incidence in the 1-year period starting 91 days after treatment initiation (the treatment exposure period). In total, 1196 and 149 women initiating zoledronate and 14,764 and 25,058 initiating OBPs were eligible in the Swedish and Dutch registries, respectively. Owing to the small Dutch zoledronate sample, only the Swedish data were used to compare fracture incidences between treatment groups. ADCs showed a numerically higher fracture incidence in the zoledronate than in the OBPs group (hazard ratio 1.09-1.21; not statistically significant, p > 0.05). For both treatment groups, OCA showed a higher fracture incidence in the baseline risk period than in the treatment exposure period, indicating a treatment effect. OCA showed a similar or greater effect in the zoledronate group compared with the OBPs group. ADC and OCA each possesses advantages and disadvantages. Combining both methods may provide an estimate of real-world treatment efficacy that could potentially complement clinical trial findings.

Spectrophotometric analysis of the effectiveness of a novel in-office laser-assisted tooth bleaching method using Er,Cr:YSGG laser.

PubMed

Dionysopoulos, Dimitrios; Strakas, Dimitrios; Tolidis, Kosmas; Tsitrou, Effrosyni; Koumpia, Effimia; Koliniotou-Koumpia, Eugenia

2017-11-01

The purpose of this in vitro study was to compare the effectiveness of a novel Er,Cr:YSGG laser-assisted in-office tooth bleaching method with a conventional method by spectrophotometric analysis of the tooth color change. Furthermore, the influence of the application time of the bleaching gel on the effectiveness of the methods and the maintenance of the results 7 days and 1 month after the treatments were also evaluated. Twenty-four bovine incisors were stained and randomly distributed into four groups. Group 1 specimens received an in-office bleaching treatment with 35% H 2 O 2 for 2 × 15 min. Group 2 specimens received the same treatment but with extended application time (2 × 20 min). In Group 3, the same in-office bleaching procedure (2 × 15 min) was carried out as that in Group 1, using Er,Cr:YSGG laser irradiation for 2 × 15 s on each specimen to catalyze the reaction of H 2 O 2 breakdown. Group 4 specimens received the same bleaching treatment as Group 3 but with extended application time (2 × 20 min). Er,Cr:YSGG laser-assisted tooth bleaching treatment is more effective than the conventional treatment regarding color change of the teeth. Application time of the bleaching agent may influence the effectiveness of the methods. The color change of the tested treatments decreases after 7 days and 1 month. The clinical relevance of this study is that this novel laser-assisted bleaching treatment may be more advantageous in color change and application time compared to the conventional bleaching treatment.

Measuring the individual benefit of a medical or behavioral treatment using generalized linear mixed-effects models.

PubMed

Diaz, Francisco J

2016-10-15

We propose statistical definitions of the individual benefit of a medical or behavioral treatment and of the severity of a chronic illness. These definitions are used to develop a graphical method that can be used by statisticians and clinicians in the data analysis of clinical trials from the perspective of personalized medicine. The method focuses on assessing and comparing individual effects of treatments rather than average effects and can be used with continuous and discrete responses, including dichotomous and count responses. The method is based on new developments in generalized linear mixed-effects models, which are introduced in this article. To illustrate, analyses of data from the Sequenced Treatment Alternatives to Relieve Depression clinical trial of sequences of treatments for depression and data from a clinical trial of respiratory treatments are presented. The estimation of individual benefits is also explained. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The performance of different propensity score methods for estimating marginal hazard ratios.

PubMed

Austin, Peter C

2013-07-20

Propensity score methods are increasingly being used to reduce or minimize the effects of confounding when estimating the effects of treatments, exposures, or interventions when using observational or non-randomized data. Under the assumption of no unmeasured confounders, previous research has shown that propensity score methods allow for unbiased estimation of linear treatment effects (e.g., differences in means or proportions). However, in biomedical research, time-to-event outcomes occur frequently. There is a paucity of research into the performance of different propensity score methods for estimating the effect of treatment on time-to-event outcomes. Furthermore, propensity score methods allow for the estimation of marginal or population-average treatment effects. We conducted an extensive series of Monte Carlo simulations to examine the performance of propensity score matching (1:1 greedy nearest-neighbor matching within propensity score calipers), stratification on the propensity score, inverse probability of treatment weighting (IPTW) using the propensity score, and covariate adjustment using the propensity score to estimate marginal hazard ratios. We found that both propensity score matching and IPTW using the propensity score allow for the estimation of marginal hazard ratios with minimal bias. Of these two approaches, IPTW using the propensity score resulted in estimates with lower mean squared error when estimating the effect of treatment in the treated. Stratification on the propensity score and covariate adjustment using the propensity score result in biased estimation of both marginal and conditional hazard ratios. Applied researchers are encouraged to use propensity score matching and IPTW using the propensity score when estimating the relative effect of treatment on time-to-event outcomes. Copyright © 2012 John Wiley & Sons, Ltd.

Alternating treatments design: one strategy for comparing the effects of two treatments in a single subject.

PubMed Central

Barlow, D H; Hayes, S C

1979-01-01

A little used and often confused design, capable of comparing two treatments within a single subject, has been termed, variously, a multielement baseline design, a multiple schedule design, and a randomization design. The background of these terms is reviewed, and a new, more descriptive term, Alternating Treatments Design, is proposed. Critical differences between this design and a Simultaneous Treatment Design are outlined, and experimental questions answerable by each design are noted. Potential problems with multiple treatment interference in this procedure are divided into sequential confounding, carryover effects, and alternation effects and the importance of these issues vis-a-vis other single-case experimental designs is considered. Methods of minimizing multiple treatment interference as well as methods of studying these effects are outlined. Finally, appropriate uses of Alternating Treatments Designs are described and discussed in the context of recent examples. PMID:489478

Assessing treatment effects in older breast cancer patients: systematic review of observational research methods.

PubMed

de Glas, N A; Kiderlen, M; de Craen, A J M; Hamaker, M E; Portielje, J E A; van de Velde, C J H; Liefers, G J; Bastiaannet, E

2015-03-01

Solid evidence of treatment effects in older women with breast cancer is lacking, as they are generally underrepresented in randomized clinical trials on which guideline recommendations are based. An alternative way to study treatment effects in older patients could be to use data from observational studies. However, using appropriate methods in analyzing observational data is a key condition in order to draw valid conclusions, as directly comparing treatments generally results in biased estimates due to confounding by indication. The aim of this systematic review was to investigate the methods that have been used in observational studies that assessed the effects of breast cancer treatment on survival, breast cancer survival and recurrence in older patients (aged 65 years and older). Studies were identified through systematic review of the literature published between January 1st 2009 and December 13th 2013 in the PubMed database and EMBASe. Finally, 31 studies fulfilled the inclusion criteria. Of these, 22 studies directly compared two treatments. Fifteen out of these 22 studies addressed the problem of confounding by indication, while seven studies did not. Nine studies used some form of instrumental variable analysis. In conclusion, the vast majority of observational studies that investigate treatment effects in older breast cancer patients compared treatments directly. These studies are therefore likely to be biased. Observational research will be essential to improve treatment and outcome of older breast cancer patients, but the use of accurate methods is essential to draw valid conclusions from this type of data. Copyright © 2015 Elsevier Ltd. All rights reserved.

Applying Propensity Score Methods in Medical Research: Pitfalls and Prospects

PubMed Central

Luo, Zhehui; Gardiner, Joseph C.; Bradley, Cathy J.

2012-01-01

The authors review experimental and nonexperimental causal inference methods, focusing on assumptions for the validity of instrumental variables and propensity score (PS) methods. They provide guidance in four areas for the analysis and reporting of PS methods in medical research and selectively evaluate mainstream medical journal articles from 2000 to 2005 in the four areas, namely, examination of balance, overlapping support description, use of estimated PS for evaluation of treatment effect, and sensitivity analyses. In spite of the many pitfalls, when appropriately evaluated and applied, PS methods can be powerful tools in assessing average treatment effects in observational studies. Appropriate PS applications can create experimental conditions using observational data when randomized controlled trials are not feasible and, thus, lead researchers to an efficient estimator of the average treatment effect. PMID:20442340

Optimizing acupuncture treatment for dry eye syndrome: a systematic review.

PubMed

Kim, Bong Hyun; Kim, Min Hee; Kang, Se Hyun; Nam, Hae Jeong

2018-05-03

In a former meta-analysis review, acupuncture was considered a potentially effective treatment for dry eye syndrome (DES), but there were heterogeneities among the outcomes. We updated the meta-analysis and conducted subgroup analysis to reduce the heterogeneity and suggest the most effective acupuncture method based on clinical trials. We searched for randomized controlled trials (RCTs) in 10 databases (MEDLINE, EMBASE, CENTAL, AMED, SCOPUS, CNKI, Wangfang database, Oriental Medicine Advanced Searching Integrated System (OASIS), Koreamed, J-stage) and searched by hand to compare the effects of acupuncture and artificial tears (AT). We also conducted subgroup analysis by (1) method of intervention (acupuncture only or acupuncture plus AT), (2) intervention frequency (less than 3 times a week or more than 3 times a week), (3) period of treatment (less than 4 weeks or more than 4 weeks), and (4) acupoints (BL1, BL2, ST1, ST2, TE23, Ex-HN5). The Bucher method was used for subgroup comparisons. Nineteen studies with 1126 patients were included. Significant improvements on the Schirmer test (weighted mean difference[WMD], 2.14; 95% confidence interval[CI], 0.93 to 3.34; p = 0.0005) and break up time (BUT) (WMD, 0.98; 95% CI, 0.79 to 1.18; p < 0.00001) were reported. In the subgroup analysis, acupuncture plus AT treatment had a weaker effect in BUT but a stronger effect on the Schirmer test and a better overall effect than acupuncture alone. For treatment duration, treatment longer than 1 month was more effective than shorter treatment. With regard to treatment frequency, treatment less than three times a week was more effective than more frequent treatment. In the acupoint analysis, acupuncture treatment including the BL2 and ST1 acupoints was less effective than treatment that did not include them. None of those factors reduced the heterogeneity. Acupuncture was more effective than AT in treating DES but showed high heterogeneity. Intervention differences did not influence the heterogeneity.

Instrumental Variable Methods for Continuous Outcomes That Accommodate Nonignorable Missing Baseline Values.

PubMed

Ertefaie, Ashkan; Flory, James H; Hennessy, Sean; Small, Dylan S

2017-06-15

Instrumental variable (IV) methods provide unbiased treatment effect estimation in the presence of unmeasured confounders under certain assumptions. To provide valid estimates of treatment effect, treatment effect confounders that are associated with the IV (IV-confounders) must be included in the analysis, and not including observations with missing values may lead to bias. Missing covariate data are particularly problematic when the probability that a value is missing is related to the value itself, which is known as nonignorable missingness. In such cases, imputation-based methods are biased. Using health-care provider preference as an IV method, we propose a 2-step procedure with which to estimate a valid treatment effect in the presence of baseline variables with nonignorable missing values. First, the provider preference IV value is estimated by performing a complete-case analysis using a random-effects model that includes IV-confounders. Second, the treatment effect is estimated using a 2-stage least squares IV approach that excludes IV-confounders with missing values. Simulation results are presented, and the method is applied to an analysis comparing the effects of sulfonylureas versus metformin on body mass index, where the variables baseline body mass index and glycosylated hemoglobin have missing values. Our result supports the association of sulfonylureas with weight gain. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nonparametric methods for doubly robust estimation of continuous treatment effects.

PubMed

Kennedy, Edward H; Ma, Zongming; McHugh, Matthew D; Small, Dylan S

2017-09-01

Continuous treatments (e.g., doses) arise often in practice, but many available causal effect estimators are limited by either requiring parametric models for the effect curve, or by not allowing doubly robust covariate adjustment. We develop a novel kernel smoothing approach that requires only mild smoothness assumptions on the effect curve, and still allows for misspecification of either the treatment density or outcome regression. We derive asymptotic properties and give a procedure for data-driven bandwidth selection. The methods are illustrated via simulation and in a study of the effect of nurse staffing on hospital readmissions penalties.

[A treatment to serious esophageal cicatrices stenosi by metal and silica gel dilator].

PubMed

Li, J; Chen, X; Sun, C; Liu, H

1999-12-01

To find an effective method of treating the esophageal cicatricial stenosis. Six cases with esophageal cicatricial stenosis were treated by mental and silica gel dilator. The effects in all six cases were satisfactory and no any complications were finded. The method is safe, effective and of no complications, the treatment time is shorter also.

Network meta-analysis, electrical networks and graph theory.

PubMed

Rücker, Gerta

2012-12-01

Network meta-analysis is an active field of research in clinical biostatistics. It aims to combine information from all randomized comparisons among a set of treatments for a given medical condition. We show how graph-theoretical methods can be applied to network meta-analysis. A meta-analytic graph consists of vertices (treatments) and edges (randomized comparisons). We illustrate the correspondence between meta-analytic networks and electrical networks, where variance corresponds to resistance, treatment effects to voltage, and weighted treatment effects to current flows. Based thereon, we then show that graph-theoretical methods that have been routinely applied to electrical networks also work well in network meta-analysis. In more detail, the resulting consistent treatment effects induced in the edges can be estimated via the Moore-Penrose pseudoinverse of the Laplacian matrix. Moreover, the variances of the treatment effects are estimated in analogy to electrical effective resistances. It is shown that this method, being computationally simple, leads to the usual fixed effect model estimate when applied to pairwise meta-analysis and is consistent with published results when applied to network meta-analysis examples from the literature. Moreover, problems of heterogeneity and inconsistency, random effects modeling and including multi-armed trials are addressed. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.

Research on common methods for evaluating the operation effect of integrated wastewater treatment facilities of iron and steel enterprises

NASA Astrophysics Data System (ADS)

Bingsheng, Xu

2017-04-01

Considering the large quantities of wastewater generated from iron and steel enterprises in China, this paper is aimed to research the common methods applied for evaluating the integrated wastewater treatment effect of iron and steel enterprises. Based on survey results on environmental protection performance, technological economy, resource & energy consumption, services and management, an indicator system for evaluating the operation effect of integrated wastewater treatment facilities is set up. By discussing the standards and industrial policies in and out of China, 27 key secondary indicators are further defined on the basis of investigation on main equipment and key processes for wastewater treatment, so as to determine the method for setting key quantitative and qualitative indicators for evaluation indicator system. It is also expected to satisfy the basic requirements of reasonable resource allocation, environmental protection and sustainable economic development, further improve the integrated wastewater treatment effect of iron and steel enterprises, and reduce the emission of hazardous substances and environmental impact.

Estimating scaled treatment effects with multiple outcomes.

PubMed

Kennedy, Edward H; Kangovi, Shreya; Mitra, Nandita

2017-01-01

In classical study designs, the aim is often to learn about the effects of a treatment or intervention on a single outcome; in many modern studies, however, data on multiple outcomes are collected and it is of interest to explore effects on multiple outcomes simultaneously. Such designs can be particularly useful in patient-centered research, where different outcomes might be more or less important to different patients. In this paper, we propose scaled effect measures (via potential outcomes) that translate effects on multiple outcomes to a common scale, using mean-variance and median-interquartile range based standardizations. We present efficient, nonparametric, doubly robust methods for estimating these scaled effects (and weighted average summary measures), and for testing the null hypothesis that treatment affects all outcomes equally. We also discuss methods for exploring how treatment effects depend on covariates (i.e., effect modification). In addition to describing efficiency theory for our estimands and the asymptotic behavior of our estimators, we illustrate the methods in a simulation study and a data analysis. Importantly, and in contrast to much of the literature concerning effects on multiple outcomes, our methods are nonparametric and can be used not only in randomized trials to yield increased efficiency, but also in observational studies with high-dimensional covariates to reduce confounding bias.

Adjusting for the Confounding Effects of Treatment Switching—The BREAK-3 Trial: Dabrafenib Versus Dacarbazine

PubMed Central

Abrams, Keith R.; Amonkar, Mayur M.; Stapelkamp, Ceilidh; Swann, R. Suzanne

2015-01-01

Background. Patients with previously untreated BRAF V600E mutation-positive melanoma in BREAK-3 showed a median overall survival (OS) of 18.2 months for dabrafenib versus 15.6 months for dacarbazine (hazard ratio [HR], 0.76; 95% confidence interval, 0.48–1.21). Because patients receiving dacarbazine were allowed to switch to dabrafenib at disease progression, we attempted to adjust for the confounding effects on OS. Materials and Methods. Rank preserving structural failure time models (RPSFTMs) and the iterative parameter estimation (IPE) algorithm were used. Two analyses, “treatment group” (assumes treatment effect could continue until death) and “on-treatment observed” (assumes treatment effect disappears with discontinuation), were used to test the assumptions around the durability of the treatment effect. Results. A total of 36 of 63 patients (57%) receiving dacarbazine switched to dabrafenib. The adjusted OS HRs ranged from 0.50 to 0.55, depending on the analysis. The RPSFTM and IPE “treatment group” and “on-treatment observed” analyses performed similarly well. Conclusion. RPSFTM and IPE analyses resulted in point estimates for the OS HR that indicate a substantial increase in the treatment effect compared with the unadjusted OS HR of 0.76. The results are uncertain because of the assumptions associated with the adjustment methods. The confidence intervals continued to cross 1.00; thus, the adjusted estimates did not provide statistically significant evidence of a treatment benefit on survival. However, it is clear that a standard intention-to-treat analysis will be confounded in the presence of treatment switching—a reliance on unadjusted analyses could lead to inappropriate practice. Adjustment analyses provide useful additional information on the estimated treatment effects to inform decision making. Implications for Practice: Treatment switching is common in oncology trials, and the implications of this for the interpretation of the clinical effectiveness and cost-effectiveness of the novel treatment are important to consider. If patients who switch treatments benefit from the experimental treatment and a standard intention-to-treat analysis is conducted, the overall survival advantage associated with the new treatment could be underestimated. The present study applied established statistical methods to adjust for treatment switching in a trial that compared dabrafenib and dacarbazine for metastatic melanoma. The results showed that this led to a substantially increased estimate of the overall survival treatment effect associated with dabrafenib. PMID:26040620

Tutorial in Biostatistics: Instrumental Variable Methods for Causal Inference*

PubMed Central

Baiocchi, Michael; Cheng, Jing; Small, Dylan S.

2014-01-01

A goal of many health studies is to determine the causal effect of a treatment or intervention on health outcomes. Often, it is not ethically or practically possible to conduct a perfectly randomized experiment and instead an observational study must be used. A major challenge to the validity of observational studies is the possibility of unmeasured confounding (i.e., unmeasured ways in which the treatment and control groups differ before treatment administration which also affect the outcome). Instrumental variables analysis is a method for controlling for unmeasured confounding. This type of analysis requires the measurement of a valid instrumental variable, which is a variable that (i) is independent of the unmeasured confounding; (ii) affects the treatment; and (iii) affects the outcome only indirectly through its effect on the treatment. This tutorial discusses the types of causal effects that can be estimated by instrumental variables analysis; the assumptions needed for instrumental variables analysis to provide valid estimates of causal effects and sensitivity analysis for those assumptions; methods of estimation of causal effects using instrumental variables; and sources of instrumental variables in health studies. PMID:24599889

Treatment Effect Estimation Using Nonlinear Two-Stage Instrumental Variable Estimators: Another Cautionary Note.

PubMed

Chapman, Cole G; Brooks, John M

2016-12-01

To examine the settings of simulation evidence supporting use of nonlinear two-stage residual inclusion (2SRI) instrumental variable (IV) methods for estimating average treatment effects (ATE) using observational data and investigate potential bias of 2SRI across alternative scenarios of essential heterogeneity and uniqueness of marginal patients. Potential bias of linear and nonlinear IV methods for ATE and local average treatment effects (LATE) is assessed using simulation models with a binary outcome and binary endogenous treatment across settings varying by the relationship between treatment effectiveness and treatment choice. Results show that nonlinear 2SRI models produce estimates of ATE and LATE that are substantially biased when the relationships between treatment and outcome for marginal patients are unique from relationships for the full population. Bias of linear IV estimates for LATE was low across all scenarios. Researchers are increasingly opting for nonlinear 2SRI to estimate treatment effects in models with binary and otherwise inherently nonlinear dependent variables, believing that it produces generally unbiased and consistent estimates. This research shows that positive properties of nonlinear 2SRI rely on assumptions about the relationships between treatment effect heterogeneity and choice. © Health Research and Educational Trust.

Monitoring post-fire vegetation rehabilitation projects: A common approach for non-forested ecosystems

USGS Publications Warehouse

Wirth, Troy A.; Pyke, David A.

2007-01-01

Emergency Stabilization and Rehabilitation (ES&R) and Burned Area Emergency Response (BAER) treatments are short-term, high-intensity treatments designed to mitigate the adverse effects of wildfire on public lands. The federal government expends significant resources implementing ES&R and BAER treatments after wildfires; however, recent reviews have found that existing data from monitoring and research are insufficient to evaluate the effects of these activities. The purpose of this report is to: (1) document what monitoring methods are generally used by personnel in the field; (2) describe approaches and methods for post-fire vegetation and soil monitoring documented in agency manuals; (3) determine the common elements of monitoring programs recommended in these manuals; and (4) describe a common monitoring approach to determine the effectiveness of future ES&R and BAER treatments in non-forested regions. Both qualitative and quantitative methods to measure effectiveness of ES&R treatments are used by federal land management agencies. Quantitative methods are used in the field depending on factors such as funding, personnel, and time constraints. There are seven vegetation monitoring manuals produced by the federal government that address monitoring methods for (primarily) vegetation and soil attributes. These methods vary in their objectivity and repeatability. The most repeatable methods are point-intercept, quadrat-based density measurements, gap intercepts, and direct measurement of soil erosion. Additionally, these manuals recommend approaches for designing monitoring programs for the state of ecosystems or the effect of management actions. The elements of a defensible monitoring program applicable to ES&R and BAER projects that most of these manuals have in common are objectives, stratification, control areas, random sampling, data quality, and statistical analysis. The effectiveness of treatments can be determined more accurately if data are gathered using an approach that incorporates these six monitoring program design elements and objectives, as well as repeatable procedures to measure cover, density, gap intercept, and soil erosion within each ecoregion and plant community. Additionally, using a common monitoring program design with comparable methods, consistently documenting results, and creating and maintaining a central database for query and reporting, will ultimately allow a determination of the effectiveness of post-fire rehabilitation activities region-wide.

A hybrid method in combining treatment effects from matched and unmatched studies.

PubMed

Byun, Jinyoung; Lai, Dejian; Luo, Sheng; Risser, Jan; Tung, Betty; Hardy, Robert J

2013-12-10

The most common data structures in the biomedical studies have been matched or unmatched designs. Data structures resulting from a hybrid of the two may create challenges for statistical inferences. The question may arise whether to use parametric or nonparametric methods on the hybrid data structure. The Early Treatment for Retinopathy of Prematurity study was a multicenter clinical trial sponsored by the National Eye Institute. The design produced data requiring a statistical method of a hybrid nature. An infant in this multicenter randomized clinical trial had high-risk prethreshold retinopathy of prematurity that was eligible for treatment in one or both eyes at entry into the trial. During follow-up, recognition visual acuity was accessed for both eyes. Data from both eyes (matched) and from only one eye (unmatched) were eligible to be used in the trial. The new hybrid nonparametric method is a meta-analysis based on combining the Hodges-Lehmann estimates of treatment effects from the Wilcoxon signed rank and rank sum tests. To compare the new method, we used the classic meta-analysis with the t-test method to combine estimates of treatment effects from the paired and two sample t-tests. We used simulations to calculate the empirical size and power of the test statistics, as well as the bias, mean square and confidence interval width of the corresponding estimators. The proposed method provides an effective tool to evaluate data from clinical trials and similar comparative studies. Copyright © 2013 John Wiley & Sons, Ltd.

Regenerating mahogany (Swietenia macrophylla) from seed in Quintana Roo, Mexico: the effects of sowing method and clearing treatment.

Treesearch

Patricia Negreros-Castilloa; Laura K. Snookb; Carl W. Mize

2003-01-01

Honduras or bigleaf mahogany (Swietenia macrophylla King) is the most commercially important timber species in the Neotropics, but it often does not regenerate successfully after harvesting. Effective methods are needed to sustain or increase mahogany yields by increasing regeneration. This study evaluates the effects of three treatments (slash, fell and burn; slash,...

Under What Assumptions Do Site-by-Treatment Instruments Identify Average Causal Effects?

ERIC Educational Resources Information Center

Reardon, Sean F.; Raudenbush, Stephen W.

2013-01-01

The increasing availability of data from multi-site randomized trials provides a potential opportunity to use instrumental variables methods to study the effects of multiple hypothesized mediators of the effect of a treatment. We derive nine assumptions needed to identify the effects of multiple mediators when using site-by-treatment interactions…

["The most ill go into psychoanalytic treatment"? Critical comments on an article in Report Psychologie].

PubMed

Richter, R; Hartmann, A; Meyer, A E; Rüger, U

1994-01-01

Thomas and Schmitz claim that they "deliver a proof for the effectiveness of humanistic methods" (p. 25) with their study. However, they did not or were not able to verify their claim due to several reasons: The authors did not say if and if so to what extent the treatments carried out within the framework of the TK-regulation were treatments using humanistic methods. The validity of the only criterium used by the authors, the average duration of the inability to work, must be questioned. The inferential statistical treatment of the data is insufficient; a non-parametrical evaluation is necessary. Especially missing are personal details concerning the treatment groups (age, sex, occupation, method, duration and frequency of therapy), which are indispensable for a differentiated interpretation. In addition there are numerous formal faults (wrong quotations, mistakes in tables, unclear terms etc.). In view of this criticism we come to the conclusion that the results are to a large degree worthless, at least until several of our objections have been refuted by further information and adequate inferential statistical methods. This study is especially unsuitable to prove a however defined "effectiveness of out-patient psychotherapies", therefore also not suitable to prove the effectiveness of those treatments conducted within the framework of the TK-regulation and especially not suitable to prove the superiority of humanistic methods in comparison with psychoanalytic methods and behavioural therapy.

Possibilities of the treatment of certain diseases in stomatology with the help of noninvasive laser therapy

NASA Astrophysics Data System (ADS)

Navratil, Leos; Navratilova, Blanka

2000-06-01

Non-invasive laser therapy is currently frequently used in stomatological practice thanks to its analgesic, anti- inflammatory and biostimulating effects. Suitable indications and methodic procedures of treatment should be established to provide the relevant efficacy of the method. The work characteristics the efficacy of the treatment in selected indications with checking suitable physical parameters of laser radiation. The study was carried out on total of 382 patients divided into three groups depending on the method of the treatment. The treatment result were evaluated based on the above-mentioned effects expressed with the help of relevant coefficients. The result demonstrated the contribution of therapeutic laser to the treatment of herpetic affections, aphthae, erosions, decubiti on the mucous membrane, conditions after difficult extractions, papilitits, wounds after teeth resection, linqua geographica, scar and treatment aimed at reducing the dentin sensitivity.

Latent class instrumental variables: A clinical and biostatistical perspective

PubMed Central

Baker, Stuart G.; Kramer, Barnett S.; Lindeman, Karen S.

2015-01-01

In some two-arm randomized trials, some participants receive the treatment assigned to the other arm as a result of technical problems, refusal of a treatment invitation, or a choice of treatment in an encouragement design. In some before-and-after studies, the availability of a new treatment changes from one time period to this next. Under assumptions that are often reasonable, the latent class instrumental variable (IV) method estimates the effect of treatment received in the aforementioned scenarios involving all-or-none compliance and all-or-none availability. Key aspects are four initial latent classes (sometimes called principal strata) based on treatment received if in each randomization group or time period, the exclusion restriction assumption (in which randomization group or time period is an instrumental variable), the monotonicity assumption (which drops an implausible latent class from the analysis), and the estimated effect of receiving treatment in one latent class (sometimes called efficacy, the local average treatment effect, or the complier average causal effect). Since its independent formulations in the biostatistics and econometrics literatures, the latent class IV method (which has no well-established name) has gained increasing popularity. We review the latent class IV method from a clinical and biostatistical perspective, focusing on underlying assumptions, methodological extensions, and applications in our fields of obstetrics and cancer research. PMID:26239275

Esophageal foreign bodies in adults with different durations of time from ingestion to effective treatment

PubMed Central

Zhang, Xiaowen; Jiang, Yan; Fu, Tao; Zhang, Xiaoheng; Tu, Chunmei

2017-01-01

Objective This study was performed to identify the differences in clinical characteristics, operative methods, complications, and postoperative hospitalization stays for adults with esophageal foreign bodies with different durations of time from ingestion to effective treatment. Methods We retrospectively reviewed the medical records of 221 patients with a diagnosis of a foreign body in the esophagus, confirmed by rigid esophagoscopy, flexible esophagoscopy, or surgery. The differences between the two groups (Group A, ≤24 hours from ingestion to effective treatment; Group B, >24 hours from ingestion to effective treatment) were analyzed. Results Sharp foreign bodies comprised the majority of objects in the two groups, including jujube pits, bones (excluding fish bones), fish bones, dentures, and seafood shells. Foreign bodies located in the upper esophagus were more commonly observed in Group A than B. Significant differences were observed in the complication rate and length of postoperative hospitalization stays. Adults with esophageal foreign bodies had a high complication rate. Conclusions Rigid esophagoscopy can be used to remove sharp and bulky foreign bodies if more effective methods are unavailable. Effective treatment within 24 hours resulted in fewer complications and shorter postoperative hospitalization stays. PMID:28606025

Assessing the Sensitivity of Treatment Effect Estimates to Differential Follow-Up Rates: Implications for Translational Research

PubMed Central

McCaffrey, Daniel; Ramchand, Rajeev; Hunter, Sarah B.; Suttorp, Marika

2012-01-01

We develop a new tool for assessing the sensitivity of findings on treatment effectiveness to differential follow-up rates in the two treatment conditions being compared. The method censors the group with the higher response rate to create a synthetic respondent group that is then compared with the observed cases in the other condition to estimate a treatment effect. Censoring is done under various assumptions about the strength of the relationship between follow-up and outcomes to determine how informative differential dropout can alter inferences relative to estimates from models that assume the data are missing at random. The method provides an intuitive measure for understanding the strength of the association between outcomes and dropout that would be required to alter inferences about treatment effects. Our approach is motivated by translational research in which treatments found to be effective under experimental conditions are tested in standard treatment conditions. In such applications, follow-up rates in the experimental setting are likely to be substantially higher than in the standard setting, especially when observational data are used in the evaluation. We test the method on a case study evaluation of the effectiveness of an evidence-supported adolescent substance abuse treatment program (Motivational Enhancement Therapy/Cognitive Behavioral Therapy-5 [MET/CBT-5]) delivered by community-based treatment providers relative to its performance in a controlled research trial. In this case study, follow-up rates in the community based settings were extremely low (54%) compared to the experimental setting (95%) giving raise to concerns about non-ignorable drop-out. PMID:22956890

Research study of the treatment efficacy of staphylococcia in the palatine tonsils by using Raman-scattering spectroscopy method

NASA Astrophysics Data System (ADS)

Timchenko, E. V.; Timchenko, P. E.; Asadova, A. A.; Ityaksov, Yu. D.; Tyumchenkova, A. S.

2017-08-01

Analysis of effectiveness of the staphylococcal infections treatment in the tonsils is carried out using Raman spectroscopy method. Spectral changes were established in the treatment of palatine tonsils with the antibiotic Amoksiklav. It was shown that when the antibiotic dosage is 500mg / 10ml, the lines disappear at wave numbers 735 cm-1 and 783 cm-1, 986 cm-1, and 1633 cm-1, corresponding to adenine, cytosine, proteins, and amide I, which indicates the effectiveness of treatment.

Dispersion of Co/CNTs via strong electrostatic adsorption method: Thermal treatment effect

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

Akbarzadeh, Omid, E-mail: omid.akbarzadeh63@gmail.com; Abdullah, Bawadi, E-mail: bawadi-abdullah@petronas.com.my; Subbarao, Duvvuri, E-mail: duvvuri-subbarao@petronas.com.my

The effect of different thermal treatment temperature on the structure of multi-walled carbon nanotubes (MWCNTs) and Co particle dispersion on CNTs support is studied using Strong electrostatic adsorption (SEA) method. The samples tested by N{sub 2}-adsorption, field emission scanning electron microscopy (FE-SEM) and transmission electron microscopy (TEM). N{sub 2}-adsorption results showed BET surface area increased using thermal treatment and TEM images showed that increasing the thermal treatment temperature lead to flaky CNTs and defects introduced on the outer surface and Co particle dispersion increased.

Testing Public Anxiety Treatments against a Credible Placebo Control

ERIC Educational Resources Information Center

Duff, Desiree C.; Levine, Timothy R.; Beatty, Michael J.; Woolbright, Jessica; Park, Hee Sun

2007-01-01

Research investigating public speaking anxiety treatments is subject to demand effects. This study tests the relative effectiveness of systematic desensitization (SD) and multiple treatment method (MT) containing visualization therapy against no-treatment and credible placebo controls. Data (N = 238) were collected at six points in a public…

Treatment of addiction and addiction-related behavior

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

Dewey, S.L.; Brodie, J.D.; Ashby, C.R. Jr.

2000-05-02

The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a primate suffering from substance addiction. The method includes administering to a primate an effective amount of a pharmaceutical composition including gamma vinylGABA. The present invention also provides a method of treatment of nicotine addiction by treating a patient with an effective amount of a composition including gamma vinylGABA.

Treatment of addiction and addiction-related behavior

DOEpatents

Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

2000-01-01

The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a primate suffering from substance addiction. The method includes administering to a primate an effective amount of a pharmaceutical composition including gamma vinylGABA. The present invention also provides a method of treatment of nicotine addiction by treating a patient with an effective amount of a composition including gamma vinylGABA.

Dialectical Behavioral Therapy and EMDR for Adolescents in Residential Treatment: A Practical and Theoretical Perspective

ERIC Educational Resources Information Center

Lovelle, Carole

2005-01-01

DBT and EMDR as primary treatment methods provide effective treatment for adolescents in the setting of group residential facilities. Regardless of the intensity of the pathology or the length of stay, these compatible treatment methods provide adolescents with significant decreases in the impact of traumatic memories and increased emotional…

No major differences found between the effects of microwave-based and conventional heat treatment methods on two different liquid foods.

PubMed

Géczi, Gábor; Horváth, Márk; Kaszab, Tímea; Alemany, Gonzalo Garnacho

2013-01-01

Extension of shelf life and preservation of products are both very important for the food industry. However, just as with other processes, speed and higher manufacturing performance are also beneficial. Although microwave heating is utilized in a number of industrial processes, there are many unanswered questions about its effects on foods. Here we analyze whether the effects of microwave heating with continuous flow are equivalent to those of traditional heat transfer methods. In our study, the effects of heating of liquid foods by conventional and continuous flow microwave heating were studied. Among other properties, we compared the stability of the liquid foods between the two heat treatments. Our goal was to determine whether the continuous flow microwave heating and the conventional heating methods have the same effects on the liquid foods, and, therefore, whether microwave heat treatment can effectively replace conventional heat treatments. We have compared the colour, separation phenomena of the samples treated by different methods. For milk, we also monitored the total viable cell count, for orange juice, vitamin C contents in addition to the taste of the product by sensory analysis. The majority of the results indicate that the circulating coil microwave method used here is equivalent to the conventional heating method based on thermal conduction and convection. However, some results in the analysis of the milk samples show clear differences between heat transfer methods. According to our results, the colour parameters (lightness, red-green and blue-yellow values) of the microwave treated samples differed not only from the untreated control, but also from the traditional heat treated samples. The differences are visually undetectable, however, they become evident through analytical measurement with spectrophotometer. This finding suggests that besides thermal effects, microwave-based food treatment can alter product properties in other ways as well.

No Major Differences Found between the Effects of Microwave-Based and Conventional Heat Treatment Methods on Two Different Liquid Foods

PubMed Central

Géczi, Gábor; Horváth, Márk; Kaszab, Tímea; Alemany, Gonzalo Garnacho

2013-01-01

Extension of shelf life and preservation of products are both very important for the food industry. However, just as with other processes, speed and higher manufacturing performance are also beneficial. Although microwave heating is utilized in a number of industrial processes, there are many unanswered questions about its effects on foods. Here we analyze whether the effects of microwave heating with continuous flow are equivalent to those of traditional heat transfer methods. In our study, the effects of heating of liquid foods by conventional and continuous flow microwave heating were studied. Among other properties, we compared the stability of the liquid foods between the two heat treatments. Our goal was to determine whether the continuous flow microwave heating and the conventional heating methods have the same effects on the liquid foods, and, therefore, whether microwave heat treatment can effectively replace conventional heat treatments. We have compared the colour, separation phenomena of the samples treated by different methods. For milk, we also monitored the total viable cell count, for orange juice, vitamin C contents in addition to the taste of the product by sensory analysis. The majority of the results indicate that the circulating coil microwave method used here is equivalent to the conventional heating method based on thermal conduction and convection. However, some results in the analysis of the milk samples show clear differences between heat transfer methods. According to our results, the colour parameters (lightness, red-green and blue-yellow values) of the microwave treated samples differed not only from the untreated control, but also from the traditional heat treated samples. The differences are visually undetectable, however, they become evident through analytical measurement with spectrophotometer. This finding suggests that besides thermal effects, microwave-based food treatment can alter product properties in other ways as well. PMID:23341982

A narrative review of non-operative treatment, especially traditional Chinese medicine therapy, for lumbar intervertebral disc herniation.

PubMed

Zhang, Bo; Xu, Haidong; Wang, Juntao; Liu, Bin; Sun, Guodong

2017-01-01

Lumbar intervertebral disc herniation (LIDH), as the main contributor to low back pain and sciatica, imposes a heavy burden on both the individual and society. Non-operative treatment or conservative treatment has proven effective in alleviation of the symptoms of LIDH and are considered to be a first-line choice for most cases. Active lifestyle, physical therapy, complementary and alternative medicine therapy or Traditional Chinese medicine (TCM) therapy, and pharmacotherapy are routinely used as effective non-operative treatment for LIDH patients. However, how to choose one or several conservative treatments with higher efficacy, less side effects, minimal injury, and low cost is still a challenge for doctors and LIDH patients. Furthermore, there are some national characteristics for some conservative treatments in different countries, which bring difficulties for the widespread use of these methods. Here we initiated a search on the non-operative treatment especially TCM therapy for LIDH mainly using PubMed, Web of Science, China National Knowledge Internet (CNKI), and Chinese biomedicine database since the 1980s with no restriction of language. According to these related references, we gave a narrative review which emphasizes up-to-date knowledge regarding the effectiveness and safety of various conservative methods with special consideration for TCM therapy including acupuncture, autonomy, Chinese massage, and Chinese herbal medicines, for LIDH treatment. We hope this review will further contribute to an understanding of conservative treatment as an important choice for LIDH patients and provide useful information for the development of more effective conservative methods for LIDH treatment.

Evaluations and Comparisons of Treatment Effects Based on Best Combinations of Biomarkers with Applications to Biomedical Studies

PubMed Central

Chen, Xiwei; Yu, Jihnhee

2014-01-01

Abstract Many clinical and biomedical studies evaluate treatment effects based on multiple biomarkers that commonly consist of pre- and post-treatment measurements. Some biomarkers can show significant positive treatment effects, while other biomarkers can reflect no effects or even negative effects of the treatments, giving rise to a necessity to develop methodologies that may correctly and efficiently evaluate the treatment effects based on multiple biomarkers as a whole. In the setting of pre- and post-treatment measurements of multiple biomarkers, we propose to apply a receiver operating characteristic (ROC) curve methodology based on the best combination of biomarkers maximizing the area under the receiver operating characteristic curve (AUC)-type criterion among all possible linear combinations. In the particular case with independent pre- and post-treatment measurements, we show that the proposed method represents the well-known Su and Liu's (1993) result. Further, proceeding from derived best combinations of biomarkers' measurements, we propose an efficient technique via likelihood ratio tests to compare treatment effects. We show an extensive Monte Carlo study that confirms the superiority of the proposed test in comparison with treatment effects based on multiple biomarkers in a paired data setting. For practical applications, the proposed method is illustrated with a randomized trial of chlorhexidine gluconate on oral bacterial pathogens in mechanically ventilated patients as well as a treatment study for children with attention deficit-hyperactivity disorder and severe mood dysregulation. PMID:25019920

Comparison of Instructional Methods for Screening, Brief Intervention, and Referral to Treatment for Substance Use in Nursing Education.

PubMed

Knopf-Amelung, Sarah; Gotham, Heather; Kuofie, Araba; Young, Pamela; Manney Stinson, Ronalda; Lynn, Jolene; Barker, Kendra; Hildreth, Jessica

Most nursing programs lack curriculum on substance use. This project evaluated 3 didactic instructional methods for teaching baccalaureate nursing students about screening, brief intervention, and referral to treatment for substance use. In-person, asynchronous narrated slides and interactive online instructional methods were all effective in developing students' competency; however, active learning methods (in-person and interactive online course) were more effective in changing students' attitudes about their role in screening and intervening for drug use.

Effectiveness and efficacy of minimally invasive lung volume reduction surgery for emphysema

PubMed Central

Pertl, Daniela; Eisenmann, Alexander; Holzer, Ulrike; Renner, Anna-Theresa; Valipour, A.

2014-01-01

Lung emphysema is a chronic, progressive and irreversible destruction of the lung tissue. Besides non-medical therapies and the well established medical treatment there are surgical and minimally invasive methods for lung volume reduction (LVR) to treat severe emphysema. This report deals with the effectiveness and cost-effectiveness of minimally invasive methods compared to other treatments for LVR in patients with lung emphysema. Furthermore, legal and ethical aspects are discussed. No clear benefit of minimally invasive methods compared to surgical methods can be demonstrated based on the identified and included evidence. In order to assess the different methods for LVR regarding their relative effectiveness and safety in patients with lung emphysema direct comparative studies are necessary. PMID:25295123

Effectiveness and efficacy of minimally invasive lung volume reduction surgery for emphysema.

PubMed

Pertl, Daniela; Eisenmann, Alexander; Holzer, Ulrike; Renner, Anna-Theresa; Valipour, A

2014-01-01

Lung emphysema is a chronic, progressive and irreversible destruction of the lung tissue. Besides non-medical therapies and the well established medical treatment there are surgical and minimally invasive methods for lung volume reduction (LVR) to treat severe emphysema. This report deals with the effectiveness and cost-effectiveness of minimally invasive methods compared to other treatments for LVR in patients with lung emphysema. Furthermore, legal and ethical aspects are discussed. No clear benefit of minimally invasive methods compared to surgical methods can be demonstrated based on the identified and included evidence. In order to assess the different methods for LVR regarding their relative effectiveness and safety in patients with lung emphysema direct comparative studies are necessary.

Selective detection of cavitation bubbles by triplet pulse sequence in high-intensity focused ultrasound treatment

NASA Astrophysics Data System (ADS)

Iwasaki, Ryosuke; Nagaoka, Ryo; Yoshizawa, Shin; Umemura, Shin-ichiro

2018-07-01

Acoustic cavitation bubbles are known to enhance the heating effect in high-intensity focused ultrasound (HIFU) treatment. The detection of cavitation bubbles with high sensitivity and selectivity is required to predict the therapeutic and side effects of cavitation, and ensure the efficacy and safety of the treatment. A pulse inversion (PI) technique has been widely used for imaging microbubbles through enhancing the second-harmonic component of echo signals. However, it has difficulty in separating the nonlinear response of microbubbles from that due to nonlinear propagation. In this study, a triplet pulse (3P) method was investigated to specifically image cavitation bubbles by extracting the 1.5th fractional harmonic component. The proposed 3P method depicted cavitation bubbles with a contrast ratio significantly higher than those in conventional imaging methods with and without PI. The results suggest that the 3P method is effective for specifically detecting microbubbles in cavitation-enhanced HIFU treatment.

Planting methods and treatment for black walnut seedlings.

Treesearch

Robert D. Williams

1974-01-01

Neither planting method nor stock treatment had any appreciable effect on survival and growth of black walnut, but survival and growth were significantly affected by the planting site and site preparation.

Treatment Effects of a Relationship-Strengthening Intervention for Economically Disadvantaged New Parents

ERIC Educational Resources Information Center

Charles, Pajarita; Jones, Anne; Guo, Shenyang

2014-01-01

Objective: The purpose of the present study was to evaluate the treatment effects of a relationship skills and family strengthening intervention for n = 726 high-risk, disadvantaged new parents. Method: Hierarchical linear modeling and regression models were used to assess intervention treatment effects. These findings were subsequently verified…

Recent Developments in the Assessment and Treatment of Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Berman, Noah C.; Abramowitz, Jonathan S.

2010-01-01

Although tremendous strides have recently been made in the development of assessment and treatment methods for pediatric obsessive-compulsive disorder (OCD), more accurate methods for diagnosis, more effective treatments, and more refined instruments for monitoring progress during therapy are still needed. The present commentary highlights the…

Heavily Oiled Salt Marsh following the Deepwater Horizon Oil Spill, Ecological Comparisons of Shoreline Cleanup Treatments and Recovery

PubMed Central

Zengel, Scott; Bernik, Brittany M.; Rutherford, Nicolle; Nixon, Zachary; Michel, Jacqueline

2015-01-01

The Deepwater Horizon oil spill affected hundreds of kilometers of coastal wetland shorelines, including salt marshes with persistent heavy oiling that required intensive shoreline “cleanup” treatment. Oiled marsh treatment involves a delicate balance among: removing oil, speeding the degradation of remaining oil, protecting wildlife, fostering habitat recovery, and not causing further ecological damage with treatment. To examine the effectiveness and ecological effects of treatment during the emergency response, oiling characteristics and ecological parameters were compared over two years among heavily oiled test plots subject to: manual treatment, mechanical treatment, natural recovery (no treatment, oiled control), as well as adjacent reference conditions. An additional experiment compared areas with and without vegetation planting following treatment. Negative effects of persistent heavy oiling on marsh vegetation, intertidal invertebrates, and shoreline erosion were observed. In areas without treatment, oiling conditions and negative effects for most marsh parameters did not considerably improve over two years. Both manual and mechanical treatment were effective at improving oiling conditions and vegetation characteristics, beginning the recovery process, though recovery was not complete by two years. Mechanical treatment had additional negative effects of mixing oil into the marsh soils and further accelerating erosion. Manual treatment appeared to strike the right balance between improving oiling and habitat conditions while not causing additional detrimental effects. However, even with these improvements, marsh periwinkle snails showed minimal signs of recovery through two years, suggesting that some ecosystem components may lag vegetation recovery. Planting following treatment quickened vegetation recovery and reduced shoreline erosion. Faced with comparable marsh oiling in the future, we would recommend manual treatment followed by planting. We caution against the use of intensive treatment methods with lesser marsh oiling. Oiled controls (no treatment “set-asides”) are essential for judging marsh treatment effectiveness and ecological effects; we recommend their use when applying intensive treatment methods. PMID:26200349

[Physical therapy for idiopathic scoliosis].

PubMed

Steffan, K

2015-11-01

The objective is the description and summary of the current state of idiopathic scoliosis treatment with physical therapy based on new scientific knowledge and concluded from more than 15 years of experience as a leading physician in two well-known clinics specializing in the conservative treatment of scoliosis. Based on current scientific publications on physical therapy in scoliosis treatment and resulting from the considerable personal experience gained working with conservative treatment and consulting scoliosis patients (as inpatients and outpatients), the current methods of physical therapy have been compared and evaluated. Physical therapy according to Schroth and Vojta therapy are at present the most common and effective methods in the physical treatment of idiopathic scoliosis. These methods can be applied during inpatient or outpatient treatment or intensified in the practice of specialized therapists. As there are only a few scientific studies on this subject, the author's findings are based mainly on his own experiences of the conservative treatment of idiopathic scoliosis. Athough these experiences are the results of over 15 years of working in the field of therapy, and the Schroth method in combination with corrective bracing presents highly promising results, it would nevertheless be desirable to conduct detailed scientific studies to verify the effectiveness of conservative treatment.

Effect of dental drawings and coloring on attitudes of child patients.

PubMed

Maruyama, S; Koyazu, T

1988-01-01

Young children can feel great anxiety and/or fear when facing their dental examination and treatment, and may refuse to be examined. To help children overcome these emotions, we originated a method called "Dental Drawings and Coloring". We investigated whether the new method might be effective for 207 children between the ages of two and four who had completed treatment and had returned for their first check-up, about three months later. Results showed that using the method of "Dental Drawings and Coloring" worked fairly effectively in alleviating their anxiety and fear.

Latent class instrumental variables: a clinical and biostatistical perspective.

PubMed

Baker, Stuart G; Kramer, Barnett S; Lindeman, Karen S

2016-01-15

In some two-arm randomized trials, some participants receive the treatment assigned to the other arm as a result of technical problems, refusal of a treatment invitation, or a choice of treatment in an encouragement design. In some before-and-after studies, the availability of a new treatment changes from one time period to this next. Under assumptions that are often reasonable, the latent class instrumental variable (IV) method estimates the effect of treatment received in the aforementioned scenarios involving all-or-none compliance and all-or-none availability. Key aspects are four initial latent classes (sometimes called principal strata) based on treatment received if in each randomization group or time period, the exclusion restriction assumption (in which randomization group or time period is an instrumental variable), the monotonicity assumption (which drops an implausible latent class from the analysis), and the estimated effect of receiving treatment in one latent class (sometimes called efficacy, the local average treatment effect, or the complier average causal effect). Since its independent formulations in the biostatistics and econometrics literatures, the latent class IV method (which has no well-established name) has gained increasing popularity. We review the latent class IV method from a clinical and biostatistical perspective, focusing on underlying assumptions, methodological extensions, and applications in our fields of obstetrics and cancer research. Copyright © 2015 John Wiley & Sons, Ltd.

Examining the Foundations of Methods That Assess Treatment Effect Heterogeneity across Intermediate Outcomes

ERIC Educational Resources Information Center

Feller, Avi; Miratrix, Luke

2015-01-01

The goal of this study is to better understand how methods for estimating treatment effects of latent groups operate. In particular, the authors identify where violations of assumptions can lead to biased estimates, and explore how covariates can be critical in the estimation process. For each set of approaches, the authors first review the…

Effect of source, drying method and treatment schedule on treatability of red pine

Treesearch

Stan Lebow; Cherilyn Hatfield; Steve Halverson

2006-01-01

Although sapwood of pine species is generally considered to be readily treated with preservatives, penetration is sometimes variable. The cause of this variability is poorly understood. This study evaluated the effect of geographic source, method of drying, and treatment parameters on penetration of a preservative in red pine lumber. Lumber from Wisconsin and Michigan...

A 20 Year Review of Punishment and Alternative Methods to Treat Problem Behaviors in Developmentally Delayed Persons.

ERIC Educational Resources Information Center

Matson, Johnny L.; Taras, Marie E.

1989-01-01

Studies assessing treatments for severe behavior problems of developmentally delayed persons were reviewed. Procedures used in the 382 studies, published from 1967-1987, were analyzed in terms of problem behaviors, side effects, and treatment methods. Also examined were number of studies reported yearly, maintenance and generalization of effects,…

Accounting for dropout in xenografted tumour efficacy studies: integrated endpoint analysis, reduced bias and better use of animals.

PubMed

Martin, Emma C; Aarons, Leon; Yates, James W T

2016-07-01

Xenograft studies are commonly used to assess the efficacy of new compounds and characterise their dose-response relationship. Analysis often involves comparing the final tumour sizes across dose groups. This can cause bias, as often in xenograft studies a tumour burden limit (TBL) is imposed for ethical reasons, leading to the animals with the largest tumours being excluded from the final analysis. This means the average tumour size, particularly in the control group, is underestimated, leading to an underestimate of the treatment effect. Four methods to account for dropout due to the TBL are proposed, which use all the available data instead of only final observations: modelling, pattern mixture models, treating dropouts as censored using the M3 method and joint modelling of tumour growth and dropout. The methods were applied to both a simulated data set and a real example. All four proposed methods led to an improvement in the estimate of treatment effect in the simulated data. The joint modelling method performed most strongly, with the censoring method also providing a good estimate of the treatment effect, but with higher uncertainty. In the real data example, the dose-response estimated using the censoring and joint modelling methods was higher than the very flat curve estimated from average final measurements. Accounting for dropout using the proposed censoring or joint modelling methods allows the treatment effect to be recovered in studies where it may have been obscured due to dropout caused by the TBL.

ESTIMATING PERSON-CENTERED TREATMENT (PeT) EFFECTS USING INSTRUMENTAL VARIABLES: AN APPLICATION TO EVALUATING PROSTATE CANCER TREATMENTS

PubMed Central

BASU, ANIRBAN

2014-01-01

SUMMARY This paper builds on the methods of local instrumental variables developed by Heckman and Vytlacil (1999, 2001, 2005) to estimate person-centered treatment (PeT) effects that are conditioned on the person’s observed characteristics and averaged over the potential conditional distribution of unobserved characteristics that lead them to their observed treatment choices. PeT effects are more individualized than conditional treatment effects from a randomized setting with the same observed characteristics. PeT effects can be easily aggregated to construct any of the mean treatment effect parameters and, more importantly, are well suited to comprehend individual-level treatment effect heterogeneity. The paper presents the theory behind PeT effects, and applies it to study the variation in individual-level comparative effects of prostate cancer treatments on overall survival and costs. PMID:25620844

Meta-analysis of two studies in the presence of heterogeneity with applications in rare diseases.

PubMed

Friede, Tim; Röver, Christian; Wandel, Simon; Neuenschwander, Beat

2017-07-01

Random-effects meta-analyses are used to combine evidence of treatment effects from multiple studies. Since treatment effects may vary across trials due to differences in study characteristics, heterogeneity in treatment effects between studies must be accounted for to achieve valid inference. The standard model for random-effects meta-analysis assumes approximately normal effect estimates and a normal random-effects model. However, standard methods based on this model ignore the uncertainty in estimating the between-trial heterogeneity. In the special setting of only two studies and in the presence of heterogeneity, we investigate here alternatives such as the Hartung-Knapp-Sidik-Jonkman method (HKSJ), the modified Knapp-Hartung method (mKH, a variation of the HKSJ method) and Bayesian random-effects meta-analyses with priors covering plausible heterogeneity values; R code to reproduce the examples is presented in an appendix. The properties of these methods are assessed by applying them to five examples from various rare diseases and by a simulation study. Whereas the standard method based on normal quantiles has poor coverage, the HKSJ and mKH generally lead to very long, and therefore inconclusive, confidence intervals. The Bayesian intervals on the whole show satisfying properties and offer a reasonable compromise between these two extremes. © 2016 The Authors. Biometrical Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

rpsftm: An R Package for Rank Preserving Structural Failure Time Models

PubMed Central

Allison, Annabel; White, Ian R; Bond, Simon

2018-01-01

Treatment switching in a randomised controlled trial occurs when participants change from their randomised treatment to the other trial treatment during the study. Failure to account for treatment switching in the analysis (i.e. by performing a standard intention-to-treat analysis) can lead to biased estimates of treatment efficacy. The rank preserving structural failure time model (RPSFTM) is a method used to adjust for treatment switching in trials with survival outcomes. The RPSFTM is due to Robins and Tsiatis (1991) and has been developed by White et al. (1997, 1999). The method is randomisation based and uses only the randomised treatment group, observed event times, and treatment history in order to estimate a causal treatment effect. The treatment effect, ψ, is estimated by balancing counter-factual event times (that would be observed if no treatment were received) between treatment groups. G-estimation is used to find the value of ψ such that a test statistic Z(ψ) = 0. This is usually the test statistic used in the intention-to-treat analysis, for example, the log rank test statistic. We present an R package that implements the method of rpsftm. PMID:29564164

rpsftm: An R Package for Rank Preserving Structural Failure Time Models.

PubMed

Allison, Annabel; White, Ian R; Bond, Simon

2017-12-04

Treatment switching in a randomised controlled trial occurs when participants change from their randomised treatment to the other trial treatment during the study. Failure to account for treatment switching in the analysis (i.e. by performing a standard intention-to-treat analysis) can lead to biased estimates of treatment efficacy. The rank preserving structural failure time model (RPSFTM) is a method used to adjust for treatment switching in trials with survival outcomes. The RPSFTM is due to Robins and Tsiatis (1991) and has been developed by White et al. (1997, 1999). The method is randomisation based and uses only the randomised treatment group, observed event times, and treatment history in order to estimate a causal treatment effect. The treatment effect, ψ , is estimated by balancing counter-factual event times (that would be observed if no treatment were received) between treatment groups. G-estimation is used to find the value of ψ such that a test statistic Z ( ψ ) = 0. This is usually the test statistic used in the intention-to-treat analysis, for example, the log rank test statistic. We present an R package that implements the method of rpsftm.

Using Non-experimental Data to Estimate Treatment Effects

PubMed Central

Stuart, Elizabeth A.; Marcus, Sue M.; Horvitz-Lennon, Marcela V.; Gibbons, Robert D.; Normand, Sharon-Lise T.

2009-01-01

While much psychiatric research is based on randomized controlled trials (RCTs), where patients are randomly assigned to treatments, sometimes RCTs are not feasible. This paper describes propensity score approaches, which are increasingly used for estimating treatment effects in non-experimental settings. The primary goal of propensity score methods is to create sets of treated and comparison subjects who look as similar as possible, in essence replicating a randomized experiment, at least with respect to observed patient characteristics. A study to estimate the metabolic effects of antipsychotic medication in a sample of Florida Medicaid beneficiaries with schizophrenia illustrates methods. PMID:20563313

No effect of forearm band and extensor strengthening exercises for the treatment of tennis elbow: a prospective randomised study.

PubMed

Luginbühl, Rolf; Brunner, Florian; Schneeberger, Alberto G

2008-01-01

The objective of this prospective randomised study was to analyse the effect of the forearm support band and of strengthening exercises for the treatment of tennis elbow. Twenty-nine patients with 30 tennis elbows were randomised into 3 groups of treatment: (I) forearm support band, (II) strengthening exercises and (III) both methods. The patients had a standardised examination at their first visit, and then after 6 weeks, 3 months and 1 year. At the latest follow-up, there was a significant improvement of the symptoms compared to before treatment (p<0.0001), considering all patients independently of the methods of treatment. However, no differences in the scores were found between the 3 groups of treatment (p=0.27), indicating that no beneficial influence was found either for the strengthening exercises or for the forearm support band. Improvement seems to occur with time, independent of the method of treatment used.

Subpopulation Treatment Effect Pattern Plot (STEPP) analysis for continuous, binary and count outcomes

PubMed Central

Yip, Wai-Ki; Bonetti, Marco; Cole, Bernard F; Barcella, William; Wang, Xin Victoria; Lazar, Ann; Gelber, Richard D

2016-01-01

Background For the past few decades, randomized clinical trials have provided evidence for effective treatments by comparing several competing therapies. Their successes have led to numerous new therapies to combat many diseases. However, since their conclusions are based on the entire cohort in the trial, the treatment recommendation is for everyone, and may not be the best option for an individual. Medical research is now focusing more on providing personalized care for patients, which requires investigating how patient characteristics, including novel biomarkers, modify the effect of current treatment modalities. This is known as heterogeneity of treatment effects. A better understanding of the interaction between treatment and patient specific prognostic factors will enable practitioners to expand the availability of tailored therapies, with the ultimate goal of improving patient outcomes. The Subpopulation Treatment Effect Pattern Plot (STEPP) approach was developed to allow researchers to investigate the heterogeneity of treatment effects on survival outcomes across values of a (continuously measured) covariate, such as a biomarker measurement. Methods Here, we extend the STEPP approach to continuous, binary and count outcomes which can be easily modeled using generalized linear models. With this extension of STEPP, these additional types of treatment effects within subpopulations defined with respect to a covariate of interest can be estimated, and the statistical significance of any observed heterogeneity of treatment effect can be assessed using permutation tests. The desirable feature that commonly used models are applied to well-defined patient subgroups to estimate treatment effects is retained in this extension. Results We describe a simulation study to confirm that the proper Type I error rate is maintained when there is no treatment heterogeneity, and a power study to show that the statistics have power to detect treatment heterogeneity under alternative scenarios. As an illustration, we apply the methods to data from the Aspirin/Folate Polyp Prevention Study, a clinical trial evaluating the effect of oral aspirin, folic acid, or both as a chemoprevention agent against colorectal adenomas. The pre-existing R software package stepp has been extended to handle continuous, binary and count data using Gaussian, Bernoulli and Poisson models, and it is available on the Comprehensive R Archive Network. Conclusions The extension of the method and the availability of new software now permit STEPP to be applied to the full range of clinical trial end points. PMID:27094489

Evaluation of toxicity and estrogenicity of the landfill-concentrated leachate during advanced oxidation treatment: chemical analyses and bioanalytical tools.

PubMed

Wang, Guifang; Lu, Gang; Zhao, Jiandi; Yin, Pinghe; Zhao, Ling

2016-08-01

Landfill-concentrated leachate from membrane separation processes is a potential pollution source for the surroundings. In this study, the toxicity and estrogenicity potentials of concentrated leachate prior to and during UV-Fenton and Fenton treatments were assessed by a combination of chemical (di (2-ethylhexyl) phthalate and dibutyl phthalate were chosen as targets) and biological (Daphnia magna, Chlorella vulgaris, and E-screen assay) analyses. Removal efficiencies of measured di (2-ethylhexyl) phthalate and dibutyl phthalate were more than 97 % after treatment with the two methods. Biological tests showed acute toxicity effects on D. magna tests in untreated concentrated leachate samples, whereas acute toxicity on C. vulgaris tests was not observed. Both treatment methods were found to be efficient in reducing acute toxicity effects on D. magna tests. The E-screen test showed concentrated leachate had significant estrogenicity, UV-Fenton and Fenton treatment, especially the former, were effective methods for reducing estrogenicity of concentrated leachate. The EEQchem (estradiol equivalent concentration) of all samples could only explain 0.218-5.31 % range of the EEQbio. These results showed that UV-Fenton reagent could be considered as a suitable method for treatment of concentrated leachate, and the importance of the application of an integrated (biological + chemical) analytical approach for a comprehensive evaluation of treatment suitability.

Sterilization Effect of Wet Oxygen Plasma in the Bubbling Method.

PubMed

Tamazawa, Kaoru; Shintani, Hideharu; Tamazawa, Yoshinori; Shimauchi, Hidetoshi

2015-01-01

A new low-temperature sterilization method to replace the ethylene oxide gas sterilization is needed. Strong bactericidal effects of OH and O2H radicals are well known. The purpose of this study was to evaluate the sterilization effect of wet oxygen ("O2+H2O") plasma in the bubbling method, confirming the effect of humidity. Sterility assurance was confirmed by using a biological indicator (Geobacillus stearothermophilus ATCC7953, Namsa, USA). One hundred and eight samples (10(5) spores/carrier) were divided into three groups of 36 in each for treatment with a different type of gas (O2, O2+H2O, Air+H2O). Plasma processing was conducted using a plasma ashing apparatus (13.56 MHz, PACK-3(®), Y. A. C., Japan) under various gas pressures (13, 25, 50 Pa) and gas flows (50, 100, 200 sccm). Fixed plasma treatment parameters were power at 150 W, temperature of 60 ℃, treatment time of 10 min. The samples after treatment were incubated in trypticase soy broth at 58 ℃ for 72 h. The negative culture rate in the "O2+H2O" group was significantly (Mantel-Haenszel procedure, p<0.001) higher than in the other gas groups. It is suggested that the significant sterilization effect of the "O2+H2O" group depends on the bubbling method which is the method of introducing vapor into the chamber. The bubbling method seems able to generate OH and O2H radicals in a stable way.

Using single-case experimental design methodology to evaluate the effects of the ABC method for nursing staff on verbal aggressive behaviour after acquired brain injury.

PubMed

Winkens, Ieke; Ponds, Rudolf; Pouwels, Climmy; Eilander, Henk; van Heugten, Caroline

2014-01-01

The ABC method is a basic and simplified form of behavioural modification therapy for use by nurses. ABC refers to the identification of Antecedent events, target Behaviours, and Consequent events. A single-case experimental AB design was used to evaluate the effects of the ABC method on a woman diagnosed with olivo-ponto-cerebellar ataxia. Target behaviour was verbal aggressive behaviour during ADL care, assessed at 9 time points immediately before implementation of the ABC method and at 36 time points after implementation. A randomisation test showed a significant treatment effect between the baseline and intervention phases (t = .58, p = .03; ES [Nonoverlap All Pairs] = .62). Visual analysis, however, showed that the target behaviour was still present after implementation of the method and that on some days the nurses even judged the behaviour to be more severe than at baseline. Although the target behaviour was still present after treatment, the ABC method seems to be a promising tool for decreasing problem behaviour in patients with acquired brain injury. It is worth investigating the effects of this method in future studies. When interpreting single-subject data, both visual inspection and statistical analysis are needed to determine whether treatment is effective and whether the effects lead to clinically desirable results.

Simultaneous Synthesis of Treatment Effects and Mapping to a Common Scale: An Alternative to Standardisation

ERIC Educational Resources Information Center

Ades, A. E.; Lu, Guobing; Dias, Sofia; Mayo-Wilson, Evan; Kounali, Daphne

2015-01-01

Objective: Trials often may report several similar outcomes measured on different test instruments. We explored a method for synthesising treatment effect information both within and between trials and for reporting treatment effects on a common scale as an alternative to standardisation Study design: We applied a procedure that simultaneously…

The Impact of Five Missing Data Treatments on a Cross-Classified Random Effects Model

ERIC Educational Resources Information Center

Hoelzle, Braden R.

2012-01-01

The present study compared the performance of five missing data treatment methods within a Cross-Classified Random Effects Model environment under various levels and patterns of missing data given a specified sample size. Prior research has shown the varying effect of missing data treatment options within the context of numerous statistical…

A model-based test for treatment effects with probabilistic classifications.

PubMed

Cavagnaro, Daniel R; Davis-Stober, Clintin P

2018-05-21

Within modern psychology, computational and statistical models play an important role in describing a wide variety of human behavior. Model selection analyses are typically used to classify individuals according to the model(s) that best describe their behavior. These classifications are inherently probabilistic, which presents challenges for performing group-level analyses, such as quantifying the effect of an experimental manipulation. We answer this challenge by presenting a method for quantifying treatment effects in terms of distributional changes in model-based (i.e., probabilistic) classifications across treatment conditions. The method uses hierarchical Bayesian mixture modeling to incorporate classification uncertainty at the individual level into the test for a treatment effect at the group level. We illustrate the method with several worked examples, including a reanalysis of the data from Kellen, Mata, and Davis-Stober (2017), and analyze its performance more generally through simulation studies. Our simulations show that the method is both more powerful and less prone to type-1 errors than Fisher's exact test when classifications are uncertain. In the special case where classifications are deterministic, we find a near-perfect power-law relationship between the Bayes factor, derived from our method, and the p value obtained from Fisher's exact test. We provide code in an online supplement that allows researchers to apply the method to their own data. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

[Modality of combined methods of quantitative and qualitative research in evaluation of therapeutic effects of Chinese medicine].

PubMed

Liu, Jian-ping

2011-05-01

The core of evidence-based medicine lies in implementing the current best available evidence of clinical research to direct the decision making in clinical practice, incorporation of individual experience and value and preference of patients. However, the current evaluation method for clinical therapeutic effect cannot reflect the humanity and wholesomeness as well as individualized tailored treatment of Chinese medicine (CM) by using randomized controlled trials. This assay addressed the complex intervention of highly individualized treatment of CM and its societal characteristics, and the author proposes a model for the evaluation of therapeutic effects of CM in which quantitative and qualitative methods are combined, embodying the characteristics of the social and natural sciences in CM. The model can show the dynamic process of CM diagnosis and treatment from a perspective of the whole system and can be used for the evaluation of complex intervention of CM. We hope to raise a different thinking and method from the new drug development in the therapeutic effect evaluation.

Comparing methods for estimation of heterogeneous treatment effects using observational data from health care databases.

PubMed

Wendling, T; Jung, K; Callahan, A; Schuler, A; Shah, N H; Gallego, B

2018-06-03

There is growing interest in using routinely collected data from health care databases to study the safety and effectiveness of therapies in "real-world" conditions, as it can provide complementary evidence to that of randomized controlled trials. Causal inference from health care databases is challenging because the data are typically noisy, high dimensional, and most importantly, observational. It requires methods that can estimate heterogeneous treatment effects while controlling for confounding in high dimensions. Bayesian additive regression trees, causal forests, causal boosting, and causal multivariate adaptive regression splines are off-the-shelf methods that have shown good performance for estimation of heterogeneous treatment effects in observational studies of continuous outcomes. However, it is not clear how these methods would perform in health care database studies where outcomes are often binary and rare and data structures are complex. In this study, we evaluate these methods in simulation studies that recapitulate key characteristics of comparative effectiveness studies. We focus on the conditional average effect of a binary treatment on a binary outcome using the conditional risk difference as an estimand. To emulate health care database studies, we propose a simulation design where real covariate and treatment assignment data are used and only outcomes are simulated based on nonparametric models of the real outcomes. We apply this design to 4 published observational studies that used records from 2 major health care databases in the United States. Our results suggest that Bayesian additive regression trees and causal boosting consistently provide low bias in conditional risk difference estimates in the context of health care database studies. Copyright © 2018 John Wiley & Sons, Ltd.

Comparing the effects of cryotherapy with nitrous oxide gas versus topical corticosteroids in the treatment of oral lichen planus.

PubMed

Amanat, Dariush; Ebrahimi, Hooman; Zahedani, Maryam Zahed; Zeini, Nasim; Pourshahidi, Sara; Ranjbar, Zahra

2014-01-01

Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa with treatment challenges for clinicians. The objective of this study is to compare the effects of cryotherapy as a new modality with topical corticosteroids as a conventional therapy in the treatment of OLP. Thirty patients with bilateral OLP lesions were selected. From each patient a lesion on one side was chosen randomly for a single session of cryotherapy with nitrous oxide gas and the lesion on the other side received triamcinolone acetonide 0.1% ointment in orabase. Treatment outcome was measured by means of an appearance score, pain score (visual analogue scale), and severity of lesions before treatment and after 2, 4 and 6 weeks of treatment. Paired samples t-test and Wilcoxon test. In both methods of treatment sign score, pain score and severity of lesions was significantly reduced in all follow-up sessions (P<0.05). But the treatment outcome and relapse was not significantly different between the two treatment methods (P>0.05). Cryotherapy with nitrous oxide gas is as effective as topical triamcinolone acetonide in the treatment of OLP with no systemic side effects and needs less patient compliance. It can be considered as an alternative or adjuvant therapy in OLP patients to reduce the use of treatments with adverse effects.

[Bright light therapy in pregnant women depression--3 case studies].

PubMed

Krzystanek, Marek; Krupka-Matuszczyk, Irena

2006-01-01

Bright light therapy (BLT) is a new method of biological treatment in psychiatry. Good tolerance makes it an attractive method used not only in seasonal affective disorder. An episode of depression during pregnancy may be a new indication. The study aimed to describe effects of treatment of depression in 3 pregnant women. The women were out-patients in their 6-th, 7-th and 8-th months of pregnancy and diagnosed with depression according to ICD-10 criteria. The treatment was a morning exposure to 1 hour 5 000 LUX bright light from Monday to Friday. The antidepressant effect was assessed after the 2nd and 4th week of BLT. Side effects of BLT were monitored over the whole BLT treatment period. The mean improvement of depressive symptoms after 2 and 4 weeks of BLT was 33% and 55%, respectively. Side effects were not observed in any of the patients. Morning BLT seems to be an effective and a very well tolerated mode of treatment of pregnant women suffering from non-seasonal depression. The manner and length of BLT maintenance treatment requires further studies.

Lignin-blocking treatment of biomass and uses thereof

DOEpatents

Yang, Bin [Hanover, NH; Wyman, Charles E [Norwich, VT

2009-10-20

Disclosed is a method for converting cellulose in a lignocellulosic biomass. The method provides for a lignin-blocking polypeptide and/or protein treatment of high lignin solids. The treatment enhances cellulase availability in cellulose conversion. Cellulase efficiencies are improved by the protein or polypeptide treatment. The treatment may be used in combination with steam explosion and acid prehydrolysis techniques. Hydrolysis yields from lignin containing biomass are enhanced 5-20%, and enzyme utilization is increased from 10% to 50%. Thus, a more efficient and economical method of processing lignin containing biomass materials utilizes a polypeptide/protein treatment step that effectively blocks lignin binding of cellulase.

Using Case-Mix Adjustment Methods To Measure the Effectiveness of Substance Abuse Treatment: Three Examples Using Client Employment Outcomes.

ERIC Educational Resources Information Center

Koenig, Lane; Fields, Errol L.; Dall, Timothy M.; Ameen, Ansari Z.; Harwood, Henrick J.

This report demonstrates three applications of case-mix methods using regression analysis. The results are used to assess the relative effectiveness of substance abuse treatment providers. The report also examines the ability of providers to improve client employment outcomes, an outcome domain relatively unexamined in the assessment of provider…

Sterilization of microorganisms by the supercritical carbon dioxide micro-bubble method.

PubMed

Ishikawa, H; Shimoda, M; Shiratsuchi, H; Osajima, Y

1995-10-01

Lactobacillus brevis and Saccharomyces cerevisiae were completely sterilized by the supercritical (SC) CO2 micro-bubble method. Gaseous (G) and liquid (LQ) CO2 were used in a similar manner to compare the sterilizing effect. Among the three treatments, the microorganisms were only effectively sterilized by the SC CO2 treatment at 25 MPa and 35 degrees C.

Yarding-method and slash-treatment effects on compaction, humus, and variation in plantation soils.

Treesearch

Don Minore; Howard G. Weatherly

1988-01-01

Soil penetration-resistance and soil-humus frequency were measured on 86 progeny-test plantations in southwestern Oregon to determine the effects of yarding method and slash treatment on soil compaction and humus, and a disturbance index was calculated for each plantation. Compaction and humus loss were more severe on tractor-yarded, machine-piled plantations than on...

Effects of three mulch treatments on initial postfire erosion in north-central Arizona

Treesearch

George H. Riechers; Jan L. Beyers; Peter R. Robichaud; Karen Jennings; Erin Kreutz; Jeff Moll

2008-01-01

Mulching after wildfires is a common treatment designed to protect bare ground from raindrop impact and reduce subsequent erosion. We tested the effectiveness of three mulching methods on the Indian Fire near Prescott, Arizona, USA. The first method felled all fire-killed trees, chipped the logs and limbs, and spread the chips across the hillslope with a mobile...

Dropout among patients in qualified alcohol detoxification treatment: the effect of treatment motivation is moderated by Trauma Load

PubMed Central

2013-01-01

Background Motivation to change has been proposed as a prerequisite for behavioral change, although empirical results are contradictory. Traumatic experiences are frequently found amongst patients in alcohol treatment, but this has not been systematically studied in terms of effects on treatment outcomes. This study aimed to clarify whether individual Trauma Load explains some of the inconsistencies between motivation to change and behavioral change. Methods Over the course of two months in 2009, 55 patients admitted to an alcohol detoxification unit of a psychiatric hospital were enrolled in this study. At treatment entry, we assessed lifetime Trauma Load and motivation to change. Mode of discharge was taken from patient files following therapy. We tested whether Trauma Load moderates the effect of motivation to change on dropout from alcohol detoxification using multivariate methods. Results 55.4% dropped out of detoxification treatment, while 44.6% completed the treatment. Age, gender and days in treatment did not differ between completers and dropouts. Patients who dropped out reported more traumatic event types on average than completers. Treatment completers had higher scores in the URICA subscale Maintenance. Multivariate methods confirmed the moderator effect of Trauma Load: among participants with high Trauma Load, treatment completion was related to higher Maintenance scores at treatment entry; this was not true among patients with low Trauma Load. Conclusions We found evidence that the effect of motivation to change on detoxification treatment completion is moderated by Trauma Load: among patients with low Trauma Load, motivation to change is not relevant for treatment completion; among highly burdened patients, however, who a priori have a greater risk of dropping out, a high motivation to change might make the difference. This finding justifies targeted and specific interventions for highly burdened alcohol patients to increase their motivation to change. PMID:23514277

Statistical primer: propensity score matching and its alternatives.

PubMed

Benedetto, Umberto; Head, Stuart J; Angelini, Gianni D; Blackstone, Eugene H

2018-06-01

Propensity score (PS) methods offer certain advantages over more traditional regression methods to control for confounding by indication in observational studies. Although multivariable regression models adjust for confounders by modelling the relationship between covariates and outcome, the PS methods estimate the treatment effect by modelling the relationship between confounders and treatment assignment. Therefore, methods based on the PS are not limited by the number of events, and their use may be warranted when the number of confounders is large, or the number of outcomes is small. The PS is the probability for a subject to receive a treatment conditional on a set of baseline characteristics (confounders). The PS is commonly estimated using logistic regression, and it is used to match patients with similar distribution of confounders so that difference in outcomes gives unbiased estimate of treatment effect. This review summarizes basic concepts of the PS matching and provides guidance in implementing matching and other methods based on the PS, such as stratification, weighting and covariate adjustment.

Multisystemic Therapy and Functional Family Therapy Compared on their Effectiveness Using the Propensity Score Method.

PubMed

Eeren, Hester V; Goossens, Lucas M A; Scholte, Ron H J; Busschbach, Jan J V; van der Rijken, Rachel E A

2018-01-09

Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals. In this study, these interventions were compared on their effectiveness using a quasi-experimental design. Between October, 2009 and June, 2014, outcome data were collected from 697 adolescents (mean age 15.3 (SD 1.48), 61.9% male) assigned to either MST or FFT (422 MST; 275 FFT). Data were gathered during Routine Outcome Monitoring. The primary outcome was externalizing problem behavior (Child Behavior Checklist and Youth Self Report). Secondary outcomes were the proportion of adolescents living at home, engaged in school or work, and who lacked police contact during treatment. Because of the non-random assignment, a propensity score method was used to control for observed pre-treatment differences. Because the risk-need-responsivity (RNR) model guided treatment assignment, effectiveness was also estimated in youth with and without a court order as an indicator of their risk level. Looking at the whole sample, no difference in effect was found with regard to externalizing problems. For adolescents without a court order, effects on externalizing problems were larger after MST. Because many more adolescents with a court order were assigned to MST compared to FFT, the propensity score method could not balance the treatment groups in this subsample. In conclusion, few differences between MST and FFT were found. In line with the RNR model, higher risk adolescents were assigned to the more intensive treatment, namely MST. In the group with lower risk adolescents, this more intensive treatment was more effective in reducing externalizing problems.

Estimating the effect of a rare time-dependent treatment on the recurrent event rate.

PubMed

Smith, Abigail R; Zhu, Danting; Goodrich, Nathan P; Merion, Robert M; Schaubel, Douglas E

2018-05-30

In many observational studies, the objective is to estimate the effect of treatment or state-change on the recurrent event rate. If treatment is assigned after the start of follow-up, traditional methods (eg, adjustment for baseline-only covariates or fully conditional adjustment for time-dependent covariates) may give biased results. We propose a two-stage modeling approach using the method of sequential stratification to accurately estimate the effect of a time-dependent treatment on the recurrent event rate. At the first stage, we estimate the pretreatment recurrent event trajectory using a proportional rates model censored at the time of treatment. Prognostic scores are estimated from the linear predictor of this model and used to match treated patients to as yet untreated controls based on prognostic score at the time of treatment for the index patient. The final model is stratified on matched sets and compares the posttreatment recurrent event rate to the recurrent event rate of the matched controls. We demonstrate through simulation that bias due to dependent censoring is negligible, provided the treatment frequency is low, and we investigate a threshold at which correction for dependent censoring is needed. The method is applied to liver transplant (LT), where we estimate the effect of development of post-LT End Stage Renal Disease (ESRD) on rate of days hospitalized. Copyright © 2018 John Wiley & Sons, Ltd.

[Relapse prevention in drug addicts].

PubMed

Rácz, József

2013-12-01

The literature review deals with methods of relapse prevention. Relapse prevention is the key in the treatment of clients with drug addictions according to the transtheoretical model of change. If relapse prevention is more effective then not only the relapse would be prevented, but the client would leave the circulus vitiosus of relapses. Among psychotherapies cognitive behavioural methods are proven effective. Shorter forms of cognitive therapies are also available: for example, cognitive bias modification. Pharmacotherapy partly decreases craving of the clients or ceases the effects of psychoactive substances. Specific pharmacotherapeutic methods prevent relapses in a non-abstinent treatment design. Here the goal is not the abstinence in a short time, but the reduction of harms associated with drug use. In this way, a new target group of drug users can be involved in treatment.

Random forests of interaction trees for estimating individualized treatment effects in randomized trials.

PubMed

Su, Xiaogang; Peña, Annette T; Liu, Lei; Levine, Richard A

2018-04-29

Assessing heterogeneous treatment effects is a growing interest in advancing precision medicine. Individualized treatment effects (ITEs) play a critical role in such an endeavor. Concerning experimental data collected from randomized trials, we put forward a method, termed random forests of interaction trees (RFIT), for estimating ITE on the basis of interaction trees. To this end, we propose a smooth sigmoid surrogate method, as an alternative to greedy search, to speed up tree construction. The RFIT outperforms the "separate regression" approach in estimating ITE. Furthermore, standard errors for the estimated ITE via RFIT are obtained with the infinitesimal jackknife method. We assess and illustrate the use of RFIT via both simulation and the analysis of data from an acupuncture headache trial. Copyright © 2018 John Wiley & Sons, Ltd.

The management of the painful bipartite patella: a systematic review.

PubMed

McMahon, Samuel E; LeRoux, Johannes A; Smith, Toby O; Hing, Caroline B

2016-09-01

This study aimed to identify the most effective method for the treatment of the symptomatic bipartite patella. A systematic review of the literature was completed, and all studies assessing the management of a bipartite patella were included. Owing to the paucity of randomised controlled trials, a narrative review of 22 studies was completed. A range of treatments were assessed: conservative measures, open and arthroscopic fixation or excision and soft tissue release and excision. All of the methods provided results ranging from good to excellent, with acceptable complication rates. This is a poorly answered treatment question. No firm guidance can be given as to the most appropriate method of treating the symptomatic bipartite patella. This study suggests that there are a number of effective treatments with acceptable complication rates and it may be that treatments that conserve the patella are more appropriate for larger fragments. IV.

Improving the sludge disintegration efficiency of sonication by combining with alkalization and thermal pre-treatment methods.

PubMed

Şahinkaya, S; Sevimli, M F; Aygün, A

2012-01-01

One of the most serious problems encountered in biological wastewater treatment processes is the production of waste activated sludge (WAS). Sonication, which is an energy-intensive process, is the most powerful sludge pre-treatment method. Due to lack of information about the combined pre-treatment methods of sonication, the combined pre-treatment methods were investigated and it was aimed to improve the disintegration efficiency of sonication by combining sonication with alkalization and thermal pre-treatment methods in this study. The process performances were evaluated based on the quantities of increases in soluble chemical oxygen demand (COD), protein and carbohydrate. The releases of soluble COD, carbohydrate and protein by the combined methods were higher than those by sonication, alkalization and thermal pre-treatment alone. Degrees of sludge disintegration in various options of sonication were in the following descending order: sono-alkalization > sono-thermal pre-treatment > sonication. Therefore, it was determined that combining sonication with alkalization significantly improved the sludge disintegration and decreased the required energy to reach the same yield by sonication. In addition, effects on sludge settleability and dewaterability and kinetic mathematical modelling of pre-treatment performances of these methods were investigated. It was proven that the proposed model accurately predicted the efficiencies of ultrasonic pre-treatment methods.

Should we expand the toolbox of psychiatric treatment methods to include Repetitive Transcranial Magnetic Stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders.

PubMed

Slotema, Christina W; Blom, Jan Dirk; Hoek, Hans W; Sommer, Iris E C

2010-07-01

Repetitive transcranial magnetic stimulation (rTMS) is a safe treatment method with few side effects. However, efficacy for various psychiatric disorders is currently not clear. A literature search was performed from 1966 through October 2008 using PubMed, Ovid Medline, Embase Psychiatry, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, and PsycINFO. The following search terms were used: transcranial magnetic stimulation, TMS, repetitive TMS, psychiatry, mental disorder, psychiatric disorder, anxiety disorder, attention-deficit hyperactivity disorder, bipolar disorder, catatonia, mania, depression, obsessive-compulsive disorder, psychosis, posttraumatic stress disorder, schizophrenia, Tourette's syndrome, bulimia nervosa, and addiction. Data were obtained from randomized, sham-controlled studies of rTMS treatment for depression (34 studies), auditory verbal hallucinations (AVH, 7 studies), negative symptoms in schizophrenia (7 studies), and obsessive-compulsive disorder (OCD, 3 studies). Studies of rTMS versus electroconvulsive treatment (ECT, 6 studies) for depression were meta-analyzed. Standardized mean effect sizes of rTMS versus sham were computed based on pretreatment-posttreatment comparisons. The mean weighted effect size of rTMS versus sham for depression was 0.55 (P < .001). Monotherapy with rTMS was more effective than rTMS as adjunctive to antidepressant medication. ECT was superior to rTMS in the treatment of depression (mean weighted effect size -0.47, P = .004). In the treatment of AVH, rTMS was superior to sham treatment, with a mean weighted effect size of 0.54 (P < .001). The mean weighted effect size for rTMS versus sham in the treatment of negative symptoms in schizophrenia was 0.39 (P = .11) and for OCD, 0.15 (P = .52). Side effects were mild, yet more prevalent with high-frequency rTMS at frontal locations. It is time to provide rTMS as a clinical treatment method for depression, for auditory verbal hallucinations, and possibly for negative symptoms. We do not recommend rTMS for the treatment of OCD. (c) Copyright 2010 Physicians Postgraduate Press, Inc.

Physical and Psychological Effects of Head Treatment in the Supine Position Using Specialized Ayurveda-Based Techniques

PubMed Central

Iwawaki, Yoko; Uebaba, Kazuo; Yamamoto, Yoko; Takishita, Yukie; Harada, Kiyomi; Shibata, Akemi; Narumoto, Jin; Fukui, Kenji

2016-01-01

Abstract Objective: To clarify the physical and psychological effects of head massage performed in the supine position using Ayurveda-based techniques (head treatment). Design: Twenty-four healthy female students were included in the study. Using a crossover study design, the same participants were enrolled in both the head treatment intervention group and control group. There was an interval of 1 week or more between measurements. Outcome measures: The physiologic indices measured included blood pressure and heart rate fluctuations (high frequency and low frequency/high frequency). The psychological markers measured included liveliness, depression, and boredom using the visual analogue scale method. State anxiety was measured using the State-Trait Anxiety Inventory method. Results: The parasympathetic nerve activity increased immediately after head treatment. Upon completion of head treatment, the parasympathetic nerve predominance tended to gradually ease. Head treatment boosted freshness and relieved anxiety. Conclusions: The results suggest that head treatment has a relaxing and refreshing effect and may be used to provide comfort. PMID:27163344

The Nature and Treatment of Speech Fright.

ERIC Educational Resources Information Center

Cronin, Michael

This paper reviews the literature on speech fright in the workplace and examines its symptoms, effects, and causes. The paper also identifies various methods of treatment that have proven effective when adapted to individual and situational factors responsible for anxiety. The paper lists seven specific treatments directed toward improving public…

Treatment of addiction and addiction-related behavior

DOEpatents

Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

2004-12-07

The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a mammal suffering from substance addiction. The method includes administering to a mammal an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. The present invention also provides a method of treatment of cocaine, morphine, heroin, nicotine, amphetamine, methamphetamine, or ethanol addiction by treating a mammal with an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof.

Buprenorphine Treatment of Opioid-Dependent Pregnant Women: A Comprehensive Review

PubMed Central

Jones, Hendrée E.; Arria, Amelia M.; Baewert, Andjela; Heil, Sarah H.; Kaltenbach, Karol; Martin, Peter R.; Coyle, Mara G.; Selby, Peter; Stine, Susan M.; Fischer, Gabriele

2015-01-01

Aims This paper reviews the published literature regarding outcomes following maternal treatment with buprenorphine in five areas: maternal efficacy, fetal effects, neonatal effects, effects on breast milk, and longer-term developmental effects. Methods Within each outcome area, findings are summarized first for the 3 randomized controlled trials and then for the 44 non-randomized studies (i.e., prospective studies, case reports and series, and retrospective chart reviews), only 28 of which involve independent samples. Results Results indicate that maternal treatment with buprenorphine has comparable efficacy to methadone, although difficulties may exist with current buprenorphine induction methods. The available fetal data suggest buprenorphine results in less physiologic suppression of fetal heart rate and movements than methadone. Regarding neonatal effects, perhaps the single definitive conclusion is that prenatal buprenorphine treatment results in a clinically significant less severe neonatal abstinence syndrome (NAS) than treatment with methadone. The limited research suggests that, like methadone, buprenorphine is compatible with breastfeeding. Data available thus far suggest that there are no deleterious effects of in utero buprenorphine exposure on infant development. Conclusions Buprenorphine produces a less severe neonatal abstinence syndrome than methadone, but there is still a role for methadone in the treatment of opioid dependence during pregnancy. PMID:23106923

A new modeling and inference approach for the Systolic Blood Pressure Intervention Trial outcomes.

PubMed

Yang, Song; Ambrosius, Walter T; Fine, Lawrence J; Bress, Adam P; Cushman, William C; Raj, Dominic S; Rehman, Shakaib; Tamariz, Leonardo

2018-06-01

Background/aims In clinical trials with time-to-event outcomes, usually the significance tests and confidence intervals are based on a proportional hazards model. Thus, the temporal pattern of the treatment effect is not directly considered. This could be problematic if the proportional hazards assumption is violated, as such violation could impact both interim and final estimates of the treatment effect. Methods We describe the application of inference procedures developed recently in the literature for time-to-event outcomes when the treatment effect may or may not be time-dependent. The inference procedures are based on a new model which contains the proportional hazards model as a sub-model. The temporal pattern of the treatment effect can then be expressed and displayed. The average hazard ratio is used as the summary measure of the treatment effect. The test of the null hypothesis uses adaptive weights that often lead to improvement in power over the log-rank test. Results Without needing to assume proportional hazards, the new approach yields results consistent with previously published findings in the Systolic Blood Pressure Intervention Trial. It provides a visual display of the time course of the treatment effect. At four of the five scheduled interim looks, the new approach yields smaller p values than the log-rank test. The average hazard ratio and its confidence interval indicates a treatment effect nearly a year earlier than a restricted mean survival time-based approach. Conclusion When the hazards are proportional between the comparison groups, the new methods yield results very close to the traditional approaches. When the proportional hazards assumption is violated, the new methods continue to be applicable and can potentially be more sensitive to departure from the null hypothesis.

Lignin blockers and uses thereof

DOEpatents

Yang, Bin [West Lebanon, NH; Wyman, Charles E [Norwich, VT

2011-01-25

Disclosed is a method for converting cellulose in a lignocellulosic biomass. The method provides for a lignin-blocking polypeptide and/or protein treatment of high lignin solids. The treatment enhances cellulase availability in cellulose conversion and allows for the determination of optimized pretreatment conditions. Additionally, ethanol yields from a Simultaneous Saccharification and Fermentation process are improved 5-25% by treatment with a lignin-blocking polypeptide and/or protein. Thus, a more efficient and economical method of processing lignin containing biomass materials utilizes a polypeptide/protein treatment step that effectively blocks lignin binding of cellulase.

Using the Experience Sampling Method in the Context of Contingency Management for Substance Abuse Treatment

ERIC Educational Resources Information Center

Husky, Mathilde M.; Mazure, Carolyn M.; Carroll, Kathleen M.; Barry, Danielle; Petry, Nancy M.

2008-01-01

Contingency management (CM) treatments have been shown to be effective in reducing substance use. This manuscript illustrates how the experience sampling method (ESM) can depict behavior and behavior change and can be used to explore CM treatment mechanisms. ESM characterizes idiosyncratic patterns of behavior and offers the potential to determine…

Effects of concentrated and dephytinized wheat bran and rice bran addition on bread properties.

PubMed

Özkaya, Berrin; Baumgartner, Burcu; Özkaya, Hazım

2018-02-01

Wheat bran and rice bran were concentrated in terms of dietary fiber and were dephytinized by two different methods (fermentation and hydrothermal). Untreated, concentrated, concentrated-dephytinized by fermentation method, and concentrated-dephytinized by hydrothermal method bran samples were each incorporated into flour at levels of 0, 10, 15, and 20%, and their effects on bread properties were investigated. Unprocessed wheat bran and rice bran addition decreased the volume yield, and the specific volume of the bread depends on the incorporation level. A further decrease was observed with the addition of concentrated bran. However, the dephytinization treatments slightly improved these values. The same pattern was observed for the total number of cells and the total cell area of bread crumbs. Both wheat bran and rice bran were observed to cause a darker crumb color, and the effects of bran samples on crumb color were more pronounced after the dephytinization treatment. The addition of concentrated wheat bran and rice bran significantly increased hardness, as well as decreasing springiness, cohesiveness, and resilience of the bread, depending on the bran levels. Although dephytinization treatments enhanced the textural properties of bread, these results were still inferior to those obtained using bread produced with untreated bran. Regarding the dephytinization treatments, the influence of fermentation treatment on bread properties was slightly beneficial compared to hydrothermal treatment. Consumption of dietary fiber offers a range of health benefits. Cereal bran has great potential as a dietary fiber source. However, this bran's high phytic acid content and adverse effects on bread quality limit that potential. It is possible to obtain high dietary fiber and low phytic acid bran samples through bran concentration and dephytinization treatments. The dephytinization treatment is an effective method for degradation of phytic acid. The negative effects of wheat bran and rice bran on bread quality decreased significantly following the dephytinization treatments. This study demonstrated that fiber-enriched bread with low phytic acid content and acceptable texture can be produced using concentrated and dephytinized bran. © 2017 Wiley Periodicals, Inc.

A comparison of multiple imputation methods for incomplete longitudinal binary data.

PubMed

Yamaguchi, Yusuke; Misumi, Toshihiro; Maruo, Kazushi

2018-01-01

Longitudinal binary data are commonly encountered in clinical trials. Multiple imputation is an approach for getting a valid estimation of treatment effects under an assumption of missing at random mechanism. Although there are a variety of multiple imputation methods for the longitudinal binary data, a limited number of researches have reported on relative performances of the methods. Moreover, when focusing on the treatment effect throughout a period that has often been used in clinical evaluations of specific disease areas, no definite investigations comparing the methods have been available. We conducted an extensive simulation study to examine comparative performances of six multiple imputation methods available in the SAS MI procedure for longitudinal binary data, where two endpoints of responder rates at a specified time point and throughout a period were assessed. The simulation study suggested that results from naive approaches of a single imputation with non-responders and a complete case analysis could be very sensitive against missing data. The multiple imputation methods using a monotone method and a full conditional specification with a logistic regression imputation model were recommended for obtaining unbiased and robust estimations of the treatment effect. The methods were illustrated with data from a mental health research.

The Treatment of Challenging Behaviour in Intellectual Disabilities: Cost-Effectiveness Analysis

ERIC Educational Resources Information Center

Romeo, R.; Knapp, M.; Tyrer, P.; Crawford, M.; Oliver-Africano, P.

2009-01-01

Background: Antipsychotic drugs are used in the routine treatment of adults with intellectual disabilities (ID) and challenging behaviour in the UK despite limited evidence of their effectiveness. There is no evidence on their cost-effectiveness. Methods: The relative cost-effectiveness of risperidone, haloperidol and placebo in treating…

Analysis of the Interaction of Student Characteristics with Method in Micro-Teaching.

ERIC Educational Resources Information Center

Chavers, Katherine; And Others

A study examined the comparative effects on microteaching performance of (1) eight different methods of teacher training and (2) the interaction of method with student characteristics. Subjects, 71 enrollees in an educational psychology course, were randomly assigned to eight treatment groups (including one control group). Treatments consisted of…

Comparison of shear test methods for evaluating the bond strength of resin cement to zirconia ceramic.

PubMed

Kim, Jae-Hoon; Chae, Soyeon; Lee, Yunhee; Han, Geum-Jun; Cho, Byeong-Hoon

2014-11-01

This study compared the sensitivity of three shear test methods for measuring the shear bond strength (SBS) of resin cement to zirconia ceramic and evaluated the effects of surface treatment methods on the bonding. Polished zirconia ceramic (Cercon base, DeguDent) discs were randomly divided into four surface treatment groups: no treatment (C), airborne-particle abrasion (A), conditioning with Alloy primer (Kuraray Medical Co.) (P) and conditioning with Alloy primer after airborne-particle abrasion (AP). The bond strengths of the resin cement (Multilink N, Ivoclar Vivadent) to the zirconia specimens of each surface treatment group were determined by three SBS test methods: the conventional SBS test with direct filling of the mold (Ø 4 mm × 3 mm) with resin cement (Method 1), the conventional SBS test with cementation of composite cylinders (Ø 4 mm × 3 mm) using resin cement (Method 2) and the microshear bond strength (μSBS) test with cementation of composite cylinders (Ø 0.8 mm × 1 mm) using resin cement (Method 3). Both the test method and the surface treatment significantly influenced the SBS values. In Method 3, as the SBS values increased, the coefficients of variation decreased and the Weibull parameters increased. The AP groups showed the highest SBS in all of the test methods. Only in Method 3 did the P group show a higher SBS than the A group. The μSBS test was more sensitive to differentiating the effects of surface treatment methods than the conventional SBS tests. Primer conditioning was a stronger contributing factor for the resin bond to zirconia ceramic than was airborne-particle abrasion.

Motion induced interplay effects for VMAT radiotherapy.

PubMed

Edvardsson, Anneli; Nordström, Fredrik; Ceberg, Crister; Ceberg, Sofie

2018-04-19

The purpose of this study was to develop a method to simulate breathing motion induced interplay effects for volumetric modulated arc therapy (VMAT), to verify the proposed method with measurements, and to use the method to investigate how interplay effects vary with different patient- and machine specific parameters. VMAT treatment plans were created on a virtual phantom in a treatment planning system (TPS). Interplay effects were simulated by dividing each plan into smaller sub-arcs using an in-house developed software and shifting the isocenter for each sub-arc to simulate a sin 6 breathing motion in the superior-inferior direction. The simulations were performed for both flattening-filter (FF) and flattening-filter free (FFF) plans and for different breathing amplitudes, period times, initial breathing phases, dose levels, plan complexities, CTV sizes, and collimator angles. The resulting sub-arcs were calculated in the TPS, generating a dose distribution including the effects of motion. The interplay effects were separated from dose blurring and the relative dose differences to 2% and 98% of the CTV volume (ΔD 98% and ΔD 2% ) were calculated. To verify the simulation method, measurements were carried out, both static and during motion, using a quasi-3D phantom and a motion platform. The results of the verification measurements during motion were comparable to the results of the static measurements. Considerable interplay effects were observed for individual fractions, with the minimum ΔD 98% and maximum ΔD 2% being  -16.7% and 16.2%, respectively. The extent of interplay effects was larger for FFF compared to FF and generally increased for higher breathing amplitudes, larger period times, lower dose levels, and more complex treatment plans. Also, the interplay effects varied considerably with the initial breathing phase, and larger variations were observed for smaller CTV sizes. In conclusion, a method to simulate motion induced interplay effects was developed and verified with measurements, which allowed for a large number of treatment scenarios to be investigated. The simulations showed large interplay effects for individual fractions and that the extent of interplay effects varied with the breathing pattern, FFF/FF, dose level, CTV size, collimator angle, and the complexity of the treatment plan.

Motion induced interplay effects for VMAT radiotherapy

NASA Astrophysics Data System (ADS)

Edvardsson, Anneli; Nordström, Fredrik; Ceberg, Crister; Ceberg, Sofie

2018-04-01

The purpose of this study was to develop a method to simulate breathing motion induced interplay effects for volumetric modulated arc therapy (VMAT), to verify the proposed method with measurements, and to use the method to investigate how interplay effects vary with different patient- and machine specific parameters. VMAT treatment plans were created on a virtual phantom in a treatment planning system (TPS). Interplay effects were simulated by dividing each plan into smaller sub-arcs using an in-house developed software and shifting the isocenter for each sub-arc to simulate a sin6 breathing motion in the superior–inferior direction. The simulations were performed for both flattening-filter (FF) and flattening-filter free (FFF) plans and for different breathing amplitudes, period times, initial breathing phases, dose levels, plan complexities, CTV sizes, and collimator angles. The resulting sub-arcs were calculated in the TPS, generating a dose distribution including the effects of motion. The interplay effects were separated from dose blurring and the relative dose differences to 2% and 98% of the CTV volume (ΔD98% and ΔD2%) were calculated. To verify the simulation method, measurements were carried out, both static and during motion, using a quasi-3D phantom and a motion platform. The results of the verification measurements during motion were comparable to the results of the static measurements. Considerable interplay effects were observed for individual fractions, with the minimum ΔD98% and maximum ΔD2% being  ‑16.7% and 16.2%, respectively. The extent of interplay effects was larger for FFF compared to FF and generally increased for higher breathing amplitudes, larger period times, lower dose levels, and more complex treatment plans. Also, the interplay effects varied considerably with the initial breathing phase, and larger variations were observed for smaller CTV sizes. In conclusion, a method to simulate motion induced interplay effects was developed and verified with measurements, which allowed for a large number of treatment scenarios to be investigated. The simulations showed large interplay effects for individual fractions and that the extent of interplay effects varied with the breathing pattern, FFF/FF, dose level, CTV size, collimator angle, and the complexity of the treatment plan.

Contrasting Effects of Errorless Naming Treatment and Gestural Facilitation for Word Retrieval in Aphasia

PubMed Central

Raymer, Anastasia M.; McHose, Beth; Smith, Kimberly G.; Iman, Lisa; Ambrose, Alexis; Casselton, Colleen

2011-01-01

Purpose We compared the effects of two treatments for aphasic word retrieval impairments, errorless naming treatment (ENT) and gestural facilitation of naming (GES), within the same individuals, anticipating that the use of gesture would enhance the effect of treatment over errorless treatment alone. In addition to picture naming, we evaluated results for other outcome measures that were largely untested in earlier ENT studies. Methods In a single participant crossover treatment design, we examined the effects of ENT and GES in eight individuals with stroke-induced aphasia and word retrieval impairments (three semantic anomia, five phonologic anomia) in counterbalanced phases across participants. We evaluated effects of the two treatments for a daily picture naming/gesture production probe measure and in standardized aphasia tests and communication rating scales administered across phases of the experiment. Results Both treatments led to improvements in naming of trained words (small-to-large effect sizes) in individuals with semantic and phonologic anomia. Small generalized naming improvements were noted for three individuals with phonologic anomia. GES improved use of corresponding gestures for trained words (large effect sizes). Results were largely maintained at one month post treatment completion. Increases in scores on standardized aphasia testing also occurred for both ENT and GES training. Discussion Both ENT and GES led to improvements in naming measures, with no clear difference between treatments. Increased use of gestures following GES providing a potential compensatory means of communication for those who did not improve verbal skills. Both treatments are considered to be effective methods to promote recovery of word retrieval and verbal production skills in individuals with aphasia. PMID:22047100

Optimization of radiotherapy. Some notes on the principles and practice of optimization in cancer treatment and implications for clinical research.

PubMed

Andrews, J R

1981-01-01

Two methods dominate cancer treatment--one, the traditional best practice, individualized treatment method and two, the a priori determined decision method of the interinstitutional, cooperative, clinical trial. In the first, choices are infinite and can be made at the time of treatment; in the second, choices are finite and are made in advance of treatment on a random basis. Neither method systematically selects, identifies, or formalizes the optimum level of effect in the treatment chosen. Of the two, it can be argued that the first, other things being equal, is more likely to select the optimum treatment. The determination of level of effect for the optimization of cancer treatment requires the generation of dose-response relationships for both benefit and risk and the introduction of benefit and risk considerations and judgements. The clinical trial, as presently constituted, doses not yield this kind of information, it being, generally, of the binary yes or no, better or worse type. The best practice, individualized treatment method can yield, when adequately documented, both a range of dose-response relationships and a variety of benefit and risk considerations. The presentation will be limited to a consideration of a single modality of cancer treatment, radiation therapy, but an analogy with other modalities of cancer treatment will be inferred. Criteria for optimization will be developed and graphic means for its identification and formalization will be demonstrated with examples taken from the radiotherapy literature. The general problem of optimization theory and practice will be discussed; the necessity for its exploration in relation to the increasing complexity of cancer treatment will be developed; and recommendations for clinical research will be made including a proposal for the support of clinics as an alternative to the support of programs.

[Puncture scrotostomy--a treatment method in acute inflammatory diseases of the scrotal organs].

PubMed

Shapoval, V I; Asimov, D A; Lesovoĭ, V N

1989-01-01

A method for the treatment of acute inflammatory diseases of the scrotal organs by means of puncture scrotostomy, which consists in passing the indwelling micro-irrigator into a cavity of the serous sheath of the testis and epididymis and administration via this route of antibacterial and resolving preparations for 4-5 days, is suggested. A method approved in treatment of 45 patients permits to avoid surgical intervention, and is highly effective.

Do observational studies using propensity score methods agree with randomized trials? A systematic comparison of studies on acute coronary syndromes

PubMed Central

Dahabreh, Issa J.; Sheldrick, Radley C.; Paulus, Jessica K.; Chung, Mei; Varvarigou, Vasileia; Jafri, Haseeb; Rassen, Jeremy A.; Trikalinos, Thomas A.; Kitsios, Georgios D.

2012-01-01

Aims Randomized controlled trials (RCTs) are the gold standard for assessing the efficacy of therapeutic interventions because randomization protects from biases inherent in observational studies. Propensity score (PS) methods, proposed as a potential solution to confounding of the treatment–outcome association, are widely used in observational studies of therapeutic interventions for acute coronary syndromes (ACS). We aimed to systematically assess agreement between observational studies using PS methods and RCTs on therapeutic interventions for ACS. Methods and results We searched for observational studies of interventions for ACS that used PS methods to estimate treatment effects on short- or long-term mortality. Using a standardized algorithm, we matched observational studies to RCTs based on patients’ characteristics, interventions, and outcomes (‘topics’), and we compared estimates of treatment effect between the two designs. When multiple observational studies or RCTs were identified for the same topic, we performed a meta-analysis and used the summary relative risk for comparisons. We matched 21 observational studies investigating 17 distinct clinical topics to 63 RCTs (median = 3 RCTs per observational study) for short-term (7 topics) and long-term (10 topics) mortality. Estimates from PS analyses differed statistically significantly from randomized evidence in two instances; however, observational studies reported more extreme beneficial treatment effects compared with RCTs in 13 of 17 instances (P = 0.049). Sensitivity analyses limited to large RCTs, and using alternative meta-analysis models yielded similar results. Conclusion For the treatment of ACS, observational studies using PS methods produce treatment effect estimates that are of more extreme magnitude compared with those from RCTs, although the differences are rarely statistically significant. PMID:22711757

Treatment-induced mucositis: an old problem with new remedies.

PubMed

Symonds, R P

1998-05-01

Mucositis may be a painful, debilitating, dose-limiting side-effect of both chemotherapy and radiotherapy for which there is no widely accepted prophylaxis or effective treatment. The basis of management is pain relief, prevention of dehydration and adequate nutrition. When tested vigorously, most antiseptic mouthwashes and anti-ulcer agents are ineffective. Simple mechanical cleansing by saline is the most effective traditional measure. A variety of new agents are effective. Granulocyte macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) act outwith the haemopoeitic system and can reduce mucositis, but the best schedule, dosage and method of administration is not known or which is the best growth factor to prevent this side-effect. A placebo-controlled randomized trial of antibiotic pastilles has shown a significant reduction in mucositis and weight loss during radiotherapy for head and neck cancer. Another method to reduce radiation effects in normal tissue is to stimulate cells to divide before radiotherapy by silver nitrate or interleukin 1. These methods may be particularly effective when given along with hyperfractionated radiation treatment such as CHART.

Effect of In Situ Annealing Treatment on the Mobility and Morphology of TIPS-Pentacene-Based Organic Field-Effect Transistors.

PubMed

Yang, Fuqiang; Wang, Xiaolin; Fan, Huidong; Tang, Ying; Yang, Jianjun; Yu, Junsheng

2017-08-23

In this work, organic field-effect transistors (OFETs) with a bottom gate top contact structure were fabricated by using a spray-coating method, and the influence of in situ annealing treatment on the OFET performance was investigated. Compared to the conventional post-annealing method, the field-effect mobility of OFET with 60 °C in situ annealing treatment was enhanced nearly four times from 0.056 to 0.191 cm 2 /Vs. The surface morphologies and the crystallization of TIPS-pentacene films were characterized by optical microscope, atomic force microscope, and X-ray diffraction. We found that the increased mobility was mainly attributed to the improved crystallization and highly ordered TIPS-pentacene molecules.

Effect of In Situ Annealing Treatment on the Mobility and Morphology of TIPS-Pentacene-Based Organic Field-Effect Transistors

NASA Astrophysics Data System (ADS)

Yang, Fuqiang; Wang, Xiaolin; Fan, Huidong; Tang, Ying; Yang, Jianjun; Yu, Junsheng

2017-08-01

In this work, organic field-effect transistors (OFETs) with a bottom gate top contact structure were fabricated by using a spray-coating method, and the influence of in situ annealing treatment on the OFET performance was investigated. Compared to the conventional post-annealing method, the field-effect mobility of OFET with 60 °C in situ annealing treatment was enhanced nearly four times from 0.056 to 0.191 cm2/Vs. The surface morphologies and the crystallization of TIPS-pentacene films were characterized by optical microscope, atomic force microscope, and X-ray diffraction. We found that the increased mobility was mainly attributed to the improved crystallization and highly ordered TIPS-pentacene molecules.

A Comparison of pical Root Resorption in Incisors after Fixed Orthodontic Treatment with Standard Edgewise and Straight Wire (MBT) Method

PubMed Central

Zahed Zahedani, SM; Oshagh, M; Momeni Danaei, Sh; Roeinpeikar, SMM

2013-01-01

Statement of Problem: One of the major outcomes of orthodontic treatment is the apical root resorption of teeth moved during the treatment. Identifying the possible risk factors, are necessary for every orthodontist. Purpose: The aim of this study was to compare the rate of apical root resorption after fixed orthodontic treatment with standard edgewise and straight wire (MBT) method, and also to evaluate other factors effecting the rate of root resorption in orthodontic treatments. Materials and Method: In this study, parallel periapical radiographs of 127 patients imaging a total of 737 individual teeth, were collected. A total of 76 patients were treated by standard edgewise and 51 patients by straight wire method. The periapical radiographs were scanned and then the percentage of root resorption was calculated by Photoshop software. The data were analyzed by Paired-Samples t-test and the Generalized Linear Model adopting the SPSS 15.0. Results: In patients treated with straight wire method (MBT), mean root resorption was 18.26% compared to 14.82% in patients treated with standard edgewise technique (p< .05). Male patients had higher rate of root resorption,statistically significant (p< .05). Age at onset of treatment, duration of treatment, type of dental occlusion, premolar extractions and the use of intermaxillary elastics had no significant effect on the root resorption in this study. Conclusion: Having more root resorption in the straight wire method and less in the standard edgewise technique can be attributed to more root movement in pre-adjusted MBT technique due to the brackets employed in this method. PMID:24724131

Normalized methodology for medical infrared imaging

NASA Astrophysics Data System (ADS)

Vargas, J. V. C.; Brioschi, M. L.; Dias, F. G.; Parolin, M. B.; Mulinari-Brenner, F. A.; Ordonez, J. C.; Colman, D.

2009-01-01

A normalized procedure for medical infrared imaging is suggested, and illustrated by a leprosy and hepatitis C treatment follow-up, in order to investigate the effect of concurrent treatment which has not been reported before. A 50-year-old man with indeterminate leprosy and a 20-year history of hepatitis C was monitored for 587 days, starting from the day the patient received treatment for leprosy. Standard therapy for hepatitis C started 30 days later. Both visual observations and normalized infrared imaging were conducted periodically to assess the response to leprosy treatment. The primary end points were effectiveness of the method under different boundary conditions over the period, and rapid assessment of the response to leprosy treatment. The patient achieved sustained hepatitis C virological response 6 months after the end of the treatment. The normalized infrared results demonstrate the leprosy treatment success in spite of the concurrent hepatitis C treatment, since day 87, whereas repigmentation was visually assessed only after day 182, and corroborated with a skin biopsy on day 390. The method detected the effectiveness of the leprosy treatment in 87 days, whereas repigmentation started only in 182 days. Hepatitis C and leprosy treatment did not affect each other.

Effective Treatments of Late-Life Depression in Long-Term Care Facilities: A Systematic Review

ERIC Educational Resources Information Center

Yoon, Seokwon; Moon, Sung Seek; Pitner, Ronald

2018-01-01

Purpose: The purpose of this study was to identify effective treatment to manage the depression of older residents. Methods: Using Klein and Bloom's criteria, we analyzed the number of subjects, designs and methodologies, residential types, intervention types and duration of treatment, standardized measures, and findings. Data searches were…

FROM CUTTING TO CASTING: IMPACT AND INITIAL BARRIERS TO THE PONSETI METHOD OF CLUBFOOT TREATMENT IN CHINA

PubMed Central

Lu, Ning; Zhao, Li; Du, Qing; Liu, Yakun; Oprescu, Florin I; Morcuende, Jose A

2010-01-01

In 2005, a nationwide clubfoot treatment program focused on the Ponseti method -an effective, affordable and minimally-invasive method- was initiated in China. The purpose of this study was to evaluate and identify barriers to the program. A qualitative study (rapid ethnographic study) was conducted using semi-structured interviews of 44 physicians who attended four of the 10 Ponseti training workshops, focus groups with parents of children with clubfoot, and observation. Several barriers to the Ponseti method are quite unique due to China's size, socio-economics, culture, politics, and healthcare systems. The barriers were classified into seven themes: (i) physician education, (ii) caregiver compliance, (iii) culture, (iv) public awareness, (v) poverty, (vi) financial constraints for physicians/hospitals, and (vii) challenges of the treatment process. A number of suggestions that could be helpful in reducing or eliminating the effects of these barriers were also identified: (i) pamphlets explaining clubfoot and treatment for caregivers, (ii) directories of Ponseti providers, (iii) funding/financial support, and (iv) improving public awareness. The information from this study provides healthcare planners with knowledge to assist in meeting the needs of the population and continued implementation of effective and culturally appropriate awareness and treatment programs for clubfoot throughout China. PMID:21045964

A SMART Data Analysis Method for Constructing Adaptive Treatment Strategies for Substance Use Disorders

PubMed Central

Ertefaie, Ashkan; Lucy, Xi; Lynch, Kevin G.; McKay, James R.; Oslin, David; Almirall, Daniel

2016-01-01

Aims To demonstrate how Q-learning, a novel data analysis method, can be used with data from a sequential, multiple assignment, randomized trial (SMART) to construct empirically an adaptive treatment strategy (ATS) that is more tailored than the ATSs already embedded in a SMART. Method We use Q-learning with data from the Extending Treatment Effectiveness of Naltrexone (ExTENd) SMART (N=250) to construct empirically an ATS employing naltrexone, behavioral intervention, and telephone disease management to reduce alcohol consumption over 24 weeks in alcohol dependent individuals. Results Q-learning helped to identify a subset of individuals who, despite showing early signs of response to naltrexone, require additional treatment to maintain progress. Conclusions Q-learning can inform the development of more cost-effective, stepped-care strategies for treating substance use disorders. PMID:28029718

On "an experimental evaluation of sensorimotor patterning": a critique.

PubMed

Zigler, E; Seitz, V

1975-03-01

A critique was presented of a study by Neman, Roos, McCann, Menolascino, and Heal (1975) in which a sensorimotor training method of treatment for retarded children was evaluated. They presented evidence which they interpreted as support for the effectiveness of this treatment method in benefiting their sample of retarded individuals. Many shortcomings of the Neman et al. study were pointed out in the areas of evaluating the theoretical rationale underlying the treatment, subject selection, procedure, statistical analyses, and interpretation of the findings. In addition, the problems raised by the premature release of the findings to the press were discussed. Special note was made of the potential harmful effects of this publicity on retarded children and their families. The important role and responsibility of the National Association for Retarded Citizens in endorsing and recommending treatment methods for retarded individuals was also discussed.

[Comparative assessment of results in cervical vertigo pharmacotherapy vs physiotherapy treatment].

PubMed

Olszewski, Jurek; Repetowski, Marcin; Kuśmierczyk, Krzysztof

2007-01-01

The aim of the study was to assess the effectiveness of pharmacotherapy and physiotherapy in cervical vertigo treatment. 80 patients with cervical vertigo (41 women and 39 men), aged 20 to 85, were treated by pharmacotherapy or physiotherapy. There were two groups: group I was treated by pharmacotherapy and group II was treated by physiotherapy and kinesitherapy. The effects of vertigo treatment were assessed by positional nystagmus testing according to Cawthorne and Rosen; cervical nystagmus testing in neck rotation test; by everyday task self-control cards and vertigo staging system according to Silvoniemi (0-4 points). The effects of treatment were assessed before therapy, 6 and 12 weeks after therapy. Patients from group I were treated by Nootropil and Betaserc; group II received magnetic Fidel, laserotherapy, massage and kinesitherapy exercises. The obtained results showed that the most useful methods of cervical vertigo diagnosis were neck rotation test and Rose method. The average number of points (according to Silvoniemi scale) on the basis of ten everyday activities, was lower after 6 weeks of treatment than before the treatment and the lowest after 12 weeks of treatment. The difference was higher in group II than in group I. Patients treated by physiotherapy (group II) performed better in everyday activities than the patients treated by pharmacotherapy (group I). Cervical vertigo treatment by physiotherapy is cheap and underestimated method.

Endoscopic methods in the treatment of early-stage esophageal cancer

PubMed Central

2014-01-01

Most patients with early esophageal cancer restricted to the mucosa may be offered endoscopic therapy, which is similarly effective, less invasive and less expensive than esophagectomy. Selection of appropriate relevant treatment and therapy methods should be performed at a specialized center with adequate facilities. The selection of an endoscopic treatment method for high-grade dysplasia and early-stage esophageal adenocarcinoma requires that tumor infiltration is restricted to the mucosa and that there is no neighboring lymph node metastasis. In squamous cell carcinoma, this treatment method is accepted in cases of tumors invading only up to the lamina propria of mucosa (m2). Tumors treated with the endoscopic method should be well or moderately differentiated and should not invade lymphatic or blood vessels. When selecting endoscopic treatments for these lesions, a combination of endoscopic resection and endoscopic ablation methods should be considered. PMID:25097676

REMOVAL OF URANIUM FROM DRINKING WATER BY CONVENTIONAL TREATMENT METHODS

EPA Science Inventory

The USEPA currently does not regulate uranium in drinking water but will be revising the radionuclide regulations during 1989 and will propose a maximum contaminant level for uranium. The paper presents treatment technology information on the effectiveness of conventional method...

[The effectiveness of psychoanalytic-interactional therapy in borderline personality disorder: a study of clinical data].

PubMed

Leichsenring, Falk; Masuhr, Oliver; Jaeger, Ulrich; Dally, Andreas; Streeck, Ulrich

2007-01-01

Different methods are available for the psychotherapeutic treatment of patients with severe structural mental disorders. Psychoanalytic-interactional therapy is among those methods which have been clinically proven to be effective for many years. Psychoanalytic-interactional therapy was derived from analytic psychotherapy specifically to allow for the treatment of severely disturbed patients, e.g. patients with borderline personality disorders, prepsychotic disorders, addictions and perversions. In a naturalistic study, the effectiveness of psychoanalytic-interactional therapy was tested in a sample of patients with borderline personality disorders (N = 132). The patients were treated at the Clinic Tiefenbrunn near Goettingen, Germany. Standardized, reliable and valid diagnostic instruments were used to study the treatment effects. Psychoanalytic-interactional therapy was found to significantly improve target symptoms, general symptoms, interpersonal problems and life satisfaction. The results are discussed with regard to the treatment of severely disturbed patients.

The migration and transformation behaviors of heavy metals during the hydrothermal treatment of sewage sludge.

PubMed

Huang, Hua-Jun; Yuan, Xing-Zhong

2016-01-01

Various hydrothermal treatment methods, including hydrothermal carbonization, liquefaction and sub/super-critical water gasification, have been applied to the disposal of sewage sludge for producing bio-materials or bio-fuels. It has become a research hotspot whether the heavy metals contained in sewage sludge can be well treated/stabilized after the hydrothermal treatments. This review firstly summarized the methods of assessing heavy metals' contamination level/risk and then discussed the migration and transformation behaviors of heavy metals from the following aspects: the effect of reaction temperature, the effect of additives (catalysts and other biomass), the effect of the type of solvent and the effect of reaction time. This review can provide an important reference for the further study of the migration and transformation behaviors of heavy metals during the hydrothermal treatment of sewage sludge. Copyright © 2015 Elsevier Ltd. All rights reserved.

High degree reduction and restoration of graphene oxide on SiO2 at low temperature via remote Cu-assisted plasma treatment.

PubMed

Obata, Seiji; Sato, Minoru; Akada, Keishi; Saiki, Koichiro

2018-06-15

A high throughput synthesis method of graphene has been required for a long time to apply graphene to industrial applications. Of the various synthesis methods, the chemical exfoliation of graphite via graphene oxide (GO) is advantageous as far as productivity is concerned; however, the quality of the graphene produced by this method is far inferior to that synthesized by other methods, such as chemical vapor deposition on metals. Developing an effective reduction and restoration method for GO on dielectric substrates has been therefore a key issue. Here, we present a method for changing GO deposited on a dielectric substrate into high crystallinity graphene at 550 °C; this method uses CH 4 /H 2 plasma and a Cu catalyst. We found that Cu remotely catalyzed the high degree reduction and restoration of GO on SiO 2 and the effect ranged over at least 8 mm. With this method, field-effect transistor devices can be fabricated without any post treatment such as a transfer process. This plasma treatment increased electron and hole mobilities of GO to 480 cm 2 V -1 s -1 and 460 cm 2 V -1 s -1 respectively; these values were more than 50 times greater than that of conventional reduced GO. Furthermore, the on-site conversion ensured that the shape of the GO sheets remained unchanged after the treatment. This plasma treatment realizes the high throughput synthesis of a desired shaped graphene on any substrate without any residue and damage being caused by the transfer process; as such, it expands the potential applicability of graphene.

High degree reduction and restoration of graphene oxide on SiO2 at low temperature via remote Cu-assisted plasma treatment

NASA Astrophysics Data System (ADS)

Obata, Seiji; Sato, Minoru; Akada, Keishi; Saiki, Koichiro

2018-06-01

A high throughput synthesis method of graphene has been required for a long time to apply graphene to industrial applications. Of the various synthesis methods, the chemical exfoliation of graphite via graphene oxide (GO) is advantageous as far as productivity is concerned; however, the quality of the graphene produced by this method is far inferior to that synthesized by other methods, such as chemical vapor deposition on metals. Developing an effective reduction and restoration method for GO on dielectric substrates has been therefore a key issue. Here, we present a method for changing GO deposited on a dielectric substrate into high crystallinity graphene at 550 °C this method uses CH4/H2 plasma and a Cu catalyst. We found that Cu remotely catalyzed the high degree reduction and restoration of GO on SiO2 and the effect ranged over at least 8 mm. With this method, field-effect transistor devices can be fabricated without any post treatment such as a transfer process. This plasma treatment increased electron and hole mobilities of GO to 480 cm2 V‑1 s‑1 and 460 cm2 V‑1 s‑1 respectively; these values were more than 50 times greater than that of conventional reduced GO. Furthermore, the on-site conversion ensured that the shape of the GO sheets remained unchanged after the treatment. This plasma treatment realizes the high throughput synthesis of a desired shaped graphene on any substrate without any residue and damage being caused by the transfer process; as such, it expands the potential applicability of graphene.

Improvement of the technique in treatment of internal hemorrhoids with Nd:YAG laser

NASA Astrophysics Data System (ADS)

Bao, Xiao-qing; Zhu, Jing; Shi, Hong-Min

2005-07-01

Objective: To observe and study the improvement of the technique in treatment of internal hemorrhoids with Nd:YAG laser and evaluate the effective rate. Methods: 60 patients of internal hemorrhoids were treated with Nd:YAG laser (10-15mw) irradiating on the mucosa of the lesions. Results: Among 60 patients, 57 patients were primarily cured with one treatment, 3 patients were primarily cured with two treatments. The effective rate was 95% with one treatment, and it reached to 100% with two treatments. Conclusions: the improvement of the technique in treatment of internal hemorrhoids with Nd:YAG laser is effective and easy to operate.

ALGORITHM FOR TREATMENT OF PATIENTS WITH MESIAL OCCLUSION USING PROPRIETARY ORTHODONTIC DEVICE.

PubMed

Flis, P; Filonenko, V; Doroshenko, N

2017-10-01

Early elimination of dentoalveolar apparatus orthodontic disorders is the dominant concept in the treatment technique. to present a sagittal anomalies treatment algorithm, of Class III particularly, in the transitional bite period by the proposed design of individual orthodontic devices with a movable ramp. The treatment algorithm consisted of several blocks: the motivation, the etiological factors establishment, the plan and treatment tactics creation basing on careful diagnosis, the stages of the active period of treatment and the patient management in the retention period. Anthropometric measurements of the maxilla and mandible models were performed to determine the degree of dental arches development. The length of the dental arches was determined on the models by the Nance method in combination with the Huckaba method and the sagital dimensions by the Mirgasizov's method. The leading role in the patients examination was taken by lateral cephalograms analyzing using the Sassouni Plus method. The proposed construction of an orthodontic appliance consists of a plastic base, a vestibular arc, retaining clasps and a ramp, which is connected with a base with two torsion springs. To demonstrate the effectiveness of the proposed construction, an example of the patient Y. treatment of at the age of 6 years 9 months is presented. After the treatment, positive morphological, functional and aesthetic changes were established. The usage of proposed orthodontic appliance with movable ramp allows to start orthodontic treatment at early age, increases its effectiveness and reduce the number of complications. The expediency of stage-by-stage treatment is approved by a positive results of such method. To achieve stable results, it is important to individualize their prognosis even at the planning stage of orthodontic treatment.

Clustering of longitudinal data by using an extended baseline: A new method for treatment efficacy clustering in longitudinal data.

PubMed

Schramm, Catherine; Vial, Céline; Bachoud-Lévi, Anne-Catherine; Katsahian, Sandrine

2018-01-01

Heterogeneity in treatment efficacy is a major concern in clinical trials. Clustering may help to identify the treatment responders and the non-responders. In the context of longitudinal cluster analyses, sample size and variability of the times of measurements are the main issues with the current methods. Here, we propose a new two-step method for the Clustering of Longitudinal data by using an Extended Baseline. The first step relies on a piecewise linear mixed model for repeated measurements with a treatment-time interaction. The second step clusters the random predictions and considers several parametric (model-based) and non-parametric (partitioning, ascendant hierarchical clustering) algorithms. A simulation study compares all options of the clustering of longitudinal data by using an extended baseline method with the latent-class mixed model. The clustering of longitudinal data by using an extended baseline method with the two model-based algorithms was the more robust model. The clustering of longitudinal data by using an extended baseline method with all the non-parametric algorithms failed when there were unequal variances of treatment effect between clusters or when the subgroups had unbalanced sample sizes. The latent-class mixed model failed when the between-patients slope variability is high. Two real data sets on neurodegenerative disease and on obesity illustrate the clustering of longitudinal data by using an extended baseline method and show how clustering may help to identify the marker(s) of the treatment response. The application of the clustering of longitudinal data by using an extended baseline method in exploratory analysis as the first stage before setting up stratified designs can provide a better estimation of treatment effect in future clinical trials.

A unified procedure for meta-analytic evaluation of surrogate end points in randomized clinical trials

PubMed Central

Dai, James Y.; Hughes, James P.

2012-01-01

The meta-analytic approach to evaluating surrogate end points assesses the predictiveness of treatment effect on the surrogate toward treatment effect on the clinical end point based on multiple clinical trials. Definition and estimation of the correlation of treatment effects were developed in linear mixed models and later extended to binary or failure time outcomes on a case-by-case basis. In a general regression setting that covers nonnormal outcomes, we discuss in this paper several metrics that are useful in the meta-analytic evaluation of surrogacy. We propose a unified 3-step procedure to assess these metrics in settings with binary end points, time-to-event outcomes, or repeated measures. First, the joint distribution of estimated treatment effects is ascertained by an estimating equation approach; second, the restricted maximum likelihood method is used to estimate the means and the variance components of the random treatment effects; finally, confidence intervals are constructed by a parametric bootstrap procedure. The proposed method is evaluated by simulations and applications to 2 clinical trials. PMID:22394448

Combined of ultrasound irradiation with high hydrostatic pressure (US/HHP) as a new method to improve immobilization of dextranase onto alginate gel.

PubMed

Bashari, Mohanad; Abbas, Shabbar; Xu, Xueming; Jin, Zhengyu

2014-07-01

In this research work, dextranase was immobilized onto calcium alginate beads by the combination of ultrasonic irradiation and high hydrostatic pressure (US/HHP) treatments. Effects of US/HHP treatments on loading efficiency and immobilization yield of dextranase enzyme onto calcium alginate beads were investigated. Furthermore, the activities of immobilized enzymes prepared with and without US/HHP treatments and that prepared with ultrasonic irradiation (US) and high hydrostatic pressure (HHP), as a function of pH, temperature, recyclability and enzyme kinetic parameters, were compared with that for free enzyme. The maximum loading efficiency and the immobilization yield were observed when the immobilized dextranase was prepared with US (40 W at 25 kHz for 15 min) combined with HHP (400 MPa for 15 min), under which the loading efficiency and the immobilization yield increased by 88.92% and 80.86%, respectively, compared to immobilized enzymes prepared without US/HHP treatment. On the other hand, immobilized enzyme prepared with US/HHP treatment showed Vmax, KM, catalytic and specificity constants values higher than that for the immobilized enzyme prepared with HHP treatment, indicated that, this new US/HHP method improved the catalytic kinetics activity of immobilized dextranase at all the reaction conditions studied. Compared to immobilized enzyme prepared either with US or HHP, the immobilized enzymes prepared with US/HHP method exhibited a higher: pH optimum, optimal reaction temperature, thermal stability and recyclability, and lower activation energy, which, illustrating the effectiveness of the US/HHP method. These results indicated that, the combination of US and HHP treatments could be an effective method for improving the immobilization of enzymes in polymers. Copyright © 2014 Elsevier B.V. All rights reserved.

Effectiveness of creative and productive instructional method towards students' learning achievement in steel structure course

NASA Astrophysics Data System (ADS)

Sugiyanto, Pribadi, Supriyanto, Bambang

2017-09-01

The purpose of this study was to investigate the effectiveness of Creative & Productive instructional method compared with conventional method. This research was a quasi-experimental study involving all Civil Engineering students at Universitas Negeri Malang who were taking a course of Steel Structure. The students were randomly assigned to two different treatment groups, 30 students in experimental group and 37 students in the control group. It was assumed that these groups were equal in all relevant aspects; they differed only in the treatment administered. We used the t-test to test the hypothesis. The results of this research suggest that: (l) the use of Creative & Productive instructional method can significantly improve students' learning achievement, (2) the use of Creative & Productive instructional method can significantly improve students' retention, (3) students' motivation has a significant effect on their learning achievement, and (4) students' motivation has a significant effect on their retention.

The Effect of Photodynamic Therapy in the Treatment of Chronic Periodontitis: A Review of Literature.

PubMed

Meimandi, Mansour; Talebi Ardakani, Mohammad Reza; Esmaeil Nejad, Azadeh; Yousefnejad, Parisa; Saebi, Khosro; Tayeed, Mohammad Hossein

2017-01-01

Introduction: Chronic periodontitis is the most common periodontal disease which is related to the chronic accumulation of bacterial plaque. Since mechanical methods are not sufficient in the treatment of this disease, administration of local/systemic antibiotic is recommended following mechanical debridement. However, side effects of antibiotics such as microbial resistance and patient allergy led to development of alternative methods. One of these suggested methods is the antimicrobial photodynamic therapy (aPDT). PDT is a local noninvasive treatment modality without the side effects caused by antibiotics. The aim of this study was to review the articles related to the application of PDT with laser in the treatment of chronic periodontitis. Review of literature: In the present review of literature, the authors used key words such as chronic periodontitis, laser and photodynamic therapy, and conducted a literature search via Google Scholar and PubMed for the period of 1990 to 2015. A total of 47 articles in English were found. The articles that were not associated with the topic of research and review articles were deleted and only clinical trials were evaluated. After reviewing 23 articles' abstracts, the full texts of 16 articles were analyzed. Conclusion: Considering the safety, the lack of side effects and general advantages like more patient compliance, the PDT treatment with scaling and root planing (SRP) is recommended as an efficient adjunctive modality for the treatment of localized chronic periodontitis especially during the maintenance phase in non-surgical treatment.

Identifying cut points for biomarker defined subset effects in clinical trials with survival endpoints.

PubMed

He, Pei

2014-07-01

The advancements in biotechnology and genetics lead to an increasing research interest in personalized medicine, where a patient's genetic profile or biological traits contribute to choosing the most effective treatment for the patient. The process starts with finding a specific biomarker among all possible candidates that can best predict the treatment effect. After a biomarker is chosen, identifying a cut point of the biomarker value that splits the patients into treatment effective and non-effective subgroups becomes an important scientific problem. Numerous methods have been proposed to validate the predictive marker and select the appropriate cut points either prospectively or retrospectively using clinical trial data. In trials with survival outcomes, the current practice applies an interaction testing procedure and chooses the cut point that minimizes the p-values for the tests. Such method assumes independence between the baseline hazard and biomarker value. In reality, however, this assumption is often violated, as the chosen biomarker might also be prognostic in addition to its predictive nature for treatment effect. In this paper we propose a block-wise estimation and a sequential testing approach to identify the cut point in biomarkers that can group the patients into subsets based on their distinct treatment outcomes without assuming independence between the biomarker and baseline hazard. Numerical results based on simulated survival data show that the proposed method could pinpoint accurately the cut points in biomarker values that separate the patient subpopulations into subgroups with distinctive treatment outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis

PubMed Central

2010-01-01

Background Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented. Methods Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. Results In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others. In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective. In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment. Conclusions From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage. PMID:20236531

Primary treatments for clinically localised prostate cancer: a comprehensive lifetime cost-utility analysis.

PubMed

Cooperberg, Matthew R; Ramakrishna, Naren R; Duff, Steven B; Hughes, Kathleen E; Sadownik, Sara; Smith, Joseph A; Tewari, Ashutosh K

2013-03-01

WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Multiple treatment alternatives exist for localised prostate cancer, with few high-quality studies directly comparing their comparative effectiveness and costs. The present study is the most comprehensive cost-effectiveness analysis to date for localised prostate cancer, conducted with a lifetime horizon and accounting for survival, health-related quality-of-life, and cost impact of secondary treatments and other downstream events, as well as primary treatment choices. The analysis found minor differences, generally slightly favouring surgical methods, in quality-adjusted life years across treatment options. However, radiation therapy (RT) was consistently more expensive than surgery, and some alternatives, e.g. intensity-modulated RT for low-risk disease, were dominated - that is, both more expensive and less effective than competing alternatives. To characterise the costs and outcomes associated with radical prostatectomy (open, laparoscopic, or robot-assisted) and radiation therapy (RT: dose-escalated three-dimensional conformal RT, intensity-modulated RT, brachytherapy, or combination), using a comprehensive, lifetime decision analytical model. A Markov model was constructed to follow hypothetical men with low-, intermediate-, and high-risk prostate cancer over their lifetimes after primary treatment; probabilities of outcomes were based on an exhaustive literature search yielding 232 unique publications. In each Markov cycle, patients could have remission, recurrence, salvage treatment, metastasis, death from prostate cancer, and death from other causes. Utilities for each health state were determined, and disutilities were applied for complications and toxicities of treatment. Costs were determined from the USA payer perspective, with incorporation of patient costs in a sensitivity analysis. Differences across treatments in quality-adjusted life years across methods were modest, ranging from 10.3 to 11.3 for low-risk patients, 9.6-10.5 for intermediate-risk patients and 7.8-9.3 for high-risk patients. There were no statistically significant differences among surgical methods, which tended to be more effective than RT methods, with the exception of combined external beam + brachytherapy for high-risk disease. RT methods were consistently more expensive than surgical methods; costs ranged from $19 901 (robot-assisted prostatectomy for low-risk disease) to $50 276 (combined RT for high-risk disease). These findings were robust to an extensive set of sensitivity analyses. Our analysis found small differences in outcomes and substantial differences in payer and patient costs across treatment alternatives. These findings may inform future policy discussions about strategies to improve efficiency of treatment selection for localised prostate cancer. © 2012 BJU International.

Wastewater Treatment and Reuse Treatment Technology Evaluation and Development

EPA Science Inventory

This project will assess the effectiveness of a Biomass Concentrator Reactor (BCR) to remove endocrine disrupting chemicals (EDCs) from wastewater. This technology could provide an alternative to traditional wastewater treatment methods.

Semiparametric estimation of treatment effect in a pretest-posttest study.

PubMed

Leon, Selene; Tsiatis, Anastasios A; Davidian, Marie

2003-12-01

Inference on treatment effects in a pretest-posttest study is a routine objective in medicine, public health, and other fields. A number of approaches have been advocated. We take a semiparametric perspective, making no assumptions about the distributions of baseline and posttest responses. By representing the situation in terms of counterfactual random variables, we exploit recent developments in the literature on missing data and causal inference, to derive the class of all consistent treatment effect estimators, identify the most efficient such estimator, and outline strategies for implementation of estimators that may improve on popular methods. We demonstrate the methods and their properties via simulation and by application to a data set from an HIV clinical trial.

Double propensity-score adjustment: A solution to design bias or bias due to incomplete matching.

PubMed

Austin, Peter C

2017-02-01

Propensity-score matching is frequently used to reduce the effects of confounding when using observational data to estimate the effects of treatments. Matching allows one to estimate the average effect of treatment in the treated. Rosenbaum and Rubin coined the term "bias due to incomplete matching" to describe the bias that can occur when some treated subjects are excluded from the matched sample because no appropriate control subject was available. The presence of incomplete matching raises important questions around the generalizability of estimated treatment effects to the entire population of treated subjects. We describe an analytic solution to address the bias due to incomplete matching. Our method is based on using optimal or nearest neighbor matching, rather than caliper matching (which frequently results in the exclusion of some treated subjects). Within the sample matched on the propensity score, covariate adjustment using the propensity score is then employed to impute missing potential outcomes under lack of treatment for each treated subject. Using Monte Carlo simulations, we found that the proposed method resulted in estimates of treatment effect that were essentially unbiased. This method resulted in decreased bias compared to caliper matching alone and compared to either optimal matching or nearest neighbor matching alone. Caliper matching alone resulted in design bias or bias due to incomplete matching, while optimal matching or nearest neighbor matching alone resulted in bias due to residual confounding. The proposed method also tended to result in estimates with decreased mean squared error compared to when caliper matching was used.

Double propensity-score adjustment: A solution to design bias or bias due to incomplete matching

PubMed Central

2016-01-01

Propensity-score matching is frequently used to reduce the effects of confounding when using observational data to estimate the effects of treatments. Matching allows one to estimate the average effect of treatment in the treated. Rosenbaum and Rubin coined the term “bias due to incomplete matching” to describe the bias that can occur when some treated subjects are excluded from the matched sample because no appropriate control subject was available. The presence of incomplete matching raises important questions around the generalizability of estimated treatment effects to the entire population of treated subjects. We describe an analytic solution to address the bias due to incomplete matching. Our method is based on using optimal or nearest neighbor matching, rather than caliper matching (which frequently results in the exclusion of some treated subjects). Within the sample matched on the propensity score, covariate adjustment using the propensity score is then employed to impute missing potential outcomes under lack of treatment for each treated subject. Using Monte Carlo simulations, we found that the proposed method resulted in estimates of treatment effect that were essentially unbiased. This method resulted in decreased bias compared to caliper matching alone and compared to either optimal matching or nearest neighbor matching alone. Caliper matching alone resulted in design bias or bias due to incomplete matching, while optimal matching or nearest neighbor matching alone resulted in bias due to residual confounding. The proposed method also tended to result in estimates with decreased mean squared error compared to when caliper matching was used. PMID:25038071

Effects of hot boning and moisture enhancement on the eating quality of cull cow beef.

PubMed

Pivotto, L M; Campbell, C P; Swanson, K; Mandell, I B

2014-01-01

The effects of chilling method and moisture enhancement were examined for improving eating quality of semimembranosus (SM) and longissimus lumborum (LL) from 62 cull beef cows. Chilling method included hot boning muscles after 45 to 60 min postmortem or conventional chilling for 24 h. Moisture enhancement included 1) a non-injected control (CONT) or injection processing (10% of product weight) using 2) Sodium Tripolyphosphate/salt (Na/STP), 3) Sodium Citrate (NaCIT), 4) Calcium Ascorbate (CaASC), or 5) Citrus Juices (CITRUS). Chilling method by moisture enhancement treatment interactions (P<0.09) were due to decreased hue, chroma and sarcomere length values in hot boned vs. conventionally chilled product (SM and LL) for CaASC vs. other moisture enhancement treatments. Chilling method by moisture enhancement treatment interactions (P<0.05) were due to decreased shear force and increased tenderness in conventionally chilled vs. hot boned LL using CaASC vs. Na/STP. Moisture enhancement can improve tenderness of cull cow beef depending on combinations of chilling method and moisture enhancement treatments used. © 2013.

A new method to assess Pavlovian conditioning of psychostimulant drug effects.

PubMed

Damianopoulos, E N; Carey, R J

1994-07-01

Experimental studies of psychoactive drugs by pavlovian drug-conditioning methods, which originally began with investigations of drug-induced responses mediated by the autonomic nervous system, have now been expanded to include drug-induced response effects expressed as modulations of spontaneous motoric behaviors. In the latter application, however, equivalent behavioral response outcomes in post-treatment tests for conditioning can occur following a psychostimulant drug treatment either through drug interference effects on habituation processes, drug-induced stress effects and/or by pavlovian conditioning of the drug-induced motoric activation effect. Current methodologies for the study of pavlovian conditioned drug effects and/or drug sensitization cannot distinguish among these possibilities. This methodological inadequacy was addressed by a modification of the conventional paired-unpaired treatment protocol. In the new protocol, the animal is sequentially placed into two test compartments with the drug treatment administered in conjunction with placement into the second test compartment. This design permits a differentiation of a pavlovian conditioned drug responses from non-conditioned drug effects through continuous measurement of the non-drug behavioral baseline in both the drug and non-drug control treatment groups combined with multiple response measurements and post-treatment tests for conditioning at variable post-conditioning intervals. The present study details the use of the new modified pavlovian protocol with repeated cocaine (10 mg/kg) treatment. A cocaine conditioned response at 1, 7, and 21 days post-conditioning was identified and distinguished from habituation and stress effects.

A standardized mean difference effect size for multiple baseline designs across individuals.

PubMed

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

2013-12-01

Single-case designs are a class of research methods for evaluating treatment effects by measuring outcomes repeatedly over time while systematically introducing different condition (e.g., treatment and control) to the same individual. The designs are used across fields such as behavior analysis, clinical psychology, special education, and medicine. Emerging standards for single-case designs have focused attention on methods for summarizing and meta-analyzing findings and on the need for effect sizes indices that are comparable to those used in between-subjects designs. In the previous work, we discussed how to define and estimate an effect size that is directly comparable to the standardized mean difference often used in between-subjects research based on the data from a particular type of single-case design, the treatment reversal or (AB)(k) design. This paper extends the effect size measure to another type of single-case study, the multiple baseline design. We propose estimation methods for the effect size and its variance, study the estimators using simulation, and demonstrate the approach in two applications. Copyright © 2013 John Wiley & Sons, Ltd.

Implementing a Modular Research-Supported Treatment in Child Welfare: Effects and Obstacles

ERIC Educational Resources Information Center

Schuler, Brittany R.; Lee, Bethany R.; Kolivoski, Karen M.; Attman, Nicole P.; Lindsey, Michael A.

2016-01-01

Objective: Increasing rates of mental health needs in child welfare clients highlight the importance of training child welfare workers in effective mental health interventions. This pilot study evaluates the effects of training public child welfare workers and interns in modularized research-supported treatments (RSTs). Methods: We compared…

Adjusting for the Confounding Effects of Treatment Switching-The BREAK-3 Trial: Dabrafenib Versus Dacarbazine.

PubMed

Latimer, Nicholas R; Abrams, Keith R; Amonkar, Mayur M; Stapelkamp, Ceilidh; Swann, R Suzanne

2015-07-01

Patients with previously untreated BRAF V600E mutation-positive melanoma in BREAK-3 showed a median overall survival (OS) of 18.2 months for dabrafenib versus 15.6 months for dacarbazine (hazard ratio [HR], 0.76; 95% confidence interval, 0.48-1.21). Because patients receiving dacarbazine were allowed to switch to dabrafenib at disease progression, we attempted to adjust for the confounding effects on OS. Rank preserving structural failure time models (RPSFTMs) and the iterative parameter estimation (IPE) algorithm were used. Two analyses, "treatment group" (assumes treatment effect could continue until death) and "on-treatment observed" (assumes treatment effect disappears with discontinuation), were used to test the assumptions around the durability of the treatment effect. A total of 36 of 63 patients (57%) receiving dacarbazine switched to dabrafenib. The adjusted OS HRs ranged from 0.50 to 0.55, depending on the analysis. The RPSFTM and IPE "treatment group" and "on-treatment observed" analyses performed similarly well. RPSFTM and IPE analyses resulted in point estimates for the OS HR that indicate a substantial increase in the treatment effect compared with the unadjusted OS HR of 0.76. The results are uncertain because of the assumptions associated with the adjustment methods. The confidence intervals continued to cross 1.00; thus, the adjusted estimates did not provide statistically significant evidence of a treatment benefit on survival. However, it is clear that a standard intention-to-treat analysis will be confounded in the presence of treatment switching-a reliance on unadjusted analyses could lead to inappropriate practice. Adjustment analyses provide useful additional information on the estimated treatment effects to inform decision making. Treatment switching is common in oncology trials, and the implications of this for the interpretation of the clinical effectiveness and cost-effectiveness of the novel treatment are important to consider. If patients who switch treatments benefit from the experimental treatment and a standard intention-to-treat analysis is conducted, the overall survival advantage associated with the new treatment could be underestimated. The present study applied established statistical methods to adjust for treatment switching in a trial that compared dabrafenib and dacarbazine for metastatic melanoma. The results showed that this led to a substantially increased estimate of the overall survival treatment effect associated with dabrafenib. ©AlphaMed Press.

[History of "special therapeutic directions": the example of homeopathy].

PubMed

Hopff, W H

1996-04-01

As for generally accepted therapeutic methods, the "special methods" may appear to be effective due to spontaneous recovery provided by nature. A great number of sceptical physicians are aware of this fact. The pharmacologist works continuously to differentiate effects directly caused by medical treatments - mainly drugs - from effects resulting from spontaneous recovery. This is one of the most difficult problems in medical treatment. As a representative example of all "special methods", we concentrate here on the history of homeopathy. As is generally known, there is no conformity in homeopathy, for example monotherapy versus therapy with complex homeopathic products; refusing the simile-rule; treatment with high potencies versus treatment with low potencies; classic versus scholastic homeopathy. The number of homeopathies really equals the number of homeopathic physicians. For this reason, instruction in homeopathy on the academic level is impossible. In addition, we have to forget all natural laws only to prove that "potentiation" may be true. Therapeutic success due purely to chance may be explained rationally and is occasionally seen in all other "special methods". The theories of homeopaths for the action with homeopathic products are neither in accordance with our natural laws nor comply with a rational philosophy.

A Meta-Analytic Investigation of Therapy Modality Outcomes for Sexually Abused Children and Adolescents: An Exploratory Study

ERIC Educational Resources Information Center

Hetzel-Riggin, Melanie D.; Brausch, Amy M.; Montgomery, Brad S.

2007-01-01

Objective: The purpose of the current study was to investigate the independent effects of different treatment elements on a number of secondary problems related to childhood and adolescent sexual abuse, as well as investigate a number of different moderators of treatment effectiveness. Method: Twenty-eight studies that provided treatment outcome…

Sudden Gains during Psychological Treatments of Anxiety and Depression: A Meta-Analysis

ERIC Educational Resources Information Center

Aderka, Idan M.; Nickerson, Angela; Boe, Hans Jakob; Hofmann, Stefan G.

2012-01-01

Objective: The present study quantitatively reviewed the literature on sudden gains in psychological treatments for anxiety and depression. The authors examined the short- and long-term effects of sudden gains on treatment outcome as well as moderators of these effects. Method: The authors conducted a literature search using PubMed, PsycINFO, the…

Ethnicity as a Moderator of Treatment Effects on Parent-Child Interaction for Children with ADHD

ERIC Educational Resources Information Center

Jones, Heather A.; Epstein, Jeffery N.; Hinshaw, Stephen P.; Owens, Elizabeth B.; Chi, Terry C.; Arnold, L. Eugene; Hoza, Betsy; Wells, Karen C.

2010-01-01

Objective: To examine ethnic differences in observed parenting and child behavior and the moderating effects of ethnicity on the relationship between treatment and parent and child behavior. Method: Observations of 508 children with ADHD (ages 7-9) and their caregivers, collected during the Multimodal Treatment Study of ADHD, were analyzed using…

The Effectiveness of Picture Exchange Communication System (PECS) Training for Teachers of Children with Autism: A Pragmatic, Group Randomised Controlled Trial

ERIC Educational Resources Information Center

Howlin, Patricia; Gordon, R. Kate; Pasco, Greg; Wade, Angie; Charman, Tony

2007-01-01

Objective: To assess the effectiveness of expert training and consultancy for teachers of children with autism spectrum disorder in the use of the Picture Exchange Communication System (PECS). Method: Design: Group randomised, controlled trial (3 groups: immediate treatment, delayed treatment, no treatment). Participants: 84 elementary school…

Brief Strategic Family Therapy versus Treatment as Usual: Results of a Multisite Randomized Trial for Substance Using Adolescents

ERIC Educational Resources Information Center

Robbins, Michael S.; Feaster, Daniel J.; Horigian, Viviana E.; Rohrbaugh, Michael; Shoham, Varda; Bachrach, Ken; Miller, Michael; Burlew, Kathleen A.; Hodgkins, Candy; Carrion, Ibis; Vandermark, Nancy; Schindler, Eric; Werstlein, Robert; Szapocznik, Jose

2011-01-01

Objective: To determine the effectiveness of brief strategic family therapy (BSFT; an evidence-based family therapy) compared to treatment as usual (TAU) as provided in community-based adolescent outpatient drug abuse programs. Method: A randomized effectiveness trial in the National Drug Abuse Treatment Clinical Trials Network compared BSFT to…

A Randomized Trial of Longitudinal Effects of Low-Intensity Responsivity Education/Prelinguistic Milieu Teaching

ERIC Educational Resources Information Center

Warren, Steven F.; Fey, Marc E.; Finestack, Lizbeth, H.; Brady, Nancy C.; Bredin-Oja, Shelley L.; Fleming, Kandace K.

2008-01-01

Purpose: To evaluate the longitudinal effects of a 6-month course of responsivity education (RE)/prelinguistic milieu teaching (PMT) for young children with developmental delay. Method: Fifty-one children, age 24-33 months, with fewer than 10 expressive words were randomly assigned to early-treatment/no-treatment groups. All treatment was added as…

Effects of a Format-based Second Language Teaching Method in Kindergarten.

ERIC Educational Resources Information Center

Uilenburg, Noelle; Plooij, Frans X.; de Glopper, Kees; Damhuis, Resi

2001-01-01

Focuses on second language teaching with a format-based method. The differences between a format-based teaching method and a standard approach used as treatments in a quasi-experimental, non-equivalent control group are described in detail. Examines whether the effects of a format-based teaching method and a standard foreign language method differ…

Experimental Study on Vacuum Dynamic Consolidation Treatment of Soft Soil Foundation

NASA Astrophysics Data System (ADS)

Fu-lai, Ni; Xin, Wen; Xiao-bin, Zhang; Wei, Li

2017-11-01

In view of the deficiency of the saturated silt clay foundation reinforced by the dynamic consolidation method, combination the project of soft foundation treatment test area in Tangshan, the reaserch analysed indexes, included groundwater level, pore water pressure, settlement about soil layer and so on, by use of field tests and indoor geotechnical tests, The results showed that the whole reinforcement effect with vacuum dynamic compaction method to blow fill foundation is obvious, due to the result of vacuum precipitation, generally, the excess pore water pressure can be dissipated by 90% above in 2 days around and the effective compaction coefficient can reached more than 0.9,the research work in soft foundation treatment engineering provide a new method and thought to similar engineering.

Effects of Intensive Voice Treatment (the Lee Silverman Voice Treatment [LSVT]) on Vowel Articulation in Dysarthric Individuals with Idiopathic Parkinson Disease: Acoustic and Perceptual Findings

ERIC Educational Resources Information Center

Sapir, Shimon; Spielman, Jennifer L.; Ramig, Lorraine O.; Story, Brad H.; Fox, Cynthia

2007-01-01

Purpose: To evaluate the effects of intensive voice treatment targeting vocal loudness (the Lee Silverman Voice Treatment [LSVT]) on vowel articulation in dysarthric individuals with idiopathic Parkinson's disease (PD). Method: A group of individuals with PD receiving LSVT (n = 14) was compared to a group of individuals with PD not receiving LSVT…

Chinese Herbal Medicine for Postpartum Depression: A Systematic Review of Randomized Controlled Trials

PubMed Central

Li, Yongle; Chen, Zijie; Yu, Ning; Yao, Keyu; Che, Yiwen; Xi, Yupeng

2016-01-01

Background. Postpartum depression (PPD) does great harm to women following childbirth. The aim of this study was to conduct a systematic review of the literature to assess the efficacy and safety of CHM for the treatment of PPD. Methods. Published or ongoing registered trials were searched for from the inception of the various databases to December 31, 2015. Data extraction and methodology assessment were conducted independently by two researchers. RevMan 5.3 software was used to analyze the data. Results. Forty-seven registered clinical trials (RCTs) were identified and reviewed. The results showed CHM alone or in combination with routine treatments could reduce HAMD score, EPDS score, incidence of adverse events, TESS, and SERS. CHM combined with routine treatment was more effective in increasing serum estradiol levels and reducing progesterone levels than routine treatment alone. Meanwhile, pooled data revealed that MRLQS combined with routine treatments or MRLQS plus MSHS combined with routine treatments were more effective than other therapeutic methods in TCM. MRLQS plus MSHS alone was found to be an effective alternative when compared to routine treatments. Conclusions. This review suggested that CHM was safe and effective in the treatment of PPD. However, this could not be proven conclusively. To ensure evidence-based clinical practice, more rigorously designed trials are warranted. PMID:27774110

Alternative Methods for Handling Attrition

PubMed Central

Foster, E. Michael; Fang, Grace Y.

2009-01-01

Using data from the evaluation of the Fast Track intervention, this article illustrates three methods for handling attrition. Multiple imputation and ignorable maximum likelihood estimation produce estimates that are similar to those based on listwise-deleted data. A panel selection model that allows for selective dropout reveals that highly aggressive boys accumulate in the treatment group over time and produces a larger estimate of treatment effect. In contrast, this model produces a smaller treatment effect for girls. The article's conclusion discusses the strengths and weaknesses of the alternative approaches and outlines ways in which researchers might improve their handling of attrition. PMID:15358906

[Therapeutic strategies targeting brain tumor stem cells].

PubMed

Toda, Masahiro

2009-07-01

Progress in stem cell research reveals cancer stem cells to be present in a variety of malignant tumors. Since they exhibit resistance to anticancer drugs and radiotherapy, analysis of their properties has been rapidly carried forward as an important target for the treatment of intractable malignancies, including brain tumors. In fact, brain cancer stem cells (BCSCs) have been isolated from brain tumor tissue and brain tumor cell lines by using neural stem cell culture methods and isolation methods for side population (SP) cells, which have high drug-efflux capacity. Although the analysis of the properties of BCSCs is the most important to developing methods in treating BCSCs, the absence of BCSC purification methods should be remedied by taking it up as an important research task in the immediate future. Thus far, there are no effective treatment methods for BCSCs, and several treatment methods have been proposed based on the cell biology characteristics of BCSCs. In this article, I outline potential treatment methods damaging treatment-resistant BCSCs, including immunotherapy which is currently a topic of our research.

Using forecast modelling to evaluate treatment effects in single-group interrupted time series analysis.

PubMed

Linden, Ariel

2018-05-11

Interrupted time series analysis (ITSA) is an evaluation methodology in which a single treatment unit's outcome is studied serially over time and the intervention is expected to "interrupt" the level and/or trend of that outcome. ITSA is commonly evaluated using methods which may produce biased results if model assumptions are violated. In this paper, treatment effects are alternatively assessed by using forecasting methods to closely fit the preintervention observations and then forecast the post-intervention trend. A treatment effect may be inferred if the actual post-intervention observations diverge from the forecasts by some specified amount. The forecasting approach is demonstrated using the effect of California's Proposition 99 for reducing cigarette sales. Three forecast models are fit to the preintervention series-linear regression (REG), Holt-Winters (HW) non-seasonal smoothing, and autoregressive moving average (ARIMA)-and forecasts are generated into the post-intervention period. The actual observations are then compared with the forecasts to assess intervention effects. The preintervention data were fit best by HW, followed closely by ARIMA. REG fit the data poorly. The actual post-intervention observations were above the forecasts in HW and ARIMA, suggesting no intervention effect, but below the forecasts in the REG (suggesting a treatment effect), thereby raising doubts about any definitive conclusion of a treatment effect. In a single-group ITSA, treatment effects are likely to be biased if the model is misspecified. Therefore, evaluators should consider using forecast models to accurately fit the preintervention data and generate plausible counterfactual forecasts, thereby improving causal inference of treatment effects in single-group ITSA studies. © 2018 John Wiley & Sons, Ltd.

Atomic Oxygen Treatment and Its Effect on a Variety of Artist's Media

NASA Technical Reports Server (NTRS)

Miller, Sharon K. R.; Banks, Bruce A.; Waters, Deborah L.

2005-01-01

Atomic oxygen treatment has been investigated as an unconventional option for art restoration where conventional methods have not been effective. Exposure of surfaces to atomic oxygen was first performed to investigate the durability of materials in the low Earth orbit environment of space. The use of the ground based environmental simulation chambers, developed for atomic oxygen exposure testing, has been investigated in collaboration with conservators at a variety of institutions, as a method to clean the surfaces of works of art. The atomic oxygen treatment technique has been evaluated as a method to remove soot and char from the surface of oil paint (both varnished and unvarnished), watercolors, acrylic paint, and fabric as well as the removal of graffiti and other marks from surfaces which are too porous to lend themselves to conventional solvent removal techniques. This paper will discuss the treatment of these surfaces giving an example of each and a discussion of the treatment results.

[Clinical effects of shen-nourishing and menstruation-regulating method combined with triptorelin acetate injection on patient with luteinized unruptured follicle syndrome].

PubMed

Yan-hua, Chen; Fang, Lian; Shi, Na

2011-12-01

To study the clinical effects of Shen-nourishing and menstruation-regulating method (SNMRM) combined with Triptorelin Acetate Injection (TAI) on patients with luteinized unruptured follicle syndrome (LUFS). Sixty-two LUFS patients were randomly assigned to the treatment group and the control group. TAI was given to patients in the control group while SNMRM + TAI was given to those in the treatment group. The ovulation rate and the pregnancy rate were observed in the two groups. The ovulation rate in the treatment group was higher than that in the control group, but without significant difference (85.53% versus 79.07%, P > 0.05). The pregnancy rate was significantly higher in the treatment group than in the control group (56.25% vs 30.00%, P < 0.05). Treatment of LUFS by SNMRM + TAI could improve the ovulation rate and the pregnancy rate, indicating that LUFS patients' ovary functions could be improved by using different menstruation regulating methods during different follicular development phases.

Osthole Enhances the Therapeutic Efficiency of Stem Cell Transplantation in Neuroendoscopy Caused Traumatic Brain Injury.

PubMed

Tao, Zhen-Yu; Gao, Peng; Yan, Yu-Hui; Li, Hong-Yan; Song, Jie; Yang, Jing-Xian

2017-01-01

Neuroendoscopy processes can cause severe traumatic brain injury. Existing therapeutic methods, such as neural stem cell transplantation and osthole have not been proven effective. Therefore, there is an emerging need on the development of new techniques for the treatment of brain injuries. In this study we propose to combine the above stem cell based methods and then evaluate the efficiency and accuracy of the new method. Mice were randomly divided into four groups: group 1 (brain injury alone); group 2 (osthole); group 3 (stem cell transplantation); and group 4 (osthole combined with stem cell transplantation). We carried out water maze task to exam spatial memory. Immunocytochemistry was used to test the inflammatory condition of each group, and the differentiation of stem cells. To evaluate the condition of the damaged blood brain barrier restore, we detect the Evans blue (EB) extravasation across the blood brain barrier. The result shows that osthole and stem cell transplantation combined therapeutic method has a potent effect on improving the spatial memory. This combined method was more effective on inhibiting inflammation and preventing neuronal degeneration than the single treated ones. In addition, there was a distinct decline of EB extravasation in the combined treatment groups, which was not observed in single treatment groups. Most importantly, the combined usage of osthole and stem cell transplantation provide a better treatment for the traumatic brain injury caused by neuroendoscopy. The collective evidence indicates osthole combined with neural stem cell transplantation is superior than either method alone for the treatment of traumatic brain injury caused by neuroendoscopy.

Diagnosis before treatment: Identifying dairy farmers' determinants for the adoption of sustainable practices in gastrointestinal nematode control.

PubMed

Vande Velde, F; Claerebout, E; Cauberghe, V; Hudders, L; Van Loo, H; Vercruysse, J; Charlier, J

2015-09-15

Anthelmintic resistance is emerging in dairy cattle and this can result in a lack of effective control and production losses. Therefore, sustainable control strategies, such as targeted treatments (TT) and targeted selected treatments (TST), should be adopted by the industry. TT and TST approaches require the use of diagnostic methods to take informed treatment decisions. To understand the factors affecting the farmers' intention to adopt diagnostic methods before implementing anthelmintic drugs ('adoption intention'), a cross-sectional survey was carried out in dairy farms in Belgium (Flanders). A framework was constructed to predict adoption intentions based on two fundamental theories in the field of behavioural psychology and health psychology: the Theory of Planned Behaviour and the Health Belief Model. In the tested model, adoption intentions were predicted based on attitudes towards anthelminthics, attitudes towards diagnostic methods, subjective norms, behavioural control and perceived risk. Structural equation modelling was used for analyses. The model fitted the data well and explained 46% of the variance in adoption intention of diagnostics. The factors 'attitude towards diagnostic methods' and 'subjective norm'; i.e. the influence of significant others, had the strongest, positive influence on adoption intention of diagnostic methods. 'Perceived behavioural control' had a weak, positive effect on intention. Further, 'attitude towards the use of anthelmintic drugs' had a negative effect on adoption intention of the diagnostic methods. This implicates an effect of current behaviour on future adoption, which should be considered in future research. Factors measuring risk perception of anthelmintic resistance; perceived severity and perceived susceptibility, had no effect on the adoption intention of diagnostic methods. The threat of anthelmintic resistance is perceived to be low for dairy herds. The study further did not find any differences in the effects of the predictors for young stock and adult dairy cows. The results of this study can be used to develop communication strategies to advertise sustainable nematode control on dairy farms. Copyright © 2015 Elsevier B.V. All rights reserved.

Understanding Treatment Effect Estimates When Treatment Effects Are Heterogeneous for More Than One Outcome.

PubMed

Brooks, John M; Chapman, Cole G; Schroeder, Mary C

2018-06-01

Patient-centred care requires evidence of treatment effects across many outcomes. Outcomes can be beneficial (e.g. increased survival or cure rates) or detrimental (e.g. adverse events, pain associated with treatment, treatment costs, time required for treatment). Treatment effects may also be heterogeneous across outcomes and across patients. Randomized controlled trials are usually insufficient to supply evidence across outcomes. Observational data analysis is an alternative, with the caveat that the treatments observed are choices. Real-world treatment choice often involves complex assessment of expected effects across the array of outcomes. Failure to account for this complexity when interpreting treatment effect estimates could lead to clinical and policy mistakes. Our objective was to assess the properties of treatment effect estimates based on choice when treatments have heterogeneous effects on both beneficial and detrimental outcomes across patients. Simulation methods were used to highlight the sensitivity of treatment effect estimates to the distributions of treatment effects across patients across outcomes. Scenarios with alternative correlations between benefit and detriment treatment effects across patients were used. Regression and instrumental variable estimators were applied to the simulated data for both outcomes. True treatment effect parameters are sensitive to the relationships of treatment effectiveness across outcomes in each study population. In each simulation scenario, treatment effect estimate interpretations for each outcome are aligned with results shown previously in single outcome models, but these estimates vary across simulated populations with the correlations of treatment effects across patients across outcomes. If estimator assumptions are valid, estimates across outcomes can be used to assess the optimality of treatment rates in a study population. However, because true treatment effect parameters are sensitive to correlations of treatment effects across outcomes, decision makers should be cautious about generalizing estimates to other populations.

[Electrophysical effects in combined treatment of neurosensory hypoacusis].

PubMed

Morenko, V M; Enin, I P

2002-01-01

The authors consider different methods of electrobiophysical impacts on the body in the treatment of neurosensory hypoacusis: laser beam, laser puncture, electrostimulation, magnetotherapy, magnetolasertherapy, electrophoresis, etc. These methods find more and more intensive application in modern medicine. Further success of physiotherapy for neurosensory hypoacusis depends on adequate knowledge about mechanisms of action of each physical method used and introduction of novel techniques.

Physiotherapy for patients with soft tissue shoulder disorders: a systematic review of randomised clinical trials.

PubMed Central

van der Heijden, G. J.; van der Windt, D. A.; de Winter, A. F.

1997-01-01

OBJECTIVE: To assess the effectiveness of physiotherapy for patients with soft tissue shoulder disorders. DESIGN: A systematic computerised literature search of Medline and Embase, supplemented with citation tracking, for relevant trials with random allocation published before 1996. SUBJECTS: Patients treated with physiotherapy for disorders of soft tissue of the shoulder. MAIN OUTCOME MEASURES: Success rates, mobility, pain, functional status. RESULTS: Six of the 20 assessed trials satisfied at least five of eight validity criteria. Assessment of methods was often hampered by insufficient information on various validity criteria, and trials were often flawed by lack of blinding, high proportions of withdrawals from treatment, and high proportions of missing values. Trial sizes were small: only six trials included intervention groups of more than 25 patients. Ultrasound therapy, evaluated in six trials, was not shown to be effective. Four other trials favoured physiotherapy (laser therapy or manipulation), but the validity of their methods was unsatisfactory. CONCLUSIONS: There is evidence that ultrasound therapy is ineffective in the treatment of soft tissue shoulder disorders. Due to small trial sizes and unsatisfactory methods, evidence for the effectiveness of other methods of physiotherapy is inconclusive. For all methods of treatment, trials were too heterogeneous with respect to included patients, index and reference treatments, and follow up to merit valid statistical pooling. Future studies should show whether physiotherapy is superior to treatment with drugs, steroid injections, or a wait and see policy. PMID:9233322

Evaluating principal surrogate endpoints with time-to-event data accounting for time-varying treatment efficacy.

PubMed

Gabriel, Erin E; Gilbert, Peter B

2014-04-01

Principal surrogate (PS) endpoints are relatively inexpensive and easy to measure study outcomes that can be used to reliably predict treatment effects on clinical endpoints of interest. Few statistical methods for assessing the validity of potential PSs utilize time-to-event clinical endpoint information and to our knowledge none allow for the characterization of time-varying treatment effects. We introduce the time-dependent and surrogate-dependent treatment efficacy curve, ${\\mathrm {TE}}(t|s)$, and a new augmented trial design for assessing the quality of a biomarker as a PS. We propose a novel Weibull model and an estimated maximum likelihood method for estimation of the ${\\mathrm {TE}}(t|s)$ curve. We describe the operating characteristics of our methods via simulations. We analyze data from the Diabetes Control and Complications Trial, in which we find evidence of a biomarker with value as a PS.

Best (but oft-forgotten) practices: propensity score methods in clinical nutrition research.

PubMed

Ali, M Sanni; Groenwold, Rolf Hh; Klungel, Olaf H

2016-08-01

In observational studies, treatment assignment is a nonrandom process and treatment groups may not be comparable in their baseline characteristics, a phenomenon known as confounding. Propensity score (PS) methods can be used to achieve comparability of treated and nontreated groups in terms of their observed covariates and, as such, control for confounding in estimating treatment effects. In this article, we provide a step-by-step guidance on how to use PS methods. For illustrative purposes, we used simulated data based on an observational study of the relation between oral nutritional supplementation and hospital length of stay. We focused on the key aspects of PS analysis, including covariate selection, PS estimation, covariate balance assessment, treatment effect estimation, and reporting. PS matching, stratification, covariate adjustment, and weighting are discussed. R codes and example data are provided to show the different steps in a PS analysis. © 2016 American Society for Nutrition.

Effects of speech and language treatment on recovery from aphasia.

PubMed

Shewan, C M; Kertesz, A

1984-11-01

Language recovery in aphasic patients who received one of three types of speech and language treatment was compared with that in aphasic patients who received no treatment. One hundred aphasic patients were followed from 2 to 4 weeks postonset for 1 year or until recovery, using a standardized test battery administered at systematic intervals. Both treatment methods provided by trained speech-language pathologists were efficacious, while the method provided by trained nonprofessionals approached statistical significance. Small group size prevented resolution of the question of whether one type of treatment was superior to another.

A Comparison of pical Root Resorption in Incisors after Fixed Orthodontic Treatment with Standard Edgewise and Straight Wire (MBT) Method.

PubMed

Zahed Zahedani, Sm; Oshagh, M; Momeni Danaei, Sh; Roeinpeikar, Smm

2013-09-01

One of the major outcomes of orthodontic treatment is the apical root resorption of teeth moved during the treatment. Identifying the possible risk factors, are necessary for every orthodontist. The aim of this study was to compare the rate of apical root resorption after fixed orthodontic treatment with standard edgewise and straight wire (MBT) method, and also to evaluate other factors effecting the rate of root resorption in orthodontic treatments. In this study, parallel periapical radiographs of 127 patients imaging a total of 737 individual teeth, were collected. A total of 76 patients were treated by standard edgewise and 51 patients by straight wire method. The periapical radiographs were scanned and then the percentage of root resorption was calculated by Photoshop software. The data were analyzed by Paired-Samples t-test and the Generalized Linear Model adopting the SPSS 15.0. In patients treated with straight wire method (MBT), mean root resorption was 18.26% compared to 14.82% in patients treated with standard edgewise technique (p< .05). Male patients had higher rate of root resorption,statistically significant (p< .05). Age at onset of treatment, duration of treatment, type of dental occlusion, premolar extractions and the use of intermaxillary elastics had no significant effect on the root resorption in this study. Having more root resorption in the straight wire method and less in the standard edgewise technique can be attributed to more root movement in pre-adjusted MBT technique due to the brackets employed in this method.

Active treatments for amblyopia: a review of the methods and evidence base.

PubMed

Suttle, Catherine M

2010-09-01

Treatment for amblyopia commonly involves passive methods such as occlusion of the non-amblyopic eye. An evidence base for these methods is provided by animal models of visual deprivation and plasticity in early life and randomised controlled studies in humans with amblyopia. Other treatments of amblyopia, intended to be used instead of or in conjunction with passive methods, are known as 'active' because they require some activity on the part of the patient. Active methods are intended to enhance treatment of amblyopia in a number of ways, including increased compliance and attention during the treatment periods (due to activities that are interesting for the patient) and the use of stimuli designed to activate and to encourage connectivity between certain cortical cell types. Active methods of amblyopia treatment are widely available and are discussed to some extent in the literature, but in many cases the evidence base is unclear, and effectiveness has not been thoroughly tested. This review looks at the techniques and evidence base for a range of these methods and discusses the need for an evidence-based approach to the acceptance and use of active amblyopia treatments.

Components of Effective Cognitive-Behavioral Therapy for Pediatric Headache: A Mixed Methods Approach

PubMed Central

Law, Emily F.; Beals-Erickson, Sarah E.; Fisher, Emma; Lang, Emily A.; Palermo, Tonya M.

2017-01-01

Internet-delivered treatment has the potential to expand access to evidence-based cognitive-behavioral therapy (CBT) for pediatric headache, and has demonstrated efficacy in small trials for some youth with headache. We used a mixed methods approach to identify effective components of CBT for this population. In Study 1, component profile analysis identified common interventions delivered in published RCTs of effective CBT protocols for pediatric headache delivered face-to-face or via the Internet. We identified a core set of three treatment components that were common across face-to-face and Internet protocols: 1) headache education, 2) relaxation training, and 3) cognitive interventions. Biofeedback was identified as an additional core treatment component delivered in face-to-face protocols only. In Study 2, we conducted qualitative interviews to describe the perspectives of youth with headache and their parents on successful components of an Internet CBT intervention. Eleven themes emerged from the qualitative data analysis, which broadly focused on patient experiences using the treatment components and suggestions for new treatment components. In the Discussion, these mixed methods findings are integrated to inform the adaptation of an Internet CBT protocol for youth with headache. PMID:29503787

Components of Effective Cognitive-Behavioral Therapy for Pediatric Headache: A Mixed Methods Approach.

PubMed

Law, Emily F; Beals-Erickson, Sarah E; Fisher, Emma; Lang, Emily A; Palermo, Tonya M

2017-01-01

Internet-delivered treatment has the potential to expand access to evidence-based cognitive-behavioral therapy (CBT) for pediatric headache, and has demonstrated efficacy in small trials for some youth with headache. We used a mixed methods approach to identify effective components of CBT for this population. In Study 1, component profile analysis identified common interventions delivered in published RCTs of effective CBT protocols for pediatric headache delivered face-to-face or via the Internet. We identified a core set of three treatment components that were common across face-to-face and Internet protocols: 1) headache education, 2) relaxation training, and 3) cognitive interventions. Biofeedback was identified as an additional core treatment component delivered in face-to-face protocols only. In Study 2, we conducted qualitative interviews to describe the perspectives of youth with headache and their parents on successful components of an Internet CBT intervention. Eleven themes emerged from the qualitative data analysis, which broadly focused on patient experiences using the treatment components and suggestions for new treatment components. In the Discussion, these mixed methods findings are integrated to inform the adaptation of an Internet CBT protocol for youth with headache.

Multivariate evaluation of the effectiveness of treatment efficacy of cypermethrin against sea lice (Lepeophtheirus salmonis) in Atlantic salmon (Salmo salar)

PubMed Central

2013-01-01

Background The sea louse Lepeophtheirus salmonis is the most important ectoparasite of farmed Atlantic salmon (Salmo salar) in Norwegian aquaculture. Control of sea lice is primarily dependent on the use of delousing chemotherapeutants, which are both expensive and toxic to other wildlife. The method most commonly used for monitoring treatment effectiveness relies on measuring the percentage reduction in the mobile stages of Lepeophtheirus salmonis only. However, this does not account for changes in the other sea lice stages and may result in misleading or incomplete interpretation regarding the effectiveness of treatment. With the aim of improving the evaluation of delousing treatments, we explored multivariate analyses of bath treatments using the topical pyrethroid, cypermethrin, in salmon pens at five Norwegian production sites. Results Conventional univariate analysis indicated reductions of over 90% in mobile stages at all sites. In contrast, multivariate analyses indicated differing treatment effectiveness between sites (p-value < 0.01) based on changes in the proportion and abundance of the chalimus and PAAM (pre-adult and adult males) stages. Low water temperatures and shortened intervals between sampling after treatment may account for the differences in the composition of chalimus and PAAM stage groups following treatment. Using multivariate analysis, such factors could be separated from those which were attributable to inadequate treatment or chemotherapeutant failure. Conclusions Multivariate analyses for evaluation of treatment effectiveness against multiple life cycle stages of L. salmonis yield additional information beyond that derivable from univariate methods. This can aid in the identification of causes of apparent treatment failure in salmon aquaculture. PMID:24354936

Masking Treatment and its Effect on Tinnitus Parameters.

PubMed

Aytac, Ismail; Baysal, Elif; Gulsen, Secaattin; Tumuklu, Koray; Durucu, Cengiz; Mumbuc, Lütfi Semih; Kanlikama, MUzaffer

2017-12-01

Tinnitus is described as the perception of sound without any external acoustic stimulation. Any pathology of auditory pathways or any system of the human body may result with tinnitus. The pathophysiology of tinnitus accompanying the disorders of auditory system is not fully understood and there is not any particular effective treatment method has been specified. Tinnitus masking therapy has been reported as an effective treatment modality in the treatment of tinnitus. In this study, the results of tinnitus masking treatment on the parameters were evaluated prospectively. Patients with normal physical examination was enrolled in the study. Blood tests (complete blood count, biochemical analysis of lipid profile, and thyroid hormones), pure tone audiometry, tympanometric measurement of the middle ear pressure and stapedial reflexes were performed, Sixty six patients with normal results of blood tests and normal hearing thresholds with type A tympanogram were included. Tinnitus sufferers questionnaires (socio-demographics, clinical information, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI) was filled, audiological tests were performed, tinnitus parameters (frequency, intensity, minimal masking levels, residual inhibition) were measured. After four weeks of the treatment the questionnaires were repeated. Masking treatment for tinnitus patients resulted with significant decrease in Tinnitus Handicap Inventory and VAS scores. After four weeks of the masking treatment the questionnaire was repeated. Twenty patients did not respond to treatment. Masking therapy is one of the most effective methods of treatment for tinnitus patients. Masking therapy, that is not invasive and cost-effective has an important place in the treatment of tinnitus. Especially in a short time provides a significant reduction in tinnitus parameters.

An Automatic Approach for Analyzing Treatment Effectiveness Based on Medication Hierarchy - The Myocardial Infarction Case Study.

PubMed

Li, Yingxue; Hu, Yiying; Yang, Jingang; Li, Xiang; Liu, Haifeng; Xie, Guotong; Xu, Meilin; Hu, Jingyi; Yang, Yuejin

2017-01-01

Treatment effectiveness plays a fundamental role in patient therapies. In most observational studies, researchers often design an analysis pipeline for a specific treatment based on the study cohort. To evaluate other treatments in the data set, much repeated and multifarious work including cohort construction, statistical analysis need to be done. In addition, as treatments are often with an intrinsic hierarchical relationship, many rational comparable treatment pairs can be derived as new treatment variables besides the original single treatment one from the original cohort data set. In this paper, we propose an automatic treatment effectiveness analysis approach to solve this problem. With our approach, clinicians can assess the effect of treatments not only more conveniently but also more thoroughly and comprehensively. We applied this method to a real world case of estimating the drug effectiveness on Chinese Acute Myocardial Infarction (CAMI) data set and some meaningful results are obtained for potential improvement of patient treatments.

Comparative evaluation of tensile bond strength of a polyvinyl acetate-based resilient liner following various denture base surface pre-treatment methods and immersion in artificial salivary medium: An in vitro study.

PubMed

Philip, Jacob M; Ganapathy, Dhanraj M; Ariga, Padma

2012-07-01

This study was formulated to evaluate and estimate the influence of various denture base resin surface pre-treatments (chemical and mechanical and combinations) upon tensile bond strength between a poly vinyl acetate-based denture liner and a denture base resin. A universal testing machine was used for determining the bond strength of the liner to surface pre-treated acrylic resin blocks. The data was analyzed by one-way analysis of variance and the t-test (α =.05). This study infers that denture base surface pre-treatment can improve the adhesive tensile bond strength between the liner and denture base specimens. The results of this study infer that chemical, mechanical, and mechano-chemical pre-treatments will have different effects on the bond strength of the acrylic soft resilient liner to the denture base. Among the various methods of pre-treatment of denture base resins, it was inferred that the mechano-chemical pre-treatment method with air-borne particle abrasion followed by monomer application exhibited superior bond strength than other methods with the resilient liner. Hence, this method could be effectively used to improve bond strength between liner and denture base and thus could minimize delamination of liner from the denture base during function.

Dropout among patients in qualified alcohol detoxification treatment: the effect of treatment motivation is moderated by Trauma Load.

PubMed

Odenwald, Michael; Semrau, Peter

2013-03-21

Motivation to change has been proposed as a prerequisite for behavioral change, although empirical results are contradictory. Traumatic experiences are frequently found amongst patients in alcohol treatment, but this has not been systematically studied in terms of effects on treatment outcomes. This study aimed to clarify whether individual Trauma Load explains some of the inconsistencies between motivation to change and behavioral change. Over the course of two months in 2009, 55 patients admitted to an alcohol detoxification unit of a psychiatric hospital were enrolled in this study. At treatment entry, we assessed lifetime Trauma Load and motivation to change. Mode of discharge was taken from patient files following therapy. We tested whether Trauma Load moderates the effect of motivation to change on dropout from alcohol detoxification using multivariate methods. 55.4% dropped out of detoxification treatment, while 44.6% completed the treatment. Age, gender and days in treatment did not differ between completers and dropouts. Patients who dropped out reported more traumatic event types on average than completers. Treatment completers had higher scores in the URICA subscale Maintenance. Multivariate methods confirmed the moderator effect of Trauma Load: among participants with high Trauma Load, treatment completion was related to higher Maintenance scores at treatment entry; this was not true among patients with low Trauma Load. We found evidence that the effect of motivation to change on detoxification treatment completion is moderated by Trauma Load: among patients with low Trauma Load, motivation to change is not relevant for treatment completion; among highly burdened patients, however, who a priori have a greater risk of dropping out, a high motivation to change might make the difference. This finding justifies targeted and specific interventions for highly burdened alcohol patients to increase their motivation to change.

Quantifying and Testing Indirect Effects in Simple Mediation Models when the Constituent Paths Are Nonlinear

ERIC Educational Resources Information Center

Hayes, Andrew F.; Preacher, Kristopher J.

2010-01-01

Most treatments of indirect effects and mediation in the statistical methods literature and the corresponding methods used by behavioral scientists have assumed linear relationships between variables in the causal system. Here we describe and extend a method first introduced by Stolzenberg (1980) for estimating indirect effects in models of…

Cognitive behavioural therapy and mindfulness based stress reduction may be equally effective in reducing anxiety and depression in adults with autism spectrum disorders.

PubMed

Sizoo, Bram B; Kuiper, Erik

2017-05-01

Anxiety and depression co-occur in 50-70% of adults with autism spectrum disorder (ASD) but treatment methods for these comorbid problems have not been systematically studied. Recently, two ASD-tailored protocols were published: mindfulness based stress reduction (MBSR) and cognitive behavioural therapy (CBT). We wanted to investigate if both methods are equally effective in reducing anxiety and depression symptoms among adults with ASD. 59 adults with ASD and anxiety or depression scores above 7 on the Hospital Anxiety and Depression Scale, gave informed consent to participate; 27 followed the CBT protocol, and 32 the MBSR treatment protocol. Anxiety and depression scores, autism symptoms, rumination, and global mood were registered at the start, at the end of the 13-week treatment period, and at 3-months follow-up. Irrational beliefs and mindful attention awareness were used as process measures during treatment and at follow-up. Results indicate that both MBSR and CBT are associated with a reduction in anxiety and depressive symptoms among adults with ASD, with a sustained effect at follow-up, but without a main effect for treatment group. A similar pattern was seen for the reduction of autistic symptoms, rumination and the improvement in global mood. There are some indications that MBSR may be preferred over CBT with respect to the treatment effect on anxiety when the scores on measures of irrational beliefs or positive global mood at baseline are high. Mindfulness and cognitive behavioral therapies are both promising treatment methods for reducing comorbid anxiety and depression in adults with ASD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Systematic review: the effect on surrogates of making treatment decisions for others.

PubMed

Wendler, David; Rid, Annette

2011-03-01

Clinical practice relies on surrogates to make or help to make treatment decisions for incapacitated adults; however, the effect of this practice on surrogates has not been evaluated. To assess the effect on surrogates of making treatment decisions for adults who cannot make their own decisions. Empirical studies published in English and listed in MEDLINE, EMBASE, CINAHL, BIOETHICSLINE, PsycINFO, or Scopus before 1 July 2010. Eligible studies provided quantitative or qualitative empirical data, by evaluating surrogates, regarding the effect on surrogates of making treatment decisions for an incapacitated adult. Information on study location, number and type of surrogates, timing of data collection, type of decisions, patient setting, methods, main findings, and limitations. 40 studies, 29 using qualitative and 11 using quantitative methods, provided data on 2854 surrogates, more than one half of whom were family members of the patient. Most surrogates were surveyed several months to years after making treatment decisions, the majority of which were end-of-life decisions. The quantitative studies found that at least one third of surrogates experienced a negative emotional burden as the result of making treatment decisions. The qualitative studies reported that many or most surrogates experienced negative emotional burden. The negative effects on surrogates were often substantial and typically lasted months or, in some cases, years. The most common negative effects cited by surrogates were stress, guilt over the decisions they made, and doubt regarding whether they had made the right decisions. Nine of the 40 studies also reported beneficial effects on a few surrogates, the most common of which were supporting the patient and feeling a sense of satisfaction. Knowing which treatment is consistent with the patient's preferences was frequently cited as reducing the negative effect on surrogates. Thirty-two of the 40 articles reported data collected in the United States. Because the study populations were relatively homogenous, it is unclear whether the findings apply to other groups. In some cases, the effect of making treatment decisions could not be isolated from that of other stressors, such as grief or prognostic uncertainty. Nine of the studies had a response rate less than 50%, and 9 did not report a response rate. Many of the studies had a substantial interval between the treatment decisions and data collection. Making treatment decisions has a negative emotional effect on at least one third of surrogates, which is often substantial and typically lasts months (or sometimes years). Future research should evaluate ways to reduce this burden, including methods to identify which treatment options are consistent with the patient's preferences. National Institutes of Health.

A Century of Misunderstanding: The History of the Development of Post Traumatic Stress Disorder Understanding in the United States Military

DTIC Science & Technology

2015-06-12

development of treatment for servicemen and women suffering from PTSD, and the treatment methods unique to WWII, Korea, Vietnam, and the GWOT eras...the development of treatment for servicemen and women suffering from PTSD, and the treatment methods unique to WWII, Korea, Vietnam, and the GWOT...Army began to acknowledge the effects that PTSD has on the force, and implemented programs and procedures, medicinal and psychological, in order to

Antitumor effects of electrochemical treatment

PubMed Central

González, Maraelys Morales; Zamora, Lisset Ortíz; Cabrales, Luis Enrique Bergues; Sierra González, Gustavo Victoriano; de Oliveira, Luciana Oliveira; Zanella, Rodrigo; Buzaid, Antonio Carlos; Parise, Orlando; Brito, Luciana Macedo; Teixeira, Cesar Augusto Antunes; Gomes, Marina das Neves; Moreno, Gleyce; Feo da Veiga, Venicio; Telló, Marcos; Holandino, Carla

2013-01-01

Electrochemical treatment is an alternative modality for tumor treatment based on the application of a low intensity direct electric current to the tumor tissue through two or more platinum electrodes placed within the tumor zone or in the surrounding areas. This treatment is noted for its great effectiveness, minimal invasiveness and local effect. Several studies have been conducted worldwide to evaluate the antitumoral effect of this therapy. In all these studies a variety of biochemical and physiological responses of tumors to the applied treatment have been obtained. By this reason, researchers have suggested various mechanisms to explain how direct electric current destroys tumor cells. Although, it is generally accepted this treatment induces electrolysis, electroosmosis and electroporation in tumoral tissues. However, action mechanism of this alternative modality on the tumor tissue is not well understood. Although the principle of Electrochemical treatment is simple, a standardized method is not yet available. The mechanism by which Electrochemical treatment affects tumor growth and survival may represent more complex process. The present work analyzes the latest and most important research done on the electrochemical treatment of tumors. We conclude with our point of view about the destruction mechanism features of this alternative therapy. Also, we suggest some mechanisms and strategies from the thermodynamic point of view for this therapy. In the area of Electrochemical treatment of cancer this tool has been exploited very little and much work remains to be done. Electrochemical treatment constitutes a good therapeutic option for patients that have failed the conventional oncology methods. PMID:23592904

Comparison of Effectiveness of the Metacognition Treatment and the Mindfulness-Based Stress Reduction Treatment on Global and Specific Life Quality of Women with Breast Cancer

PubMed Central

Rahmani, Soheila; Talepasand, Siavash; Ghanbary-Motlagh, ALi

2014-01-01

Background This study is conducted to compare the metacognition treatment and the mindfulness-based stress reduction treatment on life quality of women with breast cancer. Methods In a quasi-experimental design, with pre-test, post-test and control group, 36 patients with diagnosis of breast cancer, among patients who referred to the Division of Oncology and Radiotherapy of Imam Hossein hospital in Tehran, were selected in accessible way and were assigned randomly to three experimental groups, the first group receiving meta-cognition treatment (n=12), the second one receiving mindfulness-based stress reduction program (n=12), and the other was the control group. Participants completed global life quality in cancer patient's questionnaire and specific quality of life in breast cancer patient's questionnaire in three stages: baseline, after intervention and two-month follow-up. Data were analyzed using the multivariate repeated measurement model. Results Findings showed both treatments were effective in improving global and specific quality of life in patients with breast cancer. The mindfulness -based stress reduction treatment excelled in functions and roles, fatigue, pain, future perspective and treatment side effects symptoms at the end of the treatment and follow-up in comparison to the metacognition treatment. Conclusion Results of this research showed the mindfulness-based stress reduction treatment can be effective in improving global and specific life quality of women with breast cancer and is a selective method for improving quality of life in patients. PMID:25628839

Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial.

PubMed

Triscari, Maria Teresa; Faraci, Palmira; Catalisano, Dario; D'Angelo, Valerio; Urso, Viviana

2015-01-01

The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization.

Effectiveness of cognitive behavioral therapy integrated with systematic desensitization, cognitive behavioral therapy combined with eye movement desensitization and reprocessing therapy, and cognitive behavioral therapy combined with virtual reality exposure therapy methods in the treatment of flight anxiety: a randomized trial

PubMed Central

Triscari, Maria Teresa; Faraci, Palmira; Catalisano, Dario; D’Angelo, Valerio; Urso, Viviana

2015-01-01

The purpose of the research was to compare the effectiveness of the following treatment methods for fear of flying: cognitive behavioral therapy (CBT) integrated with systematic desensitization, CBT combined with eye movement desensitization and reprocessing therapy, and CBT combined with virtual reality exposure therapy. Overall, our findings have proven the efficacy of all interventions in reducing fear of flying in a pre- to post-treatment comparison. All groups showed a decrease in flight anxiety, suggesting the efficiency of all three treatments in reducing self-report measures of fear of flying. In particular, our results indicated significant improvements for the treated patients using all the treatment programs, as shown not only by test scores but also by participation in the post-treatment flight. Nevertheless, outcome measures maintained a significant effect at a 1-year follow-up. In conclusion, combining CBT with both the application of eye movement desensitization and reprocessing treatment and the virtual stimuli used to expose patients with aerophobia seemed as efficient as traditional cognitive behavioral treatments integrated with systematic desensitization. PMID:26504391

A Study on the System for Treatment of ADHD Using Virtual Reality

DTIC Science & Technology

2001-10-25

following disadvantages; side - effects ( Ritalin can cause a cancer of liver[4]), needs of much time and efforts from many persons concerned. To...Unlike the existing treatment methods, VR Therapy system does not have any side effects and can present many situations to a subject without...system for treatment of ADHD using Virtual Reality technology. Psychotherapy using VR has some advantages that it is safer and more effective than

Using Audit Information to Adjust Parameter Estimates for Data Errors in Clinical Trials

PubMed Central

Shepherd, Bryan E.; Shaw, Pamela A.; Dodd, Lori E.

2013-01-01

Background Audits are often performed to assess the quality of clinical trial data, but beyond detecting fraud or sloppiness, the audit data is generally ignored. In earlier work using data from a non-randomized study, Shepherd and Yu (2011) developed statistical methods to incorporate audit results into study estimates, and demonstrated that audit data could be used to eliminate bias. Purpose In this manuscript we examine the usefulness of audit-based error-correction methods in clinical trial settings where a continuous outcome is of primary interest. Methods We demonstrate the bias of multiple linear regression estimates in general settings with an outcome that may have errors and a set of covariates for which some may have errors and others, including treatment assignment, are recorded correctly for all subjects. We study this bias under different assumptions including independence between treatment assignment, covariates, and data errors (conceivable in a double-blinded randomized trial) and independence between treatment assignment and covariates but not data errors (possible in an unblinded randomized trial). We review moment-based estimators to incorporate the audit data and propose new multiple imputation estimators. The performance of estimators is studied in simulations. Results When treatment is randomized and unrelated to data errors, estimates of the treatment effect using the original error-prone data (i.e., ignoring the audit results) are unbiased. In this setting, both moment and multiple imputation estimators incorporating audit data are more variable than standard analyses using the original data. In contrast, in settings where treatment is randomized but correlated with data errors and in settings where treatment is not randomized, standard treatment effect estimates will be biased. And in all settings, parameter estimates for the original, error-prone covariates will be biased. Treatment and covariate effect estimates can be corrected by incorporating audit data using either the multiple imputation or moment-based approaches. Bias, precision, and coverage of confidence intervals improve as the audit size increases. Limitations The extent of bias and the performance of methods depend on the extent and nature of the error as well as the size of the audit. This work only considers methods for the linear model. Settings much different than those considered here need further study. Conclusions In randomized trials with continuous outcomes and treatment assignment independent of data errors, standard analyses of treatment effects will be unbiased and are recommended. However, if treatment assignment is correlated with data errors or other covariates, naive analyses may be biased. In these settings, and when covariate effects are of interest, approaches for incorporating audit results should be considered. PMID:22848072

Evaluating Methods for Estimating Program Effects

ERIC Educational Resources Information Center

Reichardt, Charles S.

2011-01-01

I define a treatment effect in terms of a comparison of outcomes and provide a typology of all possible comparisons that can be used to estimate treatment effects, including comparisons that are relatively unknown in both the literature and practice. I then assess the relative merit, worth, and value of all possible comparisons based on the…

By-products of the Thermal Treatment of Hazardous Waste: Formation and Health Effects

PubMed Central

Walsh, Maud; Cormier, Stephania; Varner, Kurt; Dellinger, Barry

2011-01-01

Destruction of toxic chemicals by thermal treatment can be a highly effective method for remediation of sites contaminated with hazardous substances. Of the 977 Superfund source control treatment projects in the United States from 1982 to 2005, 16% used incineration or other thermal treatments (the proportion is similar for 126 projects in the period 2002–2005).1 However, as with other technologies, if thermal treatments are not matched correctly with the site or are improperly operated, harmful by-products can form, requiring further treatment. PMID:22684359

Automatic identification of comparative effectiveness research from Medline citations to support clinicians’ treatment information needs

PubMed Central

Zhang, Mingyuan; Fiol, Guilherme Del; Grout, Randall W.; Jonnalagadda, Siddhartha; Medlin, Richard; Mishra, Rashmi; Weir, Charlene; Liu, Hongfang; Mostafa, Javed; Fiszman, Marcelo

2014-01-01

Online knowledge resources such as Medline can address most clinicians’ patient care information needs. Yet, significant barriers, notably lack of time, limit the use of these sources at the point of care. The most common information needs raised by clinicians are treatment-related. Comparative effectiveness studies allow clinicians to consider multiple treatment alternatives for a particular problem. Still, solutions are needed to enable efficient and effective consumption of comparative effectiveness research at the point of care. Objective Design and assess an algorithm for automatically identifying comparative effectiveness studies and extracting the interventions investigated in these studies. Methods The algorithm combines semantic natural language processing, Medline citation metadata, and machine learning techniques. We assessed the algorithm in a case study of treatment alternatives for depression. Results Both precision and recall for identifying comparative studies was 0.83. A total of 86% of the interventions extracted perfectly or partially matched the gold standard. Conclusion Overall, the algorithm achieved reasonable performance. The method provides building blocks for the automatic summarization of comparative effectiveness research to inform point of care decision-making. PMID:23920677

Diapause Prevention Effect of Bombyx mori by Dimethyl Sulfoxide

PubMed Central

Yamamoto, Takayuki; Mase, Keisuke; Sawada, Hiroshi

2013-01-01

HCl treatment has been, for about 80 years, the primary method for the prevention of entry into embryonic diapauses of Bombyx mori. This is because no method is as effective as the HCl treatment. In this study, we discovered that dimethyl sulfoxide (DMSO) prevented entry into the diapause of the silkworm, Bombyx mori. The effect of diapause prevention was 78% as a result of treatment with 100% DMSO concentration, and the effect was comparable to that of the HCl treatment. In contrast, in the case of non-diapause eggs, hatchability was decreased by DMSO in a concentration-dependent manner. The effect of DMSO was restricted within 24 hours after oviposition of diapause eggs, and the critical period was slightly shorter than the effective period of the HCl treatment. DMSO analogs, such as dimethyl formamide (DMF) and dimethyl sulfide (DMS), did little preventive effect against the diapause. Furthermore, we also investigated the permeation effects of chemical compounds by DMSO. When treated with an inhibitor of protein kinase CK2 (CK2) dissolved in DMSO, the prevention rate of the diapause was less than 40%. This means that the inhibition effect by the CK2 inhibitor was the inhibition of embryonic development after diapause prevention by DMSO. These data suggest that DMSO has the effects of preventing from entering into the diapause and permeation of chemicals into diapause eggs. PMID:23675522

Potential of electric discharge plasma methods in abatement of volatile organic compounds originating from the food industry.

PubMed

Preis, S; Klauson, D; Gregor, A

2013-01-15

Increased volatile organic compounds emissions and commensurate tightening of applicable legislation mean that the development and application of effective, cost-efficient abatement methods are areas of growing concern. This paper reviews the last two decades' publications on organic vapour emissions from food processing, their sources, impacts and treatment methods. An overview of the latest developments in conventional air treatment methods is presented, followed by the main focus of the paper, non-thermal plasma technology. The results of the review suggest that non-thermal plasma technology, in its pulsed corona discharge configuration, is an emerging treatment method with potential for low-cost, effective abatement of a wide spectrum of organic air pollutants. It is found that the combination of plasma treatment with catalysis is a development trend that demonstrates considerable potential. The as yet relatively small number of plasma treatment applications is considered to be due to the novelty of pulsed electric discharge techniques and a lack of reliable pulse generators and reactors. Other issues acting as barriers to widespread adoption of the technique include the possible formation of stable oxidation by-products, residual ozone and nitrogen oxides, and sensitivity towards air humidity. Copyright © 2012 Elsevier Ltd. All rights reserved.

Initial Effects of Reproduction Cutting Treatments on Residual Hard Mast Production in the Ouachita Mountains

Treesearch

Roger W. Perry; Ronald E. Thill

2003-01-01

We compared indices of total hard mast production (oak and hickory combined) in 20, second-growth, pine-hardwood stands under five treatments to determine the effects of different reproduction treatments on mast production in the Ouachita Mountains. We evaluated mast production in mature unharvested controls and stands under four reproduction cutting methods (single-...

Apparent Covariation between Child Habit Disorders: Effects of Successful Treatment for Thumb Sucking on Untargeted Chronic Hair Pulling.

ERIC Educational Resources Information Center

Friman, Patrick C.; Hove, Gayleen

1987-01-01

The study examined effects of aversive taste treatment of thumb sucking on untreated habitual hair pulling by two young males (ages 2 and 5). Concomitant with successful treatment of thumb sucking, hair pulling was also eliminated. Results suggest an efficient method for changing behaviors that are difficult to treat directly. (Author/JW)

The differential effects of heat-shocking on the viability of spores from Bacillus anthracis, Bacillus subtilis, and Clostridium sporogenes after treatment with peracetic acid- and glutaraldehyde-based disinfectants

PubMed Central

March, Jordon K; Pratt, Michael D; Lowe, Chinn-Woan; Cohen, Marissa N; Satterfield, Benjamin A; Schaalje, Bruce; O'Neill, Kim L; Robison, Richard A

2015-01-01

This study investigated (1) the susceptibility of Bacillus anthracis (Ames strain), Bacillus subtilis (ATCC 19659), and Clostridium sporogenes (ATCC 3584) spores to commercially available peracetic acid (PAA)- and glutaraldehyde (GA)-based disinfectants, (2) the effects that heat-shocking spores after treatment with these disinfectants has on spore recovery, and (3) the timing of heat-shocking after disinfectant treatment that promotes the optimal recovery of spores deposited on carriers. Suspension tests were used to obtain inactivation kinetics for the disinfectants against three spore types. The effects of heat-shocking spores after disinfectant treatment were also determined. Generalized linear mixed models were used to estimate 6-log reduction times for each spore type, disinfectant, and heat treatment combination. Reduction times were compared statistically using the delta method. Carrier tests were performed according to AOAC Official Method 966.04 and a modified version that employed immediate heat-shocking after disinfectant treatment. Carrier test results were analyzed using Fisher's exact test. PAA-based disinfectants had significantly shorter 6-log reduction times than the GA-based disinfectant. Heat-shocking B. anthracis spores after PAA treatment resulted in significantly shorter 6-log reduction times. Conversely, heat-shocking B. subtilis spores after PAA treatment resulted in significantly longer 6-log reduction times. Significant interactions were also observed between spore type, disinfectant, and heat treatment combinations. Immediately heat-shocking spore carriers after disinfectant treatment produced greater spore recovery. Sporicidal activities of disinfectants were not consistent across spore species. The effects of heat-shocking spores after disinfectant treatment were dependent on both disinfectant and spore species. Caution must be used when extrapolating sporicidal data of disinfectants from one spore species to another. Heat-shocking provides a more accurate picture of spore survival for only some disinfectant/spore combinations. Collaborative studies should be conducted to further examine a revision of AOAC Official Method 966.04 relative to heat-shocking. PMID:26185111

Two-micron (Thulium) Laser Prostatectomy: An Effective Method for BPH Treatment.

PubMed

Jiang, Qi; Xia, Shujie

2014-01-01

The two-micron (thulium) laser is the newest laser technique for treatment of bladder outlet obstruction resulting from benign prostatic hyperplasia (BPH). It takes less operative time than standard techniques, provides clear vision and lower blood loss as well as shorter catheterization times and hospitalization times. It has been identified to be a safe and efficient method for BPH treatment regardless of the prostate size.

Assessment of different pre-treatment methods for the removal of limonene in citrus waste and their effect on methane potential and methane production rate.

PubMed

Ruiz, Begoña; de Benito, Amparo; Rivera, José Daniel; Flotats, Xavier

2016-12-01

The objective of this study was to assess the limonene removal efficiency of three pre-treatment methods when applied to citrus waste and to evaluate their effects on the biochemical methane potential and the methane production rate using batch anaerobic tests. The methods tested were based on removal (biological pretreatment by fungi) or recovery (steam distillation and ethanol extraction) of limonene. All the treatments decreased the concentration of limonene in orange peel, with average efficiencies of 22%, 44% and 100% for the biological treatment, steam distillation and ethanol extraction, respectively. By-products from limonene biodegradation by fungi exhibited an inhibitory effect also, not making interesting the biological pretreatment. The methane potential and production rate of the treated orange peel increased significantly after applying the recovery strategies, which separated and recovered simultaneously other inhibitory components of the citrus essential oil. Apart from the high recovery efficiency of the ethanol extraction process, it presented a favourable energy balance. © The Author(s) 2016.

PNF and manual therapy treatment results of patients with cervical spine osteoarthritis.

PubMed

Maicki, Tomasz; Bilski, Jan; Szczygieł, Elżbieta; Trąbka, Rafał

2017-09-22

The aim of this study was to evaluate the effectiveness of PNF and manual therapy methods in the treatment of patients with cervical spine osteoarthritis, especially their efficacy in reducing pain and improving functionality in everyday life. Long-term results were also compared in order to determine which method of treatment is more effective. Eighty randomly selected females aged 45-65 were included in the study. They were randomly divided into two groups of 40 persons. One group received PNF treatment and the other received manual therapy (MAN.T). To evaluate functional capabilities, the Functional Rating Index was used. To evaluate changes in pain, a shortened version of the McGill Questionnaire was used. The PNF group achieved a greater reduction in pain than the MAN.T group. The PNF group showed a greater improvement in performing daily activities such as sleeping, personal care, travelling, work, recreation, lifting, walking and standing as well as decreased intensity and frequency of pain compared to the MAN.T group. The PNF method proved to be more effective in both short (after two weeks) and long (after three months) term.

The efficacy of subsurface flow reed bed treatment in the removal of Campylobacter spp., faecal coliforms and Escherichia coli from poultry litter.

PubMed

Duggan, J; Bates, M P; Phillips, C A

2001-06-01

The use of poultry waste as a fertiliser on arable land is an accepted method of waste treatment. However, run-off from such practices may result in contamination of the watercourse by human pathogens. In this study the effectiveness of using constructed wetlands as an alternative treatment for poultry manure waste was evaluated. Enumeration of Campylobacter spp., Escherichia coli, total coliforms and total aerobes were carried out on influent and effluent samples from reed beds loaded with poultry waste. For both sequential loading and continuous loading there was a statistically significant mean log reduction of 3.56 and 4.25 for E. coli, 3.2 and 3.88 for coliforms, 3.85 and 4.2 for total aerobic counts and 3.13 and 2.96 for Campylobacter spp., respectively. This method, which has been previously recognised as cost-effective and environmentally acceptable, provides an efficient method for reducing numbers of these bacteria in poultry waste and therefore an effective alternative treatment for such waste or waters containing run off from land previously spread with poultry manure.

[Effects of different drying methods on processing performance and quality in bulbus of Tulipa edulis].

PubMed

Yang, Xiao-hua; Guo, Qiao-sheng; Zhu, Zai-biao; Chen, Jun; Miao, Yuan-yuan; Yang, Ying; Sun, Yuan

2015-10-01

Effects of different drying methods including sun drying, steamed, boiled, constant temperature drying (at 40, 50, 60 °C) on appearance, hardness, rehydration ratio, dry rate, moisture, total ash, extractive and polysaccharides contents were studied to provide the basis of standard processing method for Tulipa edulis bulbus. The results showed that the treatments of sun drying and 40 °C drying showed higher rehydration ratios, but lower dry rate, higher hardness, worse color, longer time and obvious distortion and shrinkage in comparison with other drying methods. The treatments of 60 °C constant temperature drying resulted in shorter drying time, lower water and higher polysaccharides content. Drying time is shorter and appearance quality is better in the treatment of steaming and boiling compared with other treatments, but the content of extractive and polysaccharides decreased significantly. The treatments of 50 °C constant temperature drying led to similar appearance quality of bulb to commercial bulb, and it resulted in lowest hardness and highest dry rate as well as higher rehydration ratio, extractive and polysaccharides content, moderate moisture and total ash contents among these treatments. Based on the results obtained, 50 °C constant temperature drying is the better way for the processing of T. edulis bulbus.

Missing Data in Alcohol Clinical Trials with Binary Outcomes

PubMed Central

Hallgren, Kevin A.; Witkiewitz, Katie; Kranzler, Henry R.; Falk, Daniel E.; Litten, Raye Z.; O’Malley, Stephanie S.; Anton, Raymond F.

2017-01-01

Background Missing data are common in alcohol clinical trials for both continuous and binary endpoints. Approaches to handle missing data have been explored for continuous outcomes, yet no studies have compared missing data approaches for binary outcomes (e.g., abstinence, no heavy drinking days). The present study compares approaches to modeling binary outcomes with missing data in the COMBINE study. Method We included participants in the COMBINE Study who had complete drinking data during treatment and who were assigned to active medication or placebo conditions (N=1146). Using simulation methods, missing data were introduced under common scenarios with varying sample sizes and amounts of missing data. Logistic regression was used to estimate the effect of naltrexone (vs. placebo) in predicting any drinking and any heavy drinking outcomes at the end of treatment using four analytic approaches: complete case analysis (CCA), last observation carried forward (LOCF), the worst-case scenario of missing equals any drinking or heavy drinking (WCS), and multiple imputation (MI). In separate analyses, these approaches were compared when drinking data were manually deleted for those participants who discontinued treatment but continued to provide drinking data. Results WCS produced the greatest amount of bias in treatment effect estimates. MI usually yielded less biased estimates than WCS and CCA in the simulated data, and performed considerably better than LOCF when estimating treatment effects among individuals who discontinued treatment. Conclusions Missing data can introduce bias in treatment effect estimates in alcohol clinical trials. Researchers should utilize modern missing data methods, including MI, and avoid WCS and CCA when analyzing binary alcohol clinical trial outcomes. PMID:27254113

The cost-effectiveness of methadone maintenance as a health care intervention.

PubMed

Barnett, P G

1999-04-01

Cost-effectiveness analysis using life-years of survival as the measure of treatment benefit is widely used in the economic evaluation of health care interventions but has not been applied to substance abuse treatment. The cost-effectiveness of methadone maintenance was evaluated to demonstrate the feasibility of applying this method to substance abuse treatment. A literature review was undertaken to determine the effect of methadone treatment on the rate of mortality associated with opiate addiction. Information was also obtained on the average cost and duration of treatment. A two-state Markov model was used to estimate the incremental effect of methadone on the life span and treatment cost of a cohort of 25-year-old heroin users. Providing opiate addicts with access to methadone maintenance has an incremental cost-effectiveness ratio of $5915 per life-year gained (that is, for every year of life that is saved by providing methadone to opiate addicts, an additional $5915 in treatment costs are incurred). One-way sensitivity analysis determined that the ratio was less than $10,000 per-life year over a wide range of modeling assumptions. The ratio determined for methadone is lower than that of many common medical therapies, and well within the $50,000 threshold for judging cost-effectiveness. Even if decision makers do not wish use the same ratio that is applied to the general population, this method allows substance abuse treatment enhancements to be compared to improvements in health services offered to individuals with substance abuse disorders. Future work will require information on the impact of methadone treatment on the cost of health care and public programs, the indirect costs incurred by patients, and adjustments to reflect quality of life.

Comparison of the helical tomotherapy against the multileaf collimator-based intensity-modulated radiotherapy and 3D conformal radiation modalities in lung cancer radiotherapy

PubMed Central

Mavroidis, P; Shi, C; Plataniotis, G A; Delichas, M G; Costa Ferreira, B; Rodriguez, S; Lind, B K; Papanikolaou, N

2011-01-01

Objectives The aim of this study was to compare three-dimensional (3D) conformal radiotherapy and the two different forms of IMRT in lung cancer radiotherapy. Methods Cases of four lung cancer patients were investigated by developing a 3D conformal treatment plan, a linac MLC-based step-and-shoot IMRT plan and an HT plan for each case. With the use of the complication-free tumour control probability (P+) index and the uniform dose concept as the common prescription point of the plans, the different treatment plans were compared based on radiobiological measures. Results The applied plan evaluation method shows the MLC-based IMRT and the HT treatment plans are almost equivalent over the clinically useful dose prescription range; however, the 3D conformal plan inferior. At the optimal dose levels, the 3D conformal treatment plans give an average P+ of 48.1% for a effective uniform dose to the internal target volume (ITV) of 62.4 Gy, whereas the corresponding MLC-based IMRT treatment plans are more effective by an average ΔP+ of 27.0% for a Δ effective uniform dose of 16.3 Gy. Similarly, the HT treatment plans are more effective than the 3D-conformal plans by an average ΔP+ of 23.8% for a Δ effective uniform dose of 11.6 Gy. Conclusion A radiobiological treatment plan evaluation can provide a closer association of the delivered treatment with the clinical outcome by taking into account the dose–response relations of the irradiated tumours and normal tissues. The use of P – effective uniform dose diagrams can complement the traditional tools of evaluation to compare and effectively evaluate different treatment plans. PMID:20858664

Investigating bang for your training buck: a randomized controlled trial comparing three methods of training clinicians in two core strategies of dialectical behavior therapy.

PubMed

Dimeff, Linda A; Harned, Melanie S; Woodcock, Eric A; Skutch, Julie M; Koerner, Kelly; Linehan, Marsha M

2015-05-01

The present study examined the efficacy of online training (OLT), instructor-led training (ILT), and a treatment manual (TM) in training mental health clinicians in two core strategies of Dialectical Behavior Therapy (DBT): chain analysis and validation. A randomized controlled trial compared OLT, ILT, and TM among clinicians naïve to DBT (N=172) who were assessed at baseline, post-training, and 30, 60, and 90 days following training. Primary outcomes included satisfaction, self-efficacy, motivation, knowledge, clinical proficiency, and clinical use. Overall, ILT outperformed OLT and TM in satisfaction, self-efficacy, and motivation, whereas OLT was the most effective method for increasing knowledge. The conditions did not differ in observer-rated clinical proficiency or self-reported clinical use, which both increased to moderate levels after training. In addition, ILT was particularly effective at improving motivation to use chain analysis, whereas OLT was particularly effective at increasing knowledge of validation strategies. These findings suggest that these types of brief, didactic trainings may be effective methods of increasing knowledge of new treatment strategies, but may not be sufficient to enable clinicians to achieve a high level of clinical use or proficiency. Additional research examining the possible advantages of matching training methods to types of treatment strategies may help to determine a tailored, more effective approach to training clinicians in empirically supported treatments. Copyright © 2015. Published by Elsevier Ltd.

Olive mill wastewater treatment in Jordan: A Review

NASA Astrophysics Data System (ADS)

Bawab, Abeer Al; Ghannam, Noor; Abu-Mallouh, Saida; Bozeya, Ayat; Abu-Zurayk, Rund A.; Al-Ajlouni, Yazan A.; Alshawawreh, Fida'a.; Odeh, Fadwa; Abu-Dalo, Muna A.

2018-02-01

The environmental impact of olive mill wastewater (OMW) pollution is a public concern. OMW contains high levels of phenols, organic compounds, chemical oxygen demand (COD), biological oxygen demand (BOD), microorganisms, nutrients, and toxic compounds. The treatment of OMW has been investigated by many researchers in the Mediterranean region, using several treatment techniques to remove contaminants from OMW. These techniques include chemical, biological, physiochemical, and biophysical techniques. Surfactants and some adsorbents were used in chemical techniques, anaerobic and aerobic in biological techniques, while the combined treatment methods used Electroosmosis, ozonation and electrocoagulation processes as physiochemical methods, and ultrasonic irradiation combined with aerobic biodegradation as biophysical method. The effects of OMW, whether treated or untreated, have been evaluated on both plants’ growth and soil properties. The treatment methods as well as the environmental impact of OMW in Jordan were summarized in this review.

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

Cheong, S-K; Kim, J

Purpose: The aim of the study is the application of a Failure Modes and Effects Analysis (FMEA) to access the risks for patients undergoing a Low Dose Rate (LDR) Prostate Brachytherapy Treatment. Methods: FMEA was applied to identify all the sub processes involved in the stages of identifying patient, source handling, treatment preparation, treatment delivery, and post treatment. These processes characterize the radiation treatment associated with LDR Prostate Brachytherapy. The potential failure modes together with their causes and effects were identified and ranked in order of their importance. Three indexes were assigned for each failure mode: the occurrence rating (O),more » the severity rating (S), and the detection rating (D). A ten-point scale was used to score each category, ten being the number indicating most severe, most frequent, and least detectable failure mode, respectively. The risk probability number (RPN) was calculated as a product of the three attributes: RPN = O X S x D. The analysis was carried out by a working group (WG) at UPMC. Results: The total of 56 failure modes were identified including 32 modes before the treatment, 13 modes during the treatment, and 11 modes after the treatment. In addition to the protocols already adopted in the clinical practice, the prioritized risk management will be implanted to the high risk procedures on the basis of RPN score. Conclusion: The effectiveness of the FMEA method was established. The FMEA methodology provides a structured and detailed assessment method for the risk analysis of the LDR Prostate Brachytherapy Procedure and can be applied to other radiation treatment modes.« less

The Efficacy of Functional Electrical Stimulation of the Abdominal Muscles in the Treatment of Chronic Constipation in Patients with Multiple Sclerosis: A Pilot Study

PubMed Central

Peace, Carla

2016-01-01

Chronic constipation in patients with multiple sclerosis (MS) is common and the current methods of treatment are ineffective in some patients. Anecdotal observations suggest that functional electrical stimulation (FES) of the abdominal muscles may be effective in the management of constipation in these patients. Patients and Methods. In this exploratory investigation we studied the effects of FES on the whole gut transit time (WGTT) and the colonic transit time (CTT). In addition, we evaluated the treatment effect on the patients' constipation-related quality of life and on the use of laxatives and the use of manual bowel evacuation. FES was given for 30 minutes twice a day for a period of six weeks. Four female patients were studied. Results. The WGTT and CTT and constipation-related quality of life improved in all patients. The patients' use of laxatives was reduced. No adverse effects of FES treatment were reported. Conclusion. The findings of this pilot study suggest that FES applied to the abdominal muscles may be an effective treatment modality for severe chronic constipation in patients with MS. PMID:27200190

The effectiveness of psychoanalytic-interactional psychotherapy in borderline personality disorder.

PubMed

Leichsenring, Falk; Masuhr, Oliver; Jaeger, Ulrich; Dally, Andreas; Streeck, Ulrich

2010-01-01

Different methods are available for the psychotherapeutic treatment of patients with severe personality disorders. In Germany, a special form of dynamically oriented therapy called psychoanalytic-interactional psychotherapy or method (PiM) has been clinically applied for many years. PiM was derived from psychoanalytic therapy and has been specifically adapted for the treatment of severely disordered patients, for example, patients with borderline personality disorders, prepsychotic disorders, addictions, and perversions. In a naturalistic study, the effectiveness of PiM was tested in a sample of patients with borderline personality disorders (N = 132). The patients were treated in the Clinic Tiefenbrunn near Göettingen. Standardized, reliable, and valid diagnostic instruments were used to study the treatment effects. According to the results, PiM achieved significant improvements in target symptoms, general symptoms, interpersonal problems, and contentedness with life. The results are discussed with regard to the treatment of severely disordered patients.

Effect of Melt Superheating Treatment on the Latent Heat Release of Sn

NASA Astrophysics Data System (ADS)

Xu, Junfeng; Dang, Bo; Fan, Dandan; Jian, Zengyun

2017-03-01

The accuracy of the baseline evaluation is of importance for calculating the transition enthalpy such as the latent heat of the crystallization. This study demonstrates the modified method of the equivalent non-latent heat baseline, by which the transition enthalpy can be measured accurately according to the transition peak in differential scanning calorimetric curve. With this method, the effect of melt superheating treatment time on the latent heat release upon the solidification of tin is investigated. The results show that the latent heat increases by increasing the treatment time, and is close to a constant when the treatment time is large enough, indicating the homogeneous system. And then, a simple model is established to describe the changes of the crystallization latent heat with the treatment time, which is confirmed by the experimental data of Sn.

Use of Atmospheric Pressure Cold Plasma for Meat Industry.

PubMed

Lee, Juri; Lee, Cheol Woo; Yong, Hae In; Lee, Hyun Jung; Jo, Cheorun; Jung, Samooel

2017-01-01

Novel, effective methods to control and prevent spoilage and contamination by pathogenic microorganisms in meat and meat products are in constant demand. Non-thermal pasteurization is an ideal method for the preservation of meat and meat products because it does not use heat during the pasteurization process. Atmospheric pressure cold plasma (APCP) is a new technology for the non-thermal pasteurization of meat and meat products. Several recent studies have shown that APCP treatment reduces the number of pathogenic microorganisms in meat and meat products. Furthermore, APCP treatment can be used to generate nitrite, which is an essential component of the curing process. Here, we introduce the effectiveness of APCP treatment as a pasteurization method and/or curing process for use in the meat and meat product processing industry.

Use of Atmospheric Pressure Cold Plasma for Meat Industry

PubMed Central

Lee, Juri; Lee, Cheol Woo; Yong, Hae In; Lee, Hyun Jung; Jo, Cheorun; Jung, Samooel

2017-01-01

Novel, effective methods to control and prevent spoilage and contamination by pathogenic microorganisms in meat and meat products are in constant demand. Non-thermal pasteurization is an ideal method for the preservation of meat and meat products because it does not use heat during the pasteurization process. Atmospheric pressure cold plasma (APCP) is a new technology for the non-thermal pasteurization of meat and meat products. Several recent studies have shown that APCP treatment reduces the number of pathogenic microorganisms in meat and meat products. Furthermore, APCP treatment can be used to generate nitrite, which is an essential component of the curing process. Here, we introduce the effectiveness of APCP treatment as a pasteurization method and/or curing process for use in the meat and meat product processing industry. PMID:28943759

Effect of novel food processing methods on packaging: structure, composition, and migration properties.

PubMed

Guillard, V; Mauricio-Iglesias, M; Gontard, N

2010-11-01

Classical stabilization techniques (thermal treatments) usually involve food to be packed after being processed. On the contrary and increasingly, novel food processing methods, such as high pressure or microwaves, imply that both packaging and foodstuff undergo the stabilization treatment. Moreover, novel treatments (UV light, irradiation, ozone, cold plasma) are specifically used for disinfection and sterilization of the packaging material itself. Therefore, in the last several years a number of papers have focused on the effects of these new treatments on food-packaging interactions with a special emphasis on chemical migration and safety concerns. New packaging materials merged on the market with specific interest regarding the environment (i.e. bio-sourced materials) or mechanical and barrier properties (i.e. nanocomposites packaging materials). It is time to evaluate the knowledge about how these in-package food technologies affect food/packaging interactions, and especially for novel biodegradable and/or active materials. This article presents the effect of high pressure treatment, microwave heating, irradiation, UV-light, ozone and, cold plasma treatment on food/packaging interactions.

Studies on Application of Aroma Finish on Silk Fabric

NASA Astrophysics Data System (ADS)

Hipparagi, Sanganna Aminappa; Srinivasa, Thirumalappa; Das, Brojeswari; Naik, Subhas Venkatappa; Purushotham, Serampur Parappa

2016-10-01

Aromatic treatments on textiles have gained importance in the recent years. In the present article work has been done on fragrance finish application on silk material. Silk is an expensive natural fibre used for apparel purpose and known for its feel and appeal. Incorporation of fragrance material in silk product, will add more value to it. Present work focuses to impart durable aroma finish for silk products to be home washed or subjected to dry cleaning. Microencapsulated aroma chemical has been used for the treatment. Impregnation method, Exhaust method, Dip-Pad-Dry method and Spray method have been used to see the influence of application method on the uptake and performance. Evaluation of the aroma treated material has been done through subjective evaluation as per Odor Intensity Reference Scaling (OIRS). Effect of the aroma finishing on the physical properties of the fabric has also been studied. No adverse effect has been observed on the stiffness of the fabric after the aroma treatment.

Effects of mechanical and chemical control on Microstegium vimineum and its associates in central West Virginia

Treesearch

Jonathan Pomp; Dave McGill; William Grafton; Rakesh Chandran; Russ Richardson

2010-01-01

Various studies have identified methods for effectively controlling Japanese stilt grass [Microstegium vimineum (Trin.) A. Camus]. However, the effect of M. vimineum control treatments on native flora has not been documented. This is of particular interest because an effective M. vimineum control method that...

Effectiveness of mouse minute virus inactivation by high temperature short time treatment technology: a statistical assessment.

PubMed

Murphy, Marie; Quesada, Guillermo Miro; Chen, Dayue

2011-11-01

Viral contamination of mammalian cell cultures in GMP manufacturing facility represents a serious safety threat to biopharmaceutical industry. Such adverse events usually require facility shutdown for cleaning/decontamination, and thus result in significant loss of production and/or delay of product development. High temperature short time (HTST) treatment of culture media has been considered as an effective method to protect GMP facilities from viral contaminations. Log reduction factor (LRF) has been commonly used to measure the effectiveness of HTST treatment for viral inactivation. However, in order to prevent viral contaminations, HTST treatment must inactivate all infectious viruses (100%) in the medium batch since a single virus is sufficient to cause contamination. Therefore, LRF may not be the most appropriate indicator for measuring the effectiveness of HTST in preventing viral contaminations. We report here the use of the probability to achieve complete (100%) virus inactivation to assess the effectiveness of HTST treatment. By using mouse minute virus (MMV) as a model virus, we have demonstrated that the effectiveness of HTST treatment highly depends upon the level of viral contaminants in addition to treatment temperature and duration. We believe that the statistical method described in this report can provide more accurate information about the power and potential limitation of technologies such as HTST in our shared quest to mitigate the risk of viral contamination in manufacturing facilities. Copyright © 2011 The International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

Generated effect modifiers (GEM’s) in randomized clinical trials

PubMed Central

Petkova, Eva; Tarpey, Thaddeus; Su, Zhe; Ogden, R. Todd

2017-01-01

In a randomized clinical trial (RCT), it is often of interest not only to estimate the effect of various treatments on the outcome, but also to determine whether any patient characteristic has a different relationship with the outcome, depending on treatment. In regression models for the outcome, if there is a non-zero interaction between treatment and a predictor, that predictor is called an “effect modifier”. Identification of such effect modifiers is crucial as we move towards precision medicine, that is, optimizing individual treatment assignment based on patient measurements assessed when presenting for treatment. In most settings, there will be several baseline predictor variables that could potentially modify the treatment effects. This article proposes optimal methods of constructing a composite variable (defined as a linear combination of pre-treatment patient characteristics) in order to generate an effect modifier in an RCT setting. Several criteria are considered for generating effect modifiers and their performance is studied via simulations. An example from a RCT is provided for illustration. PMID:27465235

[Laparoscopic treatment of hepatic cysts].

PubMed

Gaspari, A L; Di Lorenzo, N; Sica, G; De Ascentis, G; Rossi, M; Ferranti, F

1995-03-01

Laparoscopic treatment of simple hepatic cysts is reported. Recent indications to conservative surgical treatment for this benign disease are considered and different therapeutic options are analyzed. Surgical technique adopted in two cases observed is illustrated. In conclusion, the Authors consider laparoscopic treatment as an effective method for a mini-invasive surgical approach.

Multi-barrier approach for removing organic micropollutants using mobile water treatment systems.

PubMed

Yu, Youngbeom; Choi, Yang Hun; Choi, Jaewon; Choi, Soohoon; Maeng, Sung Kyu

2018-05-20

The diversity of organic micropollutants (OMPs) in aquatic environments has been increasing rapidly during the last decade. Therefore, it is important to monitor and attenuate emerging contaminants before they can negatively affect the aquatic environment. However, due to the diversity and complexity of OMPs, there are limitations to using a single method for treating a combination of these pollutants. To address this issue, a mobile water treatment system (MWTS) equipped with different treatment units was designed to remove OMPs under field conditions. The MWTS was configured with various modular units including coagulation, flocculation, dissolved air flotation, membrane filtration, ozone oxidation, granular activated carbon, and UV disinfection. Each treatment unit could be operated either individually or in different combinations to identify the optimal configuration of treatment units for the removal of OMPs. To investigate the effectiveness of the MWTS, twelve OMPs were selected and introduced simultaneously into the feed water samples collected from different rivers throughout Korea. The current study proved that the MTWS is an effective solution to treat OMPs and is a time saving treatment system. The combined effects of the different treatment units removed over 99% of the selected OMPs, regardless of their physicochemical properties. Moreover, since the system is mobile, on-site analyses can be conducted to identify the most effective treatment method and configuration for each OMP. Copyright © 2018 Elsevier B.V. All rights reserved.

Dietary maifanite supplementation did not affect the apparent total tract digestibility of calcium and phosphorus in growing pigs

PubMed Central

Bai, Li Li; Ming, Dong Xu; Dong, Shu Ren; Yang, Zhong Yue; Wang, Wen Hui; Zhang, Shuai; Piao, Xiang Shu

2018-01-01

Objective This study was conducted to determine the effects of dietary maifanite supplementation and fecal collection method on the apparent total tract digestibility (ATTD) of calcium (Ca) and phosphorus (P) and blood parameters in growing pigs. Methods Thirty-six growing barrows (Duroc×Landrace×Yorkshire; 27.0±2.6 kg) were allotted to six dietary treatments with 6 pigs per treatment according to body weight in a completely randomized design. The experimental treatments were: i) Low Ca+cornstarch (2.25%), ii) Low Ca+maifanite (2.25%), iii) Medium Ca+cornstarch (1.42%), iv) Medium Ca+maifanite (1.42%), v) High Ca+cornstarch (0.64%), and vi) High Ca+maifanite (0.64%). Feces were collected by the total collection (TC) and indicator method (IM). At the beginning and the end of the experiment, blood samples were collected from each pig. Results For the TC method, there were no difference in Ca intake, fecal Ca output, Ca retention and the ATTD of Ca between cornstarch and maifanite diets at the same dietary Ca level. However, urinary Ca excretion was lower (p = 0.01) in pigs fed low Ca diets without maifanite supplementation compared with other dietary treatments. Dietary maifanite supplementation had no effect on the P metabolism in growing pigs. For the IM method, there was no difference in Ca digestibility between cornstarch and maifanite diets at the same dietary Ca level. The ATTD of P was greater (p<0.01) in pigs fed the high Ca diet with maifanite supplementation compared with the high Ca diet with cornstarch treatment. Dietary inclusion of maifanite had no effect on blood parameters in growing pigs. Conclusion Dietary maifanite supplementation had no effect on the ATTD of Ca and P and serum parameters in growing pigs. The IM resulted in lower digestibility values than the TC method. PMID:28728391

[Surgical treatment of recurrent inguinal hernia].

PubMed

Orokhovskiĭ, V I; Papazov, F K; Vasilćhenko, V G; Mezhakov, S V; Shvanits, Sh

1993-01-01

The experience with surgical treatment of 89 patients with recurrent inguinal hernia is presented. A method for hernioplasty with the use of the pyramidal muscle transferred for covering the inguinal space is described. In 37 patients, no hernia recurrence and injury to the femoral vessels were revealed. This was indicative of the effectiveness of the method suggested.

Cognitive-Behavioral Therapies for Young People in Outpatient Treatment for Nonopioid Drug Use

ERIC Educational Resources Information Center

Filges, Trine; Jorgensen, Anne-Marie Klint

2018-01-01

Objectives: This review evaluates the evidence on the effects of cognitive-behavioral therapy (CBT) on drug use reduction for young people in treatment for nonopioid drug use. Method: We followed Campbell Collaboration guidelines to conduct a systematic review of randomized and nonrandomized trials. Meta-analytic methods were used to…

Desensitization And Study-Skills Training As Treatment For Two Types of Test-Anxious Students

ERIC Educational Resources Information Center

Osterhouse, Robert A.

1972-01-01

This study compared the effectiveness of systematic desensitization and training in efficient study methods for reducing test anxiety among subjects selected on the basis of two types of self reported anxiety. Desensitization offered more promise as a treatment method for test anxiety than did training in study skills. (Author)

A Stability Enhancement Method for Centrifugal Compressors using Active Control Casing Treatment System

NASA Astrophysics Data System (ADS)

Zhao, Yuanyang; Xiao, Jun; Li, Liansheng; Yang, Qichao; Liu, Guangbin; Wang, Le

2015-08-01

The centrifugal compressors are widely used in many fields. When the centrifugal compressors operate at the edge of the surge line, the compressor will be unstable. In addition, if the centrifugal compressor runs at this situation long time, the damage will be occurred on compressor. There are some kinds of method to improve and enlarge the range of the centrifugal compressors, such as inlet guide vane, and casing treatment. For casing treatment method, some structures have been researched, such as holed recirculation, basic slot casing treatment and groove casing treatment. All these researches are the passive methods. This paper present a new stability enhancement method based Active Control Casing Treatment (ACCT). All parts of this new method are introduced in detail. The control strategy of the system is mentioned in the paper. As a research sample, a centrifugal compressor having this system is researched using CFD method. The study focuses on the effect of the active control system on the impeller flow. The vortex in impeller is changed by the active control system. And this leads to the suppression of the extension of vortex blockage in impeller and to contribute to the enhancement of the compressor operating range.

[Randomized controlled trials of needle knife therapy combined with rotation traction manipulation for the treatment of cervical spondylotic radiculopathy].

PubMed

Zhou, Zhong-Liang; Su, Guo-Hong; Zheng, Bao-Zhu; Zuo, Yu-Zhu; Wei, Fu-Liang

2016-09-25

To compare the therapeutic effects between needle knife therapy combined with rotation traction manipulation and rotation traction manipulation for the treatment of cervical spondylotic radiculopathy. From November 2013 to June 2015, 80 patients with cervical spondylotic radiculopathy meeting the inclusion criteria were divided into two groups randomly:the control group in which 39 patients were treated with rotation traction manipulation, and the treatment group in which 41 patients were treated with needle knife combined with rotation traction manipulation. The patients in the control group were treated once dayly for 2 weeks, which was 1 course. The patients in the treatment group were treated with needle knife firstly once a week for 2 weeks, which was 1 course;then were treated with the same methods as the patients in the control group. The symptoms, signs score and the therapeutic effects of the two groups before and after treatment were observed. After treatment, symptoms and signs scores declined in both groups( P <0.05). The results of the treatment group were better than effects in the control group( P <0.05). In the treatment group, 19 patients got an excellent result, 16 good, 5 fair and 1 bad;while in the control group, 10 patients got an excellent result, 10 good, 16 fair and 3 bad;the results of the treatment group were better than the results of the control group( P <0.01). Needle knife combined with rotation traction manipulation is an effective method for the treatment of cervical spondylotic radiculopathy, which is better than using manipulation method simply. Needle knife therapy has follow advantages:improving local blood circulation, reducing local content of pain substance, increasing production of substances resisting pain, opening channels and collaterals, and make body reaching new static and dynamic balance on the new foundation.

Using Ensemble-Based Methods for Directly Estimating Causal Effects: An Investigation of Tree-Based G-Computation

ERIC Educational Resources Information Center

Austin, Peter C.

2012-01-01

Researchers are increasingly using observational or nonrandomized data to estimate causal treatment effects. Essential to the production of high-quality evidence is the ability to reduce or minimize the confounding that frequently occurs in observational studies. When using the potential outcome framework to define causal treatment effects, one…

Assessing the Generalizability of Estimates of Causal Effects from Regression Discontinuity Designs

ERIC Educational Resources Information Center

Bloom, Howard S.; Porter, Kristin E.

2012-01-01

In recent years, the regression discontinuity design (RDD) has gained widespread recognition as a quasi-experimental method that when used correctly, can produce internally valid estimates of causal effects of a treatment, a program or an intervention (hereafter referred to as treatment effects). In an RDD study, subjects or groups of subjects…

The use of EEG Biofeedback/Neurofeedback in psychiatric rehabilitation.

PubMed

Markiewcz, Renata

2017-12-30

The aim of the systematic review was to evaluate the use of EEG Biofeedback/Neurofeedback in patients treated for mental disorders. The review covered publications analyzing influences and effects of therapy in patients receiving psychiatric treatment based on EEG Biofeedback/Neurofeedback. Selection of publications was made by searching PubMed and Scopus databases. 328 records concerning applications of the presented method were identified in total, including 84 records for patients diagnosed with mental disorders. The analysis of studies indicates that EEG Biofeedback/Neurofeedback is used for treatment of neurological, somatic and mental disorders. Its psychiatric applications for clinically diagnosed disorders include treatmentof depression, anorexia, dyslexia, dysgraphia, ADD, ADHD, schizophrenia, abuse of substances, neuroses, PTSD, and Alzheimer's disease. Research results imply that the neuromodulating effect of the therapy positively influences cognitive processes, mood, and anxiety levels. Positive effects of EEG Biofeedback confirm usefulness of this method as a main or auxiliary method in treatment of people with mental disorders. On the basis of conducted studies, it is worthwhile to consider inclusion of this method into the comprehensive neurorehabilitation activities.

Physical Methods for Seed Invigoration: Advantages and Challenges in Seed Technology

PubMed Central

Araújo, Susana de Sousa; Paparella, Stefania; Dondi, Daniele; Bentivoglio, Antonio; Carbonera, Daniela; Balestrazzi, Alma

2016-01-01

In the context of seed technology, the use of physical methods for increasing plant production offers advantages over conventional treatments based on chemical substances. The effects of physical invigoration treatments in seeds can be now addressed at multiple levels, ranging from morpho-structural aspects to changes in gene expression and protein or metabolite accumulation. Among the physical methods available, “magneto-priming” and irradiation with microwaves (MWs) or ionizing radiations (IRs) are the most promising pre-sowing seed treatments. “Magneto-priming” is based on the application of magnetic fields and described as an eco-friendly, cheap, non-invasive technique with proved beneficial effects on seed germination, vigor and crop yield. IRs, as γ-rays and X-rays, have been widely regarded as a powerful tool in agricultural sciences and food technology. Gamma-rays delivered at low dose have showed to enhance germination percentage and seedling establishment, acting as an actual ‘priming’ treatment. Different biological effects have been observed in seeds subjected to MWs and X-rays but knowledge about their impact as seed invigoration agent or stimulatory effects on germination need to be further extended. Ultraviolet (UV) radiations, namely UV-A and UV-C have shown to stimulate positive impacts on seed health, germination, and seedling vigor. For all mentioned physical treatments, extensive fundamental and applied research is still needed to define the optimal dose, exposition time, genotype- and environment-dependent irradiation conditions. Electron paramagnetic resonance has an enormous potential in seed technology not fully explored to monitor seed invigoration treatments and/or identifying the best suitable irradiation dose or time-point to stop the treatment. The present manuscript describes the use of physical methods for seed invigoration, while providing a critical discussion on the constraints and advantages. The future perspectives related to the use of these approaches to address the need of seed technologists, producers and trade markers will be also highlighted. PMID:27242847

The Effect of Femtosecond Laser Treatment on the Effectiveness of Resin-Zirconia Adhesive: An In Vitro Study

PubMed Central

Vicente Prieto, María; Gomes, Ana Luisa Caseiro; Montero Martín, Javier; Alvarado Lorenzo, Alfonso; Seoane Mato, Vicente; Albaladejo Martínez, Alberto

2016-01-01

Introduction: When aesthetics is compromised, dental ceramics are excellent materials for dental restorations; owing to their optical properties and biocompatibility, zirconia ceramics are particularly interesting. Self-adhesive resin cements are the most suitable for bonding to zirconia ceramics, but traditional adhesive chemistry is ineffective and surface treatments are required to improve the adhesive bonding between resin and zirconia. The aim of this study was to evaluate the effect of femtosecond laser treatment on the shear bond strength (SBS) of self-adhesive resin cement on zirconia surfaces and to contrast it with other different surface conditioning methods. Methods: Sixty square-shaped zirconia samples were divided randomly into four groups (n = 15) according to their surface conditioning method: the NT group - no surface treatment; the APA25 group - airborne abrasion with 25 μm alumina particles; the TSC group - tribochemical silica coating, and the FS group - femtosecond laser irradiation (800 nm, 4 mJ, 40 fs/pulse, 1 kHz). Self-adhesive resin cements were bonded at the centre of samples, and after 72 hours, they were tested for SBS with a universal testing machine at a crosshead speed of 0.5 mm/min, until fracture. Five zirconia surfaces for each group were subjected to a surface morphology analysis by scanning electron microscopy (SEM). The failure modes were noted and a third of the specimens were prepared to morphological analysis. Results: The NT group showed lower SBS values than the other groups. Femtosecond laser treatment demonstrated higher values than the control and APA25 groups and similar values to those of the TSC group. In the APA25 group, the surface conditioning method had values close to those of the TSC group, but lower than those obtained with femtosecond laser treatment. Conclusion: The treatment of zirconia with femtosecond laser irradiation created a consistent and profound surface roughness, improving the adhesive effectiveness of the zirconia-resin interface. PMID:28491255

Choosing Models for Health Care Cost Analyses: Issues of Nonlinearity and Endogeneity

PubMed Central

Garrido, Melissa M; Deb, Partha; Burgess, James F; Penrod, Joan D

2012-01-01

Objective To compare methods of analyzing endogenous treatment effect models for nonlinear outcomes and illustrate the impact of model specification on estimates of treatment effects such as health care costs. Data Sources Secondary data on cost and utilization for inpatients hospitalized in five Veterans Affairs acute care facilities in 2005–2006. Study Design We compare results from analyses with full information maximum simulated likelihood (FIMSL); control function (CF) approaches employing different types and functional forms for the residuals, including the special case of two-stage residual inclusion; and two-stage least squares (2SLS). As an example, we examine the effect of an inpatient palliative care (PC) consultation on direct costs of care per day. Data Collection/Extraction Methods We analyzed data for 3,389 inpatients with one or more life-limiting diseases. Principal Findings The distribution of average treatment effects on the treated and local average treatment effects of a PC consultation depended on model specification. CF and FIMSL estimates were more similar to each other than to 2SLS estimates. CF estimates were sensitive to choice and functional form of residual. Conclusions When modeling cost or other nonlinear data with endogeneity, one should be aware of the impact of model specification and treatment effect choice on results. PMID:22524165

Causal mediation analysis with multiple mediators in the presence of treatment noncompliance.

PubMed

Park, Soojin; Kürüm, Esra

2018-05-20

Randomized experiments are often complicated because of treatment noncompliance. This challenge prevents researchers from identifying the mediated portion of the intention-to-treated (ITT) effect, which is the effect of the assigned treatment that is attributed to a mediator. One solution suggests identifying the mediated ITT effect on the basis of the average causal mediation effect among compliers when there is a single mediator. However, considering the complex nature of the mediating mechanisms, it is natural to assume that there are multiple variables that mediate through the causal path. Motivated by an empirical analysis of a data set collected in a randomized interventional study, we develop a method to estimate the mediated portion of the ITT effect when both multiple dependent mediators and treatment noncompliance exist. This enables researchers to make an informed decision on how to strengthen the intervention effect by identifying relevant mediators despite treatment noncompliance. We propose a nonparametric estimation procedure and provide a sensitivity analysis for key assumptions. We conduct a Monte Carlo simulation study to assess the finite sample performance of the proposed approach. The proposed method is illustrated by an empirical analysis of JOBS II data, in which a job training intervention was used to prevent mental health deterioration among unemployed individuals. Copyright © 2018 John Wiley & Sons, Ltd.

Effect of the chlortetracycline addition method on methane production from the anaerobic digestion of swine wastewater.

PubMed

Huang, Lu; Wen, Xin; Wang, Yan; Zou, Yongde; Ma, Baohua; Liao, Xindi; Liang, Juanboo; Wu, Yinbao

2014-10-01

Effects of antibiotic residues on methane production in anaerobic digestion are commonly studied using the following two antibiotic addition methods: (1) adding manure from animals that consume a diet containing antibiotics, and (2) adding antibiotic-free animal manure spiked with antibiotics. This study used chlortetracycline (CTC) as a model antibiotic to examine the effects of the antibiotic addition method on methane production in anaerobic digestion under two different swine wastewater concentrations (0.55 and 0.22mg CTC/g dry manure). The results showed that CTC degradation rate in which manure was directly added at 0.55mg CTC/g (HSPIKE treatment) was lower than the control values and the rest of the treatment groups. Methane production from the HSPIKE treatment was reduced (p<0.05) by 12% during the whole experimental period and 15% during the first 7days. The treatments had no significant effect on the pH and chemical oxygen demand value of the digesters, and the total nitrogen of the 0.55mg CTC/kg manure collected from mediated swine was significantly higher than the other values. Therefore, different methane production under different antibiotic addition methods might be explained by the microbial activity and the concentrations of antibiotic intermediate products and metabolites. Because the primary entry route of veterinary antibiotics into an anaerobic digester is by contaminated animal manure, the most appropriate method for studying antibiotic residue effects on methane production may be using manure from animals that are given a particular antibiotic, rather than adding the antibiotic directly to the anaerobic digester. Copyright © 2014. Published by Elsevier B.V.

Effect of electrical energy on the efficacy of biofilm treatment using the bioelectric effect

PubMed Central

Kim, Young Wook; Subramanian, Sowmya; Gerasopoulos, Konstantinos; Ben-Yoav, Hadar; Wu, Hsuan-Chen; Quan, David; Carter, Karen; Meyer, Mariana T; Bentley, William E; Ghodssi, Reza

2015-01-01

Background/Objectives: The use of electric fields in combination with small doses of antibiotics for enhanced treatment of biofilms is termed the ‘bioelectric effect’ (BE). Different mechanisms of action for the AC and DC fields have been reported in the literature over the last two decades. In this work, we conduct the first study on the correlation between the electrical energy and the treatment efficacy of the bioelectric effect on Escherichia coli K-12 W3110 biofilms. Methods: A thorough study was performed through the application of alternating (AC), direct (DC) and superimposed (SP) potentials of different amplitudes on mature E. coli biofilms. The electric fields were applied in combination with the antibiotic gentamicin (10 μg/ml) over a course of 24 h, after the biofilms had matured for 24 h. The biofilms were analysed using the crystal violet assay, the colony-forming unit method and fluorescence microscopy. Results: Results show that there is no statistical difference in treatment efficacy between the DC-, AC- and SP-based BE treatment of equivalent energies (analysis of variance (ANOVA) P>0.05) for voltages <1 V. We also demonstrate that the efficacy of the BE treatment as measured by the crystal violet staining method and colony-forming unit assay is proportional to the electrical energy applied (ANOVA P<0.05). We further verify that the treatment efficacy varies linearly with the energy of the BE treatment (r2 =0.984). Our results thus suggest that the energy of the electrical signal is the primary factor in determining the efficacy of the BE treatment, at potentials less than the media electrolysis voltage. Conclusions: Our results demonstrate that the energy of the electrical signal, and not the type of electrical signal (AC or DC or SP), is the key to determine the efficacy of the BE treatment. We anticipate that this observation will pave the way for further understanding of the mechanism of action of the BE treatment method and may open new doors to the use of electric fields in the treatment of bacterial biofilms. PMID:28721233

A Review of Behavioral Conceptualizations and Treatments of Child Noncompliance.

ERIC Educational Resources Information Center

Houlihan, Daniel; And Others

1992-01-01

This review of behavioral conceptualizations and approaches to the treatment of child noncompliance includes discussion of behavioral definitions, methods of assessment, types of behavioral interventions, generalization of treatment effects, future research directions, and potential ethical concerns. (Author/JDD)

Fractional non-ablative laser treatment at 1410 nm wavelength for periorbital wrinkles - reviscometrical and clinical evaluation.

PubMed

Augustyniak, Anna; Rotsztejn, Helena

2016-10-01

The aim of the research was to establish the influence of 1410-nm fractional non-ablative laser treatment on skin aging in the eye area. The reviscometer reference test is an objective method of estimating the flexibility of the skin. The photographic records were used as the auxiliary method of the therapy quality effectiveness. The study involved the group of 13 people (12 females and 1 male, aged 33-47 with prototype II and III according to the Fitzpatrick scale), who underwent two sessions of fractional non-ablative laser therapy (wavelength of 1410 nm) with a 2-week interval. In order to evaluate the effectiveness of the quality of the treatment a reviscometer probe was used to measure the skin elasticity (Reviscometer RVM 600). The measurements were taken twice: directly before and two weeks after the treatment. Furthermore, to facilitate the clinical evaluation an anonymous photographical documentation was prepared. An improvement of the skin flexibility in the eye area was observed and the fact was confirmed by values obtained using the reviscometer probe (significant statistic differences: P < 0.0001) as well as clinical assessment based on photographical records. On the basis of the reviscometer measurements analysis and photographical records, 1410-nm fractional non-ablative laser treatment appears to be an efficient method contributing to the improvement of the skin flexibility of the eyes area as well as to the reduction of the number of wrinkles. The post-treatment observation proves that the method is well-tolerated in the sensitive eyes area and does not cause any significant side effects.

How large must a treatment effect be before it matters to practitioners? An estimation method and demonstration.

PubMed

Miller, William R; Manuel, Jennifer Knapp

2008-09-01

Treatment research is sometimes criticised as lacking in clinical relevance, and one potential source of this friction is a disconnection between statistical significance and what clinicians regard to be a meaningful difference in outcomes. This report demonstrates a novel methodology for estimating what substance abuse practitioners regard to be clinically important differences. To illustrate the estimation method, we surveyed 50 substance abuse treatment providers participating in the National Institute on Drug Abuse (NIDA) Clinical Trials Network. Practitioners identified thresholds for clinically meaningful differences on nine common outcome variables, indicated the size of effect that would justify their learning a new treatment method and estimated current outcomes from their services. Clinicians judged a difference between two treatments to be meaningful if outcomes were improved by about 10 - 12 points on the percentage of patients totally abstaining, arrested for driving while intoxicated, employed or having abnormal liver enzymes. A 5 percentage-point reduction in patient mortality was regarded as clinically significant. On continuous outcome measures (such as percentage of days abstinent or drinks per drinking day), practitioners judged an outcome to be significant when it doubled or halved the base rate. When a new treatment meets such criteria, practitioners were interested in learning it. Effects that are statistically significant in clinical trials may be unimpressive to practitioners. Clinicians' judgements of meaningful differences can inform the powering of clinical trials.

Covariate selection with group lasso and doubly robust estimation of causal effects

PubMed Central

Koch, Brandon; Vock, David M.; Wolfson, Julian

2017-01-01

Summary The efficiency of doubly robust estimators of the average causal effect (ACE) of a treatment can be improved by including in the treatment and outcome models only those covariates which are related to both treatment and outcome (i.e., confounders) or related only to the outcome. However, it is often challenging to identify such covariates among the large number that may be measured in a given study. In this paper, we propose GLiDeR (Group Lasso and Doubly Robust Estimation), a novel variable selection technique for identifying confounders and predictors of outcome using an adaptive group lasso approach that simultaneously performs coefficient selection, regularization, and estimation across the treatment and outcome models. The selected variables and corresponding coefficient estimates are used in a standard doubly robust ACE estimator. We provide asymptotic results showing that, for a broad class of data generating mechanisms, GLiDeR yields a consistent estimator of the ACE when either the outcome or treatment model is correctly specified. A comprehensive simulation study shows that GLiDeR is more efficient than doubly robust methods using standard variable selection techniques and has substantial computational advantages over a recently proposed doubly robust Bayesian model averaging method. We illustrate our method by estimating the causal treatment effect of bilateral versus single-lung transplant on forced expiratory volume in one year after transplant using an observational registry. PMID:28636276

Covariate selection with group lasso and doubly robust estimation of causal effects.

PubMed

Koch, Brandon; Vock, David M; Wolfson, Julian

2018-03-01

The efficiency of doubly robust estimators of the average causal effect (ACE) of a treatment can be improved by including in the treatment and outcome models only those covariates which are related to both treatment and outcome (i.e., confounders) or related only to the outcome. However, it is often challenging to identify such covariates among the large number that may be measured in a given study. In this article, we propose GLiDeR (Group Lasso and Doubly Robust Estimation), a novel variable selection technique for identifying confounders and predictors of outcome using an adaptive group lasso approach that simultaneously performs coefficient selection, regularization, and estimation across the treatment and outcome models. The selected variables and corresponding coefficient estimates are used in a standard doubly robust ACE estimator. We provide asymptotic results showing that, for a broad class of data generating mechanisms, GLiDeR yields a consistent estimator of the ACE when either the outcome or treatment model is correctly specified. A comprehensive simulation study shows that GLiDeR is more efficient than doubly robust methods using standard variable selection techniques and has substantial computational advantages over a recently proposed doubly robust Bayesian model averaging method. We illustrate our method by estimating the causal treatment effect of bilateral versus single-lung transplant on forced expiratory volume in one year after transplant using an observational registry. © 2017, The International Biometric Society.

Treatment for Acquired Apraxia of Speech: Examination of Treatment Intensity and Practice Schedule

ERIC Educational Resources Information Center

Wambaugh, Julie L.; Nessler, Christina; Cameron, Rosalea; Mauszycki, Shannon C.

2013-01-01

Purpose: The authors designed this investigation to extend the development of a treatment for acquired apraxia of speech (AOS)--sound production treatment (SPT)--by examining the effects of 2 treatment intensities and 2 schedules of practice. Method: The authors used a multiple baseline design across participants and behaviors with 4 speakers with…

Effect of different oxytetracycline addition methods on its degradation behavior in soil.

PubMed

Chen, Gui-Xiu; He, Wei-Wei; Wang, Yan; Zou, Yong-De; Liang, Juan-Boo; Liao, Xin-Di; Wu, Yin-Bao

2014-05-01

The degradation behavior of veterinary antibiotics in soil is commonly studied using the following methods of adding antibiotics to the soil: (i) adding manure collected from animals fed with a diet containing antibiotics, (ii) adding antibiotic-free animal manure spiked with antibiotics and (iii) directly adding antibiotics. No research simultaneously comparing different antibiotic addition methods was found. Oxytetracycline (OTC) was used as a model antibiotic to compare the effect of the three commonly used antibiotic addition methods on OTC degradation behavior in soil. The three treatment methods have similar trends, though OTC degradation half-lives show the following significant differences (P<0.05): manure from swine fed OTC (treatment A)

Cognitive rehabilitation therapies for Alzheimer's disease: A review of methods to improve treatment engagement and self-efficacy

PubMed Central

Choi, Jimmy; Twamley, Elizabeth W.

2013-01-01

Cognitive rehabilitation therapies for Alzheimer’s disease (AD) are becoming more readily available to the geriatric population in an attempt to curb the insidious decline in cognitive and functional performance. However, people with AD may have difficulty adhering to these cognitive treatments due to denial of memory deficits, compromised brain systems, cognitive incapacity for self-awareness, general difficulty following through on daily tasks, lack of motivation, hopelessness, and apathy, all of which may be either due to the illness or be secondary to depression. Cognitive rehabilitation training exercises are also labor intensive and, unfortunately, serve as a repeated reminder about the memory impairments and attendant functional consequences. In order for cognitive rehabilitation methods to be effective, patients must be adequately engaged and motivated to not only begin a rehabilitation program but also to remain involved in the intervention until a therapeutic dosage can be attained. We review approaches to cognitive rehabilitation in AD, neuropsychological as well as psychological obstacles to effective treatment in this population, and methods that target adherence to treatment and may therefore be applicable to cognitive rehabilitation therapies for AD. The goal is to stimulate discussion among researchers and clinicians alike on how treatment effects may be mediated by engagement in treatment, and what can be done to enhance patient adherence for cognitive rehabilitation therapies in order to obtain greater cognitive and functional benefits from the treatment itself. PMID:23400790

Patent Ductus Arteriosus in the Preterm Infant: Diagnostic and Treatment Options.

PubMed

Prescott, Stephanie; Keim-Malpass, Jessica

2017-02-01

The incidence of hemodynamically significant patent ductus arteriosus (hsPDA) increases with decreasing gestational age and is associated with many common morbidities of extreme prematurity. Controversies remain surrounding the definition of hsPDA, the population of infants requiring treatment, the appropriate timing and method of treatment, and the outcomes associated with PDA and its therapies. This integrative literature review focuses on diagnostic and treatment recommendations derived from the highest levels of evidence. PubMed and CINAHL were searched using key words "neonatal" and "patent ductus arteriosus" to discover the highest levels of evidence surrounding diagnosis, treatment methods, and outcomes. The lack of consensus surrounding the diagnosis and clinical significance of PDA hinders meta-analysis across studies and confounds understanding of appropriate management strategies. Novel biomarkers, pharmaceutical choices, and transcatheter closure methods are expanding diagnostic and treatment options. Infants weighing less than 1000 g are at highest risk. Prophylactic closure is no longer recommended, although early asymptomatic therapy is still preferred by some to avoid prolonged pulmonary overcirculation or decreased renal and gut perfusion. Conservative treatment measures such as fluid restriction and diuretic administration have not consistently proven effective and are in some instances detrimental. Cyclooxygenase inhibitors are effective but have adverse renal and mesenteric effects. Oral ibuprofen is associated with lower instance of necrotizing enterocolitis. Well-defined staging criteria would aid in comparison and meta-analysis. Trials that include a control group that receives no therapy may help separate the outcomes associated with prematurity from those associated with PDA.

A generalized least squares regression approach for computing effect sizes in single-case research: application examples.

PubMed

Maggin, Daniel M; Swaminathan, Hariharan; Rogers, Helen J; O'Keeffe, Breda V; Sugai, George; Horner, Robert H

2011-06-01

A new method for deriving effect sizes from single-case designs is proposed. The strategy is applicable to small-sample time-series data with autoregressive errors. The method uses Generalized Least Squares (GLS) to model the autocorrelation of the data and estimate regression parameters to produce an effect size that represents the magnitude of treatment effect from baseline to treatment phases in standard deviation units. In this paper, the method is applied to two published examples using common single case designs (i.e., withdrawal and multiple-baseline). The results from these studies are described, and the method is compared to ten desirable criteria for single-case effect sizes. Based on the results of this application, we conclude with observations about the use of GLS as a support to visual analysis, provide recommendations for future research, and describe implications for practice. Copyright © 2011 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Expected utility versus expected regret theory versions of decision curve analysis do generate different results when treatment effects are taken into account

PubMed Central

Hozo, Iztok; Tsalatsanis, Athanasios

2016-01-01

Abstract Rationale, aims, and objectives Decision curve analysis (DCA) is a widely used method for evaluating diagnostic tests and predictive models. It was developed based on expected utility theory (EUT) and has been reformulated using expected regret theory (ERG). Under certain circumstances, these 2 formulations yield different results. Here we describe these situations and explain the variation. Methods We compare the derivations of the EUT‐ and ERG‐based formulations of DCA for a typical medical decision problem: “treat none,” “treat all,” or “use model” to guide treatment. We illustrate the differences between the 2 formulations when applied to the following clinical question: at which probability of death we should refer a terminally ill patient to hospice? Results Both DCA formulations yielded identical but mirrored results when treatment effects are ignored; they generated significantly different results otherwise. Treatment effect has a significant effect on the results derived by EUT DCA and less so on ERG DCA. The elicitation of specific values for disutilities affected the results even more significantly in the context of EUT DCA, whereas no such elicitation was required within the ERG framework. Conclusion EUT and ERG DCA generate different results when treatment effects are taken into account. The magnitude of the difference depends on the effect of treatment and the disutilities associated with disease and treatment effects. This is important to realize as the current practice guidelines are uniformly based on EUT; the same recommendations can significantly differ if they are derived based on ERG framework. PMID:27981695

Combination of photodynamic and ultrasonic therapy for treatment of infected wounds in animal model

NASA Astrophysics Data System (ADS)

Menyaev, Yulian A.; Zharov, Vladimir P.

2006-02-01

One of the important problems of modern medicine is treatment of infected wounds. There are many diversified expedients of treatment, but none of them obey the modern physician completely. The aim of this study is to develop and test a new combined method of photodynamic ultrasonic therapy (PDUST) for treatment of infected wounds with focus on experimental trials. PDUST is based on a combination of two methods: photodynamic (PD) therapy (PDT) with photosensitizer and low frequency ultrasonic (US) therapy with antibiotic as tools for treatment of wounds and effectively killing bacteria. The main parameters are: US frequency - 26.5 kHz; US tip elongation - 40+/-20 μm wavelength of light emitting diodes (LED) array - 660+/-10 nm; light intensity on biotissue surface - 1-2 mW/cm2; photosensitizer - an aluminum disulfonated phtalocyanine dissolved in a physiological solution in concentration 10 mg/l. The experiments were carried out with 70 male chinchilla rabbits divided into 7 groups, thus the dynamics of wounds healing were studied in different modes of PDUST. The PD and US methods supplement each other and in conjunction provide additive and especially synergetic effects. The experimental data demonstrated advantages of new technology in comparison with conventional methods in cases of treatment of extended suppurative inflammatory and profound wounds. The more detailed study of PDUST method's mechanism, which is based on low intensity of LED light, PD therapy and US influence is required.

Selective protection of poly(tetra-fluoroethylene) from effects of chemical etching

DOEpatents

Martinez, Robert J.; Rye, Robert R.

1991-01-01

A photolithographic method for treating an article formed of polymeric material comprises subjecting portions of a surface of the polymeric article to ionizing radiation; and then subjecting the surface to chemical etching. The ionizing radiation treatment according to the present invention minimizes the effect of the subseuent chemical etching treatment. Thus, selective protection from the effects of chemical etching can be easily provided. The present invention has particular applicability to articles formed of fluorocarbons, such as PTFE. The ionizing radiation employed in the method may comprise Mg(k.alpha.) X-rays or lower-energy electrons.

Why Measure Outcomes?

PubMed

Kuhn, John E

2016-01-01

The concept of measuring the outcomes of treatment in health care was promoted by Ernest Amory Codman in the early 1900s, but, until recently, his ideas were generally ignored. The forces that have advanced outcome measurement to the forefront of health care include the shift in payers for health care from the patient to large insurance companies or government agencies, the movement toward assessing the care of populations not individuals, and the effort to find value (or cost-effective treatments) amid rising healthcare costs. No ideal method exists to measure outcomes, and the information gathered depends on the reason the outcome information is required. Outcome measures used in research are best able to answer research questions. The methods for assessing physician and hospital performance include process measures, patient-experience measures, structure measures, and measures used to assess the outcomes of treatment. The methods used to assess performance should be validated, be reliable, and reflect a patient's perception of the treatment results. The healthcare industry must measure outcomes to identify which treatments are most effective and provide the most benefit to patients.

[Continuous subcutaneous morphine--treatment of pain in patients with terminal cancer].

PubMed

Nielsen, F B; Clemensen, S E; Olesen, A S; Hole, P

1990-06-11

Nine patients with terminal cancer were treated for pain with continuous subcutaneous injection of morphine via a portable battery-driven injection pump. Treatment was instituted on account of failure of other forms of treatment with oral or epidural morphine derivatives or on account of severe nausea and vomiting which necessitated parenteral administration. Treatment proved reasonably effective and no side effects of significance occurred. Two of the patients could be treated in their homes. The method is thus considered as suitable for treatment of pain in patients with terminal cancer.

[Helium-Oxigen (Heliox) mixture in airway obstruction

PubMed

Ulhôa, C A; Larner, L

2000-01-01

OBJECTIVE: Demonstrate the effectiveness and the good outcome of the patients treated with helium-oxygen (Heliox) mixture. This mixture (Heliox) has been used in patients with airway obstruction, from different ethiologies, who did not respond to a conventional treatment with oxygen. METHODS: Case report of five patients that received Heliox as treatment for airway obstruction. All of them had good results without side effects during the treatment. CONCLUSION: Heliox is a promising treatment for severe airway obstruction with good results in a short period of time, until the final treatment is established.

Evaluation and validation of social and psychological markers in randomised trials of complex interventions in mental health: a methodological research programme.

PubMed

Dunn, Graham; Emsley, Richard; Liu, Hanhua; Landau, Sabine; Green, Jonathan; White, Ian; Pickles, Andrew

2015-11-01

The development of the capability and capacity to evaluate the outcomes of trials of complex interventions is a key priority of the National Institute for Health Research (NIHR) and the Medical Research Council (MRC). The evaluation of complex treatment programmes for mental illness (e.g. cognitive-behavioural therapy for depression or psychosis) not only is a vital component of this research in its own right but also provides a well-established model for the evaluation of complex interventions in other clinical areas. In the context of efficacy and mechanism evaluation (EME) there is a particular need for robust methods for making valid causal inference in explanatory analyses of the mechanisms of treatment-induced change in clinical outcomes in randomised clinical trials. The key objective was to produce statistical methods to enable trial investigators to make valid causal inferences about the mechanisms of treatment-induced change in these clinical outcomes. The primary objective of this report is to disseminate this methodology, aiming specifically at trial practitioners. The three components of the research were (1) the extension of instrumental variable (IV) methods to latent growth curve models and growth mixture models for repeated-measures data; (2) the development of designs and regression methods for parallel trials; and (3) the evaluation of the sensitivity/robustness of findings to the assumptions necessary for model identifiability. We illustrate our methods with applications from psychological and psychosocial intervention trials, keeping the technical details to a minimum, leaving the reporting of the more theoretical and mathematically demanding results for publication in appropriate specialist journals. We show how to estimate treatment effects and introduce methods for EME. We explain the use of IV methods and principal stratification to evaluate the role of putative treatment effect mediators and therapeutic process measures. These results are extended to the analysis of longitudinal data structures. We consider the design of EME trials. We focus on designs to create convincing IVs, bearing in mind assumptions needed to attain model identifiability. A key area of application that has become apparent during this work is the potential role of treatment moderators (predictive markers) in the evaluation of treatment effect mechanisms for personalised therapies (stratified medicine). We consider the role of targeted therapies and multiarm trials and the use of parallel trials to help elucidate the evaluation of mediators working in parallel. In order to demonstrate both efficacy and mechanism, it is necessary to (1) demonstrate a treatment effect on the primary (clinical) outcome, (2) demonstrate a treatment effect on the putative mediator (mechanism) and (3) demonstrate a causal effect from the mediator to the outcome. Appropriate regression models should be applied for (3) or alternative IV procedures, which account for unmeasured confounding, provided that a valid instrument can be identified. Stratified medicine may provide a setting where such instruments can be designed into the trial. This work could be extended by considering improved trial designs, sample size considerations and measurement properties. The project presents independent research funded under the MRC-NIHR Methodology Research Programme (grant reference G0900678).

Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations

PubMed Central

Sommers, Juultje; Engelbert, Raoul HH; Dettling-Ihnenfeldt, Daniela; Gosselink, Rik; Spronk, Peter E; Nollet, Frans; van der Schaaf, Marike

2015-01-01

Objective: To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units. Methods: We used the EBRO method, as recommended by the ‘Dutch Evidence Based Guideline Development Platform’ to develop an ‘evidence statement for physiotherapy in the intensive care unit’. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts. Results: Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment. Conclusions: These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014. PMID:25681407

[Differences in effectiveness of intensive programs of treatment for neurotic and personality disorders. Is it worth to monitor the effectiveness of the therapeutic team?].

PubMed

Styła, Rafał

2014-01-01

To test whether three different intensive programs of treatment for neurotic and personality disorders are effective in decreasing neurotic symptoms and traits of neurotic personality and whether there are differences between them in clinical outcome. The sample consisted of 105 patients (83% female, mean age 35) diagnosed with neurosis and personality disorders that were treated in three therapeutic wards under routine inpatient conditions. The therapeutic programs are designed for patients with neurotic and personality disorders. They consist of 6-12 weeks of approximately 5 hours of eclectic group treatment (group psychotherapy, psychodrama, psychoeducation etc.). Participants filled in Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The treatment proved to be effective in diminishing neurotic symptoms (d Cohen = 0.56). More detailed analysis revealed that there was a significant interaction between the three analysed therapeutic wards and the effectiveness (12 = 0.09). The treatments offered in two institutions were effective (d Cohen = 0.80) while one of the programs did not lead to significant improvement of the patients. None of the therapeutic wards proved to be effective in changing the neurotic personality traits. There are significant differences in effectiveness of the intensive programs of treatment for neurotic and personality disorders. In the light of the literature, one can assume that the differences are more connected with the characteristics of therapeutic teams than with the methods used. The need for standard methods of effectiveness monitoring is discussed.

Subpopulation Treatment Effect Pattern Plot (STEPP) analysis for continuous, binary, and count outcomes.

PubMed

Yip, Wai-Ki; Bonetti, Marco; Cole, Bernard F; Barcella, William; Wang, Xin Victoria; Lazar, Ann; Gelber, Richard D

2016-08-01

For the past few decades, randomized clinical trials have provided evidence for effective treatments by comparing several competing therapies. Their successes have led to numerous new therapies to combat many diseases. However, since their conclusions are based on the entire cohort in the trial, the treatment recommendation is for everyone, and may not be the best option for an individual. Medical research is now focusing more on providing personalized care for patients, which requires investigating how patient characteristics, including novel biomarkers, modify the effect of current treatment modalities. This is known as heterogeneity of treatment effects. A better understanding of the interaction between treatment and patient-specific prognostic factors will enable practitioners to expand the availability of tailored therapies, with the ultimate goal of improving patient outcomes. The Subpopulation Treatment Effect Pattern Plot (STEPP) approach was developed to allow researchers to investigate the heterogeneity of treatment effects on survival outcomes across values of a (continuously measured) covariate, such as a biomarker measurement. Here, we extend the Subpopulation Treatment Effect Pattern Plot approach to continuous, binary, and count outcomes, which can be easily modeled using generalized linear models. With this extension of Subpopulation Treatment Effect Pattern Plot, these additional types of treatment effects within subpopulations defined with respect to a covariate of interest can be estimated, and the statistical significance of any observed heterogeneity of treatment effect can be assessed using permutation tests. The desirable feature that commonly used models are applied to well-defined patient subgroups to estimate treatment effects is retained in this extension. We describe a simulation study to confirm that the proper Type I error rate is maintained when there is no treatment heterogeneity, and a power study to show that the statistics have power to detect treatment heterogeneity under alternative scenarios. As an illustration, we apply the methods to data from the Aspirin/Folate Polyp Prevention Study, a clinical trial evaluating the effect of oral aspirin, folic acid, or both as a chemoprevention agent against colorectal adenomas. The pre-existing R software package stepp has been extended to handle continuous, binary, and count data using Gaussian, Bernoulli, and Poisson models, and it is available on the Comprehensive R Archive Network. The extension of the method and the availability of new software now permit STEPP to be applied to the full range of clinical trial end points. © The Author(s) 2016.

Operative and nonoperative treatment of clavicle fractures in adults

PubMed Central

2012-01-01

Background and purpose Traditionally, clavicle fractures have been treated nonoperatively. However, many recent studies have concentrated on the results of operative treatment. We assessed and compared the outcomes of operative and nonoperative treatment for acute clavicle fractures in adults. Methods We performed a systematic search of the medical literature from 1966 until the end of March 2011. We included randomized controlled trials and controlled clinical trials comparing operative and nonoperative treatment and studies comparing different operative and nonoperative treatments. We required that there should be at least 30 adult patients and a follow-up of at least 6 months in each individual trial. We used the GRADE method to assess the quality of evidence. Results 6 randomized controlled trials (n = 631) and 7 controlled clinical trials (n = 559) were included. There was moderate-quality evidence (i.e. of grade B) (1) that surgery has considerable effectiveness on better function and less disability at short follow-up, (2) of similar risk of relatively mild complications after operative or nonoperative treatment, (3) that delayed union and nonunion were more common in patients who were treated nonoperatively than in those treated operatively, and (4) that the osteosynthesis method had no effect on the incidence of delayed union or nonunion. Only 1 controlled clinical trial was found on lateral clavicle fractures with very limited (grade D) evidence. Interpretation Patients treated operatively have slightly better function and less disability than those treated nonoperatively at short follow-up, but then the effectiveness diminishes and is weak at 6 months. The different operative techniques may not differ in effectiveness or in adverse effects, but the evidence is very limited or conflicting. Surgery could be considered for active patients who require recovery to the previous level of activity in the shortest possible time. PMID:22248169

Effectiveness of Intensive, Group Therapy for Teenagers Who Stutter

ERIC Educational Resources Information Center

Fry, Jane; Millard, Sharon; Botterill, Willie

2014-01-01

Background: Treatment of adolescents who stutter is an under-researched area that would benefit from greater attention. Aims: To investigate whether an intensive treatment programme for older teenagers who stutter, aged over 16 years of age, is effective in reducing overt and covert aspects of stuttering. Methods & Procedures: A…

Causal Mediation Analysis: Warning! Assumptions Ahead

ERIC Educational Resources Information Center

Keele, Luke

2015-01-01

In policy evaluations, interest may focus on why a particular treatment works. One tool for understanding why treatments work is causal mediation analysis. In this essay, I focus on the assumptions needed to estimate mediation effects. I show that there is no "gold standard" method for the identification of causal mediation effects. In…

The Effects of Group Work with Institutionalized Elderly Persons

ERIC Educational Resources Information Center

Duyan, Veli; Sahin-Kara, Gülay; Camur Duyan, Gülsüm; Özdemir, Burcu; Megahead, Hamido A.

2017-01-01

Objectives: This research article aims to measure the effects of group therapy on institutionalized elderly in terms of reducing depression and improving psychosocial functioning. Methods: Thirty elderly nursing home residents were recruited, and 16 of them elected to receive group treatment for depression and 14 declined treatment. The…

[Application and comparison of NDT-Bobath and Vojta methods in treatment of selected pathologies of the nervous system in children].

PubMed

Jóźwiak, Sergiusz; Podogrodzki, Jacek

2010-01-01

The paper compares effectiveness of NDT-Bobath and Vojta methods in the treatment of selected dysfunctions of the nervous system in children. It evaluates applicability of both methods in prenatal and perinatal injury of the central nervous system, myelomeningocele, Down syndrome and spasticity. The existing literature is supplemented by own clinical experience of the authors. The paper forms the opinion on the constant debates on the superiority of one method over another.

Support Systems for Treatment Integrity

ERIC Educational Resources Information Center

Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

2016-01-01

Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately operationalized treatment integrity procedures…

Radiofrequency Thermotherapy for Treating Axillary Hyperhidrosis.

PubMed

Schick, Christoph H; Grallath, Tanja; Schick, Kerstin S; Hashmonai, Moshe

2016-05-01

Thermotherapy has been established between conservative and surgical options as a minimally invasive method for the treatment of axillary hyperhidrosis. The objective of this study was to present radiofrequency thermotherapy (RFTT) as a safe and effective new treatment method. Thirty adult patients with pronounced axillary hyperhidrosis were treated with RFTT with noninsulated microneedles 3 times at intervals of 6 weeks. Subjective improvement was rated using the Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI). Satisfaction and estimated reduction of sweating were monitored. Objective measurements were made using gravimetry. Adverse effects were recorded in follow-up. At the 6-month follow-up, improvement in sweating was seen in 27 patients. The HDSS dropped from 3.4 to 2.1, the DLQI improved significantly from 16 to 7. The gravimetric measurements of sweat were reduced from 221 to 33 mg/min. The average reduction of sweating was reported to be 72%. Adverse effects were generally mild and improved rapidly. Radiofrequency thermotherapy was shown to be an effective and minimally invasive treatment option for axillary hyperhidrosis. Patients described their sweating as normal. The method clearly has the potential to normalize axillary sweating.

Sensitivity Analyses of the Change in FVC in a Phase 3 Trial of Pirfenidone for Idiopathic Pulmonary Fibrosis

PubMed Central

Bradford, Williamson Z.; Fagan, Elizabeth A.; Glaspole, Ian; Glassberg, Marilyn K.; Glasscock, Kenneth F.; King, Talmadge E.; Lancaster, Lisa H.; Nathan, Steven D.; Pereira, Carlos A.; Sahn, Steven A.; Swigris, Jeffrey J.; Noble, Paul W.

2015-01-01

BACKGROUND: FVC outcomes in clinical trials on idiopathic pulmonary fibrosis (IPF) can be substantially influenced by the analytic methodology and the handling of missing data. We conducted a series of sensitivity analyses to assess the robustness of the statistical finding and the stability of the estimate of the magnitude of treatment effect on the primary end point of FVC change in a phase 3 trial evaluating pirfenidone in adults with IPF. METHODS: Source data included all 555 study participants randomized to treatment with pirfenidone or placebo in the Assessment of Pirfenidone to Confirm Efficacy and Safety in Idiopathic Pulmonary Fibrosis (ASCEND) study. Sensitivity analyses were conducted to assess whether alternative statistical tests and methods for handling missing data influenced the observed magnitude of treatment effect on the primary end point of change from baseline to week 52 in FVC. RESULTS: The distribution of FVC change at week 52 was systematically different between the two treatment groups and favored pirfenidone in each analysis. The method used to impute missing data due to death had a marked effect on the magnitude of change in FVC in both treatment groups; however, the magnitude of treatment benefit was generally consistent on a relative basis, with an approximate 50% reduction in FVC decline observed in the pirfenidone group in each analysis. CONCLUSIONS: Our results confirm the robustness of the statistical finding on the primary end point of change in FVC in the ASCEND trial and corroborate the estimated magnitude of the pirfenidone treatment effect in patients with IPF. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01366209; URL: www.clinicaltrials.gov PMID:25856121

[Methods of traditional chinese medicine in the treatment of patients with interstitial cystitis/bladder pain syndrome].

PubMed

Ignashov, A Yu; Deng, B; Kuzmin, I V; Slesarevskaya, M N

2018-03-01

In recent years, there has been an increasing interest in alternative (complementary) treatments of interstitial cystitis/bladder pain syndrome (IC/BPS). This is due both to the high incidence of IC/BPS and to a lack of effectiveness of conventional treatments. One of the directions of alternative therapies is a traditional Chinese medicine using a special diet, various animal and plant-derived medicines, breathing exercises and acupuncture. This review analyzes the accumulated experience in using traditional Chinese medicine in the treatment of patients with IC/BPS. The presented data indicate that these methods appear to be promising, since they are effective in a significant number of patients, lead to an improvement in their quality of life, are non-invasive and well tolerated. However, due to the lack of clinical studies, the efficacy of this treatment modalities needs to be confirmed.

Treatment Study Plan for Nitrate Salt Waste Remediation Revision 1.0

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

Juarez, Catherine L.; Funk, David John; Vigil-Holterman, Luciana R.

2016-03-07

The two stabilization treatment methods that are to be examined for their effectiveness in the treatment of both the unremediated and remediated nitrate salt wastes include (1) the addition of zeolite and (2) cementation. Zeolite addition is proposed based on the results of several studies and analyses that specifically examined the effectiveness of this process for deactivating nitrate salts. Cementation is also being assessed because of its prevalence as an immobilization method used for similar wastes at numerous facilities around the DOE complex, including at Los Alamos. The results of this Treatment Study Plan will be used to provide themore » basis for a Resource Conservation and Recovery Act (RCRA) permit modification request of the LANL Hazardous Waste Facility Permit for approval by the New Mexico Environment Department-Hazardous Waste Bureau (NMED-HWB) of the proposed treatment process and the associated facilities.« less

What is the impact of comorbid depression on adolescent substance abuse treatment?

PubMed

Hersh, Jacqueline; Curry, John F; Kaminer, Yifrah

2014-01-01

Substance use disorders (SUDs) are among the most common psychiatric diagnoses in adolescents. Some research suggests that comorbid depression in adolescents with SUD is associated with increased likelihood of alcohol dependence, poorer social competence, and greater risk for suicide attempts. However, little is known about how depression influences adolescent substance abuse treatment retention and outcomes. This review aimed to summarize the effects of comorbid depression on treatment retention and outcomes across 13 adolescent SUD treatment studies. RESULTS indicated that depression has a mixed relationship with treatment retention and outcomes, exerting a negative, positive, or nonsignificant effect depending on aspects of the study. More research needs to be done, particularly addressing the potential mediators and moderators of the relationship between depression and SUD outcomes. Importantly, recognizing that the studies varied widely in hypotheses and research methods, the field needs to develop more standardized methods to allow for a clearer understanding of the role of comorbid depression.

Treatment of antisocial personality disorder: Development of a practice focused framework.

PubMed

van den Bosch, L M C; Rijckmans, M J N; Decoene, S; Chapman, A L

There is little to no evidence of effective treatment methods for patients with an antisocial personality disorder (ASPD). One of the reasons could be the fact that they are often excluded from mental healthcare and thus from studies. A treatment framework based on 'state of the art' methods and best practices, offering guidelines on the treatment of ASP and possibilities for more systematical research, is urgently needed. This research involved a literature search and an international Delphi-study (N = 61 experts in research, management and clinical practice focused on ASPD). The results suggested important preconditions with regard to organization of care, healthcare workers and therapy. Conclusions are that there are many ways to coordinate effective treatment and management and work toward the increased availability of evidence based care for persons with ASPD. Copyright © 2018 Elsevier Ltd. All rights reserved.

Blanching, salting and sun drying of different pumpkin fruit slices.

PubMed

Workneh, T S; Zinash, A; Woldetsadik, K

2014-11-01

The study was aimed at assessing the quality of pumpkin (Cucuribita Spp.) slices that were subjected to pre-drying treatments and drying using two drying methods (uncontrolled sun and oven) fruit accessions. Pre-drying had significant (P ≤ 0.05) effect on the quality of dried pumpkin slices. 10 % salt solution dipped pumpkin fruit slices had good chemical quality. The two-way interaction between drying methods and pre-drying treatments had significant (P ≤ 0.05) effect on chemical qualities. Pumpkin subjected to salt solution dipping treatment and oven dried had higher chemical concentrations. Among the pumpkin fruit accessions, pumpkin accession 8007 had the superior TSS, total sugar and sugar to acid ratio after drying. Among the three pre-drying treatment, salt solution dipping treatment had significant (P ≤ 0.05) effect and the most efficient pre-drying treatment to retain the quality of dried pumpkin fruits without significant chemical quality deterioration. Salt dipping treatment combined with low temperature (60 °C) oven air circulation drying is recommended to maintain quality of dried pumpkin slices. However, since direct sun drying needs extended drying time due to fluctuation in temperature, it is recommended to develop or select best successful solar dryer for use in combination with pre-drying salt dipping or blanching treatments.

SPlinted Ligation Adapter Tagging (SPLAT), a novel library preparation method for whole genome bisulphite sequencing

PubMed Central

Manlig, Erika; Wahlberg, Per

2017-01-01

Abstract Sodium bisulphite treatment of DNA combined with next generation sequencing (NGS) is a powerful combination for the interrogation of genome-wide DNA methylation profiles. Library preparation for whole genome bisulphite sequencing (WGBS) is challenging due to side effects of the bisulphite treatment, which leads to extensive DNA damage. Recently, a new generation of methods for bisulphite sequencing library preparation have been devised. They are based on initial bisulphite treatment of the DNA, followed by adaptor tagging of single stranded DNA fragments, and enable WGBS using low quantities of input DNA. In this study, we present a novel approach for quick and cost effective WGBS library preparation that is based on splinted adaptor tagging (SPLAT) of bisulphite-converted single-stranded DNA. Moreover, we validate SPLAT against three commercially available WGBS library preparation techniques, two of which are based on bisulphite treatment prior to adaptor tagging and one is a conventional WGBS method. PMID:27899585

Glaucoma –state of the art and perspectives on treatment

PubMed Central

Wójcik-Gryciuk, Anna; Skup, Małgorzata; Waleszczyk, Wioletta J.

2015-01-01

Glaucoma is a chronic optic neuropathy characterized by progressive damage to the optic nerve, death of retinal ganglion cells and ultimately visual field loss. It is one of the leading causes of irreversible loss of vision worldwide. The most important trigger of glaucomatous damage is elevated eye pressure, and the current standard approach in glaucoma therapy is reduction of intraocular pressure (IOP). However, despite the use of effective medications or surgical treatment leading to lowering of IOP, progression of glaucomatous changes and loss of vision among patients with glaucoma is common. Therefore, it is critical to prevent vision loss through additional treatment. To implement such treatment(s), it is imperative to identify pathophysiological changes in glaucoma and develop therapeutic methods taking into account neuroprotection. Currently, there is no method of neuroprotection with long-term proven effectiveness in the treatment of glaucoma. Among the most promising molecules shown to protect the retina and optic nerve are neurotrophic factors. Thus, the current focus is on the development of safe and non-invasive methods for the long-term elevation of the intraocular level of neurotrophins through advanced gene therapy and topical eye treatment and on the search for selective agonists of neurotrophin receptors affording more efficient neuroprotection. PMID:26684267

Nonsurgical management of hypertrophic scars: evidence-based therapies, standard practices, and emerging methods.

PubMed

Atiyeh, Bishara S

2007-01-01

Hypertrophic scars, resulting from alterations in the normal processes of cutaneous wound healing, are characterized by proliferation of dermal tissue with excessive deposition of fibroblast-derived extracellular matrix proteins, especially collagen, over long periods, and by persistent inflammation and fibrosis. Hypertrophic scars are among the most common and frustrating problems after injury. As current aesthetic surgical techniques become more standardized and results more predictable, a fine scar may be the demarcating line between acceptable and unacceptable aesthetic results. However, hypertrophic scars remain notoriously difficult to eradicate because of the high recurrence rates and the incidence of side effects associated with available treatment methods. This review explores the various treatment methods for hypertrophic scarring described in the literature including evidence-based therapies, standard practices, and emerging methods, attempting to distinguish those with clearly proven efficiency from anecdotal reports about therapies of doubtful benefits while trying to differentiate between prophylactic measures and actual treatment methods. Unfortunately, the distinction between hypertrophic scar treatments and keloid treatments is not obvious in most reports, making it difficult to assess the efficacy of hypertrophic scar treatment.

A Comparison of Intention and Pantomime Gesture Treatment for Noun Retrieval in People with Aphasia

ERIC Educational Resources Information Center

Ferguson, Neina F.; Evans, Kelli; Raymer, Anastasia M.

2012-01-01

Purpose: The effects of intention gesture treatment (IGT) and pantomime gesture treatment (PGT) on word retrieval were compared in people with aphasia. Method: Four individuals with aphasia and word retrieval impairments subsequent to left-hemisphere stroke participated in a single-participant crossover treatment design. Each participant viewed…

Accounting for perception, placebo and unmasking effects in estimating treatment effects in randomised clinical trials.

PubMed

Jamshidian, Farid; Hubbard, Alan E; Jewell, Nicholas P

2014-06-01

There is a rich literature on the role of placebos in experimental design and evaluation of therapeutic agents or interventions. The importance of masking participants, investigators and evaluators to treatment assignment (treatment or placebo) has long been stressed as a key feature of a successful trial design. Nevertheless, there is considerable variability in the technical definition of the placebo effect and the impact of treatment assignments being unmasked. We suggest a formal concept of a 'perception effect' and define unmasking and placebo effects in the context of randomised trials. We employ modern tools from causal inference to derive semi-parametric estimators of such effects. The methods are illustrated on a motivating example from a recent pain trial where the occurrence of treatment-related side effects acts as a proxy for unmasking. © The Author(s) 2011 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Effects of processing and in vitro proteolytic digestion on soybean and yambean hemagglutinins.

PubMed

Ojimelukwe, P C; Onuoha, C C; Obanu, Z A

1995-06-01

Some conventional processing methods were applied on yambean and soybean seeds and flour samples. They include soaking fermentation, cooking whole seeds in the presence and absence of trona, autoclaving and dry heat treatment of flour samples. Hemagglutinating activity was assayed for after processing treatments. The hemagglutinating proteins from these seeds were classified based on their solubility properties. Effects of the presence of 0.01% concentration of trypsin, pepsin and proteases on agglutination of human red blood cells were also evaluated. Most processing methods, particularly cooking whole seeds for 1-2 h, soaking and fermentation, reduced hemagglutinating activity on cow red blood cells. Size reduction accompanied by heat treatment was effective in eliminating hemagglutination. Both the albumin and globulin fractions of the soybean showed hemagglutinating activity but only the albumin fraction of the yambean had agglutinating properties. Proteolytic action of proteases was more effective in reduction of hemagglutinating activity than that of trypsin and pepsin.

[Insulin pump in type 2 diabetes: B-cell focused treatment].

PubMed

Picková, Klára; Rušavý, Zdeněk

Type 2 diabetes is a disorder characterized by insulin resistance and progressive deterioration of B-cell insulin secretion. B-cell protective strategies for lowering glucolipotoxicity by rapid achievement of normoglycemia using exogenous insulin improve their function and prolong diabetes remission. Insulin pump is an effective treatment method in newly diagnosed diabetes, where even short-term pump therapy is B-cell protective. Combination therapy with insulin pump and antidiabetics targeting the incretin system acts in synergy to protect the B-cell. While the positive effect of insulin pump is apparent even a year after stopping the therapy, the effect of incretins lasts only while on the medication. Short-term insulin treatment, especially delivered by insulin pump, is an effective method of B-cell protection in recent type 2 diabetes.Key words: B-cell function - diabetes mellitus - insulin pump - insulin resistance - type 2 diabetes.

Evaluating the effects of pinyon thinning treatments at a wildland urban interface

Treesearch

J. R. Matchett; Matthew Brooks; Anne Halford; Dale Johnson; Helen Smith

2010-01-01

This study evaluated the short-term effects of thinning methods for pinyon pine woodlands at two sites in the southwestern Great Basin. Both cut/pile/burn and mastication treatments were equally effective at reducing the target fuels which were mature, live pinyon trees. Application costs though differed substantially, with the cut/pile/burn technique being less...

Statistical power in parallel group point exposure studies with time-to-event outcomes: an empirical comparison of the performance of randomized controlled trials and the inverse probability of treatment weighting (IPTW) approach.

PubMed

Austin, Peter C; Schuster, Tibor; Platt, Robert W

2015-10-15

Estimating statistical power is an important component of the design of both randomized controlled trials (RCTs) and observational studies. Methods for estimating statistical power in RCTs have been well described and can be implemented simply. In observational studies, statistical methods must be used to remove the effects of confounding that can occur due to non-random treatment assignment. Inverse probability of treatment weighting (IPTW) using the propensity score is an attractive method for estimating the effects of treatment using observational data. However, sample size and power calculations have not been adequately described for these methods. We used an extensive series of Monte Carlo simulations to compare the statistical power of an IPTW analysis of an observational study with time-to-event outcomes with that of an analysis of a similarly-structured RCT. We examined the impact of four factors on the statistical power function: number of observed events, prevalence of treatment, the marginal hazard ratio, and the strength of the treatment-selection process. We found that, on average, an IPTW analysis had lower statistical power compared to an analysis of a similarly-structured RCT. The difference in statistical power increased as the magnitude of the treatment-selection model increased. The statistical power of an IPTW analysis tended to be lower than the statistical power of a similarly-structured RCT.

Fullerenols as a new therapeutic approach in nanomedicine.

PubMed

Grebowski, Jacek; Kazmierska, Paulina; Krokosz, Anita

2013-01-01

Recently, much attention has been paid to the bioactive properties of water-soluble fullerene derivatives: fullerenols, with emphasis on their pro- and antioxidative properties. Due to their hydrophilic properties and the ability to scavenge free radicals, fullerenols may, in the future, provide a serious alternative to the currently used pharmacological methods in chemotherapy, treatment of neurodegenerative diseases, and radiobiology. Some of the most widely used drugs in chemotherapy are anthracycline antibiotics. Anthracycline therapy, in spite of its effective antitumor activity, induces systemic oxidative stress, which interferes with the effectiveness of the treatment and results in serious side effects. Fullerenols may counteract the harmful effects of anthracyclines by scavenging free radicals and thereby improve the effects of chemotherapy. Additionally, due to the hollow spherical shape, fullerenols may be used as drug carriers. Moreover, because of the existence of the currently ineffective ways for neurodegenerative diseases treatment, alternative compounds, which could prevent the negative effects of oxidative stress in the brain, are still sought. In the search of alternative methods of treatment and diagnosis, today's science is increasingly reaching for tools in the field of nanomedicine, for example, fullerenes and their water-soluble derivatives, which is addressed in the present paper.

Fullerenols as a New Therapeutic Approach in Nanomedicine

PubMed Central

2013-01-01

Recently, much attention has been paid to the bioactive properties of water-soluble fullerene derivatives: fullerenols, with emphasis on their pro- and antioxidative properties. Due to their hydrophilic properties and the ability to scavenge free radicals, fullerenols may, in the future, provide a serious alternative to the currently used pharmacological methods in chemotherapy, treatment of neurodegenerative diseases, and radiobiology. Some of the most widely used drugs in chemotherapy are anthracycline antibiotics. Anthracycline therapy, in spite of its effective antitumor activity, induces systemic oxidative stress, which interferes with the effectiveness of the treatment and results in serious side effects. Fullerenols may counteract the harmful effects of anthracyclines by scavenging free radicals and thereby improve the effects of chemotherapy. Additionally, due to the hollow spherical shape, fullerenols may be used as drug carriers. Moreover, because of the existence of the currently ineffective ways for neurodegenerative diseases treatment, alternative compounds, which could prevent the negative effects of oxidative stress in the brain, are still sought. In the search of alternative methods of treatment and diagnosis, today's science is increasingly reaching for tools in the field of nanomedicine, for example, fullerenes and their water-soluble derivatives, which is addressed in the present paper. PMID:24222914

Pharmacological and Nonpharmacological Methods of Treatment for Fragile

DTIC Science & Technology

2007-02-01

deficit disorders, mental retardation, or autism spectrum disorders. We seek to address the most effective methods of treatment (pharmacological and...ophthalmology and dental so that families can obtain these services from specific professionals with an interest in FX syndrome. School liaison...aberrant behavioral responses to stress. Affected males may suffer learning disabilities, attention deficit disorders, mental retardation, and autism

Power Consideration for Three-Level Growth Models

ERIC Educational Resources Information Center

Li, Wei; Konstantopoulos, Spyros

2016-01-01

The purpose of this study is extend previous methods by Raudenbush and Liu (2001) and Spybrook et al. (2011), and provide methods for power analysis of tests of treatment effects in studies of polynomial change with two levels of nesting (e.g., students and schools) where the treatment is either at the third level (e.g., school intervention) or at…

Rigorous control conditions diminish treatment effects in weight loss randomized controlled trials

PubMed Central

Dawson, John A.; Kaiser, Kathryn A.; Affuso, Olivia; Cutter, Gary R.; Allison, David B.

2015-01-01

Background It has not been established whether control conditions with large weight losses (WLs) diminish expected treatment effects in WL or prevention of weight gain (PWG) randomized controlled trials (RCTs). Subjects/Methods We performed a meta-analysis of 239 WL/PWG RCTs that include a control group and at least one treatment group. A maximum likelihood meta-analysis framework is used in order to model and understand the relationship between treatment effects and control group outcomes. Results Under the informed model, an increase in control group WL of one kilogram corresponds with an expected shrinkage of the treatment effect by 0.309 kg [95% CI (−0.480, −0.138), p = 0.00081]; this result is robust against violations of the model assumptions. Conclusions We find that control conditions with large weight losses diminish expected treatment effects. Our investigation may be helpful to clinicians as they design future WL/PWG studies. PMID:26449419

Comparison of the effectiveness of three different treatment methods for temporomandibular joint disc displacement without reduction.

PubMed

Tatli, U; Benlidayi, M E; Ekren, O; Salimov, F

2017-05-01

The aim of this study was to compare the effectiveness of three treatment methods for unilateral temporomandibular joint (TMJ) disc displacement without reduction (DDwoR). One hundred and twenty patients with unilateral TMJ DDwoR were assigned randomly to one of three treatment groups (40 patients in each): group 1 received arthrocentesis, group 2 received stabilization splint therapy following arthrocentesis, and group 3 received splint therapy only. The groups were compared in terms of pain (visual analogue scale), joint function (maximum mouth opening and laterotrusive movements), disability and psychological status (validated questionnaire), and success rates. These were recorded before treatment and during follow-up after treatment (1, 3, and 6 months). The between-group and within-group differences in the data were analyzed statistically. The baseline characteristics were similar in all groups (P>0.05). Significant improvements were noted in all parameters compared to baseline values in all groups (all P<0.01). Groups 1 and 2 showed comparable outcomes that were superior to those of group 3. Arthrocentesis reduces pain and functional impairment more rapidly and effectively than splint therapy. Simultaneous splint application has no additional effect on the effectiveness of arthrocentesis for the treatment of unilateral DDwoR. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Generalizing Observational Study Results: Applying Propensity Score Methods to Complex Surveys

PubMed Central

DuGoff, Eva H; Schuler, Megan; Stuart, Elizabeth A

2014-01-01

ObjectiveTo provide a tutorial for using propensity score methods with complex survey data. Data SourcesSimulated data and the 2008 Medical Expenditure Panel Survey. Study DesignUsing simulation, we compared the following methods for estimating the treatment effect: a naïve estimate (ignoring both survey weights and propensity scores), survey weighting, propensity score methods (nearest neighbor matching, weighting, and subclassification), and propensity score methods in combination with survey weighting. Methods are compared in terms of bias and 95 percent confidence interval coverage. In Example 2, we used these methods to estimate the effect on health care spending of having a generalist versus a specialist as a usual source of care. Principal FindingsIn general, combining a propensity score method and survey weighting is necessary to achieve unbiased treatment effect estimates that are generalizable to the original survey target population. ConclusionsPropensity score methods are an essential tool for addressing confounding in observational studies. Ignoring survey weights may lead to results that are not generalizable to the survey target population. This paper clarifies the appropriate inferences for different propensity score methods and suggests guidelines for selecting an appropriate propensity score method based on a researcher’s goal. PMID:23855598

Generalizing observational study results: applying propensity score methods to complex surveys.

PubMed

Dugoff, Eva H; Schuler, Megan; Stuart, Elizabeth A

2014-02-01

To provide a tutorial for using propensity score methods with complex survey data. Simulated data and the 2008 Medical Expenditure Panel Survey. Using simulation, we compared the following methods for estimating the treatment effect: a naïve estimate (ignoring both survey weights and propensity scores), survey weighting, propensity score methods (nearest neighbor matching, weighting, and subclassification), and propensity score methods in combination with survey weighting. Methods are compared in terms of bias and 95 percent confidence interval coverage. In Example 2, we used these methods to estimate the effect on health care spending of having a generalist versus a specialist as a usual source of care. In general, combining a propensity score method and survey weighting is necessary to achieve unbiased treatment effect estimates that are generalizable to the original survey target population. Propensity score methods are an essential tool for addressing confounding in observational studies. Ignoring survey weights may lead to results that are not generalizable to the survey target population. This paper clarifies the appropriate inferences for different propensity score methods and suggests guidelines for selecting an appropriate propensity score method based on a researcher's goal. © Health Research and Educational Trust.

Effects of flotation-restricted environmental stimulation technique on stress-related muscle pain: what makes the difference in therapy--attention-placebo or the relaxation response?

PubMed

Bood, Sven A; Sundequist, Ulf; Kjellgren, Anette; Nordstrom, Gun; Norlander, Torsten

2005-01-01

The purpose of the present study was to examine the potential effects of attention-placebo on flotation tank therapy. Flotation-restricted environmental stimulation technique is a method whereby an individual lies in a floating tank and all stimuli are reduced to a minimum. Thirty-two patients were diagnosed as having stress-related muscular pain. In addition, 16 of the participants had received the diagnosis of burnout depression. The patients were treated with flotation-restricted environmental stimulation technique for six weeks. One-half of the patients were also given special attention for 12 weeks (high attention), while the remainder received attention for only six weeks (normal attention). The participants exhibited lowered blood pressure, reduced pain, anxiety, depression, stress and negative affectivity, as well as increased optimism, energy and positive affectivity. The results were largely unaffected by the degree of attention-placebo or diagnosis. It was concluded that flotation therapy is an effective, noninvasive method for treating stress-related pain, and that the method is not more affected by placebo than by other methods currently used in pain treatment. The treatment of both burnout depression and pain related to muscle tension constitutes a major challenge for the patient as well as the care provider, an area in which great gains can be made if the treatment is effective. Flotation therapy may constitute an integral part of such treatment.

Impact of Family Planning and Business Trainings on Private-Sector Health Care Providers in Nigeria.

PubMed

Ugaz, Jorge; Leegwater, Anthony; Chatterji, Minki; Johnson, Doug; Baruwa, Sikiru; Toriola, Modupe; Kinnan, Cynthia

2017-06-01

Private health care providers are an important source of modern contraceptives in Sub-Saharan Africa, yet they face many challenges that might be addressed through targeted training. This study measures the impact of a package of trainings and supportive supervision activities targeted to private health care providers in Lagos State, Nigeria, on outcomes including range of contraceptive methods offered, providers' knowledge and quality of counseling, recordkeeping practices, access to credit and revenue. A total of 965 health care facilities were randomly assigned to treatment and control groups. Facilities in the treatment group-but not those in the control group-were offered a training package that included a contraceptive technology update and interventions to improve counseling and clinical skills and business practices. Multivariate regression analysis of data collected through facility and mystery client surveys was used to estimate effects. The training program had a positive effect on the range of contraceptive methods offered, with facilities in the treatment group providing more methods than facilities in the control group. The training program also had a positive impact on the quality of counseling services, especially on the range of contraceptive methods discussed by providers, their interpersonal skills and overall knowledge. Facilities in the treatment group were more likely than facilities in the control group to have good recordkeeping practices and to have obtained loans. No effect was found on revenue generation. Targeted training programs can be effective tools to improve the provision of family planning services through private providers.

Non-invasive monitoring of cytokine-based regenerative treatment of cartilage by hyperspectral unmixing (Conference Presentation)

NASA Astrophysics Data System (ADS)

Mahbub, Saabah B.; Succer, Peter; Gosnell, Martin E.; Anwaer, Ayad G.; Herbert, Benjamin; Vesey, Graham; Goldys, Ewa M.

2016-03-01

Extracting biochemical information from tissue autofluorescence is a promising approach to non-invasively monitor disease treatments at a cellular level, without using any external biomarkers. Our recently developed unsupervised hyperspectral unmixing by Dependent Component Analysis (DECA) provides robust and detailed metabolic information with proper account of intrinsic cellular heterogeneity. Moreover this method is compatible with established methods of fluorescent biomarker labelling. Recently adipose-derived stem cell (ADSC) - based therapies have been introduced for treating different diseases in animals and humans. ADSC have been shown promise in regenerative treatments for osteoarthritis and other bone and joint disorders. One of the mechanism of their action is their anti-inflammatory effects within osteoarthritic joints which aid the regeneration of cartilage. These therapeutic effects are known to be driven by secretions of different cytokines from the ADSCs. We have been using the hyperspectral unmixing techniques to study in-vitro the effects of ADSC-derived cytokine-rich secretions with the cartilage chip in both human and bovine samples. The study of metabolic effects of different cytokine treatment on different cartilage layers makes it possible to compare the merits of those treatments for repairing cartilage.

Consensus Treatments for Moderate Juvenile Dermatomyositis: Beyond the First Two Months

PubMed Central

Huber, Adam M.; Robinson, Angela B.; Reed, Ann M.; Abramson, Leslie; Bout-Tabaku, Sharon; Carrasco, Ruy; Curran, Megan; Feldman, Brian M.; Gewanter, Harry; Griffin, Thomas; Haines, Kathleen; Sanzari, Joseph M.; Hoeltzel, Mark F.; Isgro, Josephine; Kahn, Philip; Lang, Bianca; Lawler, Patti; Shaham, Bracha; Schmeling, Heinrike; Scuccimarri, Rosie; Shishov, Michael; Stringer, Elizabeth; Wohrley, Julie; Ilowite, Norman T.; Wallace, Carol

2011-01-01

Objectives To use consensus methods and the considerable expertise contained within the Children’s Arthritis and Rheumatology Research Alliance (CARRA) organization, to extend the 3 previously developed treatment plans for moderate juvenile dermatomyositis (JDM) to span the full course of treatment. Methods A consensus meeting was held in Chicago on April 23–24, 2010 involving 30 pediatric rheumatologists and 4 lay participants. Nominal group technique was used to achieve consensus on treatment plans which represented typical management of moderate JDM. A pre-conference survey of CARRA, completed by 151/272 (56%) members, was used to provide additional guidance to discussion. Results Consensus was reached on timing and rate of steroid tapering, duration of steroid therapy, and actions to be taken if patients were unchanged, worsening, experiencing medication side effects or disease complications. Of particular importance, a single, consensus steroid taper was developed. Conclusions We were able to develop consensus treatment plans which describe therapy for moderate JDM throughout the treatment course. These treatment plans can now be used clinically, and data collected prospectively regarding treatment effectiveness and toxicity. This will allow comparison of these treatment plans and facilitate the development of evidence-based treatment recommendations for moderate JDM. PMID:22076847

Moxibustion and other acupuncture point stimulation methods to treat breech presentation: a systematic review of clinical trials

PubMed Central

Li, Xun; Hu, Jun; Wang, Xiaoyi; Zhang, Huirui; Liu, Jianping

2009-01-01

Background Moxibustion, acupuncture and other acupoint stimulations are commonly used for the correction of breech presentation. This systematic review aims to evaluate the efficacy and safety of moxibustion and other acupoint stimulations to treat breech presentation. Methods We included randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on moxibustion, acupuncture or any other acupoint stimulating methods for breech presentation in pregnant women. All searches in PubMed, the Cochrane Library (2008 Issue 2), China National Knowledge Information (CNKI), Chinese Scientific Journal Database (VIP) and WanFang Database ended in July 2008. Two authors extracted and analyzed the data independently. Results Ten RCTs involving 2090 participants and seven CCTs involving 1409 participants were included in the present study. Meta-analysis showed significant differences between moxibustion and no treatment (RR 1.35, 95% CI 1.20 to 1.51; 3 RCTs). Comparison between moxibustion and knee-chest position did not show significant differences (RR 1.30, 95% CI 0.95 to 1.79; 3 RCTs). Moxibustion plus other therapeutic methods showed significant beneficial effects (RR 1.36, 95% CI 1.21 to 1.54; 2 RCTs). Laser stimulation was more effective than assuming the knee-chest position plus pelvis rotating. Moxibustion was more effective than no treatment (RR 1.29, 95% CI 1.17 to 1.42; 2 CCTs) but was not more effective than the knee-chest position treatment (RR 1.22, 95% CI 1.11 to 1.34; 2 CCTs). Laser stimulation at Zhiyin (BL67) was more effective than the knee-chest position treatment (RR 1.30, 95% CI 1.10 to 1.54; 2 CCTs,). Conclusion Moxibustion, acupuncture and laser acupoint stimulation tend to be effective in the correction of breech presentation. PMID:19245719

Experience of treatment of patients with granulomatous lobular mastitis

PubMed Central

Hur, Sung Mo; Cho, Dong Hui; Lee, Se Kyung; Choi, Min-Young; Bae, Soo Youn; Koo, Min Young; Kim, Sangmin; Choe, Jun-Ho; Kim, Jung-Han; Kim, Jee Soo; Nam, Seok-Jin; Yang, Jung-Hyun

2013-01-01

Purpose To present the author's experience with various treatment methods of granulomatous lobular mastitis (GLM) and to determine effective treatment methods of GLM. Methods Fifty patients who were diagnosed with GLM were classified into five groups based on the initial treatment methods they underwent, which included observation (n = 8), antibiotics (n = 3), steroid (n = 13), drainage (n = 14), and surgical excision (n = 12). The treatment processes in each group were examined and their clinical characteristics, treatment processes, and results were analyzed respectively. Results Success rates with each initial treatment were observation, 87.5%; antibiotics, 33.3%; steroids, 30.8%; drainage, 28.6%; and surgical excision, 91.7%. In most cases of observation, the lesions were small and the symptoms were mild. A total of 23 patients underwent surgical excision during treatment. Surgical excision showed particularly fast recovery, high success rate (90.3%) and low recurrence rate (8.7%). Conclusion The clinical course of GLM is complex and the outcome of each treatment type are variable. Surgery may play an important role when a lesion is determined to be mass-forming or appears localized as an abscess pocket during breast examination or imaging study. PMID:23833753

Meta-STEPP: subpopulation treatment effect pattern plot for individual patient data meta-analysis.

PubMed

Wang, Xin Victoria; Cole, Bernard; Bonetti, Marco; Gelber, Richard D

2016-09-20

We have developed a method, called Meta-STEPP (subpopulation treatment effect pattern plot for meta-analysis), to explore treatment effect heterogeneity across covariate values in the meta-analysis setting for time-to-event data when the covariate of interest is continuous. Meta-STEPP forms overlapping subpopulations from individual patient data containing similar numbers of events with increasing covariate values, estimates subpopulation treatment effects using standard fixed-effects meta-analysis methodology, displays the estimated subpopulation treatment effect as a function of the covariate values, and provides a statistical test to detect possibly complex treatment-covariate interactions. Simulation studies show that this test has adequate type-I error rate recovery as well as power when reasonable window sizes are chosen. When applied to eight breast cancer trials, Meta-STEPP suggests that chemotherapy is less effective for tumors with high estrogen receptor expression compared with those with low expression. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Curative effect of chemotherapy, KTP lasers, and CO2 lasers combined with chemotherapy in the treatment of adult laryngeal hemangioma.

PubMed

Wu, Xiufa; Mao, Wenjing; He, Peijie; Wei, Chunsheng

2018-06-01

To evaluate three methods for treating adult laryngeal hemangiomas: conventional chemotherapy, CO 2 laser combined with chemotherapy, and KTP laser. And to identify risk factors that affected the prognosis of the lesions. A retrospective analysis was performed on the data from patients with adult laryngeal hemangiomas treated by one of three aforementioned methods, the curative efficacy, and safety of those methods was compared. All cases were confirmed by suspension micro-laryngoscope examination. Pre- and post-treatment clinical photographs were taken and the outcomes were graded. Thirty-eight patients in 48 different cases were enrolled in the study between June 2010 and June 2016, and some patients were treated more than once. The treatment efficacy of the KTP laser was higher than that of chemotherapy according to the Kruskal-Wallis ANOVA test; however, the ordinal logistic regression showed that the choice of surgical procedure did not affect the treatment results; only the size of the bases of the lesions affected the prognosis of adult laryngeal hemangiomas. Pingyangmycin injection, KTP laser, and CO 2 laser combined with chemotherapy are safe and effective methods for the treatment of adult laryngeal hemangiomas. The size of base of the lesion affects the prognosis of the hemangiomas.

Acoustic Treatment Design Scaling Methods. Phase 2

NASA Technical Reports Server (NTRS)

Clark, L. (Technical Monitor); Parrott, T. (Technical Monitor); Jones, M. (Technical Monitor); Kraft, R. E.; Yu, J.; Kwan, H. W.; Beer, B.; Seybert, A. F.; Tathavadekar, P.

2003-01-01

The ability to design, build and test miniaturized acoustic treatment panels on scale model fan rigs representative of full scale engines provides not only cost-savings, but also an opportunity to optimize the treatment by allowing multiple tests. To use scale model treatment as a design tool, the impedance of the sub-scale liner must be known with confidence. This study was aimed at developing impedance measurement methods for high frequencies. A normal incidence impedance tube method that extends the upper frequency range to 25,000 Hz. without grazing flow effects was evaluated. The free field method was investigated as a potential high frequency technique. The potential of the two-microphone in-situ impedance measurement method was evaluated in the presence of grazing flow. Difficulties in achieving the high frequency goals were encountered in all methods. Results of developing a time-domain finite difference resonator impedance model indicated that a re-interpretation of the empirical fluid mechanical models used in the frequency domain model for nonlinear resistance and mass reactance may be required. A scale model treatment design that could be tested on the Universal Propulsion Simulator vehicle was proposed.

Changes of microbic associations qualitative contents in caries and its complications with the use of low-intensity laser radiation

NASA Astrophysics Data System (ADS)

Kunin, Anatoly A.; Shumilovitch, Bogdan R.; Stepanov, Nicolay N.

1996-01-01

Favorable clinical data at the absence of positive dynamics microbiological research findings in the treatment of caries and their complications give a reason to consider the treatment insufficiently effective and it is necessary to reduce the terms of an additional prophylactic observation and an antirelapse treatment of the disease. That is why researchers all over the world search for new effective methods of influence on the microflora of carious foci. Using the experience of the treatment of 40 patients with caries, 40 patients with chronic pulpitis, and 40 with chronic periodontitis high bactericidal properties of low intensive laser radiation are shown. If after the traditional treatment of foci microflora was inoculated in 62.3% of the cases, after the laser therapy session -- in 26.3% of the cases. The efficiency, ease of handling, and low expenditure of time allow us to recommend this method for a massive use in the treatment of caries and their complications.

Method of thermal strain hysteresis reduction in metal matrix composites

NASA Technical Reports Server (NTRS)

Dries, Gregory A. (Inventor); Tompkins, Stephen S. (Inventor)

1987-01-01

A method is disclosed for treating graphite reinforced metal matrix composites so as to eliminate thermal strain hysteresis and impart dimensional stability through a large thermal cycle. The method is applied to the composite post fabrication and is effective on metal matrix materials using graphite fibers manufactured by both the hot roll bonding and diffusion bonding techniques. The method consists of first heat treating the material in a solution anneal oven followed by a water quench and then subjecting the material to a cryogenic treatment in a cryogenic oven. This heat treatment and cryogenic stress reflief is effective in imparting a dimensional stability and reduced thermal strain hysteresis in the material over a -250.degree. F. to +250.degree. F. thermal cycle.

Effects of Pilates exercise programs in people with chronic low back pain: a systematic review.

PubMed

Patti, Antonino; Bianco, Antonino; Paoli, Antonio; Messina, Giuseppe; Montalto, Maria Alessandra; Bellafiore, Marianna; Battaglia, Giuseppe; Iovane, Angelo; Palma, Antonio

2015-01-01

The Pilates method has recently become a fast-growing popular way of exercise recommended for healthy individuals and those engaged in rehabilitation. Several published studies have examined the effects of Pilates method in people with chronic low back pain (LBP). The objective of this study is to describe and provide an extensive overview of the scientific literature comparing the effectiveness of the Pilates method on pain and disability in patients with chronic nonspecific LBP. The study is based on the data from the following sources: MEDLINE-NLM, MEDLINE-EBSCO, Scopus Elsevier, Cochrane, DOAJ, SciELO, and PLOSONE. Original articles and systematic reviews of adults with chronic nonspecific LBP that evaluated pain and/or disability were included in this study; studies in which the primary treatment was based on Pilates method exercises compared with no treatment, minimal intervention, other types of intervention, or other types of exercises. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adopted. The literature search included 7 electronic databases and the reference list of relevant systematic reviews and original articles to July 2014. Two independent investigators conducted the literature search and performed the synthesis as follows: Study Design; Sample (n); Disability measure; Intervention; and Main results. The searches identified a total of 128 articles. From these, 29 were considered eligible and were included in the analysis. The items were stratified as follows: Pilates method versus other kind of exercises (n = 6 trials) and Pilates method versus no treatment group or minimal intervention for short-term pain (n = 9 trials); the therapeutic effect of the Pilates method in randomized cohorts (n = 5); and analysis of reviews (n = 9). We found that there is a dearth of studies that clearly demonstrates the efficacy of a specific Pilates exercise program over another in the treatment of chronic pain. However, the consensus in the field suggests that Pilates method is more effective than minimal physical exercise intervention in reducing pain. These conclusions need to be supported by other proper investigations.

Effects of Pilates Exercise Programs in People With Chronic Low Back Pain

PubMed Central

Patti, Antonino; Bianco, Antonino; Paoli, Antonio; Messina, Giuseppe; Montalto, Maria Alessandra; Bellafiore, Marianna; Battaglia, Giuseppe; Iovane, Angelo; Palma, Antonio

2015-01-01

Abstract The Pilates method has recently become a fast-growing popular way of exercise recommended for healthy individuals and those engaged in rehabilitation. Several published studies have examined the effects of Pilates method in people with chronic low back pain (LBP). The objective of this study is to describe and provide an extensive overview of the scientific literature comparing the effectiveness of the Pilates method on pain and disability in patients with chronic nonspecific LBP. The study is based on the data from the following sources: MEDLINE-NLM, MEDLINE-EBSCO, Scopus Elsevier, Cochrane, DOAJ, SciELO, and PLOSONE. Original articles and systematic reviews of adults with chronic nonspecific LBP that evaluated pain and/or disability were included in this study; studies in which the primary treatment was based on Pilates method exercises compared with no treatment, minimal intervention, other types of intervention, or other types of exercises. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adopted. The literature search included 7 electronic databases and the reference list of relevant systematic reviews and original articles to July 2014. Two independent investigators conducted the literature search and performed the synthesis as follows: Study Design; Sample (n); Disability measure; Intervention; and Main results. The searches identified a total of 128 articles. From these, 29 were considered eligible and were included in the analysis. The items were stratified as follows: Pilates method versus other kind of exercises (n = 6 trials) and Pilates method versus no treatment group or minimal intervention for short-term pain (n = 9 trials); the therapeutic effect of the Pilates method in randomized cohorts (n = 5); and analysis of reviews (n = 9). We found that there is a dearth of studies that clearly demonstrates the efficacy of a specific Pilates exercise program over another in the treatment of chronic pain. However, the consensus in the field suggests that Pilates method is more effective than minimal physical exercise intervention in reducing pain. These conclusions need to be supported by other proper investigations. PMID:25634166

Treatment of Acne Scars and Wrinkles in Asian Patients Using Carbon-Dioxide Fractional Laser Resurfacing: Its Effects on Skin Biophysical Profiles

PubMed Central

Hwang, Young Ji; Lee, Yu Na; Choe, Yong Beom; Ahn, Kyu Joong

2013-01-01

Background Although ablative fractional resurfacing is known to be effective against photoaging and acne scars, studies on its efficacy, safety and changes in the skin characteristics of Asians are limited. Objective The aim of this study is to assess the efficacy and safety of carbon dioxide fractional laser (CO2FL) in Koreans treated for wrinkles and acne scars, and to define the changes in skin characteristics during recovery period. Methods We administered one session of CO2FL on 10 acne scar patients and 14 wrinkles patients with skin types IV and V. The surveillance of efficacy and side effects along with the measurement of biophysical properties was carried out before 1 day, 1 week, 1 month and 3 months after treatment. Results Using a non-invasive method, skin barrier damage, erythema and bronzing of skin during the recovery period were assessed, and all of the items eventually returned to the pre-treatment level. Skin elasticity was measured in the wrinkle group, and the statistically significant effect was sustained throughout the next three months. The outcome of treatment was found to be better than 'moderate improvement' in both the acne scar and wrinkle groups. Further, there were no serious side effects three months post-procedure. Conclusion CO2 FL is thought to be an effective and safe method for treating moderate to severe acne scars and wrinkles in Asians. PMID:24371392

Personalized Medicine Enrichment Design for DHA Supplementation Clinical Trial.

PubMed

Lei, Yang; Mayo, Matthew S; Carlson, Susan E; Gajewski, Byron J

2017-03-01

Personalized medicine aims to match patient subpopulation to the most beneficial treatment. The purpose of this study is to design a prospective clinical trial in which we hope to achieve the highest level of confirmation in identifying and making treatment recommendations for subgroups, when the risk levels in the control arm can be ordered. This study was motivated by our goal to identify subgroups in a DHA (docosahexaenoic acid) supplementation trial to reduce preterm birth (gestational age<37 weeks) rate. We performed a meta-analysis to obtain informative prior distributions and simulated operating characteristics to ensure that overall Type I error rate was close to 0.05 in designs with three different models: independent, hierarchical, and dynamic linear models. We performed simulations and sensitivity analysis to examine the subgroup power of models and compared results to a chi-square test. We performed simulations under two hypotheses: a large overall treatment effect and a small overall treatment effect. Within each hypothesis, we designed three different subgroup effects scenarios where resulting subgroup rates are linear, flat, or nonlinear. When the resulting subgroup rates are linear or flat, dynamic linear model appeared to be the most powerful method to identify the subgroups with a treatment effect. It also outperformed other methods when resulting subgroup rates are nonlinear and the overall treatment effect is big. When the resulting subgroup rates are nonlinear and the overall treatment effect is small, hierarchical model and chi-square test did better. Compared to independent and hierarchical models, dynamic linear model tends to be relatively robust and powerful when the control arm has ordinal risk subgroups.

Effects of sterilization treatments on the analysis of TOC in water samples.

PubMed

Shi, Yiming; Xu, Lingfeng; Gong, Dongqin; Lu, Jun

2010-01-01

Decomposition experiments conducted with and without microbial processes are commonly used to study the effects of environmental microorganisms on the degradation of organic pollutants. However, the effects of biological pretreatment (sterilization) on organic matter often have a negative impact on such experiments. Based on the principle of water total organic carbon (TOC) analysis, the effects of physical sterilization treatments on determination of TOC and other water quality parameters were investigated. The results revealed that two conventional physical sterilization treatments, autoclaving and 60Co gamma-radiation sterilization, led to the direct decomposition of some organic pollutants, resulting in remarkable errors in the analysis of TOC in water samples. Furthermore, the extent of the errors varied with the intensity and the duration of sterilization treatments. Accordingly, a novel sterilization method for water samples, 0.45 microm micro-filtration coupled with ultraviolet radiation (MCUR), was developed in the present study. The results indicated that the MCUR method was capable of exerting a high bactericidal effect on the water sample while significantly decreasing the negative impact on the analysis of TOC and other water quality parameters. Before and after sterilization treatments, the relative errors of TOC determination could be controlled to lower than 3% for water samples with different categories and concentrations of organic pollutants by using MCUR.

Risk-Stratified Imputation in Survival Analysis

PubMed Central

Kennedy, Richard E.; Adragni, Kofi P.; Tiwari, Hemant K.; Voeks, Jenifer H.; Brott, Thomas G.; Howard, George

2013-01-01

Background Censoring that is dependent on covariates associated with survival can arise in randomized trials due to changes in recruitment and eligibility criteria to minimize withdrawals, potentially leading to biased treatment effect estimates. Imputation approaches have been proposed to address censoring in survival analysis; and while these approaches may provide unbiased estimates of treatment effects, imputation of a large number of outcomes may over- or underestimate the associated variance based on the imputation pool selected. Purpose We propose an improved method, risk-stratified imputation, as an alternative to address withdrawal related to the risk of events in the context of time-to-event analyses. Methods Our algorithm performs imputation from a pool of replacement subjects with similar values of both treatment and covariate(s) of interest, that is, from a risk-stratified sample. This stratification prior to imputation addresses the requirement of time-to-event analysis that censored observations are representative of all other observations in the risk group with similar exposure variables. We compared our risk-stratified imputation to case deletion and bootstrap imputation in a simulated dataset in which the covariate of interest (study withdrawal) was related to treatment. A motivating example from a recent clinical trial is also presented to demonstrate the utility of our method. Results In our simulations, risk-stratified imputation gives estimates of treatment effect comparable to bootstrap and auxiliary variable imputation while avoiding inaccuracies of the latter two in estimating the associated variance. Similar results were obtained in analysis of clinical trial data. Limitations Risk-stratified imputation has little advantage over other imputation methods when covariates of interest are not related to treatment, although its performance is superior when covariates are related to treatment. Risk-stratified imputation is intended for categorical covariates, and may be sensitive to the width of the matching window if continuous covariates are used. Conclusions The use of the risk-stratified imputation should facilitate the analysis of many clinical trials, in which one group has a higher withdrawal rate that is related to treatment. PMID:23818434

Comparison the effectiveness of pyruvic acid 50% and salicylic acid 30% in the treatment of acne

PubMed Central

Jaffary, Fariba; Faghihi, Gita; Saraeian, Sara; Hosseini, Sayed Mohsen

2016-01-01

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles and one of the most common skin diseases. The peeling method has been recently found to be effective for acne treatment. This study aimed to compare the efficacy of pyruvic acid 50% and salicylic acid 30% peeling in the treatment of mild to moderate acne. Materials and Methods: In a prospective single-blinded clinical trial, 86 patients with acne were randomly assigned into two groups. In both groups, the routine treatment of acne (topical solution of erythromycin 4%, triclorocarban soap, and sunscreen) were used twice a day for 8 weeks. In addition, salicylic acid 30% for the control group and pyruvic acid 50% for the case group were used. In both groups, acne severity index (ASI) was calculated before and at week 2, 4, 6, and 8 of the treatment. Patient satisfaction was assessed at the end of the treatment. Side effects were recorded using a checklist. Results: In both groups, the reduction in the number of comedones, papules, and ASI were statistically significant (P < 0.001) in the course of treatment. However, it was not significant regarding the number of pustules (P = 0.09). None of the number of comedone, papules, pustules, and ASI was statistically different between study groups. Both treatment groups had similar side effects except for scaling in the fifth session, which was significantly lower in salicylic acid – treated patients (P = 0.015). Conclusion: Both pyruvic acid 50% and salicylic acid 30% are effective in the improvement of mild to moderate acne with no significant difference in efficacy and side effects. PMID:27904577

Comparison of infrared coagulation and rubber band ligation for first and second degree haemorrhoids: a randomised prospective clinical trial.

PubMed Central

Templeton, J L; Spence, R A; Kennedy, T L; Parks, T G; Mackenzie, G; Hanna, W A

1983-01-01

One hundred and thirty seven previously untreated out-patients with first and second degree haemorrhoids were allocated at random to treatment by infrared coagulation (n=66) or rubber band ligation (n=71). Complete follow up was obtained in 122 patients (60 who had undergone infrared coagulation (group 1), and 62 rubber band ligation (group 2)) at periods from three months to one year after completion of treatment. Infrared coagulation produced a satisfactory outcome in 51 patients (85%): 34 were rendered asymptomatic and 17 improved. Rubber band ligation produced a satisfactory outcome in 57 patients (92%): 33 were rendered asymptomatic and 24 improved. Both methods were equally effective in first and second degree haemorrhoids. The incidence of side effects, particularly discomfort, during and after treatment was significantly higher in those treated by rubber band ligation (p less than 0.001). This appeared to be an appreciable deterrent to future patient compliance. The number of patients losing more than 24 hours from work was higher after rubber band ligation than after infrared coagulation. The number of treatments necessary to cure symptoms did not differ significantly between the two methods. Infrared coagulation was significantly faster than rubber band ligation (p less than 0.001). Infrared coagulation is a simple, fast, and effective outpatient method for the treatment of first and second degree haemorrhoids with fewer troublesome side effects and higher patient acceptability than rubber band ligation. PMID:6404471

Constraint-induced aphasia therapy versus intensive semantic treatment in fluent aphasia.

PubMed

Wilssens, Ineke; Vandenborre, Dorien; van Dun, Kim; Verhoeven, Jo; Visch-Brink, Evy; Mariën, Peter

2015-05-01

The authors compared the effectiveness of 2 intensive therapy methods: Constraint-Induced Aphasia Therapy (CIAT; Pulvermüller et al., 2001) and semantic therapy (BOX; Visch-Brink & Bajema, 2001). Nine patients with chronic fluent aphasia participated in a therapy program to establish behavioral treatment outcomes. Participants were randomly assigned to one of two groups (CIAT or BOX). Intensive therapy significantly improved verbal communication. However, BOX treatment showed a more pronounced improvement on two communication-namely, a standardized assessment for verbal communication, the Amsterdam Nijmegen Everyday Language Test (Blomert, Koster, & Kean, 1995), and a subjective rating scale, the Communicative Effectiveness Index (Lomas et al., 1989). All participants significantly improved on one (or more) subtests of the Aachen Aphasia Test (Graetz, de Bleser, & Willmes, 1992), an impairment-focused assessment. There was a treatment-specific effect. BOX treatment had a significant effect on language comprehension and semantics, whereas CIAT treatment affected language production and phonology. The findings indicate that in patients with fluent aphasia, (a) intensive treatment has a significant effect on language and verbal communication, (b) intensive therapy results in selective treatment effects, and (c) an intensive semantic treatment shows a more striking mean improvement on verbal communication in comparison with communication-based CIAT treatment.

The association of fractional CO2 laser 10.600nm and photodynamic therapy in the treatment of onychomycosis*

PubMed Central

de Oliveira, Guilherme Bueno; Antonio, João Roberto; Antonio, Carlos Roberto; Tomé, Fernanda Alves

2015-01-01

BACKGROUND Onychomycosis is a fungal infection of the nails caused in most cases by dermatophytes Trichophyton rubrum and Trichophyton mentagrophytes. Despite numerous available antifungal drugs for therapy of this infection, the cure rate is low, with high rates of relapse after treatment and side effects. OBJECTIVES To present a new option for the treatment of onychomycosis, in search of a more effective and rapid method than conventional ones. METHODS Patients underwent two sessions of CO2 fractional laser 10.600nm associated with photodynamic therapy. Mycological and digital photography were performed before and after the treatment. RESULTS McNemar test with continuity correction and degrees of freedom = 1: for clinical cure rate, 13.06, with p=0.00005; for mycological cure, 17.05, with p=0.00005; 72% felt fully satisfied with the procedure. CONCLUSIONS The use of fractional CO2 laser 10.600nm associated with photodynamic therapy can be effective in the treatment of onychomycosis, decreasing the risk of systemic lesions that may be triggered with prolonged use of oral antifungals. PMID:26375214

Pharmacologic Treatment of Repetitive Behaviors in Autism Spectrum Disorders: Evidence of Publication Bias

PubMed Central

Volkmar, Fred R.; Bloch, Michael H.

2012-01-01

OBJECTIVE: The goal of this study was to examine the efficacy of serotonin receptor inhibitors (SRIs) for the treatment of repetitive behaviors in autism spectrum disorders (ASD). METHODS: Two reviewers searched PubMed and Clinicaltrials.gov for randomized, double-blind, placebo-controlled trials evaluating the efficacy of SRIs for repetitive behaviors in ASD. Our primary outcome was mean improvement in ratings scales of repetitive behavior. Publication bias was assessed by using a funnel plot, the Egger’s test, and a meta-regression of sample size and effect size. RESULTS: Our search identified 5 published and 5 unpublished but completed trials eligible for meta-analysis. Meta-analysis of 5 published and 1 unpublished trial (which provided data) demonstrated a small but significant effect of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.22 [95% confidence interval: 0.07–0.37], z score = 2.87, P < .005). There was significant evidence of publication bias in all analyses. When Duval and Tweedie's trim and fill method was used to adjust for the effect of publication bias, there was no longer a significant benefit of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.12 [95% confidence interval: –0.02 to 0.27]). Secondary analyses demonstrated no significant effect of type of medication, patient age, method of analysis, trial design, or trial duration on reported SRI efficacy. CONCLUSIONS: Meta-analysis of the published literature suggests a small but significant effect of SRI in the treatment of repetitive behaviors in ASD. This effect may be attributable to selective publication of trial results. Without timely, transparent, and complete disclosure of trial results, it remains difficult to determine the efficacy of available medications. PMID:22529279

Comparison of Nonoverlap Methods for Identifying Treatment Effect in Single-Subject Experimental Research

ERIC Educational Resources Information Center

Rakap, Salih; Snyder, Patricia; Pasia, Cathleen

2014-01-01

Debate is occurring about which result interpretation aides focused on examining the experimental effect should be used in single-subject experimental research. In this study, we examined seven nonoverlap methods and compared results using each method to judgments of two visual analysts. The data sources for the present study were 36 studies…

Effect of Two Different Methods of Initiating Atomoxetine on the Adverse Event Profile of Atomoxetine

ERIC Educational Resources Information Center

Greenhill, Laurence L.; Newcorn, Jeffrey H.; Gao, Haitao; Feldman, Peter D.

2007-01-01

Objective: To compare the effects of two different methods for initiating atomoxetine in terms of the incidence of early adverse events. Method: Data on atomoxetine treatment-emergent adverse events in youths, ages 6 to 18 years, were analyzed from five randomized, double-blind, placebo-controlled, acute-phase studies. Two studies involve…

The Experience of Couples in the Process of Treatment of Pathological Gambling: Couple vs. Individual Therapy.

PubMed

Tremblay, Joël; Dufour, Magali; Bertrand, Karine; Blanchette-Martin, Nadine; Ferland, Francine; Savard, Annie-Claude; Saint-Jacques, Marianne; Côté, Mélissa

2017-01-01

Context: Couple treatment for pathological gambling is an innovative strategy. There are some results supporting its potential effectiveness, but little is known about the subjective experiences of the participants. Objective: The aim of this article is to document the experiences of gamblers and their partners participating in one of two treatments, namely individual or couple. Method: In a study aiming to evaluate the efficacy of the Integrative Couple Treatment for Pathological Gambling (ICT-PG), couples who were entering specialized treatment for the addiction of one member who was a pathological gambler were randomly assigned to individual or ICT-PG. Nine months after their admission to treatment, gamblers and partners ( n = 21 couples; n = 13 ICT-PG; n = 8 individual treatment) were interviewed in semi-structured interviews. A sequenced thematization method was used to extract the major themes. Results: This study highlighted five major themes in the therapeutic process noted by the gamblers and their partners mainly after the couple treatment but also partly through the individual therapy. These were: (1) the gamblers' anxiety about having to reveal their gambling problems in couple therapy; (2) the wish to develop a mutually beneficial understanding of gambling and its effects on the partners in the two types of treatments; (3) the transformation of negative attributions through a more effective intra-couple communication fostered by the couple therapy; (4) the partners' contribution to changes in gambling behavior and prevention of relapses, which were both better supported in couple therapy; and (5) the interpersonal nature of gambling and its connections with the couples' relationship. However, gamblers who were in individual treatment were more likely to mention that their partners' involvement was not necessary. Participants likewise made a few recommendations about the conditions underlying the choice of one treatment method or the other. Discussion: Participants reported satisfaction with both treatment models, but their experience was more positive in couple treatment. Complementary benefits emerged from each form of treatment, which points to future treatments involving both types. Future research should explore both the couple processes associated with attempts to stop pathological gambling and the various ways of involving partners in the gamblers' treatment.

The Experience of Couples in the Process of Treatment of Pathological Gambling: Couple vs. Individual Therapy

PubMed Central

Tremblay, Joël; Dufour, Magali; Bertrand, Karine; Blanchette-Martin, Nadine; Ferland, Francine; Savard, Annie-Claude; Saint-Jacques, Marianne; Côté, Mélissa

2018-01-01

Context: Couple treatment for pathological gambling is an innovative strategy. There are some results supporting its potential effectiveness, but little is known about the subjective experiences of the participants. Objective: The aim of this article is to document the experiences of gamblers and their partners participating in one of two treatments, namely individual or couple. Method: In a study aiming to evaluate the efficacy of the Integrative Couple Treatment for Pathological Gambling (ICT-PG), couples who were entering specialized treatment for the addiction of one member who was a pathological gambler were randomly assigned to individual or ICT-PG. Nine months after their admission to treatment, gamblers and partners (n = 21 couples; n = 13 ICT-PG; n = 8 individual treatment) were interviewed in semi-structured interviews. A sequenced thematization method was used to extract the major themes. Results: This study highlighted five major themes in the therapeutic process noted by the gamblers and their partners mainly after the couple treatment but also partly through the individual therapy. These were: (1) the gamblers' anxiety about having to reveal their gambling problems in couple therapy; (2) the wish to develop a mutually beneficial understanding of gambling and its effects on the partners in the two types of treatments; (3) the transformation of negative attributions through a more effective intra-couple communication fostered by the couple therapy; (4) the partners' contribution to changes in gambling behavior and prevention of relapses, which were both better supported in couple therapy; and (5) the interpersonal nature of gambling and its connections with the couples' relationship. However, gamblers who were in individual treatment were more likely to mention that their partners' involvement was not necessary. Participants likewise made a few recommendations about the conditions underlying the choice of one treatment method or the other. Discussion: Participants reported satisfaction with both treatment models, but their experience was more positive in couple treatment. Complementary benefits emerged from each form of treatment, which points to future treatments involving both types. Future research should explore both the couple processes associated with attempts to stop pathological gambling and the various ways of involving partners in the gamblers' treatment. PMID:29416520

New developments in the management of periocular capillary hemangioma in children.

PubMed

Ni, Nina; Wagner, Rudolph S; Langer, Paul; Guo, Suqin

2011-01-01

The authors describe the theories of pathogenesis for capillary hemangioma and discuss the benefits and side effects of current treatment options, such as systemic and intralesional corticosteroids, laser therapy, and surgical excision. They also evaluate the recent systemic and topical applications of beta-blockers to treat infantile hemangioma. Although no major adverse events from beta-blocker treatment have been reported, the incidence of potential side effects such as bronchospasm, hypoglycemia, heart block, bradycardia, and congestive heart failure is unknown due to the novelty of the treatment. It has been postulated that topical application for localized superficial tumor may reduce systemic effects. Further research is necessary to compare the effectiveness of different treatments and to find the optimal dosing and delivery methods to minimize adverse effects in the treatment of this disorder. Copyright 2011, SLACK Incorporated.

[Measuring client satisfaction in youth mental health care: qualitative methods and satisfaction questionnaires].

PubMed

Vanderfaeillie, J; Stroobants, T; van West, D; Andries, C

2015-01-01

Quality youth care and decisions about youth care should ideally be based on a combination of empirical data, the clinical judgment of health professionals and the views and preferences of clients. Additionally, the treatment provided needs to fit in with the client's social and cultural background. Clients' views about their treatment are often collected via satisfaction measurements and particularly via satisfaction questionnaires. To make a critical analysis of the factors that determine both client satisfaction and the content of the satisfaction questionnaires used as a measurement method in youth care. We made a selective study of the relevant literature. Our results show that client satisfaction is not an indicator of the effectiveness of treatment and that the degree of client satisfaction varies according to the client's outlook and perspective. Apparently, there are many disadvantages of using questionnaires as a measurement method. For the collection of a young person's views, qualitative methods seem to be more effective than questionnaires.

Development of consensus treatment plans for juvenile localized scleroderma: a roadmap toward comparative effectiveness studies in juvenile localized scleroderma.

PubMed

Li, Suzanne C; Torok, Kathryn S; Pope, Elena; Dedeoglu, Fatma; Hong, Sandy; Jacobe, Heidi T; Rabinovich, C Egla; Laxer, Ronald M; Higgins, Gloria C; Ferguson, Polly J; Lasky, Andrew; Baszis, Kevin; Becker, Mara; Campillo, Sarah; Cartwright, Victoria; Cidon, Michael; Inman, Christi J; Jerath, Rita; O'Neil, Kathleen M; Vora, Sheetal; Zeft, Andrew; Wallace, Carol A; Ilowite, Norman T; Fuhlbrigge, Robert C

2012-08-01

Juvenile localized scleroderma (LS) is a chronic inflammatory skin disorder associated with substantial morbidity and disability. Although a wide range of therapeutic strategies has been reported in the literature, a lack of agreement on treatment specifics and accepted methods for clinical assessment has made it difficult to compare approaches and identify optimal therapy. Our objective was to develop standardized treatment plans, clinical assessments, and response criteria for active, moderate to high severity juvenile LS. A core group of pediatric rheumatologists, dermatologists, and a lay advisor was engaged by the Childhood Arthritis and Rheumatology Research Alliance (CARRA) to develop standardized treatment plans and assessment parameters for juvenile LS using consensus methods/nominal group techniques. Recommendations were validated in 2 face-to-face conferences with a larger group of practitioners with expertise in juvenile LS and with the full membership of CARRA, which encompasses the majority of pediatric rheumatologists in the US and Canada. Consensus was achieved on standardized treatment plans that reflect the prevailing treatment practices of CARRA members. Standardized clinical assessment methods and provisional treatment response criteria were also developed. Greater than 90% of pediatric rheumatologists responding to a survey (66% of CARRA membership) affirmed the final recommendations and agreed to utilize these consensus plans to treat patients with juvenile LS. Using consensus methodology, we have developed standardized treatment plans and assessment methods for juvenile LS. The high level of support among pediatric rheumatologists will support future comparative effectiveness studies and enable the development of evidence-based guidelines for the treatment of juvenile LS. Copyright © 2012 by the American College of Rheumatology.

[Difficulty influence factors of dental caries clinical treatment].

PubMed

Xuedong, Zhou; Junqi, Ling; Jingping, Liang; Jiyao, Li; Lei, Cheng; Qing, Yu; Yumei, Niu; Bin, Guo; Hui, Chen

2017-02-01

Dental caries is a major disease that threaten human's oral healthy severely with the characteristics of high incidence, low rate of treatment and high rate of retreatment. At present, restorative treatment remains the main method for caries treatment. With the development of the Minimally Invasive Cosmetic Dentistry (MICD), reasonable application of various treatment technologies, maximum preservation of tooth tissues and realizing the maximization of treatment effects become problems that call for immediate solution in dental clinics. In addition, there still exist a large number of old restorations that need standard retreatments. Here, some difficulty influence factors of dental caries clinical treatment such as systemic and oral factors, individual caries susceptibility, treatment technologies and materials, retreatment methods of old restorations and technique sensitivity are analyzed, and corresponding processing strategies are also put forward.

Pretreatment of Biomass by Aqueous Ammonia for Bioethanol Production

NASA Astrophysics Data System (ADS)

Kim, Tae Hyun; Gupta, Rajesh; Lee, Y. Y.

The methods of pretreatment of lignocellulosic biomass using aqueous ammonia are described. The main effect of ammonia treatment of biomass is delignification without significantly affecting the carbohydrate contents. It is a very effective pretreatment method especially for substrates that have low lignin contents such as agricultural residues and herbaceous feedstock. The ammonia-based pretreatment is well suited for simultaneous saccharification and co-fermentation (SSCF) because the treated biomass retains cellulose as well as hemicellulose. It has been demonstrated that overall ethanol yield above 75% of the theoretical maximum on the basis of total carbohydrate is achievable from corn stover pretreated with aqueous ammonia by way of SSCF. There are two different types of pretreatment methods based on aqueous ammonia: (1) high severity, low contact time process (ammonia recycle percolation; ARP), (2) low severity, high treatment time process (soaking in aqueous ammonia; SAA). Both of these methods are described and discussed for their features and effectiveness.

Generated effect modifiers (GEM's) in randomized clinical trials.

PubMed

Petkova, Eva; Tarpey, Thaddeus; Su, Zhe; Ogden, R Todd

2017-01-01

In a randomized clinical trial (RCT), it is often of interest not only to estimate the effect of various treatments on the outcome, but also to determine whether any patient characteristic has a different relationship with the outcome, depending on treatment. In regression models for the outcome, if there is a non-zero interaction between treatment and a predictor, that predictor is called an "effect modifier". Identification of such effect modifiers is crucial as we move towards precision medicine, that is, optimizing individual treatment assignment based on patient measurements assessed when presenting for treatment. In most settings, there will be several baseline predictor variables that could potentially modify the treatment effects. This article proposes optimal methods of constructing a composite variable (defined as a linear combination of pre-treatment patient characteristics) in order to generate an effect modifier in an RCT setting. Several criteria are considered for generating effect modifiers and their performance is studied via simulations. An example from a RCT is provided for illustration. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

DeepSurv: personalized treatment recommender system using a Cox proportional hazards deep neural network.

PubMed

Katzman, Jared L; Shaham, Uri; Cloninger, Alexander; Bates, Jonathan; Jiang, Tingting; Kluger, Yuval

2018-02-26

Medical practitioners use survival models to explore and understand the relationships between patients' covariates (e.g. clinical and genetic features) and the effectiveness of various treatment options. Standard survival models like the linear Cox proportional hazards model require extensive feature engineering or prior medical knowledge to model treatment interaction at an individual level. While nonlinear survival methods, such as neural networks and survival forests, can inherently model these high-level interaction terms, they have yet to be shown as effective treatment recommender systems. We introduce DeepSurv, a Cox proportional hazards deep neural network and state-of-the-art survival method for modeling interactions between a patient's covariates and treatment effectiveness in order to provide personalized treatment recommendations. We perform a number of experiments training DeepSurv on simulated and real survival data. We demonstrate that DeepSurv performs as well as or better than other state-of-the-art survival models and validate that DeepSurv successfully models increasingly complex relationships between a patient's covariates and their risk of failure. We then show how DeepSurv models the relationship between a patient's features and effectiveness of different treatment options to show how DeepSurv can be used to provide individual treatment recommendations. Finally, we train DeepSurv on real clinical studies to demonstrate how it's personalized treatment recommendations would increase the survival time of a set of patients. The predictive and modeling capabilities of DeepSurv will enable medical researchers to use deep neural networks as a tool in their exploration, understanding, and prediction of the effects of a patient's characteristics on their risk of failure.

The differential effects of heat-shocking on the viability of spores from Bacillus anthracis, Bacillus subtilis, and Clostridium sporogenes after treatment with peracetic acid- and glutaraldehyde-based disinfectants.

PubMed

March, Jordon K; Pratt, Michael D; Lowe, Chinn-Woan; Cohen, Marissa N; Satterfield, Benjamin A; Schaalje, Bruce; O'Neill, Kim L; Robison, Richard A

2015-10-01

This study investigated (1) the susceptibility of Bacillus anthracis (Ames strain), Bacillus subtilis (ATCC 19659), and Clostridium sporogenes (ATCC 3584) spores to commercially available peracetic acid (PAA)- and glutaraldehyde (GA)-based disinfectants, (2) the effects that heat-shocking spores after treatment with these disinfectants has on spore recovery, and (3) the timing of heat-shocking after disinfectant treatment that promotes the optimal recovery of spores deposited on carriers. Suspension tests were used to obtain inactivation kinetics for the disinfectants against three spore types. The effects of heat-shocking spores after disinfectant treatment were also determined. Generalized linear mixed models were used to estimate 6-log reduction times for each spore type, disinfectant, and heat treatment combination. Reduction times were compared statistically using the delta method. Carrier tests were performed according to AOAC Official Method 966.04 and a modified version that employed immediate heat-shocking after disinfectant treatment. Carrier test results were analyzed using Fisher's exact test. PAA-based disinfectants had significantly shorter 6-log reduction times than the GA-based disinfectant. Heat-shocking B. anthracis spores after PAA treatment resulted in significantly shorter 6-log reduction times. Conversely, heat-shocking B. subtilis spores after PAA treatment resulted in significantly longer 6-log reduction times. Significant interactions were also observed between spore type, disinfectant, and heat treatment combinations. Immediately heat-shocking spore carriers after disinfectant treatment produced greater spore recovery. Sporicidal activities of disinfectants were not consistent across spore species. The effects of heat-shocking spores after disinfectant treatment were dependent on both disinfectant and spore species. Caution must be used when extrapolating sporicidal data of disinfectants from one spore species to another. Heat-shocking provides a more accurate picture of spore survival for only some disinfectant/spore combinations. Collaborative studies should be conducted to further examine a revision of AOAC Official Method 966.04 relative to heat-shocking. © 2015 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.

Principles of Sterilization of Mars Descent Vehicle Elements

NASA Astrophysics Data System (ADS)

Trofimov, Vladislav; Deshevaya, Elena; Khamidullina, N.; Kalashnikov, Viktor

Due to COSPAR severe requirements to permissible microbiological contamination of elements of down-to-Mars S/C as well as complexity of their chemical composition and structure the exposure of such S/C elements to antimicrobial treatment (sterilization) at their integration requires application of a wide set of methods: chemical, ultraviolet, radiation. The report describes the analysis of all the aspects of applicable methods of treatment for cleaning of elements’ surfaces and inner contents from microbiota. The analysis showed that the most important, predictable and controllable method is radiation processing (of the elements which don’t change their properties after effective treatment). The experience of ionizing radiation application for sterilization of products for medicine, etc. shows that, depending on initial microbial contamination of lander elements, the required absorbed dose can be within the range 12 ÷ 35 kGr. The analysis of the effect of irregularity of radiation absorption in complex structure elements to the choice of radiation methodology was made and the algorithm of the choice of effective conditions of radiation treatment and control of sterilization efficiency was suggested. The important phase of establishing of the effective condition of each structure element treatment is experimental verification of real microbiological contamination in terms of S/C integration, contamination maximum decrease using another cleaning procedures (mechanical, chemical, ultraviolet) and determination of radiation resistance of spore microorganisms typical for the shops of space technology manufacturing and assembling. Proceeding from three parameters (irregularity of radiation absorption in a concrete element, its initial microbial contamination and resistance of microorganisms to the effect of radiation) the condition of the packed object sterilization is chosen, the condition that prevents secondary contamination, ensures given reliability of the treatment without final experimental microbiological verification only by simple control of the absorbed dose at critical points. All the process phases (from the choice of treatment conditions to provision of the procedure safety) are strictly regulated by Russian legislation in accordance with international standards.

Adjusting survival time estimates to account for treatment switching in randomized controlled trials--an economic evaluation context: methods, limitations, and recommendations.

PubMed

Latimer, Nicholas R; Abrams, Keith R; Lambert, Paul C; Crowther, Michael J; Wailoo, Allan J; Morden, James P; Akehurst, Ron L; Campbell, Michael J

2014-04-01

Treatment switching commonly occurs in clinical trials of novel interventions in the advanced or metastatic cancer setting. However, methods to adjust for switching have been used inconsistently and potentially inappropriately in health technology assessments (HTAs). We present recommendations on the use of methods to adjust survival estimates in the presence of treatment switching in the context of economic evaluations. We provide background on the treatment switching issue and summarize methods used to adjust for it in HTAs. We discuss the assumptions and limitations associated with adjustment methods and draw on results of a simulation study to make recommendations on their use. We demonstrate that methods used to adjust for treatment switching have important limitations and often produce bias in realistic scenarios. We present an analysis framework that aims to increase the probability that suitable adjustment methods can be identified on a case-by-case basis. We recommend that the characteristics of clinical trials, and the treatment switching mechanism observed within them, should be considered alongside the key assumptions of the adjustment methods. Key assumptions include the "no unmeasured confounders" assumption associated with the inverse probability of censoring weights (IPCW) method and the "common treatment effect" assumption associated with the rank preserving structural failure time model (RPSFTM). The limitations associated with switching adjustment methods such as the RPSFTM and IPCW mean that they are appropriate in different scenarios. In some scenarios, both methods may be prone to bias; "2-stage" methods should be considered, and intention-to-treat analyses may sometimes produce the least bias. The data requirements of adjustment methods also have important implications for clinical trialists.

A Standardized Mean Difference Effect Size for Single Case Designs

ERIC Educational Resources Information Center

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

2012-01-01

Single case designs are a set of research methods for evaluating treatment effects by assigning different treatments to the same individual and measuring outcomes over time and are used across fields such as behavior analysis, clinical psychology, special education, and medicine. Emerging standards for single case designs have focused attention on…

A Randomized Effectiveness Trial of Brief Cognitive-Behavioral Therapy for Depressed Adolescents Receiving Antidepressant Medication

ERIC Educational Resources Information Center

Clarke, Gregory; DeBar, Lynn; Lynch, Frances; Powell, James; Gale, John; O'Connor, Elizabeth; Ludman, Evette; Bush, Terry; Lin, Elizabeth H. B.; Von Korff, Michael; Hertert, Stephanie

2005-01-01

Objective: To test a collaborative-care, cognitive-behavioral therapy (CBT) program adjunctive to selective serotonin reuptake inhibitor (SSRI) treatment in HMO pediatric primary care. Method: A randomized effectiveness trial comparing a treatment-as-usual (TAU) control condition consisting primarily of SSRI medication delivered outside the…

Analyzing for Individual Differences in Evaluating Compensatory Education Programs. Occasional Paper No. 27.

ERIC Educational Resources Information Center

Krus, Patricia H.

Trait-Treatment Interaction (TTI), a research method for observing experimental effects of treatments on subjects of different aptitudes and learning characteristics, is suggested as an effective evaluation tool to provide evaluators and educators in compensatory education programs with information about which program is best for different kinds…

A Standardized Mean Difference Effect Size for Multiple Baseline Designs across Individuals

ERIC Educational Resources Information Center

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

2013-01-01

Single-case designs are a class of research methods for evaluating treatment effects by measuring outcomes repeatedly over time while systematically introducing different condition (e.g., treatment and control) to the same individual. The designs are used across fields such as behavior analysis, clinical psychology, special education, and…

A Scoping Review of Treatments for Older Adults with Substance Use Problems

ERIC Educational Resources Information Center

Mowbray, Orion; Quinn, Adam

2016-01-01

Objectives: To identify effective treatment services for older, substance-using adults, an examination of the evidence associated with interventions for this group is presented. Methods: Using explicit, validated criteria to identify effective interventions, 22 publications were included in a review and were subject to a critical appraisal of…

New Combinational Method for Noninvasive Treatments of Superficial Tissues for Body Aesthetics Applications

NASA Astrophysics Data System (ADS)

Rybyanets, A. N.; Naumenko, A. A.

The paper introduces an innovative combinational treatment method based on ultrasonic standing waves (USW) technology for noninvasive surgical, therapeutic, lypolitic or cosmetic treatment of tissues including subcutaneous adipose tissue, cellulite or skin on arbitrary body part of patient. The method is based on simultaneous or successive applying of constructively interfering physically and biologically sensed influences: USW, ultrasonic shear waves, radio-frequency (RF) heating, and vacuum massage. The paper provides basic physical principles of USW as well as critical comparison of USW and HIFU methods. The results of finite-elements and finite- difference modeling of USW transducer design and nodal pattern structure in tissue are presented. Biological effects of USW-tissue interaction and synergetic aspects of USW and RF combination are explored. Combinational treatment transducer designs and original in-vitro experiments on tissues are described.

Bracing and exercise-based treatment for idiopathic scoliosis.

PubMed

Kalichman, Leonid; Kendelker, Liron; Bezalel, Tomer

2016-01-01

Various conservative therapies are available for treating adolescent idiopathic scoliosis (AIS), however, the disparities between them and the evidence of their efficacy and effectiveness is still unclear. To evaluate the effectiveness of different conservative treatments on AIS. A literature-based narrative review of the English language medical literature. The most appropriate treatment for each patient should be chosen individually and based on various parameters. Bracing has been found to be a most effective conservative treatment for AIS. There is limited evidence that specific physical exercises also an effective intervention for AIS. Exercise-based physical therapy, if correctly administered, can prevent a worsening of the curve and may decrease need for bracing. In addition, physical exercises were found to be the only treatment improving respiratory function. Combining bracing with exercise increases treatment efficacy compared with a single treatment. Additional, well-designed and good quality studies are required to assess the effectiveness of different conservative methods in treating AIS. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Use of Propensity Scores in Mediation Analysis

ERIC Educational Resources Information Center

Jo, Booil; Stuart, Elizabeth A.; MacKinnon, David P.; Vinokur, Amiram D.

2011-01-01

Mediation analysis uses measures of hypothesized mediating variables to test theory for how a treatment achieves effects on outcomes and to improve subsequent treatments by identifying the most efficient treatment components. Most current mediation analysis methods rely on untested distributional and functional form assumptions for valid…

Treatment of addiction and addiction-related behavior

DOEpatents

Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

2003-01-01

The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a mammal suffering from substance addiction. The method includes administering to a mammal an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. The present invention also provides a method of treatment of cocaine, morphine, heroin, nicotine, amphetamine, methamphetamine, or ethanol addiction by treating a mammal with an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. In one embodiment, the method of the present invention includes administering to the mammal an effective amount of a composition which increases central nervous system GABA levels wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of drugs of abuse. The composition includes GVG, gabapentin, valproic acid, progabide, gamma-hydroxybutyric acid, fengabine, cetylGABA, topiramate or tiagabine or a pharmaceutically acceptable salt thereof, or an enantiomer or a racemic mixture thereof.

ECONOMICS OF INDIVIDUALIZATION IN COMPARATIVE EFFECTIVENESS RESEARCH AND A BASIS FOR A PATIENT-CENTERED HEALTH CARE

PubMed Central

Basu, Anirban

2011-01-01

The United States aspires to use information from comparative effectiveness research (CER) to reduce waste and contain costs without instituting a formal rationing mechanism or compromising patient or physician autonomy with regard to treatment choices. With such ambitious goals, traditional combinations of research designs and analytical methods used in CER may lead to disappointing results. In this paper, I study how alternate regimes of comparative effectiveness information help shape the marginal benefits (demand) curve in the population and how such perceived demand curves impact decision-making at the individual patient level and welfare at the societal level. I highlight the need to individualize comparative effectiveness research in order to generate the true (normative) demand curve for treatments. I discuss methodological principles that guide research designs for such studies. Using an example of the comparative effect of substance abuse treatments on crime, I use novel econometric methods to salvage individualized information from an existing dataset. PMID:21601299

Economics of individualization in comparative effectiveness research and a basis for a patient-centered health care.

PubMed

Basu, Anirban

2011-05-01

The United States aspires to use information from comparative effectiveness research (CER) to reduce waste and contain costs without instituting a formal rationing mechanism or compromising patient or physician autonomy with regard to treatment choices. With such ambitious goals, traditional combinations of research designs and analytical methods used in CER may lead to disappointing results. In this paper, I study how alternate regimes of comparative effectiveness information help shape the marginal benefits (demand) curve in the population and how such perceived demand curves impact decision-making at the individual patient level and welfare at the societal level. I highlight the need to individualize comparative effectiveness research in order to generate the true (normative) demand curve for treatments. I discuss methodological principles that guide research designs for such studies. Using an example of the comparative effect of substance abuse treatments on crime, I use novel econometric methods to salvage individualized information from an existing dataset. Copyright © 2011 Elsevier B.V. All rights reserved.

Accurate reporting of adherence to inhaled therapies in adults with cystic fibrosis: methods to calculate “normative adherence”

PubMed Central

Hoo, Zhe Hui; Curley, Rachael; Campbell, Michael J; Walters, Stephen J; Hind, Daniel; Wildman, Martin J

2016-01-01

Background Preventative inhaled treatments in cystic fibrosis will only be effective in maintaining lung health if used appropriately. An accurate adherence index should therefore reflect treatment effectiveness, but the standard method of reporting adherence, that is, as a percentage of the agreed regimen between clinicians and people with cystic fibrosis, does not account for the appropriateness of the treatment regimen. We describe two different indices of inhaled therapy adherence for adults with cystic fibrosis which take into account effectiveness, that is, “simple” and “sophisticated” normative adherence. Methods to calculate normative adherence Denominator adjustment involves fixing a minimum appropriate value based on the recommended therapy given a person’s characteristics. For simple normative adherence, the denominator is determined by the person’s Pseudomonas status. For sophisticated normative adherence, the denominator is determined by the person’s Pseudomonas status and history of pulmonary exacerbations over the previous year. Numerator adjustment involves capping the daily maximum inhaled therapy use at 100% so that medication overuse does not artificially inflate the adherence level. Three illustrative cases Case A is an example of inhaled therapy under prescription based on Pseudomonas status resulting in lower simple normative adherence compared to unadjusted adherence. Case B is an example of inhaled therapy under-prescription based on previous exacerbation history resulting in lower sophisticated normative adherence compared to unadjusted adherence and simple normative adherence. Case C is an example of nebulizer overuse exaggerating the magnitude of unadjusted adherence. Conclusion Different methods of reporting adherence can result in different magnitudes of adherence. We have proposed two methods of standardizing the calculation of adherence which should better reflect treatment effectiveness. The value of these indices can be tested empirically in clinical trials in which there is careful definition of treatment regimens related to key patient characteristics, alongside accurate measurement of health outcomes. PMID:27284242

Inference for the effect of treatment on survival probability in randomized trials with noncompliance and administrative censoring.

PubMed

Nie, Hui; Cheng, Jing; Small, Dylan S

2011-12-01

In many clinical studies with a survival outcome, administrative censoring occurs when follow-up ends at a prespecified date and many subjects are still alive. An additional complication in some trials is that there is noncompliance with the assigned treatment. For this setting, we study the estimation of the causal effect of treatment on survival probability up to a given time point among those subjects who would comply with the assignment to both treatment and control. We first discuss the standard instrumental variable (IV) method for survival outcomes and parametric maximum likelihood methods, and then develop an efficient plug-in nonparametric empirical maximum likelihood estimation (PNEMLE) approach. The PNEMLE method does not make any assumptions on outcome distributions, and makes use of the mixture structure in the data to gain efficiency over the standard IV method. Theoretical results of the PNEMLE are derived and the method is illustrated by an analysis of data from a breast cancer screening trial. From our limited mortality analysis with administrative censoring times 10 years into the follow-up, we find a significant benefit of screening is present after 4 years (at the 5% level) and this persists at 10 years follow-up. © 2011, The International Biometric Society.

Treatment-Resistant Depressed Youth Show a Higher Response Rate If Treatment Ends during Summer School Break

ERIC Educational Resources Information Center

Shamseddeen, Wael; Clarke, Gregory; Wagner, Karen Dineen; Ryan, Neal D.; Birmaher, Boris; Emslie, Graham; Asarnow, Joan Rosenbaum; Porta, Giovanna; Mayes, Taryn; Keller, Martin B.; Brent, David A.

2011-01-01

Objective: There is little work on the effect of school on response to treatment of depression, with available research suggesting that children and adolescents with school difficulties are less likely to respond to fluoxetine compared with those with no school difficulties. Method: Depressed adolescents in the Treatment of Resistant Depression in…

Surface Erosion Control Techniques on Newly Constructed Forest Roads

Treesearch

Johnny M. Grace; John Wilhoit; Robert Rummer; Bryce Stokes

1999-01-01

A newly constructed forest road was treated with three erosion control treatments: wood excelsior erosion mat, native grass species, and exotic grass species. The study evaluates treatment methods on the basis of sediment reduction and runoff volume reduction compared to no treatment. The erosion mat treatment was most effective in mitigating erosion losses with a 98...

Hypnosis for IBS

MedlinePlus

... the treatment options for IBS. Other psychological methods, cognitive therapy in particular, are also effective options. Hypnosis may ... Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for IBS Take Part in Online ...

Shivering Treatments for Targeted Temperature Management: A Review

PubMed Central

Jain, Akash; Gray, Maria; Slisz, Stephanie; Haymore, Joseph; Badjatia, Neeraj; Kulstad, Erik

2018-01-01

ABSTRACT Background: Shivering is common during targeted temperature management, and control of shivering can be challenging if clinicians are not familiar with the available options and recommended approaches. Purpose: The purpose of this review was to summarize the most relevant literature regarding various treatments available for control of shivering and suggest a recommended approach based on latest data. Methods: The electronic databases PubMed/MEDLINE and Google Scholar were used to identify studies for the literature review using the following keywords alone or in combination: “shivering treatment,” “therapeutic hypothermia,” “core temperature modulation devices,” and “targeted temperature management.” Results: Nonpharmacologic methods were found to have a very low adverse effect profile and ease of use but some limitations in complete control of shivering. Pharmacologic methods can effectively control shivering, but some have adverse effects, such that risks and benefits to the patient have to be balanced. Conclusion: An approach is provided which suggests that treatment for shivering control in targeted temperature management should be initiated before the onset of therapeutic hypothermia or prior to any attempt at lowering patient core temperature, with medications including acetaminophen, buspirone, and magnesium sulfate, ideally with the addition of skin counterwarming. After that, shivering intervention should be determined with the help of a shivering scale, and stepwise escalation can be implemented that balances shivering treatment with sedation, aiming to provide the most shivering reduction with the least sedating medications and reserving paralytics for the last line of treatment. PMID:29278601

Estimating the optimal dynamic antipsychotic treatment regime: Evidence from the sequential multiple assignment randomized CATIE Schizophrenia Study

PubMed Central

Shortreed, Susan M.; Moodie, Erica E. M.

2012-01-01

Summary Treatment of schizophrenia is notoriously difficult and typically requires personalized adaption of treatment due to lack of efficacy of treatment, poor adherence, or intolerable side effects. The Clinical Antipsychotic Trials in Intervention Effectiveness (CATIE) Schizophrenia Study is a sequential multiple assignment randomized trial comparing the typical antipsychotic medication, perphenazine, to several newer atypical antipsychotics. This paper describes the marginal structural modeling method for estimating optimal dynamic treatment regimes and applies the approach to the CATIE Schizophrenia Study. Missing data and valid estimation of confidence intervals are also addressed. PMID:23087488

Collective antibiotic treatment of trachoma

PubMed Central

Reinhards, J.; Weber, A.; Maxwell-Lyons, F.

1959-01-01

By the early 1950's, it was clear from numerous independent reports that certain of the broad-spectrum antibiotics were effective against the agent of trachoma. It seemed, however, that treatment had to be continued over long periods to effect a cure of the average case. With the assistance of WHO, comparative trials on a scale hitherto unprecedented in the disease—involving more than 9000 schoolchildren with active trachoma—have been conducted in Morocco since 1953 in order to assess the value of local treatment of trachoma with chlortetracycline and to develop simple and economic methods of treatment, for which there was a pressing need. Local application of 1% chlortetracycline ointment two or three times daily for 60 days gave almost 80% cures under reasonably favourable conditions and nearly 100% cures after re-treatment of cases not cured by the first course. Equally good results followed intermittent short-term treatment over longer periods. Relapse and reinfection rates were low. Collective mass treatment with antibiotics is clearly a valuable method of trachoma control. The use of intermittent treatment allows for a great economy both in antibiotics and in staff and other campaign expenses and makes possible the wide expansion of mass treatment programmes. PMID:14437176

Laser heat puncturing as highly effective method of post-tuberculous cystalgia treatment

NASA Astrophysics Data System (ADS)

Koultchavenia, Ekaterina V.; Krasnov, Vladimir A.

1999-09-01

The tuberculosis of an urine bladder in men develops less often, and recovery is authentic more often, than in women. In 39.1% of the female patients with nephrotuberculosis, a specific cystitis is finished in postturberculous cystalgia. One of starting mechanisms of disuria after urocystis tuberculosis in the women in menopause is hormonal insufficiency. The method of laserheatpuncturing, developed by us, for the treatment this complication is highly effective, does not require additional introduction of medicines, can be executed as in hospitals, and in out-patient.

Biofilm regeneration on carriers in MBBR used for vitamin C wastewater treatment.

PubMed

Hu, X B; Wang, Zh; Xu, K; Ren, H Q

2013-01-01

Methods were investigated for biofilm regeneration on carriers in a moving bed biofilm reactor used for vitamin C production wastewater treatment. Three ordinary chemical cleaning agents (hydrochloric acid, sodium hydroxide, and sodium hypochlorite) and physical drying were chosen for evaluation as methods for biofilm detachment. The results showed that these methods all had some degree of biofilm removal effectiveness. Treatment with 3% hydrochloric acid (w/w) achieved the maximum degree of biofilm detachment, at 75.2%. Biofilm biomass re-formed on carriers, from the maximum degree of biofilm detachment, quickly by an increase of 76.17 g m(-2) month(-1). It was concluded that treatment with 3% acid was the best choice for biofilm removal and regeneration.

Use of Arginine Hydrochloride in the Treatment of Metabolic Alkalosis or Hypochloremia in Pediatric Patients

PubMed Central

Hernandez, Elvin A.; Parbuoni, Kristine A.

2018-01-01

OBJECTIVES Dosing of arginine for treatment of hypochloremia or metabolic alkalosis is laborious and has inherent variability in dose selection. The primary objective of this study was to determine the efficacy of arginine in the treatment of metabolic alkalosis and hypochloremia. Secondary objectives were to determine an optimal dose, route, and frequency for arginine administration in the treatment of these conditions. METHODS This single center, retrospective, descriptive study was conducted in children who received arginine for treatment of hypochloremia or metabolic alkalosis. Treatment success was assessed by measuring serum chloride and bicarbonate concentrations after arginine administration. RESULTS Of the 464 orders analyzed, 177 met inclusion criteria in 82 unique patients. Fifty percent (n = 81) of arginine administrations used to manage hypochloremia saw normalization of abnormal chloride levels, and 83% (n = 62) of arginine administrations used to treat metabolic alkalosis saw normalization of abnormal bicarbonate levels. Patients who received arginine to resolve hypochloremia were statistically significantly more likely to have their hypochloremia resolve if they used alternative dosing methods compared to established dosing methods (76 vs. 5, p = 0.001). However, this relationship was not seen for patients with metabolic alkalosis (11 vs. 51, p = 1.000). The median percentage of calculated daily dose of arginine needed for resolution of hypochloremia was 59% and was 35% for metabolic alkalosis. CONCLUSIONS Arginine is effective to improve metabolic alkalosis and hypochloremia. Established dosing methods are not more effective than other methods in resolving metabolic alkalosis or hypochloremia. Further prospective studies are warranted to validate these results. PMID:29720912

An optical microfluidic platform for spatiotemporal biofilm treatment monitoring

NASA Astrophysics Data System (ADS)

Kim, Young Wook; Mosteller, Matthew P.; Subramanian, Sowmya; Meyer, Mariana T.; Bentley, William E.; Ghodssi, Reza

2016-01-01

Bacterial biofilms constitute in excess of 65% of clinical microbial infections, with the antibiotic treatment of biofilm infections posing a unique challenge due to their high antibiotic tolerance. Recent studies performed in our group have demonstrated that a bioelectric effect featuring low-intensity electric signals combined with antibiotics can significantly improve the efficacy of biofilm treatment. In this work, we demonstrate the bioelectric effect using sub-micron thick planar electrodes in a microfluidic device. This is critical in efforts to develop microsystems for clinical biofilm infection management, including both in vivo and in vitro applications. Adaptation of the method to the microscale, for example, can enable the development of localized biofilm infection treatment using microfabricated medical devices, while augmenting existing capabilities to perform biofilm management beyond the clinical realm. Furthermore, due to scale-down of the system, the voltage requirement for inducing the electric field is reduced further below the media electrolysis threshold. Enhanced biofilm treatment using the bioelectric effect in the developed microfluidic device elicited a 56% greater reduction in viable cell density and 26% further decrease in biomass growth compared to traditional antibiotic therapy. This biofilm treatment efficacy, demonstrated in a micro-scale device and utilizing biocompatible voltage ranges, encourages the use of this method for future clinical biofilm treatment applications.

An Evaluation of a Smartphone–Assisted Behavioral Weight Control Intervention for Adolescents: Pilot Study

PubMed Central

Duncombe, Kristina M; Lott, Mark A; Hunsaker, Sanita L; Duraccio, Kara M; Woolford, Susan J

2016-01-01

Background The efficacy of adolescent weight control treatments is modest, and effective treatments are costly and are not widely available. Smartphones may be an effective method for delivering critical components of behavioral weight control treatment including behavioral self-monitoring. Objective To examine the efficacy and acceptability of a smartphone assisted adolescent behavioral weight control intervention. Methods A total of 16 overweight or obese adolescents (mean age=14.29 years, standard deviation=1.12) received 12 weeks of combined treatment that consisted of weekly in-person group behavioral weight control treatment sessions plus smartphone self-monitoring and daily text messaging. Subsequently they received 12 weeks of electronic-only intervention, totaling 24 weeks of intervention. Results On average, participants attained modest but significant reductions in body mass index standard score (zBMI: 0.08 standard deviation units, t (13)=2.22, P=.04, d=0.63) over the in-person plus electronic-only intervention period but did not maintain treatment gains over the electronic-only intervention period. Participants self-monitored on approximately half of combined intervention days but less than 20% of electronic-only intervention days. Conclusions Smartphones likely hold promise as a component of adolescent weight control interventions but they may be less effective in helping adolescents maintain treatment gains after intensive interventions. PMID:27554704

Comparing removal of trace organic compounds and assimilable organic carbon (AOC) at advanced and traditional water treatment plants.

PubMed

Lou, Jie-Chung; Lin, Chung-Yi; Han, Jia-Yun; Tseng, Wei-Biu; Hsu, Kai-Lin; Chang, Ting-Wei

2012-06-01

Stability of drinking water can be indicated by the assimilable organic carbon (AOC). This AOC value represents the regrowth capacity of microorganisms and has large impacts on the quality of drinking water in a distribution system. With respect to the effectiveness of traditional and advanced processing methods in removing trace organic compounds (including TOC, DOC, UV(254), and AOC) from water, experimental results indicate that the removal rate of AOC at the Cheng Ching Lake water treatment plant (which utilizes advanced water treatment processes, and is hereinafter referred to as CCLWTP) is 54%, while the removal rate of AOC at the Gong Yuan water treatment plant (which uses traditional water treatment processes, and is hereinafter referred to as GYWTP) is 36%. In advanced water treatment units, new coagulation-sedimentation processes, rapid filters, and biological activated carbon filters can effectively remove AOC, total organic carbon (TOC), and dissolved organic carbon (DOC). In traditional water treatment units, coagulation-sedimentation processes are most effective in removing AOC. Simulation results and calculations made using the AutoNet method indicate that TOC, TDS, NH(3)-N, and NO(3)-N should be regularly monitored in the CCLWTP, and that TOC, temperature, and NH(3)-N should be regularly monitored in the GYWTP.

Nanotechnology-Based Detection and Targeted Therapy in Cancer: Nano-Bio Paradigms and Applications

PubMed Central

Mousa, Shaker A.; Bharali, Dhruba J.

2011-01-01

The application of nanotechnology to biomedicine, particularly in cancer diagnosis and treatment, promises to have a profound impact on healthcare. The exploitation of the unique properties of nano-sized particles for cancer therapeutics is most popularly known as nanomedicine. The goals of this review are to discuss the current state of nanomedicine in the field of cancer detection and the subsequent application of nanotechnology to treatment. Current cancer detection methods rely on the patient contacting their provider when they feel ill, or relying on non-specific screening methods, which unfortunately often result in cancers being detected only after it is too late for effective treatment. Cancer treatment paradigms mainly rely on whole body treatment with chemotherapy agents, exposing the patient to medications that non-specifically kill rapidly dividing cells, leading to debilitating side effects. In addition, the use of toxic organic solvents/excipients can hamper the further effectiveness of the anticancer drug. Nanomedicine has the potential to increase the specificity of treatment of cancer cells while leaving healthy cells intact through the use of novel nanoparticles. This review discusses the use of nanoparticles such as quantum dots, nanoshells, nanocrystals, nanocells, and dendrimers for the detection and treatment of cancer. Future directions and perspectives of this cutting-edge technology are also discussed. PMID:24212938

Three Scoring Approaches to the Neurobehavioral Symptom Inventory for Measuring Clinical Change in Service Members Receiving Intensive Treatment for Combat-Related mTBI.

PubMed

Dretsch, Michael; Bleiberg, Joseph; Williams, Kathy; Caban, Jesus; Kelly, James; Grammer, Geoffrey; DeGraba, Thomas

2016-01-01

To examine the use of the Neurobehavioral Symptom Inventory to measure clinical changes over time in a population of US service members undergoing treatment of mild traumatic brain injury and comorbid psychological health conditions. A 4-week, 8-hour per day, intensive, outpatient, interdisciplinary, comprehensive treatment program at the National Intrepid Center of Excellence in Bethesda, Maryland. Three hundred fourteen active-duty service members being treated for combat-related comorbid mild traumatic brain injury and psychological health conditions. Repeated-measures, retrospective analysis of a single-group using a pretest-posttest treatment design. Three Neurobehavioral Symptom Inventory scoring methods: (1) a total summated score, (2) the 3-factor method, and (3) the 4-factor method (with and without orphan items). All 3 scoring methods yielded statistically significant within-subject changes between admission and discharge. The evaluation of effect sizes indicated that the 3 different Neurobehavioral Symptom Inventory scoring methods were comparable. Findings indicate that the different scoring methods all have potential for assessing clinical changes in symptoms for groups of patients undergoing treatment, with no clear advantage with any one method.

Case Report. Prevention of Clozapine-Induced Granulocytopenia/Agranulocytosis with Granulocyte-Colony Stimulating Factor (G-CSF) in an Intellectually Disabled Patient with Schizophrenia

ERIC Educational Resources Information Center

Rajagopal, G.; Graham, J. G.; Haut, F. F. A.

2007-01-01

Background: While clozapine is an effective treatment for refractory schizophrenia, its use is limited by haematological side effects. Treatment options that allow continued prescription of clozapine by tackling these side effects will greatly aid patients for whom this medication is all too often their only hope of recovery. Method: In this case…

Treatment of mandibular symphyseal fracture combined with dislocated intracapsular condylar fractures.

PubMed

Xu, Xiaofeng; Shi, Jun; Xu, Bing; Dai, Jiewen; Zhang, Shilei

2015-03-01

To evaluate the treatment methods of mandibular symphyseal fracture combined with dislocated intracapsular condylar fractures (MSF&DICF) and to compare the effect of different treatment methods of condylar fractures. Twenty-eight patients with MSF&DICF were included in this study. Twenty-two sites were treated by open reduction, and all the medial condylar fragments were fixed with titanium screws; whereas the other 22 sites underwent close treatment. The surgical effect between these 2 groups was compared based on clinical examination and radiographic examination results. Seventeen of 22 condyle fractures were repositioned in the surgery group, whereas 4 of 22 condyle fractures were repositioned in the close treatment group. Statistical difference was observed between these 2 groups (P < 0.01). Functional outcomes of the patients treated in the surgical treatment group also were better than those in the close treatment group. The dislocated intracapsular condyle fractures should be treated by surgical reduction with the maintenance of the attachment of lateral pterygoid muscle, which is beneficial to repositioning the dislocated condyle to its original physiological position, to closure of the mandibular lingual gap, to restore the mandibular width.

Monitoring blood flow and photobleaching during topical ALA PDT treatment

NASA Astrophysics Data System (ADS)

Sands, Theresa L.; Sunar, Ulas; Foster, Thomas H.; Oseroff, Allan R.

2009-02-01

Photodynamic therapy (PDT) using topical aminolevulinic acid (ALA) is currently used as a clinical treatment for nonmelanoma skin cancers. In order to optimize PDT treatment, vascular shutdown early in treatment must be identified and prevented. This is especially important for topical ALA PDT where vascular shutdown is only temporary and is not a primary method of cell death. Shutdown in vasculature would limit the delivery of oxygen which is necessary for effective PDT treatment. Diffuse correlation spectroscopy (DCS) was used to monitor relative blood flow changes in Balb/C mice undergoing PDT at fluence rates of 10mW/cm2 and 75mW/cm2 for colon-26 tumors implanted intradermally. DCS is a preferable method to monitor the blood flow during PDT of lesions due to its ability to be used noninvasively throughout treatment, returning data from differing depths of tissue. Photobleaching of the photosensitizer was also monitored during treatment as an indirect manner of monitoring singlet oxygen production. In this paper, we show the conditions that cause vascular shutdown in our tumor model and its effects on the photobleaching rate.

Selective peripheral nerve resection for treatment of persistent pain around the knee joint after total knee arthroplasty.

PubMed

Zhong, Guangjun; Liang, Zhu; Kan, Jiang; Muheremu, Aikeremujiang

2018-01-01

Objective This study was performed to determine the efficacy of selective peripheral nerve resection for treatment of persistent neuropathic pain after total knee arthroplasty (TKA). Methods Patients who underwent TKA in our department from January 2013 to July 2016 and experienced persistent pain around the knee joint after TKA were retrospectively included in the current study. Sixty patients were divided into experimental and control groups according the treatment they received. The treatment effect was evaluated by the Hospital for Special Surgery (HSS) knee score and visual analog scale (VAS) pain score preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. Results The HSS knee scores were higher in both groups after than before the treatment, and HSS knee scores were significantly higher in the experimental group than in the control group. The VAS pain scores were lower in both groups after than before the treatment, and VAS pain scores were significantly lower in the experimental group than in the control group. Conclusions Selective peripheral nerve resection is an effective treatment method for persistent neuropathic pain after TKA.

Experimental use of a laser as one of the methods of physiotherapeutical treatment in lumbosacral rachialgia

NASA Astrophysics Data System (ADS)

Jagielski, Jerzy

1995-03-01

The author presents the initial comparative investigations on treatment with laser beam, diadynamic current, and combined operation of diadynamic currents and classic massage. The investigations were performed in three groups on 78 patients. The obtained results indicate great therapeutic effectiveness of laser biostimulation, better than in other treatments and a larger scope of indications for treatment with that method. According to the modified Laitinen's scale the obtained improvement was from the range of two points, corresponding to strong pain, to 0.3 points, almost complete regression of the pain.

Effect of surface treatments on shear bond strength of resin composite bonded to CAD/CAM resin-ceramic hybrid materials

PubMed Central

Güngör, Merve Bankoğlu; Bal, Bilge Turhan; Ünver, Senem; Doğan, Aylin

2016-01-01

PURPOSE The purpose of this study was to assess the effect of surface treatments on shear bond strength of resin composite bonded to thermocycled and non-thermocycled CAD/CAM resin-ceramic hybrid materials. MATERIALS AND METHODS 120 specimens (10×10×2 mm) from each material were divided into 12 groups according to different surface treatments in combination with thermal aging procedures. Surface treatment methods were airborne-particle abrasion (abraded with 50 micron alumina particles), dry grinding (grinded with 125 µm grain size bur), and hydrofluoric acid (9%) and silane application. According to the thermocycling procedure, the groups were assigned as non-thermocycled, thermocycled after packing composites, and thermocycled before packing composites. The average surface roughness of the non-thermocycled specimens were measured after surface treatments. After packing composites and thermocycling procedures, shear bond strength (SBS) of the specimens were tested. The results of surface roughness were statistically analyzed by 2-way Analysis of Variance (ANOVA), and SBS results were statistically analyzed by 3-way ANOVA. RESULTS Surface roughness of GC were significantly lower than that of LU and VE (P<.05). The highest surface roughness was observed for dry grinding group, followed by airborne particle abraded group (P<.05). Comparing the materials within the same surface treatment method revealed that untreated surfaces generally showed lower SBS values. The values of untreated LU specimens showed significantly different SBS values compared to those of other surface treatment groups (P<.05). CONCLUSION SBS was affected by surface treatments. Thermocycling did not have any effect on the SBS of the materials except acid and silane applied GC specimens, which were subjected to thermocycling before packing of the composite resin. PMID:27555894

Pharmacological and Nonpharmacological Methods of Treatment for Fragile X Syndrome

DTIC Science & Technology

2005-02-01

disorders, mental retardation, or autism spectrum disorders. We seek to address the most effective methods of treatment (pharmacological and behavioral... dental so that families can obtain these services from specific professionals with an interest in FX syndrome. School liaison services for school aged...Affected males may suffer learning disabilities, attention deficit disorders, mental retardation, and autism spectrum disorder. The Child Development

Estimation of hazard function and its associated factors in gastric cancer patients using wavelet and kernel smoothing methods.

PubMed

Ahmadi, Azadeh; Roudbari, Masoud; Gohari, Mahmood Reza; Hosseini, Bistoon

2012-01-01

Increase of mortality rates of gastric cancer in Iran and the world in recent years reveal necessity of studies on this disease. Here, hazard function for gastric cancer patients was estimated using Wavelet and Kernel methods and some related factors were assessed. Ninety- five gastric cancer patients in Fayazbakhsh Hospital between 1996 and 2003 were studied. The effects of age of patients, gender, stage of disease and treatment method on patient's lifetime were assessed. For data analyses, survival analyses using Wavelet method and Log-rank test in R software were used. Nearly 25.3% of patients were female. Fourteen percent had surgery treatment and the rest had treatment without surgery. Three fourths died and the rest were censored. Almost 9.5% of patients were in early stages of the disease, 53.7% in locally advance stage and 36.8% in metastatic stage. Hazard function estimation with the wavelet method showed significant difference for stages of disease (P<0.001) and did not reveal any significant difference for age, gender and treatment method. Only stage of disease had effects on hazard and most patients were diagnosed in late stages of disease, which is possibly one of the most reasons for high hazard rate and low survival. Therefore, it seems to be necessary a public education about symptoms of disease by media and regular tests and screening for early diagnosis.

An evaluation of exact matching and propensity score methods as applied in a comparative effectiveness study of inhaled corticosteroids in asthma

PubMed Central

Burden, Anne; Roche, Nicolas; Miglio, Cristiana; Hillyer, Elizabeth V; Postma, Dirkje S; Herings, Ron MC; Overbeek, Jetty A; Khalid, Javaria Mona; van Eickels, Daniela; Price, David B

2017-01-01

Background Cohort matching and regression modeling are used in observational studies to control for confounding factors when estimating treatment effects. Our objective was to evaluate exact matching and propensity score methods by applying them in a 1-year pre–post historical database study to investigate asthma-related outcomes by treatment. Methods We drew on longitudinal medical record data in the PHARMO database for asthma patients prescribed the treatments to be compared (ciclesonide and fine-particle inhaled corticosteroid [ICS]). Propensity score methods that we evaluated were propensity score matching (PSM) using two different algorithms, the inverse probability of treatment weighting (IPTW), covariate adjustment using the propensity score, and propensity score stratification. We defined balance, using standardized differences, as differences of <10% between cohorts. Results Of 4064 eligible patients, 1382 (34%) were prescribed ciclesonide and 2682 (66%) fine-particle ICS. The IPTW and propensity score-based methods retained more patients (96%–100%) than exact matching (90%); exact matching selected less severe patients. Standardized differences were >10% for four variables in the exact-matched dataset and <10% for both PSM algorithms and the weighted pseudo-dataset used in the IPTW method. With all methods, ciclesonide was associated with better 1-year asthma-related outcomes, at one-third the prescribed dose, than fine-particle ICS; results varied slightly by method, but direction and statistical significance remained the same. Conclusion We found that each method has its particular strengths, and we recommend at least two methods be applied for each matched cohort study to evaluate the robustness of the findings. Balance diagnostics should be applied with all methods to check the balance of confounders between treatment cohorts. If exact matching is used, the calculation of a propensity score could be useful to identify variables that require balancing, thereby informing the choice of matching criteria together with clinical considerations. PMID:28356782

Empirical Likelihood-Based Estimation of the Treatment Effect in a Pretest-Posttest Study.

PubMed

Huang, Chiung-Yu; Qin, Jing; Follmann, Dean A

2008-09-01

The pretest-posttest study design is commonly used in medical and social science research to assess the effect of a treatment or an intervention. Recently, interest has been rising in developing inference procedures that improve efficiency while relaxing assumptions used in the pretest-posttest data analysis, especially when the posttest measurement might be missing. In this article we propose a semiparametric estimation procedure based on empirical likelihood (EL) that incorporates the common baseline covariate information to improve efficiency. The proposed method also yields an asymptotically unbiased estimate of the response distribution. Thus functions of the response distribution, such as the median, can be estimated straightforwardly, and the EL method can provide a more appealing estimate of the treatment effect for skewed data. We show that, compared with existing methods, the proposed EL estimator has appealing theoretical properties, especially when the working model for the underlying relationship between the pretest and posttest measurements is misspecified. A series of simulation studies demonstrates that the EL-based estimator outperforms its competitors when the working model is misspecified and the data are missing at random. We illustrate the methods by analyzing data from an AIDS clinical trial (ACTG 175).

Empirical Likelihood-Based Estimation of the Treatment Effect in a Pretest–Posttest Study

PubMed Central

Huang, Chiung-Yu; Qin, Jing; Follmann, Dean A.

2013-01-01

The pretest–posttest study design is commonly used in medical and social science research to assess the effect of a treatment or an intervention. Recently, interest has been rising in developing inference procedures that improve efficiency while relaxing assumptions used in the pretest–posttest data analysis, especially when the posttest measurement might be missing. In this article we propose a semiparametric estimation procedure based on empirical likelihood (EL) that incorporates the common baseline covariate information to improve efficiency. The proposed method also yields an asymptotically unbiased estimate of the response distribution. Thus functions of the response distribution, such as the median, can be estimated straightforwardly, and the EL method can provide a more appealing estimate of the treatment effect for skewed data. We show that, compared with existing methods, the proposed EL estimator has appealing theoretical properties, especially when the working model for the underlying relationship between the pretest and posttest measurements is misspecified. A series of simulation studies demonstrates that the EL-based estimator outperforms its competitors when the working model is misspecified and the data are missing at random. We illustrate the methods by analyzing data from an AIDS clinical trial (ACTG 175). PMID:23729942

Estimating intervention effects of prevention programs: Accounting for noncompliance

PubMed Central

Stuart, Elizabeth A.; Perry, Deborah F.; Le, Huynh-Nhu; Ialongo, Nicholas S.

2010-01-01

Individuals not fully complying with their assigned treatments is a common problem encountered in randomized evaluations of behavioral interventions. Treatment group members rarely attend all sessions or do all “required” activities; control group members sometimes find ways to participate in aspects of the intervention. As a result, there is often interest in estimating both the effect of being assigned to participate in the intervention, as well as the impact of actually participating and doing all of the required activities. Methods known broadly as “complier average causal effects” (CACE) or “instrumental variables” (IV) methods have been developed to estimate this latter effect, but they are more commonly applied in medical and treatment research. Since the use of these statistical techniques in prevention trials has been less widespread, many prevention scientists may not be familiar with the underlying assumptions and limitations of CACE and IV approaches. This paper provides an introduction to these methods, described in the context of randomized controlled trials of two preventive interventions: one for perinatal depression among at-risk women and the other for aggressive disruptive behavior in children. Through these case studies, the underlying assumptions and limitations of these methods are highlighted. PMID:18843535

Cost-effectiveness of lung cancer screening and treatment methods: a systematic review of systematic reviews.

PubMed

Azar, Farbod Ebadifard; Azami-Aghdash, Saber; Pournaghi-Azar, Fatemeh; Mazdaki, Alireza; Rezapour, Aziz; Ebrahimi, Parvin; Yousefzadeh, Negar

2017-06-19

Due to extensive literature in the field of lung cancer and their heterogeneous results, the aim of this study was to systematically review of systematic reviews studies which reviewed the cost-effectiveness of various lung cancer screening and treatment methods. In this systematic review of systematic reviews study, required data were collected searching the following key words which selected from Mesh: "lung cancer", "lung oncology", "lung Carcinoma", "lung neoplasm", "lung tumors", "cost- effectiveness", "systematic review" and "Meta-analysis". The following databases were searched: PubMed, Cochrane Library electronic databases, Google Scholar, and Scopus. Two reviewers (RA and A-AS) evaluated the articles according to the checklist of "assessment of multiple systematic reviews" (AMSTAR) tool. Overall, information of 110 papers was discussed in eight systematic reviews. Authors focused on cost-effectiveness of lung cancer treatments in five systematic reviews. Targeted therapy options (bevacizumab, Erlotinib and Crizotinib) show an acceptable cost-effectiveness. Results of three studies failed to show cost-effectiveness of screening methods. None of the studies had used the meta-analysis method. The Quality of Health Economic Studies (QHES) tool and Drummond checklist were mostly used in assessing the quality of articles. Most perspective was related to the Payer (64 times) and the lowest was related to Social (11times). Most cases referred to Incremental analysis (82%) and also the lowest point of referral was related to Discounting (in 49% of the cases). The average quality score of included studies was calculated 9.2% from 11. Targeted therapy can be an option for the treatment of lung cancer. Evaluation of the cost-effectiveness of computerized tomographic colonography (CTC) in lung cancer screening is recommended. The perspective of the community should be more taken into consideration in studies of cost-effectiveness. Paying more attention to the topic of Discounting will be necessary in the studies.

Local and Systemic Therapies for Breast Cancer Patients: Reducing Short-term Symptoms with the Methods of Integrative Medicine

PubMed Central

Hack, C. C.; Voiß, P.; Lange, S.; Paul, A. E.; Conrad, S.; Dobos, G. J.; Beckmann, M. W.; Kümmel, S.

2015-01-01

With improved prognosis due to advances in the diagnosis and therapy of breast cancer, physicians and therapists now focus on aspects such as quality of life and the management of side effects from breast cancer treatment. Therapy- and disease-related side effects often reduce the patientʼs quality of life and can place a further burden on patients, with non-compliance or discontinuation of therapy a potential consequence. Study data have shown that therapy- and disease-related side effects can be reduced using the methods of integrative medicine. Reported benefits include improving patientsʼ wellbeing and quality of life, reducing stress, and improving patientsʼ mood, sleeping patterns and capacity to cope with disease. Examining the impact of integrative medicine on the side effects of cancer treatment would be beyond the scope of this review. This article therefore looks at short-term side effects of cancer treatment which are usually temporary and occur during or after local and systemic therapy. The focus is on mind-body medicine, acupuncture and classic naturopathic treatments developed by Sebastian Kneipp as complementary therapies. The latter includes hydrotherapy, phytotherapy, nutritional therapy, exercise therapy and a balanced lifestyle. PMID:26257404

Misspecification of Cox regression models with composite endpoints

PubMed Central

Wu, Longyang; Cook, Richard J

2012-01-01

Researchers routinely adopt composite endpoints in multicenter randomized trials designed to evaluate the effect of experimental interventions in cardiovascular disease, diabetes, and cancer. Despite their widespread use, relatively little attention has been paid to the statistical properties of estimators of treatment effect based on composite endpoints. We consider this here in the context of multivariate models for time to event data in which copula functions link marginal distributions with a proportional hazards structure. We then examine the asymptotic and empirical properties of the estimator of treatment effect arising from a Cox regression model for the time to the first event. We point out that even when the treatment effect is the same for the component events, the limiting value of the estimator based on the composite endpoint is usually inconsistent for this common value. We find that in this context the limiting value is determined by the degree of association between the events, the stochastic ordering of events, and the censoring distribution. Within the framework adopted, marginal methods for the analysis of multivariate failure time data yield consistent estimators of treatment effect and are therefore preferred. We illustrate the methods by application to a recent asthma study. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22736519

Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: a Delphi consensus.

PubMed

Schmiegelow, Kjeld; Attarbaschi, Andishe; Barzilai, Shlomit; Escherich, Gabriele; Frandsen, Thomas Leth; Halsey, Christina; Hough, Rachael; Jeha, Sima; Kato, Motohiro; Liang, Der-Cherng; Mikkelsen, Torben Stamm; Möricke, Anja; Niinimäki, Riitta; Piette, Caroline; Putti, Maria Caterina; Raetz, Elizabeth; Silverman, Lewis B; Skinner, Roderick; Tuckuviene, Ruta; van der Sluis, Inge; Zapotocka, Ester

2016-06-01

Although there are high survival rates for children with acute lymphoblastic leukaemia, their outcome is often counterbalanced by the burden of toxic effects. This is because reported frequencies vary widely across studies, partly because of diverse definitions of toxic effects. Using the Delphi method, 15 international childhood acute lymphoblastic leukaemia study groups assessed acute lymphoblastic leukaemia protocols to address toxic effects that were to be considered by the Ponte di Legno working group. 14 acute toxic effects (hypersensitivity to asparaginase, hyperlipidaemia, osteonecrosis, asparaginase-associated pancreatitis, arterial hypertension, posterior reversible encephalopathy syndrome, seizures, depressed level of consciousness, methotrexate-related stroke-like syndrome, peripheral neuropathy, high-dose methotrexate-related nephrotoxicity, sinusoidal obstructive syndrome, thromboembolism, and Pneumocystis jirovecii pneumonia) that are serious but too rare to be addressed comprehensively within any single group, or are deemed to need consensus definitions for reliable incidence comparisons, were selected for assessment. Our results showed that none of the protocols addressed all 14 toxic effects, that no two protocols shared identical definitions of all toxic effects, and that no toxic effect definition was shared by all protocols. Using the Delphi method over three face-to-face plenary meetings, consensus definitions were obtained for all 14 toxic effects. In the overall assessment of outcome of acute lymphoblastic leukaemia treatment, these expert opinion-based definitions will allow reliable comparisons of frequencies and severities of acute toxic effects across treatment protocols, and facilitate international research on cause, guidelines for treatment adaptation, preventive strategies, and development of consensus algorithms for reporting on acute lymphoblastic leukaemia treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Propranolol in Treatment of Huge and Complicated Infantile Hemangiomas in Egyptian Children

PubMed Central

Hassan, Basheir A.; Shreef, Khalid S.

2014-01-01

Background. Infantile hemangiomas (IHs) are the most common benign tumours of infancy. Propranolol has recently been reported to be a highly effective treatment for IHs. This study aimed to evaluate the efficacy and side effects of propranolol for treatment of complicated cases of IHs. Patients and Methods. This prospective clinical study included 30 children with huge or complicated IHs; their ages ranged from 2 months to 1 year. They were treated by oral propranolol. Treatment outcomes were clinically evaluated. Results. Superficial cutaneous hemangiomas began to respond to propranolol therapy within one to two weeks after the onset of treatment. The mean treatment period that was needed for the occurrence of complete resolution was 9.4 months. Treatment with propranolol was well tolerated and had few side effects. No rebound growth of the tumors was noted when propranolol dosing stopped except in one case. Conclusion. Propranolol is a promising treatment for IHs without obvious side effects. However, further studies with longer follow-up periods are needed. PMID:24899888

Propranolol in treatment of huge and complicated infantile hemangiomas in egyptian children.

PubMed

Hassan, Basheir A; Shreef, Khalid S

2014-01-01

Background. Infantile hemangiomas (IHs) are the most common benign tumours of infancy. Propranolol has recently been reported to be a highly effective treatment for IHs. This study aimed to evaluate the efficacy and side effects of propranolol for treatment of complicated cases of IHs. Patients and Methods. This prospective clinical study included 30 children with huge or complicated IHs; their ages ranged from 2 months to 1 year. They were treated by oral propranolol. Treatment outcomes were clinically evaluated. Results. Superficial cutaneous hemangiomas began to respond to propranolol therapy within one to two weeks after the onset of treatment. The mean treatment period that was needed for the occurrence of complete resolution was 9.4 months. Treatment with propranolol was well tolerated and had few side effects. No rebound growth of the tumors was noted when propranolol dosing stopped except in one case. Conclusion. Propranolol is a promising treatment for IHs without obvious side effects. However, further studies with longer follow-up periods are needed.

Effect of chemical sanitizer combined with modified atmosphere packaging on inhibiting Escherichia coli O157:H7 in commercial spinach.

PubMed

Lee, Sun-Young; Baek, Seung-Youb

2008-06-01

Escherichia coli O157:H7 contaminated spinach has recently caused several outbreaks of human illness in the USA and Canada. However, to date, there has been no study demonstrating an effective way to eliminate E. coli O157:H7 in spinach. Therefore, this study was conducted to investigate the effect of chemical sanitizers alone or in combination with packaging methods such as vacuum and modified atmosphere packaging (MAP) on inactivating E. coli O157:H7 in spinach during storage time. Spinach inoculated with E. coli O157:H7 was packaged in four different methods (air, vacuum, N(2) gas, and CO(2) gas packaging) following treatment with water, 100 ppm chlorine dioxide, or 100 ppm sodium hypochlorite for 5 min at room temperature and stored at 7+/-2 degrees C. Treatment with water did not significantly reduce levels of E. coli O157:H7 in spinach. However, treatment with chlorine dioxide and sodium hypochlorite significantly decreased levels of E. coli O157:H7 by 2.6 and 1.1 log(10)CFU/g, respectively. Levels of E. coli O157:H7 in samples packaged in air following treatments grew during storage time, whereas levels were maintained in samples packaged in other packaging methods (vacuum, N(2) gas, and CO(2) gas packaging). Therefore there were significant differences (about 3-4 log) of E. coli O157:H7 populations between samples packed in air and other packaging methods following treatment with chemical sanitizers after 7 days storage. These results suggest that the combination of treatment with chlorine dioxide and packaging methods such as vacuum and MAP may be useful for improving the microbial safety of spinach against E. coli O157:H7 during storage.

Econometric analysis to evaluate the effect of community-based health insurance on reducing informal self-care in Burkina Faso

PubMed Central

Robyn, Paul Jacob; Hill, Allan; Liu, Yuanli; Souares, Aurélia; Savadogo, Germain; Sié, Ali; Sauerborn, Rainer

2012-01-01

Objective This study examines the role of community-based health insurance (CBHI) in influencing health-seeking behaviour in Burkina Faso, West Africa. Community-based health insurance was introduced in Nouna district, Burkina Faso, in 2004 with the goal to improve access to contracted providers based at primary- and secondary-level facilities. The paper specifically examines the effect of CBHI enrolment on reducing the prevalence of seeking modern and traditional methods of self-treatment as the first choice in care among the insured population. Methods Three stages of analysis were adopted to measure this effect. First, propensity score matching was used to minimize the observed baseline differences between the insured and uninsured populations. Second, through matching the average treatment effect on the treated, the effect of insurance enrolment on health-seeking behaviour was estimated. Finally, multinomial logistic regression was applied to model demand for available health care options, including no treatment, traditional self-treatment, modern self-treatment, traditional healers and facility-based care. Results For the first choice in care sought, there was no significant difference in the prevalence of self-treatment among the insured and uninsured populations, reaching over 55% for each group. When comparing the alternative option of no treatment, CBHI played no significant role in reducing the demand for self-care (either traditional or modern) or utilization of traditional healers, while it did significantly increase consumption of facility-based care. The average treatment effect on the treated was insignificant for traditional self-care, modern self-care and traditional healer, but was significant with a positive effect for use of facility care. Discussion While CBHI does have a positive impact on facility care utilization, its effect on reducing the prevalence of self-care is limited. The policy recommendations for improving the CBHI scheme’s responsiveness to population health care demand should incorporate community-based initiatives that offer attractive and appropriate alternatives to self-care. PMID:21414993

A multi-institutional study of independent calculation verification in inhomogeneous media using a simple and effective method of heterogeneity correction integrated with the Clarkson method.

PubMed

Jinno, Shunta; Tachibana, Hidenobu; Moriya, Shunsuke; Mizuno, Norifumi; Takahashi, Ryo; Kamima, Tatsuya; Ishibashi, Satoru; Sato, Masanori

2018-05-21

In inhomogeneous media, there is often a large systematic difference in the dose between the conventional Clarkson algorithm (C-Clarkson) for independent calculation verification and the superposition-based algorithms of treatment planning systems (TPSs). These treatment site-dependent differences increase the complexity of the radiotherapy planning secondary check. We developed a simple and effective method of heterogeneity correction integrated with the Clarkson algorithm (L-Clarkson) to account for the effects of heterogeneity in the lateral dimension, and performed a multi-institutional study to evaluate the effectiveness of the method. In the method, a 2D image reconstructed from computed tomography (CT) images is divided according to lines extending from the reference point to the edge of the multileaf collimator (MLC) or jaw collimator for each pie sector, and the radiological path length (RPL) of each line is calculated on the 2D image to obtain a tissue maximum ratio and phantom scatter factor, allowing the dose to be calculated. A total of 261 plans (1237 beams) for conventional breast and lung treatments and lung stereotactic body radiotherapy were collected from four institutions. Disagreements in dose between the on-site TPSs and a verification program using the C-Clarkson and L-Clarkson algorithms were compared. Systematic differences with the L-Clarkson method were within 1% for all sites, while the C-Clarkson method resulted in systematic differences of 1-5%. The L-Clarkson method showed smaller variations. This heterogeneity correction integrated with the Clarkson algorithm would provide a simple evaluation within the range of -5% to +5% for a radiotherapy plan secondary check.

Effect of Sub- and Super-critical Water Treatment on Physicochemical Properties of Porcine Skin

PubMed Central

2015-01-01

Super- and sub-critical water treatments have been of interest as novel methods for protein hydrolysis. In the present study, we studied the effect of sub-critical water (Sub-H2O, 300℃, 80 bar) treatment as well as super-critical water (Super-H2O, 400℃, 280 bar) treatment on the physicochemical properties of porcine skin (PS), which has abundant collagen. Porcine skin was subjected to pre-thermal treatment by immersion in water at 70℃, and then treated with sub- or super-critical water. Physicochemical properties of the hydrolysates, such as molecular weight distribution, free amino acid content, amino acid profile, pH, color, and water content were determined. For the molecular weight distribution analysis, 1 kDa hydrolyzed porcine skin (H-PS) was produced by Super-H2O or Sub-H2O treatment. The free amino acid content was 57.18 mM and 30.13 mM after Sub-H2O and Super-H2O treatment, respectively. Determination of amino acid profile revealed that the content of Glu (22.5%) and Pro (30%) was higher after Super-H2O treatment than after Sub-H2O treatment, whereas the content of Gly (28%) and Ala (13.1%) was higher after Sub-H2O treatment. Super-H2O or Sub-H2O treatment affected the pH of PS, which changed from 7.29 (Raw) to 9.22 (after Sub-H2O treatment) and 9.49 (after Super-H2O treatment). Taken together, these results showed that Sub-H2O treatment was slightly more effective for hydrolysis than Super-H2O was. However, both Sub-H2O and Super-H2O treatments were effective processing methods for hydrolysis of PS collagen in a short time and can be regarded as a green chemistry technology. PMID:26761798

Effect of Sub- and Super-critical Water Treatment on Physicochemical Properties of Porcine Skin.

PubMed

Jo, Yeon-Ji; Kim, Jae-Hyeong; Jung, Kyung-Hun; Min, Sang-Gi; Chun, Ji-Yeon

2015-01-01

Super- and sub-critical water treatments have been of interest as novel methods for protein hydrolysis. In the present study, we studied the effect of sub-critical water (Sub-H2O, 300℃, 80 bar) treatment as well as super-critical water (Super-H2O, 400℃, 280 bar) treatment on the physicochemical properties of porcine skin (PS), which has abundant collagen. Porcine skin was subjected to pre-thermal treatment by immersion in water at 70℃, and then treated with sub- or super-critical water. Physicochemical properties of the hydrolysates, such as molecular weight distribution, free amino acid content, amino acid profile, pH, color, and water content were determined. For the molecular weight distribution analysis, 1 kDa hydrolyzed porcine skin (H-PS) was produced by Super-H2O or Sub-H2O treatment. The free amino acid content was 57.18 mM and 30.13 mM after Sub-H2O and Super-H2O treatment, respectively. Determination of amino acid profile revealed that the content of Glu (22.5%) and Pro (30%) was higher after Super-H2O treatment than after Sub-H2O treatment, whereas the content of Gly (28%) and Ala (13.1%) was higher after Sub-H2O treatment. Super-H2O or Sub-H2O treatment affected the pH of PS, which changed from 7.29 (Raw) to 9.22 (after Sub-H2O treatment) and 9.49 (after Super-H2O treatment). Taken together, these results showed that Sub-H2O treatment was slightly more effective for hydrolysis than Super-H2O was. However, both Sub-H2O and Super-H2O treatments were effective processing methods for hydrolysis of PS collagen in a short time and can be regarded as a green chemistry technology.

A simple method for principal strata effects when the outcome has been truncated due to death.

PubMed

Chiba, Yasutaka; VanderWeele, Tyler J

2011-04-01

In randomized trials with follow-up, outcomes such as quality of life may be undefined for individuals who die before the follow-up is complete. In such settings, restricting analysis to those who survive can give rise to biased outcome comparisons. An alternative approach is to consider the "principal strata effect" or "survivor average causal effect" (SACE), defined as the effect of treatment on the outcome among the subpopulation that would have survived under either treatment arm. The authors describe a very simple technique that can be used to assess the SACE. They give both a sensitivity analysis technique and conditions under which a crude comparison provides a conservative estimate of the SACE. The method is illustrated using data from the ARDSnet (Acute Respiratory Distress Syndrome Network) clinical trial comparing low-volume ventilation and traditional ventilation methods for individuals with acute respiratory distress syndrome.

Experimental Research and Mathematical Modeling of Parameters Effecting on Cutting Force and SurfaceRoughness in CNC Turning Process

NASA Astrophysics Data System (ADS)

Zeqiri, F.; Alkan, M.; Kaya, B.; Toros, S.

2018-01-01

In this paper, the effects of cutting parameters on cutting forces and surface roughness based on Taguchi experimental design method are determined. Taguchi L9 orthogonal array is used to investigate the effects of machining parameters. Optimal cutting conditions are determined using the signal/noise (S/N) ratio which is calculated by average surface roughness and cutting force. Using results of analysis, effects of parameters on both average surface roughness and cutting forces are calculated on Minitab 17 using ANOVA method. The material that was investigated is Inconel 625 steel for two cases with heat treatment and without heat treatment. The predicted and calculated values with measurement are very close to each other. Confirmation test of results showed that the Taguchi method was very successful in the optimization of machining parameters for maximum surface roughness and cutting forces in the CNC turning process.

Technology selection for ballast water treatment by multi-stakeholders: A multi-attribute decision analysis approach based on the combined weights and extension theory.

PubMed

Ren, Jingzheng

2018-01-01

This objective of this study is to develop a generic multi-attribute decision analysis framework for ranking the technologies for ballast water treatment and determine their grades. An evaluation criteria system consisting of eight criteria in four categories was used to evaluate the technologies for ballast water treatment. The Best-Worst method, which is a subjective weighting method and Criteria importance through inter-criteria correlation method, which is an objective weighting method, were combined to determine the weights of the evaluation criteria. The extension theory was employed to prioritize the technologies for ballast water treatment and determine their grades. An illustrative case including four technologies for ballast water treatment, i.e. Alfa Laval (T 1 ), Hyde (T 2 ), Unitor (T 3 ), and NaOH (T 4 ), were studied by the proposed method, and the Hyde (T 2 ) was recognized as the best technology. Sensitivity analysis was also carried to investigate the effects of the combined coefficients and the weights of the evaluation criteria on the final priority order of the four technologies for ballast water treatment. The sum weighted method and the TOPSIS was also employed to rank the four technologies, and the results determined by these two methods are consistent to that determined by the proposed method in this study. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of Mathematics Integration in a Teaching Methods Course on Mathematics Ability of Preservice Agricultural Education Teachers

ERIC Educational Resources Information Center

Stripling, Christopher T.; Roberts, T. Grady

2014-01-01

The purpose of this study was to determine the effects of incorporating mathematics teaching and integration strategies (MTIS) in a teaching methods course on preservice agricultural teachers' mathematics ability. The research design was quasi-experimental and utilized a nonequivalent control group. The MTIS treatment had a positive effect on the…

[Research and development of portable hypertension therapeutic apparatus based on biofeedback mechanism].

PubMed

Huang, Rong; He, Hongmei; Pi, Xitian; Diao, Ziji; Zhao, Suwen

2014-06-01

Non-drug treatment of hypertension has become a research hotspot, which might overcome the heavy economic burden and side effects of drug treatment for the patients. Because of the good treatment effect and convenient operation, a new treatment based on slow breathing training is increasingly becoming a kind of physical therapy for hypertension. This paper explains the principle of hypertension treatment based on slow breathing training method, and introduces the overall structure of the portable blood pressure controlling instrument, including breathing detection circuit, the core control module, audio module, memory module and man-machine interaction module. We give a brief introduction to the instrument and the software in this paper. The prototype testing results showed that the treatment had a significant effect on controlling the blood pressure.

Residential Treatment for Sexually Abusive Youth: An Assessment of Treatment Outcomes

ERIC Educational Resources Information Center

Jones, Christopher D.; Chancey, Roy; Lowe, Laura A.; Risler, Edwin A.

2010-01-01

Objective: This research study assesses the effectiveness of participation in a multimodal/holistic residential treatment program on changing deviant sexual interests and functional impairment among sexually abusive youth. Method: A one-group pretest posttest design was utilized to examine pretest (intake) and posttest (discharge) scores for 58…

Treatment Integrity Enhancement via Performance Feedback Conceptualized as an Exercise in Social Influence

ERIC Educational Resources Information Center

Erchul, William P.

2013-01-01

This commentary is in response to the article "Effects of Verbal and Written Performance Feedback on Treatment Adherence" (Kaufman, Codding, Markus, Tryon, & Kyse, this issue). The overall recommendation to those who study treatment integrity using performance feedback methods is to incorporate theories and research on social…

Outpatient Treatment of Dyslexia through Stimulation of the Cerebral Hemispheres.

ERIC Educational Resources Information Center

Kappers, E. Jan

1997-01-01

Integrated treatment methods of neuropsychological and cognitive origin were evaluated with 80 Dutch children (ages 6-15) with severe dyslexia. Treatment with flash cards, which exercised automatic letter-sound conversions, had a robust and slight effect in preclinical and clinical phases respectively, whereas hemisphere stimulation produced…

Effects of Smallmouth Buffalo and Potassium Permanganate Treatment on Plankton ans Pond Water Quality

USDA-ARS?s Scientific Manuscript database

Removal of intermediate hosts is one option for control of disease in channel catfish production systems. We evaluated use of predaceous fish (smallmouth buffalo) and chemical treatment (potassium permanganate) to remove snails that serve as hosts protecting Dero worms. Both methods of treatment r...

Iowa Case Management for Rural Drug Abuse

ERIC Educational Resources Information Center

Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

2009-01-01

Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

High post-irradiation ductility thermomechanical treatment for precipitation strengthened austenitic alloys

DOEpatents

Laidler, James J.; Borisch, Ronald R.; Korenko, Michael K.

1982-01-01

A method for improving the post-irradiation ductility is described which prises a solution heat treatment following which the materials are cold worked. They are included to demonstrate the beneficial effect of this treatment on the swelling resistance and the ductility of these austenitic precipitation hardenable alloys.

Osteoarthritis subpopulations and implications for clinical trial design

PubMed Central

2011-01-01

Treatment guidelines for osteoarthritis have stressed the need for research on clinical predictors of response to different treatments. However, identifying such clinical predictors of response is less easy than it seems, and there is not a given classification of osteoarthritis subpopulations. This review article highlights the key methodical issues when analyzing and designing clinical studies to detect important subgroups with respect to treatment effect. In addition, we discuss the main osteoarthritis subpopulations and give examples of how specific treatment effects in these subpopulations have been assessed. PMID:21470393

Experience of treatment of patients with granulomatous lobular mastitis.

PubMed

Hur, Sung Mo; Cho, Dong Hui; Lee, Se Kyung; Choi, Min-Young; Bae, Soo Youn; Koo, Min Young; Kim, Sangmin; Choe, Jun-Ho; Kim, Jung-Han; Kim, Jee Soo; Nam, Seok-Jin; Yang, Jung-Hyun; Lee, Jeong Eon

2013-07-01

To present the author's experience with various treatment methods of granulomatous lobular mastitis (GLM) and to determine effective treatment methods of GLM. Fifty patients who were diagnosed with GLM were classified into five groups based on the initial treatment methods they underwent, which included observation (n = 8), antibiotics (n = 3), steroid (n = 13), drainage (n = 14), and surgical excision (n = 12). The treatment processes in each group were examined and their clinical characteristics, treatment processes, and results were analyzed respectively. Success rates with each initial treatment were observation, 87.5%; antibiotics, 33.3%; steroids, 30.8%; drainage, 28.6%; and surgical excision, 91.7%. In most cases of observation, the lesions were small and the symptoms were mild. A total of 23 patients underwent surgical excision during treatment. Surgical excision showed particularly fast recovery, high success rate (90.3%) and low recurrence rate (8.7%). The clinical course of GLM is complex and the outcome of each treatment type are variable. Surgery may play an important role when a lesion is determined to be mass-forming or appears localized as an abscess pocket during breast examination or imaging study.

MEMBRANES FOR DRINKING WATER TREATMENT

EPA Science Inventory

Various treatment technologies have proven effective in controlling halogenated disinfection by-products such as precursor removal and the use of alternative disinfectants. One of the most promising methods for halogenated by-product control includes removal of precursors before ...

Comparison of the Laboratory Standard Washing Using CIPAC Washing Agent and the Domestic Washing on Three Recommended Types of Long-Lasting Insecticidal Mosquito Nets

PubMed Central

Ouattara, Jean Pierre Nabléni; Louwagie, Johanna; Pigeon, Olivier; Spanoghe, Pieter

2013-01-01

Background One of the best ways to prevent malaria is the use of insecticide-treated bed nets. Manufacturers pursue easier, safer and more efficient nets. Hence, many studies on the efficacy and wash resistance using World Health Organization standards have been reported. The commonly used detergent is “Savon de Marseille”, because it closely resembles actually used soaps. At the 54th Collaborative International Pesticides Analytical Council (CIPAC) Technical Meeting in 2010, it was suggested to replace it by a standardized “CIPAC washing agent”. The aim of this study was to investigate the difference between a laboratory hand washing simulation using the CIPAC washing agent (method-1) and a domestic washing (method-2) on different bed nets, as well as the effect of the drying process on the release of active ingredient. Methods Interceptor®, Permanet®2.0 and Netprotect® nets were used in three treatments, each repeated 20 times. The first treatment included method-1 washing and indoor drying. The second treatment included method-2 washing and indoor drying. The third treatment used method-2 washing and UV-drying. The residual insecticide contents were determined using gas chromatography. Results The washing procedure and the number of washes have a significant effect on the release of active ingredient. Statistically, the two washing methods have the same effect on removing the active ingredient from the Interceptor® and Permanet®2.0 net, but a significantly different influence on the Netprotect® nets. The drying process has no significant effect on the insecticide. Conclusion Both washing procedures affected the amount of insecticide remaining on nets independently of the impregnation technology. The active ingredient decreases with the number of washing cycles following an exponential or logarithmic model for coated nets. The laboratory hand washing simulation had more impact on the decrease of active ingredient content of the Netprotect® nets. All net types seemed to be effectively protected against UV-light. PMID:24130671

Comparing effects of fire modeling methods on simulated fire patterns and succession: a case study in the Missouri Ozarks

Treesearch

Jian Yang; Hong S. He; Brian R. Sturtevant; Brian R. Miranda; Eric J. Gustafson

2008-01-01

We compared four fire spread simulation methods (completely random, dynamic percolation. size-based minimum travel time algorithm. and duration-based minimum travel time algorithm) and two fire occurrence simulation methods (Poisson fire frequency model and hierarchical fire frequency model) using a two-way factorial design. We examined these treatment effects on...

Developing a Theory of Treatment Effect Heterogeneity through Better Design: Where Do Behavioral Science Interventions Work Best?

ERIC Educational Resources Information Center

Tipton, Elizabeth; Yeager, David; Iachan, Ronaldo

2016-01-01

Questions regarding the generalizability of results from educational experiments have been at the forefront of methods development over the past five years. This work has focused on methods for estimating the effect of an intervention in a well-defined inference population (e.g., Tipton, 2013; O'Muircheartaigh and Hedges, 2014); methods for…

Musical hallucinations: review of treatment effects

PubMed Central

Coebergh, Jan A. F.; Lauw, R. F.; Bots, R.; Sommer, I. E. C.; Blom, J. D.

2015-01-01

Background: Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. Objective: To review the effects of published treatment methods for musical hallucinations. Methods: A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analyzed the treatment results in relation to the etiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion, and other pathology, epilepsy or intoxication/pharmacology. Results: Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct etiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g., more acoustic stimulation) are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being possibly more helpful than antiepileptics (which are still better than antipsychotics). The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication/pharmacology is the main etiological factor, it is important to stop or switch the causative substance or medication. Conclusion: Treatments for musical hallucinations tend to yield favorable results when they target the main etiological factor of these phenomena. There is a need to establish the natural course of musical hallucinations, their response to non-pharmacological treatments, and their effects on the patient's quality of life. There is also a need to standardize the assessment of treatment responses, and document long-term follow up. PMID:26136708

Comparison of efficacy of chemical peeling with 25% trichloroacetic acid and 0.1% retinoic acid for facial rejuvenation

PubMed Central

Gurel, Mehmet Salih; Gungor, Sule; Tekeli, Omur; Canat, Dilek

2016-01-01

Introduction Skin aging is a problem which negatively affects the psyche of the person, social relations, as well as work life and health and which compels the patients to find appropriate treatment methods. Numerous treatment methods have been developed in order to delay aging and to reduce the aging effects in addition to having a younger, healthier and more beautiful facial appearance. Aim To compare the efficiency, cosmetic results and possible adverse effects of the peeling treatment with 25% trichloroacetic acid (TCA) and 0.1% retinoic acid for facial rejuvenation in patients presenting with skin aging. Material and methods Fifty female patients in total presenting with medium and advanced degree skin aging were subject to this study. Two separate treatment groups were formed; the first group underwent chemical skin treatment with 25% TCA while the other group was applied with 0.1% retinoic acid treatment. Following the 4 months’ treatment the patients were controlled three times in total for post lesional hypopigmentation, hyperpigmentation, scars, skin irritation and other possible changes per month. The pretreatment and first follow-up visit, and final control images were comparatively evaluated by three observers via specific software. Results The healing rates of the group subject to retinoic acid were statistically higher (p < 0.05) compared to patients in the TCA group in the final follow-up visit following the treatment according to the first and second observers. On the other hand, according to the third observer, patients applied with retinoic acid presented with higher healing rates compared to those treated with TCA, however; this rate was not statistically significant (p > 0.05). The frequency of TCA- and retinoic acid-associated adverse effects was similar in both groups (p > 0.05). As a result of both treatments, a reduction in the quality of life scores as well as a pronounced recovery (p = 0.001) in the quality of life of those patients with skin aging was observed. Conclusions The photo aging treatment option with 0.1% retinoic acid is cheaper and more feasible for patients compared to 25% TCA, and it is also as reliable and effective as TCA. PMID:27512355

Correlation- and covariance-supported normalization method for estimating orthodontic trainer treatment for clenching activity.

PubMed

Akdenur, B; Okkesum, S; Kara, S; Günes, S

2009-11-01

In this study, electromyography signals sampled from children undergoing orthodontic treatment were used to estimate the effect of an orthodontic trainer on the anterior temporal muscle. A novel data normalization method, called the correlation- and covariance-supported normalization method (CCSNM), based on correlation and covariance between features in a data set, is proposed to provide predictive guidance to the orthodontic technique. The method was tested in two stages: first, data normalization using the CCSNM; second, prediction of normalized values of anterior temporal muscles using an artificial neural network (ANN) with a Levenberg-Marquardt learning algorithm. The data set consists of electromyography signals from right anterior temporal muscles, recorded from 20 children aged 8-13 years with class II malocclusion. The signals were recorded at the start and end of a 6-month treatment. In order to train and test the ANN, two-fold cross-validation was used. The CCSNM was compared with four normalization methods: minimum-maximum normalization, z score, decimal scaling, and line base normalization. In order to demonstrate the performance of the proposed method, prevalent performance-measuring methods, and the mean square error and mean absolute error as mathematical methods, the statistical relation factor R2 and the average deviation have been examined. The results show that the CCSNM was the best normalization method among other normalization methods for estimating the effect of the trainer.

HETEROGENEITY IN TREATMENT EFFECT AND COMPARATIVE EFFECTIVENESS RESEARCH.

PubMed

Luo, Zhehui

2011-10-01

The ultimate goal of comparative effectiveness research (CER) is to develop and disseminate evidence-based information about which interventions are most effective for which patients under what circumstances. To achieve this goal it is crucial that researchers in methodology development find appropriate methods for detecting the presence and sources of heterogeneity in treatment effect (HTE). Comparing with the typically reported average treatment effect (ATE) in randomized controlled trials and non-experimental (i.e., observational) studies, identifying and reporting HTE better reflect the nature and purposes of CER. Methodologies of CER include meta-analysis, systematic review, design of experiments that encompasses HTE, and statistical correction of various types of estimation bias, which is the focus of this review.

A new proportion measure of the treatment effect captured by candidate surrogate endpoints.

PubMed

Kobayashi, Fumiaki; Kuroki, Manabu

2014-08-30

The use of surrogate endpoints is expected to play an important role in the development of new drugs, as they can be used to reduce the sample size and/or duration of randomized clinical trials. Biostatistical researchers and practitioners have proposed various surrogacy measures; however, (i) most of these surrogacy measures often fall outside the range [0,1] without any assumptions, (ii) these surrogacy measures do not provide a cut-off value for judging a surrogacy level of candidate surrogate endpoints, and (iii) most surrogacy measures are highly variable; thus, the confidence intervals are often unacceptably wide. In order to solve problems (i) and (ii), we propose a new surrogacy measure, a proportion of the treatment effect captured by candidate surrogate endpoints (PCS), on the basis of the decomposition of the treatment effect into parts captured and non-captured by the candidate surrogate endpoints. In order to solve problem (iii), we propose an estimation method based on the half-range mode method with the bootstrap distribution of the estimated surrogacy measures. Finally, through numerical experiments and two empirical examples, we show that the PCS with the proposed estimation method overcomes these difficulties. The results of this paper contribute to the reliable evaluation of how much of the treatment effect is captured by candidate surrogate endpoints. Copyright © 2014 John Wiley & Sons, Ltd.

What role does measuring medication compliance play in evaluating the efficacy of naltrexone?

PubMed

Baros, Alicia M; Latham, Patricia K; Moak, Darlene H; Voronin, Konstantin; Anton, Raymond F

2007-04-01

Compliance with medication in pharmacotherapy trials of alcoholism has been shown to be equal to, or more, important than in other areas of medicine. Research has suggested that naltrexone's effectiveness can be greatly influenced by the compliance of participants in clinical trials. Presently, we compare 2 compliance measurement methods [urine riboflavin and medication event monitoring system (MEMS)] used simultaneously to evaluate naltrexone's efficacy and the impact of compliance on the size of observable treatment effects. One hundred and thirty-seven of 160 randomized alcoholic patients completed 12-weeks (84 days) of naltrexone or placebo and cognitive behavioral therapy (CBT) or motivational enhancement therapy (MET). Urine riboflavin was determined during study weeks 2, 6, and 12. The MEMS provided a detailed computerized record of when a participant opened their medication bottle throughout the trial. Baseline predictors of MEMS (80% openings) and urine riboflavin (>or=1,500 ng/mL by fluorimetry) compliance were examined. The effects of the treatments in the compliant participants defined by one, the other, or both methods were compared and contrasted with a previously reported intent-to-treat analysis where compliance was not taken into account. Age was predictive of compliance. 105 participants were deemed compliant via urine riboflavin criteria, 87 via MEMS, and 77 when both criteria were met, with no significant differences between treatment groups. The most compliant participants showed a significant medication by therapy interaction. Those treated with naltrexone/CBT showed more abstinence days (p<0.03), less heavy drinking days (p<0.03) and less total drinks (p<0.03) than the other groups. The effect size of this interaction increased from about 0.2 in the intent-to-treat analysis, to about 0.4 to 0.5 in the compliant group analyses, with little difference between compliance measurement methods. Compliance measurement does appear to influence the evaluation of the efficacy of naltrexone within the context of CBT. Treatment effect sizes approximately doubled in the most compliant individuals. Measuring compliance by either of 2 distinct methods provides approximately similar results. As compliance with naltrexone within the context of CBT has such a large impact of treatment outcome, methods of enhancing compliance during treatment should be given the utmost attention.

Effectiveness of integrating individualized and generic complementary medicine treatments with standard care versus standard care alone for reducing preoperative anxiety.

PubMed

Attias, Samuel; Keinan Boker, Lital; Arnon, Zahi; Ben-Arye, Eran; Bar'am, Ayala; Sroka, Gideon; Matter, Ibrahim; Somri, Mostafa; Schiff, Elad

2016-03-01

Preoperative anxiety is commonly reported by people undergoing surgery. A significant number of studies have found a correlation between preoperative anxiety and post-operative morbidity. Various methods of complementary and alternative medicine (CAM) were found to be effective in alleviating preoperative anxiety. This study examined the relative effectiveness of various individual and generic CAM methods combined with standard treatment (ST) in relieving preoperative anxiety, in comparison with ST alone. Randomized controlled trial. Holding room area Three hundred sixty patients. Patients were randomly divided into 6 equal-sized groups. Group 1 received the standard treatment (ST) for anxiety alleviation with anxiolytics. The five other groups received the following, together with ST (anxiolytics): Compact Disk Recording of Guided Imagery (CDRGI); acupuncture; individual guided imagery; reflexology; and individual guided imagery combined with reflexology, based on medical staff availability. Assessment of anxiety was taken upon entering the holding room area (surgery preparation room) ('pre-treatment assessment'), and following the treatment, shortly before transfer to the operating room ('post-treatment assessment'), based on the Visual Analogue Scale (VAS) questionnaire. Data processing included comparison of VAS averages in the 'pre' and 'post' stages among the various groups. Preoperatively, CAM treatments were associated with significant reduction of anxiety level (5.54-2.32, p<0.0001). In contrast, no significant change was noted in the standard treatment group (4.92-5.44, p=0.15). Individualized CAM treatments did not differ significantly in outcomes. However, CDRGI was less effective than individualized CAM (P<0.001), but better than ST (p=0.005). Individual CAM treatments integrated within ST reduce preoperative anxiety significantly, compared to standard treatment alone, and are more effective than generic CDRGI. In light of the scope of preoperative anxiety and its implications for public health, integration of CAM therapies with ST should be considered for reducing preoperative anxiety. Copyright © 2016 Elsevier Inc. All rights reserved.

The acute management of haemorrhoids

PubMed Central

Cohen, CRG

2014-01-01

Introduction Although the acute thrombosis and strangulation of haemorrhoids is a common condition, there is no consensus as to its most effective treatment. Methods A PubMed search was undertaken for papers describing the aetiology and treatment of the acute complications of haemorrhoids. Results The anatomy and treatments for strangulated internal haemorrhoids and thrombosed perianal varices are discussed. Studies of the effectiveness and complications of conservative and operative treatments are reviewed. Conclusions Ambiguities exist in the terminology used to describe the two separate pathologies that make up the acute complications of haemorrhoids. These complications have traditionally been treated conservatively. There is evidence that early operative intervention for strangulated internal haemorrhoids is safe and effective. A suggested algorithm for treatment is given, based on the published literature. PMID:25245728

The effectiveness of opioid substitution treatments for patients with opioid dependence: a systematic review and multiple treatment comparison protocol

PubMed Central

2014-01-01

Background Opioids are psychoactive analgesic drugs prescribed for pain relief and palliative care. Due to their addictive potential, effort and vigilance in controlling prescriptions is needed to avoid misuse and dependence. Despite the effort, the prevalence of opioid use disorder continues to rise. Opioid substitution therapies are commonly used to treat opioid dependence; however, there is minimal consensus as to which therapy is most effective. Available treatments include methadone, heroin, buprenorphine, as well as naltrexone. This systematic review aims to assess and compare the effect of all available opioid substitution therapies on the treatment of opioid dependence. Methods/Design The authors will search Medline, EMBASE, PubMed, PsycINFO, Web of Science, Cochrane Library, Cochrane Clinical Trials Registry, World Health Organization International Clinical Trials Registry Platform Search Portal, and the National Institutes for Health Clinical Trials Registry. The title, abstract, and full-text screening will be completed in duplicate. When appropriate, multiple treatment comparison Bayesian meta-analytic methods will be performed to deduce summary statistics estimating the effectiveness of all opioid substitution therapies in terms of retention and response to treatment (as measured through continued opioid abuse). Discussion Using evidence gained from this systematic review, we anticipate disseminating an objective review of the current available literature on the effectiveness of all opioid substitution therapies for the treatment of opioid use disorder. The results of this systematic review are imperative to the further enhancement of clinical practice in addiction medicine. Systematic review registration PROSPERO CRD42013006507. PMID:25239213

Metal artifacts in computed tomography for radiation therapy planning: dosimetric effects and impact of metal artifact reduction.

PubMed

Giantsoudi, Drosoula; De Man, Bruno; Verburg, Joost; Trofimov, Alexei; Jin, Yannan; Wang, Ge; Gjesteby, Lars; Paganetti, Harald

2017-04-21

A significant and increasing number of patients receiving radiation therapy present with metal objects close to, or even within, the treatment area, resulting in artifacts in computed tomography (CT) imaging, which is the most commonly used imaging method for treatment planning in radiation therapy. In the presence of metal implants, such as dental fillings in treatment of head-and-neck tumors, spinal stabilization implants in spinal or paraspinal treatment or hip replacements in prostate cancer treatments, the extreme photon absorption by the metal object leads to prominent image artifacts. Although current CT scanners include a series of correction steps for beam hardening, scattered radiation and noisy measurements, when metal implants exist within or close to the treatment area, these corrections do not suffice. CT metal artifacts affect negatively the treatment planning of radiation therapy either by causing difficulties to delineate the target volume or by reducing the dose calculation accuracy. Various metal artifact reduction (MAR) methods have been explored in terms of improvement of organ delineation and dose calculation in radiation therapy treatment planning, depending on the type of radiation treatment and location of the metal implant and treatment site. Including a brief description of the available CT MAR methods that have been applied in radiation therapy, this article attempts to provide a comprehensive review on the dosimetric effect of the presence of CT metal artifacts in treatment planning, as reported in the literature, and the potential improvement suggested by different MAR approaches. The impact of artifacts on the treatment planning and delivery accuracy is discussed in the context of different modalities, such as photon external beam, brachytherapy and particle therapy, as well as by type and location of metal implants.

Metal artifacts in computed tomography for radiation therapy planning: dosimetric effects and impact of metal artifact reduction

NASA Astrophysics Data System (ADS)

Giantsoudi, Drosoula; De Man, Bruno; Verburg, Joost; Trofimov, Alexei; Jin, Yannan; Wang, Ge; Gjesteby, Lars; Paganetti, Harald

2017-04-01

A significant and increasing number of patients receiving radiation therapy present with metal objects close to, or even within, the treatment area, resulting in artifacts in computed tomography (CT) imaging, which is the most commonly used imaging method for treatment planning in radiation therapy. In the presence of metal implants, such as dental fillings in treatment of head-and-neck tumors, spinal stabilization implants in spinal or paraspinal treatment or hip replacements in prostate cancer treatments, the extreme photon absorption by the metal object leads to prominent image artifacts. Although current CT scanners include a series of correction steps for beam hardening, scattered radiation and noisy measurements, when metal implants exist within or close to the treatment area, these corrections do not suffice. CT metal artifacts affect negatively the treatment planning of radiation therapy either by causing difficulties to delineate the target volume or by reducing the dose calculation accuracy. Various metal artifact reduction (MAR) methods have been explored in terms of improvement of organ delineation and dose calculation in radiation therapy treatment planning, depending on the type of radiation treatment and location of the metal implant and treatment site. Including a brief description of the available CT MAR methods that have been applied in radiation therapy, this article attempts to provide a comprehensive review on the dosimetric effect of the presence of CT metal artifacts in treatment planning, as reported in the literature, and the potential improvement suggested by different MAR approaches. The impact of artifacts on the treatment planning and delivery accuracy is discussed in the context of different modalities, such as photon external beam, brachytherapy and particle therapy, as well as by type and location of metal implants.

Power/Sample Size Calculations for Assessing Correlates of Risk in Clinical Efficacy Trials

PubMed Central

Gilbert, Peter B.; Janes, Holly E.; Huang, Yunda

2016-01-01

In a randomized controlled clinical trial that assesses treatment efficacy, a common objective is to assess the association of a measured biomarker response endpoint with the primary study endpoint in the active treatment group, using a case-cohort, case-control, or two-phase sampling design. Methods for power and sample size calculations for such biomarker association analyses typically do not account for the level of treatment efficacy, precluding interpretation of the biomarker association results in terms of biomarker effect modification of treatment efficacy, with detriment that the power calculations may tacitly and inadvertently assume that the treatment harms some study participants. We develop power and sample size methods accounting for this issue, and the methods also account for inter-individual variability of the biomarker that is not biologically relevant (e.g., due to technical measurement error). We focus on a binary study endpoint and on a biomarker subject to measurement error that is normally distributed or categorical with two or three levels. We illustrate the methods with preventive HIV vaccine efficacy trials, and include an R package implementing the methods. PMID:27037797

An evaluation of exact matching and propensity score methods as applied in a comparative effectiveness study of inhaled corticosteroids in asthma.

PubMed

Burden, Anne; Roche, Nicolas; Miglio, Cristiana; Hillyer, Elizabeth V; Postma, Dirkje S; Herings, Ron Mc; Overbeek, Jetty A; Khalid, Javaria Mona; van Eickels, Daniela; Price, David B

2017-01-01

Cohort matching and regression modeling are used in observational studies to control for confounding factors when estimating treatment effects. Our objective was to evaluate exact matching and propensity score methods by applying them in a 1-year pre-post historical database study to investigate asthma-related outcomes by treatment. We drew on longitudinal medical record data in the PHARMO database for asthma patients prescribed the treatments to be compared (ciclesonide and fine-particle inhaled corticosteroid [ICS]). Propensity score methods that we evaluated were propensity score matching (PSM) using two different algorithms, the inverse probability of treatment weighting (IPTW), covariate adjustment using the propensity score, and propensity score stratification. We defined balance, using standardized differences, as differences of <10% between cohorts. Of 4064 eligible patients, 1382 (34%) were prescribed ciclesonide and 2682 (66%) fine-particle ICS. The IPTW and propensity score-based methods retained more patients (96%-100%) than exact matching (90%); exact matching selected less severe patients. Standardized differences were >10% for four variables in the exact-matched dataset and <10% for both PSM algorithms and the weighted pseudo-dataset used in the IPTW method. With all methods, ciclesonide was associated with better 1-year asthma-related outcomes, at one-third the prescribed dose, than fine-particle ICS; results varied slightly by method, but direction and statistical significance remained the same. We found that each method has its particular strengths, and we recommend at least two methods be applied for each matched cohort study to evaluate the robustness of the findings. Balance diagnostics should be applied with all methods to check the balance of confounders between treatment cohorts. If exact matching is used, the calculation of a propensity score could be useful to identify variables that require balancing, thereby informing the choice of matching criteria together with clinical considerations.

Estimation of treatment effect in a subpopulation: An empirical Bayes approach.

PubMed

Shen, Changyu; Li, Xiaochun; Jeong, Jaesik

2016-01-01

It is well recognized that the benefit of a medical intervention may not be distributed evenly in the target population due to patient heterogeneity, and conclusions based on conventional randomized clinical trials may not apply to every person. Given the increasing cost of randomized trials and difficulties in recruiting patients, there is a strong need to develop analytical approaches to estimate treatment effect in subpopulations. In particular, due to limited sample size for subpopulations and the need for multiple comparisons, standard analysis tends to yield wide confidence intervals of the treatment effect that are often noninformative. We propose an empirical Bayes approach to combine both information embedded in a target subpopulation and information from other subjects to construct confidence intervals of the treatment effect. The method is appealing in its simplicity and tangibility in characterizing the uncertainty about the true treatment effect. Simulation studies and a real data analysis are presented.

The Childhood Arthritis and Rheumatology Research Alliance Consensus Treatment Plans: Toward Comparative Effectiveness in the Pediatric Rheumatic Diseases.

PubMed

Ringold, Sarah; Nigrovic, Peter A; Feldman, Brian M; Tomlinson, George A; von Scheven, Emily; Wallace, Carol A; Huber, Adam M; Schanberg, Laura E; Li, Suzanne C; Weiss, Pamela F; Fuhlbrigge, Robert C; Morgan, Esi M; Kimura, Yukiko

2018-05-01

The pediatric rheumatic diseases are a heterogeneous group of rare diseases, posing a number of challenges for the use of traditional clinical and translational research methods. Innovative comparative effectiveness approaches are needed to efficiently study treatment strategies and disease outcomes. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed the consensus treatment plan (CTP) approach as a comparative effectiveness tool for research in pediatric rheumatology. CTPs are treatment strategies, developed by consensus methods among CARRA members, intended to reduce variation in treatment approaches, standardize outcome measurements, and allow for comparison of the effectiveness of different approaches with the goal of improving disease outcomes. To date, CTPs have been published for 8 different diseases and disease manifestations. The approach has been successfully piloted for juvenile localized scleroderma, systemic juvenile idiopathic arthritis (JIA), polyarticular JIA, dermatomyositis, and lupus nephritis. Large-scale studies are underway for systemic JIA and polyarticular JIA, with the CARRA patient registry serving as the data collection platform. These studies have been designed with stakeholder involvement, including active input from CARRA providers, patients, and parents, with the goal of increasing feasibility and ensuring the relevance of the outcomes. These studies include ancillary biologic specimen collection intended to support additional translational and mechanistic studies. Data from these ongoing CTP studies will provide more information on the ability of this approach to identify effective treatment strategies and improve outcomes in the pediatric rheumatic diseases. © 2018, American College of Rheumatology.

Effect of Thunder-Fire Moxibustion on Pain, Quality of Life, and Tension of Multifidus in Patients with Primary Osteoporosis: A Randomized Controlled Trial.

PubMed

Xu, Dao-Ming; Xu, Huaning; Liu, Jing; Wang, Tong; Wu, Wenzhong; Liu, Lanying; Tian, Qianmo; Li, Hanjun; Zhang, Lili; Cao, Yana

2018-05-08

BACKGROUND Primary osteoporosis is a common disease among postmenopausal women and the elderly; low back pain is the most typical clinical manifestation an is the primary reason for a clinic visit, and directly affects patients' quality of life. Anti-osteoporosis medications have undesirable side effects, and many kinds of special traditional Chinese moxibustion methods have been widely used in the clinical treatment of osteoporosis low back pain. The purpose of this study was to observe whether thunder-fire moxibustion therapy, compared to calcium supplements alone, can ease osteoporosis low back pain, improve quality of life, and reduce tension of the multifidus. MATERIAL AND METHODS Sixty-three eligible patients were enrolled in the study (7 of these patients did not finish the study and are not included in analysis). Participants were randomly divided into 2 groups: a moxibustion group that received calcium carbonate D3 and thunder-fire moxibustion therapy, and a control group that received calcium carbonate D3 only. Level of pain experienced, assessed using the visual analogue scale (VAS), and quality of life (SF-36) were measured pre-treatment, at the end of 4 weeks of treatment, and at a 1-month post-treatment evaluation. Changes in values of Young's modulus of the multifidus were also collected before and after treatment. RESULTS After 4 weeks of treatment and at 1 month after treatment had ended, low back pain in both groups was reduced relative to pre-treatment levels. The moxibustion group was significantly improved at BP, GH, SF, and MH dimensions compared to pre-treatment levels. The control group improved in BP dimensions, but not to the same extent as the moxibustion group. Similarly, after treatment for 4 weeks with moxibustion, multifidus tension was significantly reduced. CONCLUSIONS Thunder-fire moxibustion is an effective method for treating low back pain due to primary osteoporosis.

Effect of Thunder-Fire Moxibustion on Pain, Quality of Life, and Tension of Multifidus in Patients with Primary Osteoporosis: A Randomized Controlled Trial

PubMed Central

Xu, Daoming; Xu, Huaning; Liu, Jing; Liu, Lanying; Tian, Qianmo; Li, Hanjun; Zhang, Lili; Cao, Yana

2018-01-01

Background Primary osteoporosis is a common disease among postmenopausal women and the elderly; low back pain is the most typical clinical manifestation an is the primary reason for a clinic visit, and directly affects patients’ quality of life. Anti-osteoporosis medications have undesirable side effects, and many kinds of special traditional Chinese moxibustion methods have been widely used in the clinical treatment of osteoporosis low back pain. The purpose of this study was to observe whether thunder-fire moxibustion therapy, compared to calcium supplements alone, can ease osteoporosis low back pain, improve quality of life, and reduce tension of the multifidus. Material/Methods Sixty-three eligible patients were enrolled in the study (7 of these patients did not finish the study and are not included in analysis). Participants were randomly divided into 2 groups: a moxibustion group that received calcium carbonate D3 and thunder-fire moxibustion therapy, and a control group that received calcium carbonate D3 only. Level of pain experienced, assessed using the visual analogue scale (VAS), and quality of life (SF-36) were measured pre-treatment, at the end of 4 weeks of treatment, and at a 1-month post-treatment evaluation. Changes in values of Young’s modulus of the multifidus were also collected before and after treatment. Results After 4 weeks of treatment and at 1 month after treatment had ended, low back pain in both groups was reduced relative to pre-treatment levels. The moxibustion group was significantly improved at BP, GH, SF, and MH dimensions compared to pre-treatment levels. The control group improved in BP dimensions, but not to the same extent as the moxibustion group. Similarly, after treatment for 4 weeks with moxibustion, multifidus tension was significantly reduced. Conclusions Thunder-fire moxibustion is an effective method for treating low back pain due to primary osteoporosis. PMID:29735964

A Randomized Clinical Trial of Acceptance and Commitment Therapy versus Progressive Relaxation Training for Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Twohig, Michael P.; Hayes, Steven C.; Plumb, Jennifer C.; Pruitt, Larry D.; Collins, Angela B.; Hazlett-Stevens, Holly; Woidneck, Michelle R.

2010-01-01

Objective: Effective treatments for obsessive-compulsive disorder (OCD) exist, but additional treatment options are needed. The effectiveness of 8 sessions of acceptance and commitment therapy (ACT) for adult OCD was compared with progressive relaxation training (PRT). Method: Seventy-nine adults (61% female) diagnosed with OCD (mean age = 37…

Dose Response Effects of Lisdexamfetamine Dimesylate Treatment in Adults with ADHD: An Exploratory Study

ERIC Educational Resources Information Center

Faraone, Stephen V.; Spencer, Thomas J.; Kollins, Scott H.; Glatt, Stephen J.; Goodman, David

2012-01-01

Objective: To explore dose-response effects of lisdexamfetamine dimesylate (LDX) treatment for ADHD. Method: This was a 4-week, randomized, double-blinded, placebo-controlled, parallel-group, forced-dose titration study in adult participants, aged 18 to 55 years, meeting "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.)…

Time Course of Treatment Effect of OROS[R] Methylphenidate in Children with ADHD

ERIC Educational Resources Information Center

Armstrong, Robert B.; Damaraju, C. V.; Ascher, Steve; Schwarzman, Lesley; O'Neill, James; Starr, H. Lynn

2012-01-01

Objective: The authors evaluated the time course of the treatment effect of Osmotic-Release Oral System methylphenidate (OROS[R] MPH) HCl (Concerta[R], Raritan, NJ) CII in children with ADHD. Method: Data were combined from two double-blind, randomized, placebo-controlled, cross-over, analog classroom studies in children (9-12 years) with ADHD.…

Cognitive-Behaviorally-Oriented Group Rehabilitation of Adults with ADHD: Results of a 6-Month Follow-Up

ERIC Educational Resources Information Center

Salakari, Anita; Virta, Maarit; Gronroos, Nina; Chydenius, Esa; Partinen, Markku; Vataja, Risto; Kaski, Markus; Iivanainen, Matti

2010-01-01

Objective: Recently, novel psychological treatments for adult ADHD have been reported with promising results. However, studies about long-term treatment effects are scanty. The authors study effects of cognitive-behaviorally-oriented group rehabilitation during a 6-month follow-up. Method: Participating in the rehabilitation were 29 adults, of…

The Effectiveness of Two Grammar Treatment Procedures for Children with SLI: A Randomized Clinical Trial

ERIC Educational Resources Information Center

Smith-Lock, Karen M.; Leitão, Suze; Prior, Polly; Nickels, Lyndsey

2015-01-01

Purpose: This study compared the effectiveness of two grammar treatment procedures for children with specific language impairment. Method: A double-blind superiority trial with cluster randomization was used to compare a cueing procedure, designed to elicit a correct production following an initial error, to a recasting procedure, which required…

FuelCalc: A Method for Estimating Fuel Characteristics

Treesearch

Elizabeth Reinhardt; Duncan Lutes; Joe Scott

2006-01-01

This paper describes the FuelCalc computer program. FuelCalc is a tool to compute surface and canopy fuel loads and characteristics from inventory data, to support fuel treatment decisions by simulating effects of a wide range of silvicultural treatments on surface fuels and canopy fuels, and to provide linkages to stand visualization, fire behavior and fire effects...

The Effect of Repetition Types on Listening Tests in an EFL Setting

ERIC Educational Resources Information Center

Horness, Paul

2013-01-01

This study was an investigation into the effects of repetition on a listening comprehension test for second language learners. Repetition has been previously examined in a cursory way, usually as a secondary question to a primary treatment. Additionally, the method of repetition was limited to one way and to one treatment condition; therefore, it…

Non-pharmacological biological treatment approaches to difficult-to-treat depression.

PubMed

Fitzgerald, Paul B

2013-09-16

There has been substantial recent interest in novel brain stimulation treatments for difficult-to-treat depression. Electroconvulsive therapy (ECT) is a well established, effective treatment for severe depression. ECT's problematic side-effect profile and questions regarding optimal administration methods continue to be investigated. Magnetic seizure therapy, although very early in development, shows promise, with potentially similar efficacy to ECT but fewer side effects. Vagus nerve stimulation (VNS) and repetitive transcranial magnetic stimulation (rTMS) are clinically available in some countries. Limited research suggests VNS has potentially long-lasting antidepressant effects in a small group of patients. Considerable research supports the efficacy of rTMS. Both techniques require further study of optimal treatment parameters. Transcranial direct current stimulation may provide a low-cost antidepressant option if its efficacy is substantiated in larger samples. Deep brain stimulation is likely to remain reserved for patients with the most severe and difficult-to-treat depression, requiring further exploration of administration methods and its role in depression therapy. New and innovative forms of brain stimulation, including low-intensity ultrasound, low-field magnetic stimulation and epidural stimulation of the cortical surface, are in early stages of exploration and are yet to move into the clinical domain. Ongoing work is required to define which brain stimulation treatments are likely to be most useful, and in which patient groups. Clinical service development of brain stimulation treatments will likely be inconsistent and variable.

Therapeutic effects of probiotics on neonatal jaundice

PubMed Central

Liu, Wenbin; Liu, Huajun; Wang, Taisen; Tang, Xueqing

2015-01-01

Objective: To evaluate the therapeutic effects of probiotics on neonatal jaundice and the safety. Methods: Sixty-eight neonates with jaundice were divided into a control group and a treatment group (n=34) randomly, and treated by blue light phototherapy and that in combination with probiotics. The serum bilirubin levels were detected before and 1, 4, 7 days after treatment. The time when therapy showed effects and jaundice faded, clinical outcomes as well as adverse reactions were recorded. The categorical data were expressed as (±s) and compared by t test. The numerical data were expressed as (case, %) and compared by χ² test. P<0.05 was considered statistically significant. Results: Serum bilirubin levels of the two groups were similar before treatment (P>0.05). The levels significantly decreased 1, 4 and 7 days after treatment (P<0.05), but there was no significant inter-group difference on the post-treatment 1st day (P>0.05). The treatment group underwent more significant decreases on the 4th and 7th days than the control group did (P=0.002, 0.001). In the treatment group, the therapy exerted effects on (1.0±0.5) d and jaundice faded on (3.8±1.7) d, which were (2.6±0.6) d and (5.3±2.1) d respectively in the control group (P=0.001, 0.002). The effective rate of the treatment group significantly exceeded that of the control group (P=0.002). There were no obvious adverse reactions in either group. Conclusions: Probiotics lowered the serum bilirubin levels of neonates with jaundice rapidly, safely and significantly, and accelerated jaundice fading as well. This method is worthy of application in clinical practice. PMID:26649008

Aromatherapy for the Treatment of Patients with Behavioral and Psychological Symptoms of Dementia: A Descriptive Analysis of RCTs.

PubMed

Press-Sandler, Olga; Freud, Tamar; Volkov, Ilya; Peleg, Roni; Press, Yan

2016-06-01

Behavioral and psychological symptoms of dementia (BPSD) are a common problem among patients with dementia. This problem is usually treated by drugs, but they have limited efficacy and often cause adverse effects. Aromatherapy is a nonpharmacologic treatment that is simple to use and devoid of significant adverse effects. To review the literature on the effectiveness of aromatherapy treatment in patients with BPSD. A descriptive analysis of randomized clinical trials (RCTs) published in the English-language literature and cited in PubMed. Eleven articles on RCTs were found, of which 1 had fewer than 10 participants, 2 were mistakenly presented as RCTs, and another did not report treatment for BPSD. In all, 7 articles with 417 participants total (range, 15-114) were reviewed. The mean age in all studies was greater than 69 years (range, 69-85 years), and the percentage of women was 55% (range, 50%-57%). The intervention period ranged from 10 days to 12 weeks. Two studies used Melissa oil and 5 others used lavender oil. The studies described different methods of administration for the oils, including spraying and rubbing over various body organs. The duration of treatment differed among the studies. In 3 studies the investigators concluded that the treatment was not effective and in 3 that it was effective; in 1 study no clear conclusion could be drawn. The difference between positive and negative studies was not explained by differences in the study population, the type of oil, or the duration of treatment. The significant difference apparently stems from the method of administration. When the oil was applied close to the olfactory system the outcome was positive. A study should be designed to assess the effect of the site of application of aromatherapy.

Characteristics of ITO films with oxygen plasma treatment for thin film solar cell applications

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

Park, Yong Seob; Kim, Eungkwon; Hong, Byungyou

2013-12-15

Graphical abstract: The effect of O{sub 2} plasma treatment on the surface and the work function of ITO films. - Highlights: • ITO films were prepared on the glass substrate by RF magnetron sputtering method. • Effects of O{sub 2} plasma treatment on the properties of ITO films were investigated. • The work function of ITO film was changed from 4.67 to 5.66 eV by plasma treatment. - Abstract: The influence of oxygen plasma treatment on the electro-optical and structural properties of indium-tin-oxide films deposited by radio frequency magnetron sputtering method were investigated. The films were exposed at different O{submore » 2} plasma powers and for various durations by using the plasma enhanced chemical vapor deposition (PECVD) system. The resistivity of the ITO films was almost constant, regardless of the plasma treatment conditions. Although the optical transmittance of ITO films was little changed by the plasma power, the prolonged treatment slightly increased the transmittance. The work function of ITO film was changed from 4.67 eV to 5.66 eV at the plasma treatment conditions of 300 W and 60 min.« less

Quadruple therapy for eradication of Helicobacter pylori

PubMed Central

Ma, Hai-Jun; Wang, Jin-Liang

2013-01-01

AIM: To investigate quadruple therapy with rabeprazole, amoxicillin, levofloxacin and furazolidone for the eradication of Helicobacter pylori (H. pylori) infection. METHODS: A total of 147 patients were divided into the experimental treatment group (n = 78) and the standard triple treatment group (n = 69). The experimental treatment group received rabeprazole 20 mg, amoxicillin 1.0 g, levofloxacin 0.2 g and furazolidone 0.1 g, twice daily. The standard triple treatment group received omeprazole 20 mg, amoxicillin 1.0 g and clarithromycin 0.5 g, twice daily. RESULTS: One month after treatment, the 13C urea breath test was carried out to detect H. pylori. The eradication rate using per-protocol analysis was 94.3% in the experimental treatment group and 73% in the standard triple treatment group (P < 0.05), and using intention to test analysis, these figures were 86% and 67% in the two groups, respectively. Side effects were observed in 34 patients, and included mild dizziness, nausea, diarrhea and increased bowel movement. Eleven of the 34 patients needed no treatment for their side effects. CONCLUSION: Rabeprazole, amoxicillin, levofloxacin and furazolidone quadruple therapy is a safe method for the eradication of H. pylori with high efficacy and good tolerability. PMID:23429422

Removal efficiency and toxicity reduction of 4-chlorophenol with physical, chemical and biochemical methods.

PubMed

Gómez, M; Murcia, M D; Dams, R; Christofi, N; Gómez, E; Gómez, J L

2012-01-01

Chlorophenols are well-known priority pollutants and many different treatments have been assessed to facilitate their removal from industrial wastewater. However, an absolute and optimum solution still has to be practically implemented in an industrial setting. In this work, a series ofphysical, chemical and biochemical treatments have been systematically tested for the removal of 4-chlorophenol, and their results have been compared in order to determine the most effective treatment based on removal efficiency and residual by-product formation. Chemical treatments based on advanced oxidation processes (AOP) produced the best results on rate and extent of pollutant removal. The non-chemical technologies showed advantages in terms of complete (in the case of adsorption) or easy (enzymatic treatments) removal of toxic treatment by-products. The AOP methods led to the production of different photoproducts depending on the chosen treatment. Toxic products remained in most cases following treatment, though the toxicity level is significantly reduced with combination treatments. Among the treatments, a photochemical method combining UV, produced with a KrCl excilamp, and hydrogen peroxide achieved total removal of chlorophenol and all by-products and is considered the best treatment for chlorophenol removal.

[Intra-detrusor injection of botulinumtoxin in patients with refractory overactive bladder].

PubMed

Krhut, J; Kopecký, J

2007-12-01

Symptoms of overactive bladder affect the quality of patients' life significantly. There is a standard treatment consisting in application of anticholinergics or possibly other conservative methods. This treatment fails at a certain part of patients however. While radical surgical therapy used to be offered to such patients in the past, the botulinumtoxin injection is available at present. The aim of the paper is to assess the efficacy and safety of this treatment method in own set of female patients with refractory overractive bladder. The set totals of 16 female patients with refractory overactive bladder. The average age in the set is 52.7 (38-69) years. Patients were treated by the application of botulinumtoxin in the period 6/2004-12/2006; the follow-up is 21.6 (6-36) months. In all cases the Dysport preparation in the dose 1000 UI was used for application. Botulinumtoxin has been applied during a short endoscopic procedure using a flexible needle into 40 points in the detrusor. Subjective satisfaction, data from voiding diaries, urodynamic parameters and the duration of effect persistence were evaluated. Subjective satisfaction with the treatment result was reached in 13 (81.3%) patients. In 12 (75.0%) patients the full continence was obtained. Average urinary bladder evacuation frequency decreased from 15.8/24 h to 5.5/24 h after the treatment, the number of urgency episodes decreased from 7.7/24 h to 0.8/24 h while average evacuated volume increased from 107.9 to 329.0 ml. The maximum cystometric capacity increased from 151.9 ml to 311.2 ml while maximum detrusor pressure decreased from 31.0 to 143 cm H2O at urodynamic assesment. The changes in all monitored parameters were statistically significant. The effect duration was 10.3 (6-13) months. No side effects of the application were registered during the treatment. The application of botulinumtoxin into detrusor is an effective and safe treatment method for refractory overactive bladder. Final standardization of the treatment by botulinumtoxin additional studies focused especially to the research of the relation among the dose, solution and clinical effect are necessary.

Hazards of insomnia and the effects of acupuncture treatment on insomnia.

PubMed

Lin, Yu-fang; Liu, Zhi-dan; Ma, Wen; Shen, Wei-dong

2016-05-01

Insomnia is a common disease in modern society; it is made worse by increasingly fierce competition in the workplace and elsewhere, along with rapid economic and social development. Sleep disorders can result in changes in serum biomarkers and decreased immunity, and may cause maladies such as depression and cardiac diseases, as well as many other somatic symptoms. Western medications for treating insomnia can easily lead to addiction and other adverse effects. Fortunately, acupuncture can ease the symptoms of insomnia. This review summarizes the hazards associated with insomnia and the use of acupuncture in its treatment. Furthermore, the authors introduce an effective and low-cost method of treating insomnia with acupuncture. This review indicates that insomnia poses a major threat to mental health through its effects on serum components, heart function and the immune system of patients, which may lead to other physiological disorders. Anxiety and depression are the two main negative emotions affected by insomnia. Acupuncture, which has showed effectiveness against insomnia and its complications, may be an effective and complementary method for the treatment of insomnia and associated maladies.

Liquid disinfection using power impulse laser

NASA Astrophysics Data System (ADS)

Gribin, S.; Assaoul, Viktor; Markova, Elena; Gromova, Ludmila P.; Spesivtsev, Boris; Bazanov, V.

1996-05-01

The presented method is based on the bactericidal effect of micro-blast induced by various sources (laser breakdown, electrohydraulic effect...). Using elaborated conception of physical phenomena providing liquid disinfection it is possible to determine optimal conditions of water treatment. The problem of optimization is solved using methods of mathematical modeling and special experiments.

Liquid disinfection using power impulse laser

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

Gribin, S.; Assaoul, V.; Markova, E.

1996-12-31

The presented method is based on the bactericidal effect of micro-blast induced by various sources (laser breakdown, electrohydraulic effect ... ). Using elaborated conception of physical phenomena providing liquid disinfection it is possible to determine optimal conditions of water treatment. The problem of optimization is solved using methods of mathematical modeling and special experiments.

Sexual Abuse Survivors' Perceptions of the Effectiveness of EMDR and Eclectic Therapy

ERIC Educational Resources Information Center

Edmond, Tonya; Sloan, Lacey; McCarty, Dawn

2004-01-01

Objective: This article examines survivor perspectives of the effectiveness of two different treatments for trauma symptoms among adult female survivors of childhood sexual abuse--Eye movement Desensitization and Reprocessing (EMDR) and eclectic therapy. Method: Qualitative interviews obtained in the context of a mixed-methods study were conducted…

Adherence Measurement in Treatments for Disruptive Behavior Disorders: Pursuing Clear Vision through Varied Lenses

PubMed Central

Schoenwald, Sonja K.; Garland, Ann. F.; Southam-Gerow, Michael A.; Chorpita, Bruce F.; Chapman, Jason E.

2011-01-01

To extend the reach, transparency, and accountability for the implementation and outcomes of effective treatments in routine care, more clarity is needed about what happens in treatment. We attempt to (a) clarify terminology to describe and measure psychological treatment, and (b) consider what treatment adherence instruments can tell us about what happens in treatment. We reviewed the content of 11 adherence instruments for 14 evidence-based treatments for disruptive behavior problems in youth identified in an ongoing review of adherence measurement methods used in psychosocial treatment studies from 1980 – 2008. Item number, content, and level of detail varied widely. Implications are considered for the definition of effective treatments and design and testing of strategies to measure and monitor their delivery. PMID:22563149

Traditional and non-traditional treatments for autism spectrum disorder with seizures: an on-line survey

PubMed Central

2011-01-01

Background Despite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD), there is little information regarding the relative effectiveness of treatments for seizures in the ASD population. In order to determine the effectiveness of traditional and non-traditional treatments for improving seizures and influencing other clinical factor relevant to ASD, we developed a comprehensive on-line seizure survey. Methods Announcements (by email and websites) by ASD support groups asked parents of children with ASD to complete the on-line surveys. Survey responders choose one of two surveys to complete: a survey about treatments for individuals with ASD and clinical or subclinical seizures or abnormal electroencephalograms, or a control survey for individuals with ASD without clinical or subclinical seizures or abnormal electroencephalograms. Survey responders rated the perceived effect of traditional antiepileptic drug (AED), non-AED seizure treatments and non-traditional ASD treatments on seizures and other clinical factors (sleep, communication, behavior, attention and mood), and listed up to three treatment side effects. Results Responses were obtained concerning 733 children with seizures and 290 controls. In general, AEDs were perceived to improve seizures but worsened other clinical factors for children with clinical seizure. Valproic acid, lamotrigine, levetiracetam and ethosuximide were perceived to improve seizures the most and worsen other clinical factors the least out of all AEDs in children with clinical seizures. Traditional non-AED seizure and non-traditional treatments, as a group, were perceived to improve other clinical factors and seizures but the perceived improvement in seizures was significantly less than that reported for AEDs. Certain traditional non-AED treatments, particularly the ketogenic diet, were perceived to improve both seizures and other clinical factors. For ASD individuals with reported subclinical seizures, other clinical factors were reported to be worsened by AEDs and improved by non-AED traditional seizure and non-traditional treatments. The rate of side effects was reportedly higher for AEDs compared to traditional non-AED treatments. Conclusion Although this survey-based method only provides information regarding parental perceptions of effectiveness, this information may be helpful for selecting seizure treatments in individuals with ASD. PMID:21592359

The potential impact of recruitment method on sample characteristics and treatment outcomes in a psychosocial trial for women with co-occurring substance use disorder and PTSD.

PubMed

Winhusen, Theresa; Winstanley, Erin L; Somoza, Eugene; Brigham, Gregory

2012-01-01

Recruitment method can impact the sample composition of a clinical trial and, thus, the generalizability of the results, but the importance of recruitment method in substance use disorder trials has received little attention. The present paper sought to address this research gap by evaluating the association between recruitment method and sample characteristics and treatment outcomes in a substance use disorder trial. In a multi-site trial evaluating Seeking Safety (SS), relative to Women's Health Education (WHE), for women with co-occurring PTSD (either sub-threshold or full PTSD) and substance use disorders, one site assessed the method by which each participant was recruited. Data from this site (n=106), which recruited participants from newspaper advertising and clinic intakes, were analyzed. Participants recruited through advertising, relative to those from the clinic, had significantly higher levels of baseline drug use and higher rates of meeting DSM-IV-TR criteria for full PTSD. Results suggest that the effectiveness of SS in decreasing PTSD symptoms was greater for participants recruited through advertising relative to those recruited from the clinic. Conversely, the results revealed a significant treatment effect in the clinic-recruited participants, not seen in the advertising-recruited participants, with SS, relative to WHE, participants being more likely to report past week drug use during the follow-up phase. Recruitment method may impact sample composition and treatment effects. Replication of this finding would have important implications for substance use disorder efficacy trials which often utilize advertising to recruit participants. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Assessment and Management of Treatment-Refractory Obsessive-Compulsive Disorder in Children

PubMed Central

Bloch, Michael H.; Storch, Eric A.

2015-01-01

OBJECTIVE To review the assessment and treatment of treatment-refractory pediatric obsessive-compulsive disorder (OCD). METHOD A PubMed search was conducted to identify controlled trials in pediatric OCD. Additionally, practice guidelines for the treatment of adults and children were further reviewed for references in treatment-refractory OCD across the lifespan. RESULTS Pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy are effective treatments for pediatric OCD. Evidence suggests that CBT is additionally effective even in pediatric patients with refractory OCD symptoms. Antipsychotic augmentation, raising SSRI dosage, and several glutamate-modulating agents have some evidence of efficacy in adults with treatment-refractory OCD but have not been studied in pediatric populations. CONCLUSION Several pharmacological treatment options exist for children with refractory OCD symptoms. However, little evidence-based data exist to guide treatment for our most challenging pediatric OCD patients. Further research is needed to evaluate the efficacy/side-effect profile of commonly used interventions in treatment-refractory pediatric OCD. PMID:25791142

To evaluate the safety and efficiency of low level laser therapy (LLLT) in treating decubitus ulcers: a review

NASA Astrophysics Data System (ADS)

Ahmed, Ambereen

2015-03-01

Introduction: Pressure sores (decubitus ulcer) are a serious problem in health care management, especially for middleaged to older people who are bed-ridden. Although preventative measures are used, the condition remains common and development of novel, improved treatment methods are desirable. This article reviews the application of laser-based methods, previously shown to be effective in accelerating wound-healing in animal models and in the treatment of decubitus ulcers in humans. Methods: About 23 scientific articles on the effect of low level laser therapy (LLLT) on wound healing in animals and humans from 2000-2014 were reviewed. Additionally, results of several randomized controlled trials (RCTs) were reviewed, and compared with other treatment methods available. Results: Whilst carefully controlled, laboratory-based animal studies indicated that LLLT can reduce healing time for several types of injuries, however similar studies in humans failed to demonstrate consistent beneficial effects in the clinical setting. An acceleration of decubitus ulcer healing has been occasionally found, although limited to certain wavelengths and sometimes only in combination with other types of therapies. Indeed, some of the clinical articles indicated that certain laser wavelengths can have detrimental effects on time of healing. Conclusions: To date, there remains no convincing evidence that LLLT has consistent medical benefit in treating decubitus ulcers. Caution should be applied when considering LLLT since only certain wavelengths utilized have shown beneficial effects. It is concluded that, more RCTs are needed since, there is no clinical justification for LLLT, alone or in combination with other methods, in treating decubitus ulcers.

Inference of median difference based on the Box-Cox model in randomized clinical trials.

PubMed

Maruo, K; Isogawa, N; Gosho, M

2015-05-10

In randomized clinical trials, many medical and biological measurements are not normally distributed and are often skewed. The Box-Cox transformation is a powerful procedure for comparing two treatment groups for skewed continuous variables in terms of a statistical test. However, it is difficult to directly estimate and interpret the location difference between the two groups on the original scale of the measurement. We propose a helpful method that infers the difference of the treatment effect on the original scale in a more easily interpretable form. We also provide statistical analysis packages that consistently include an estimate of the treatment effect, covariance adjustments, standard errors, and statistical hypothesis tests. The simulation study that focuses on randomized parallel group clinical trials with two treatment groups indicates that the performance of the proposed method is equivalent to or better than that of the existing non-parametric approaches in terms of the type-I error rate and power. We illustrate our method with cluster of differentiation 4 data in an acquired immune deficiency syndrome clinical trial. Copyright © 2015 John Wiley & Sons, Ltd.

Novel Electrokinetic Microfluidic Detector for Evaluating Effectiveness of Microalgae Disinfection in Ship Ballast Water

PubMed Central

Maw, Myint Myint; Wang, Junsheng; Li, Fabo; Jiang, Jinhu; Song, Younan; Pan, Xinxiang

2015-01-01

Ship ballast water treatment methods face many technical challenges. The effectiveness of every treatment method usually is evaluated by using large scale equipment and a large volume of samples, which involves time-consuming, laborious, and complex operations. This paper reports the development of a novel, simple and fast platform of methodology in evaluating the efficiency and the best parameters for ballast water treatment systems, particularly in chemical disinfection. In this study, a microfluidic chip with six sample wells and a waste well was designed, where sample transportation was controlled by electrokinetic flow. The performance of this microfluidic platform was evaluated by detecting the disinfection of Dunaliella salina (D. salina) algae in ballast water treated by sodium hypochlorite (NaClO) solution. Light-induced chlorophyll fluorescence (LICF) intensity was used to determine the viability of microalgae cells in the system, which can be operated automatically with the dimension of the detector as small as 50 mm × 24 mm × 5 mm. The 40 µL volume of sample solution was used for each treatment condition test and the validity of detection can be accomplished within about five min. The results show that the viability of microalgae cells under different treatment conditions can be determined accurately and further optimal treatment conditions including concentrations of NaClO and treatment time can also be obtained. These results can provide accurate evaluation and optimal parameters for ballast water treatment methods. PMID:26516836

Single particle ICP-MS characterization of titanium dioxide, silver, and gold nanoparticles during drinking water treatment.

PubMed

Donovan, Ariel R; Adams, Craig D; Ma, Yinfa; Stephan, Chady; Eichholz, Todd; Shi, Honglan

2016-02-01

One of the most direct means for human exposure to nanoparticles (NPs) released into the environment is drinking water. Therefore, it is critical to understand the occurrence and fate of NPs in drinking water systems. The objectives of this study were to develop rapid and reliable analytical methods and apply them to investigate the fate and transportation of NPs during drinking water treatments. Rapid single particle ICP-MS (SP-ICP-MS) methods were developed to characterize and quantify titanium-containing, titanium dioxide, silver, and gold NP concentration, size, size distribution, and dissolved metal element concentration in surface water and treated drinking water. The effectiveness of conventional drinking water treatments (including lime softening, alum coagulation, filtration, and disinfection) to remove NPs from surface water was evaluated using six-gang stirrer jar test simulations. The selected NPs were nearly completely (97 ± 3%) removed after lime softening and alum coagulation/activated carbon adsorption treatments. Additionally, source and drinking waters from three large drinking water treatment facilities utilizing similar treatments with the simulation test were collected and analyzed by the SP-ICP-MS methods. Ti-containing particles and dissolved Ti were present in the river water samples, but Ag and Au were not present. Treatments used at each drinking water treatment facility effectively removed over 93% of the Ti-containing particles and dissolved Ti from the source water. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of different methods of preliminary surface treatment and magnetron sputtering on the adhesion of Si coatings

NASA Astrophysics Data System (ADS)

Borisov, D. P.; Slabodchikov, V. A.; Kuznetsov, V. M.

2017-05-01

The paper presents research results on the adhesion of Si coatings deposited by magnetron sputtering on NiTi substrates after preliminary surface treatment (cleaning and activation) with low-energy ion beams and gas discharge plasma. The adhesion properties of the coatings obtained by two methods are analyzed and compared using data of scratch and spherical abrasion tests.

Ethanol production from lignocellulose

DOEpatents

Ingram, Lonnie O.; Wood, Brent E.

2001-01-01

This invention presents a method of improving enzymatic degradation of lignocellulose, as in the production of ethanol from lignocellulosic material, through the use of ultrasonic treatment. The invention shows that ultrasonic treatment reduces cellulase requirements by 1/3 to 1/2. With the cost of enzymes being a major problem in the cost-effective production of ethanol from lignocellulosic material, this invention presents a significant improvement over presently available methods.

Testing the efficacy of the triclopyr and imazapyr using two application methods for controlling tree-of-heaven along a West Virginia highway

Treesearch

William E. Eck; David W. McGill

2007-01-01

Tree-of-heaven (Ailanthus altissima [Mill.] Swingle) is a non-native invasive plant that is spreading throughout much of the U.S. In this study, efficacy of the herbicides triclopyr and imazapyr was tested using injection and basal bark treatment methods. No treatment was 100 percent effective. Only triclopyr injection was significantly different...

Protective effects of a zinc-hydroxyapatite toothpaste on enamel erosion: SEM study

PubMed Central

Colombo, Marco; Beltrami, Riccardo; Rattalino, Davide; Mirando, Maria; Chiesa, Marco; Poggio, Claudio

2016-01-01

Summary Aim The aim of the present in vitro study was to evaluate the protective effects of a zinc-hydroxyapatite toothpaste against an erosive challenge produced by a soft drink (Coca-Cola) using Scanning Electron Microscopy (SEM). Methods Forty specimens were assigned to 4 groups of 10 specimens each (group 1: no erosive challenge, no toothpaste treatment, group 2: erosive challenge, no toothpaste treatment, group 3: erosive challenge, fluoride toothpaste treatment, group 4: erosive challenge, zinc-hydroxyapatite toothpaste treatment). The surface of each specimen was imaged by SEM. A visual rating system was used to evaluate the condition of the enamel surface; results were analyzed by nonparametric statistical methods. Results Statistically significant differences were found between the samples untreated and those immersed in Coca-Cola (group 1, 2); the highest grade of damage was found in group 2, while the lowest grade was recorded in the samples of group 4. Comparing the groups, the two analyzed toothpaste tended to protect in different extend. Conclusions In this study treatment of erosively challenged enamel with Zn-Hap toothpaste showed a clear protective effect. This was greater than the effect observed for a normal fluoride toothpaste and confirmed the potential benefit the Zn-HAP technology can provide in protecting enamel from erosive acid challenges. PMID:28149449

Technological capabilities of surface layers formation on implant made of Ti-6Al-4V ELI alloy.

PubMed

Kiel-Jamrozik, Marta; Szewczenko, Janusz; Basiaga, Marcin; Nowińska, Katarzyna

2015-01-01

The aim of the presented research was to find a combination of surface modification methods of implants made of the Ti-6Al-4V ELI alloy, that lead to formation of effective barrier for metallic ions that may infiltrate into solution. To this end, the following tests were carried out: roughness measurement, the voltamperometric tests (potentiodynamic and potentiostatic), and the ion infiltration test. The electropolishing process resulted in the lowering of surface roughness in comparison with mechanical treatment of the surface layer. The anodization process and steam sterilization increased corrosion resistance regardless of the mechanical treatment or electropolishing. The crevice corrosion tests revealed that independent of the modification method applied, the Ti-6Al-4V ELI alloy has excellent crevice corrosion resistance. The smallest quantity of ions infiltrated to the solution was observed for surface modification consisting in the mechanical treatment and anodization with the potential of 97 V. Electric parameters deter- mined during studies were the basis for effectiveness estimation of particular surface treatment methods. The research has shown that the anodization process significantly influences the pitting corrosion resistance of the Ti-6Al-4V ELI alloy independent of the previous surface treatment methods (mechanical and electrochemical). The surface layer after such modification is a protective barrier for metallic ions infiltrated to solution and protects titanium alloy against corrosive environment influence.

Memory Support Strategies and Bundles: A Pathway to Improving Cognitive Therapy for Depression?

PubMed Central

Dong, Lu; Lee, Jason Y.; Harvey, Allison G.

2017-01-01

Objective Therapist use of memory support (MS) alongside treatment-as-usual, with the goal of enhancing patient recall of treatment contents, has been of recent interest as a novel pathway to improve treatment outcome. The Memory Support Intervention involves treatment providers’ using eight specific MS strategies to promote patient memory for treatment. The present study examines to what extent therapist use of MS strategies and bundles improves patient recall of treatment contents and treatment outcome. Methods The data were drawn from a pilot randomized controlled trial reported elsewhere. Participants were 48 adults (mean age = 44.27 years, 29 females) with major depressive disorder (MDD), randomized to receive 14 sessions of either CT+Memory Support (n = 25) or CT-as-usual (n = 23). Therapist use of MS was coded using the Memory Support Rating Scale. Patient memory and treatment outcomes were assessed at baseline, mid-treatment (patient recall only), post-treatment, and 6-month follow-up. Results Participants in CT+Memory Support received significantly higher amount of MS relative to CT-as-usual. Though not reaching statistical significance, small-to-medium effects were observed between MS strategies and patient recall in the expected direction. Although MS variables were not significantly associated with changes in continuous depressive symptoms, MS was associated with better global functioning. MS also exhibited small to medium effects on treatment response and recurrence in the expected direction but not on remission, though these effects did not reach statistical significance. Conclusions These results provide initial empirical evidence supporting an active method for therapists to implement MS strategies. PMID:28221056

Treatment of idiopathic clubfoot: an historical review.

PubMed

Dobbs, M B; Morcuende, J A; Gurnett, C A; Ponseti, I V

2000-01-01

Idiopathic clubfoot, one of the most common problems in pediatric orthopaedics, is characterized by a complex three-dimensional deformity of the foot. The treatment of clubfoot is controversial and continues to be one of the biggest challenges in pediatric orthopaedics. This controversy is due in part to the difficulty in measuring and evaluating the effectiveness of different treatment methods. We believe the heart of the debate is a lack of understanding of the functional anatomy of the deformity, the biological response of young connective tissue to injury and repair, and their combined effect on the long-term treatment outcomes. The aim of this review is not only to assess the different methods of clubfoot treatment used over the years in light of an evolving understanding of the pathoanatomy of the deformity, but to also clarify factors that allow a safe, logical approach to clubfoot management. Further research will be needed to fully understand the pathogenesis of clubfoot, as well as the long-term results and quality of life for the treated foot.

Effect of heat treatment on the optical properties of perovskite BaZr0.5Ce0.3Y0.2O3-δ ceramic prepared by spark plasma sintering

NASA Astrophysics Data System (ADS)

Xing, Bohang; Cheng, Zhi; Wang, Cao; Zhao, Zhe

2017-09-01

The effect of heat treatment on the in-line transmittance of BaZr0.5Ce0.3Y0.2O3-δ (BZCY532) ceramics prepared by spark plasma sintering method was investigated. The loss of Ba in transparent BZCY532 ceramics is the key reason for the loss of transmittance during the annealing process. This problem can be effectively alleviated by using a powder bed of BZCY532. Heat treatment atmospheres, wet air and dry air, were also found to be critical for obtaining high quality transparent ceramics. A highly transparent BZCY532 ceramic with the in-line transmittance (Tin) of 71.4% at 2000 nm can be obtained by using SPS method followed by an annealing in powder bed at 1500 °C in wet air.

Effect of atmospheric plasma treatment on seed germination of rice (Oryza sativa L.)

NASA Astrophysics Data System (ADS)

Penado, Keith Nealson M.; Mahinay, Christian Lorenz S.; Culaba, Ivan B.

2018-01-01

Multiple methods of improving plant development have been utilized over the past decades. Despite these improvements, there still exists a need for better planting methods due to the increasing population of a global community. Studies have reported that plasma treatment affects the growth and germination of a variety of plant species, including a multitude of grains which often takes the bulk in the diet of the average human being. This study explores the effect of atmospheric air plasma jet treatment on the seed germination of rice (Oryza sativa L.). The seeds were treated using an atmospheric air plasma jet for 1, 2, and 3 s. The effect of plasma exposure shows a reduction of trichomes on the surface of the seed. This caused a possible increase in wettability which significantly affected the seed germ length but did not affect the seed germination count after the germination period of 72 h.

Foley catheter balloon endometrial ablation: successful treatment of three cases.

PubMed

Api, Murat; Api, Olus

2012-03-01

Endometrial ablation is one of the most effective methods for treatment of dysfunctional uterine bleeding (DUB). Balloon devices with circulating hot water inside or electrodes on the outer surface and radiofrequency-induced thermal destructors are the most recently introduced available tools for endometrial ablation. All of these methods are effective and simple but expensive technologies. The aim of this brief report is to evaluate the effectiveness and safety of a new, simple and money-saving procedure, namely foley catheter balloon endometrial ablation (FCBEA), for treatment of DUB. We present our experience with FCBEA performed on 3 women with severe meno-metrorrhagia unresponsive to medical therapy. There were no procedure-related complications with achievement of complete amenorrhea for a 19 months follow-up period. Although FCBA has yielded encouraging results, there exists a need for further investigation and validation on larger groups, before its universal application.

Ablative fractional lasers (CO(2) and Er:YAG): a randomized controlled double-blind split-face trial of the treatment of peri-orbital rhytides.

PubMed

Karsai, Syrus; Czarnecka, Agnieszka; Jünger, Michael; Raulin, Christian

2010-02-01

Ablative fractional lasers were introduced for treating facial rhytides in an attempt to achieve results comparable to traditional ablative resurfacing but with fewer side effects. However, there is conflicting evidence on how well this goal has generally been achieved as well as on the comparative value of fractional CO(2) and Er:YAG lasers. The present study compares these modalities in a randomized controlled double-blind split-face study design. Twenty-eight patients were enrolled and completed the entire study. Patients were randomly assigned to receive a single treatment on each side of the peri-orbital region, one with a fractional CO(2) and one with a fractional Er:YAG laser. The evaluation included the profilometric measurement of wrinkle depth, the Fitzpatrick wrinkle score (both before and 3 months after treatment) as well as the assessment of side effects and patient satisfaction (1, 3, 6 days and 3 months after treatment). Both modalities showed a roughly equivalent effect. Wrinkle depth and Fitzpatrick score were reduced by approximately 20% and 10%, respectively, with no appreciable difference between lasers. Side effects and discomfort were slightly more pronounced after Er:YAG treatment in the first few days, but in the later course there were more complaints following CO(2) laser treatment. Patient satisfaction was fair and the majority of patients would have undergone the treatment again without a clear preference for either method. According to the present study, a single ablative fractional treatment session has an appreciable yet limited effect on peri-orbital rhytides. When fractional CO(2) and Er:YAG lasers are used in such a manner that there are comparable post-operative healing periods, comparable cosmetic improvement occurs. Multiple sessions may be required for full effect, which cancels out the proposed advantage of fractional methods, that is, fewer side effects and less down time.

The effects of heat treatment on physical properties and surface roughness of red-bud maple (Acer trautvetteri Medw.) wood.

PubMed

Korkut, Derya Sevim; Guller, Bilgin

2008-05-01

Heat treatment is often used to improve the dimensional stability of wood. In this study, the effects of heat treatment on physical properties and surface roughness of red-bud maple (Acer trautvetteri Medw.) wood were examined. Samples obtained from Düzce Forest Enterprises, Turkey, were subjected to heat treatment at varying temperatures and durations. The physical properties of heat-treated samples were compared against controls in order to determine their; oven-dry density, air-dry density, and swelling properties. A stylus method was employed to evaluate the surface characteristics of the samples. Roughness measurements, using the stylus method, were made in the direction perpendicular to the fiber. Three main roughness parameters; mean arithmetic deviation of profile (Ra), mean peak-to-valley height (Rz), and maximum roughness (Rmax) obtained from the surface of wood, were used to evaluate the effect of heat treatment on the surface characteristics of the specimens. Significant differences were determined (p>0.05) between surface roughness parameters (Ra, Rz, Rmax) at three different temperatures and three periods of heat treatment. The results showed that the values of density, swelling and surface roughness decreased with increasing temperature treatment and treatment times. Red-bud maple wood could be utilized successfully by applying proper heat treatment techniques without any losses in investigated parameters. This is vital in areas, such as window frames, where working stability and surface smoothness are important factors.

Healing of Fatigue Crack in 1045 Steel by Using Eddy Current Treatment

PubMed Central

Yang, Chuan; Xu, Wenchen; Guo, Bin; Shan, Debin; Zhang, Jian

2016-01-01

In order to investigate the methods to heal fatigue cracks in metals, tubular specimens of 1045 steel with axial and radial fatigue cracks were treated under the eddy current. The optical microscope was employed to examine the change of fatigue cracks of specimens before and after the eddy current treatment. The results show that the fatigue cracks along the axial direction of the specimen could be healed effectively in the fatigue crack initiation zone and the crack tip zone under the eddy current treatment, and the healing could occur within a very short time. The voltage breakdown and the transient thermal compressive stress caused by the detouring of eddy current around the fatigue crack were the main factors contributing to the healing in the fatigue crack initiation zone and the crack tip zone, respectively. Eddy current treatment may be a novel and effective method for crack healing. PMID:28773761

'A life on hold': adolescents' experiences of stem cell transplantation in a long-term perspective.

PubMed

Forinder, Ulla; Posse, Ebba

2008-12-01

Stem cell transplantation is one of the treatment methods for cancer in children and adolescents which has resulted in a positive outcome. Unfortunately this method of treatment brings with it a number of late effects such as short stature, cognitive effects and infertility. However, a majority of children and adolescents experience a good quality of life. By examining their medical records this study has gained a deeper understanding of the situation for the minority of young people who describe themselves as suffering severe mental distress which they relate to their illness and treatment. The population comprised seven adolescents who sought psychotherapeutic support several years after treatment. They describe how they are affected by the feeling of being different, the loss of contact with friends and their dependence on parents. The study points to the need for long-term psychosocial support for children and adolescents who have undergone stem cell transplantation.

Healing of Fatigue Crack in 1045 Steel by Using Eddy Current Treatment.

PubMed

Yang, Chuan; Xu, Wenchen; Guo, Bin; Shan, Debin; Zhang, Jian

2016-07-29

In order to investigate the methods to heal fatigue cracks in metals, tubular specimens of 1045 steel with axial and radial fatigue cracks were treated under the eddy current. The optical microscope was employed to examine the change of fatigue cracks of specimens before and after the eddy current treatment. The results show that the fatigue cracks along the axial direction of the specimen could be healed effectively in the fatigue crack initiation zone and the crack tip zone under the eddy current treatment, and the healing could occur within a very short time. The voltage breakdown and the transient thermal compressive stress caused by the detouring of eddy current around the fatigue crack were the main factors contributing to the healing in the fatigue crack initiation zone and the crack tip zone, respectively. Eddy current treatment may be a novel and effective method for crack healing.

Kidney volume measurement methods for clinical studies on autosomal dominant polycystic kidney disease

PubMed Central

Sharma, Kanishka; Caroli, Anna; Quach, Le Van; Petzold, Katja; Bozzetto, Michela; Serra, Andreas L.; Remuzzi, Giuseppe; Remuzzi, Andrea

2017-01-01

Background In autosomal dominant polycystic kidney disease (ADPKD), total kidney volume (TKV) is regarded as an important biomarker of disease progression and different methods are available to assess kidney volume. The purpose of this study was to identify the most efficient kidney volume computation method to be used in clinical studies evaluating the effectiveness of treatments on ADPKD progression. Methods and findings We measured single kidney volume (SKV) on two series of MR and CT images from clinical studies on ADPKD (experimental dataset) by two independent operators (expert and beginner), twice, using all of the available methods: polyline manual tracing (reference method), free-hand manual tracing, semi-automatic tracing, Stereology, Mid-slice and Ellipsoid method. Additionally, the expert operator also measured the kidney length. We compared different methods for reproducibility, accuracy, precision, and time required. In addition, we performed a validation study to evaluate the sensitivity of these methods to detect the between-treatment group difference in TKV change over one year, using MR images from a previous clinical study. Reproducibility was higher on CT than MR for all methods, being highest for manual and semiautomatic contouring methods (planimetry). On MR, planimetry showed highest accuracy and precision, while on CT accuracy and precision of both planimetry and Stereology methods were comparable. Mid-slice and Ellipsoid method, as well as kidney length were fast but provided only a rough estimate of kidney volume. The results of the validation study indicated that planimetry and Stereology allow using an importantly lower number of patients to detect changes in kidney volume induced by drug treatment as compared to other methods. Conclusions Planimetry should be preferred over fast and simplified methods for accurately monitoring ADPKD progression and assessing drug treatment effects. Expert operators, especially on MR images, are required for performing reliable estimation of kidney volume. The use of efficient TKV quantification methods considerably reduces the number of patients to enrol in clinical investigations, making them more feasible and significant. PMID:28558028

Treatment of Subacromial Impingement Syndrome: Platelet-Rich Plasma or Exercise Therapy? A Randomized Controlled Trial

PubMed Central

Nejati, Parisa; Ghahremaninia, Armita; Naderi, Farrokh; Gharibzadeh, Safoora; Mazaherinezhad, Ali

2017-01-01

Background: Subacromial impingement syndrome (SAIS) is the most common disorder of the shoulder. The evidence for the effectiveness of treatment options is inconclusive and limited. Therefore, there is a need for more evidence in this regard, particularly for long-term outcomes. Hypothesis: Platelet-rich plasma (PRP) would be an effective method in treating subacromial impingement. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: This was a single-blinded randomized clinical trial with 1-, 3-, and 6-month follow-up. Sixty-two patients were randomly placed into 2 groups, receiving either PRP or exercise therapy. The outcome parameters were pain, shoulder range of motion (ROM), muscle force, functionality, and magnetic resonance imaging findings. Results: Both treatment options significantly reduced pain and increased shoulder ROM compared with baseline measurements. Both treatments also significantly improved functionality. However, the treatment choices were not significantly effective in improving muscle force. Trend analysis revealed that in the first and third months, exercise therapy was superior to PRP in pain, shoulder flexion and abduction, and functionality. However, in the sixth month, only shoulder abduction and total Western Ontario Rotator Cuff score were significantly different between the 2 groups. Conclusion: Both PRP injection and exercise therapy were effective in reducing pain and disability in patients with SAIS, with exercise therapy proving more effective. PMID:28567426

Developing adaptive interventions for adolescent substance use treatment settings: protocol of an observational, mixed-methods project.

PubMed

Grant, Sean; Agniel, Denis; Almirall, Daniel; Burkhart, Q; Hunter, Sarah B; McCaffrey, Daniel F; Pedersen, Eric R; Ramchand, Rajeev; Griffin, Beth Ann

2017-12-19

Over 1.6 million adolescents in the United States meet criteria for substance use disorders (SUDs). While there are promising treatments for SUDs, adolescents respond to these treatments differentially in part based on the setting in which treatments are delivered. One way to address such individualized response to treatment is through the development of adaptive interventions (AIs): sequences of decision rules for altering treatment based on an individual's needs. This protocol describes a project with the overarching goal of beginning the development of AIs that provide recommendations for altering the setting of an adolescent's substance use treatment. This project has three discrete aims: (1) explore the views of various stakeholders (parents, providers, policymakers, and researchers) on deciding the setting of substance use treatment for an adolescent based on individualized need, (2) generate hypotheses concerning candidate AIs, and (3) compare the relative effectiveness among candidate AIs and non-adaptive interventions commonly used in everyday practice. This project uses a mixed-methods approach. First, we will conduct an iterative stakeholder engagement process, using RAND's ExpertLens online system, to assess the importance of considering specific individual needs and clinical outcomes when deciding the setting for an adolescent's substance use treatment. Second, we will use results from the stakeholder engagement process to analyze an observational longitudinal data set of 15,656 adolescents in substance use treatment, supported by the Substance Abuse and Mental Health Services Administration, using the Global Appraisal of Individual Needs questionnaire. We will utilize methods based on Q-learning regression to generate hypotheses about candidate AIs. Third, we will use robust statistical methods that aim to appropriately handle casemix adjustment on a large number of covariates (marginal structural modeling and inverse probability of treatment weights) to compare the relative effectiveness among candidate AIs and non-adaptive decision rules that are commonly used in everyday practice. This project begins filling a major gap in clinical and research efforts for adolescents in substance use treatment. Findings could be used to inform the further development and revision of influential multi-dimensional assessment and treatment planning tools, or lay the foundation for subsequent experiments to further develop or test AIs for treatment planning.

Preventing Unintended Pregnancy and HIV Transmission: Effects of the HIV Treatment Cascade on Contraceptive Use and Choice in Rural KwaZulu-Natal

PubMed Central

Raifman, Julia; Chetty, Terusha; Tanser, Frank; Mutevedzi, Tinofa; Matthews, Philippa; Herbst, Kobus; Pillay, Deenan

2014-01-01

Background: For women living with HIV, contraception using condoms is recommended because it prevents not only unintended pregnancy but also acquisition of other sexually transmitted infections and onward transmission of HIV. Dual-method dual-protection contraception (condoms with other contraceptive methods) is preferable over single-method dual-protection contraception (condoms alone) because of its higher contraceptive effectiveness. We estimate the effect of progression through the HIV treatment cascade on contraceptive use and choice among HIV-infected women in rural South Africa. Methods: We linked population-based surveillance data on contraception collected by the Wellcome Trust Africa Centre for Health and Population Studies to data from the local antiretroviral treatment (ART) program in Hlabisa subdistrict, KwaZulu-Natal. In bivariate probit regression, we estimated the effects of progressing through the cascade on contraceptive choice among HIV-infected sexually active women aged 15–49 years (N = 3169), controlling for a wide range of potential confounders. Findings: Contraception use increased across the cascade from <40% among HIV-infected women who did not know their status to >70% among women who have been on ART for 4–7 years. Holding other factors equal (1) awareness of HIV status, (2) ART initiation, and (3) being on ART for 4–7 years increased the likelihood of single-method/dual-method dual protection by the following percentage points (pp), compared with women who were unaware of their HIV status: (1) 4.6 pp (P = 0.030)/3.5 pp (P = 0.001), (2) 10.3 pp (P = 0.003)/5.2 pp (P = 0.007), and (3) 21.6 pp (P < 0.001)/11.2 pp (P < 0.001). Conclusions: Progression through the HIV treatment cascade significantly increased the likelihood of contraception in general and contraception with condoms in particular. ART programs are likely to contribute to HIV prevention through the behavioral pathway of changing contraception use and choice. PMID:25436821

Principle component analysis (PCA) for investigation of relationship between population dynamics of microbial pathogenesis, chemical and sensory characteristics in beef slices containing Tarragon essential oil.

PubMed

Alizadeh Behbahani, Behrooz; Tabatabaei Yazdi, Farideh; Shahidi, Fakhri; Mortazavi, Seyed Ali; Mohebbi, Mohebbat

2017-04-01

Principle component analysis (PCA) was employed to examine the effect of the exerted treatments on the beef shelf life as well as discovering the correlations between the studied responses. Considering the variability of the dimensions of the responses, correlation coefficients were applied to form the matrix and extract the eigenvalue. Antimicrobial effect was evaluated on 10 pathogenic microorganisms through the methods of hole-plate diffusion method, disk diffusion method, pour plate method, minimum inhibitory concentration and minimum bactericidal/fungicidal concentration. Antioxidant potential and total phenolic content were examined through the method of 2,2-diphenyl-1-picrylhydrazyl (DPPH) and Folin-Ciocalteu method, respectively. The components were identified through gas chromatography and gas chromatography/mass spectrometry. Barhang seed mucilage (BSM) based edible coating containing 0, 0.5, 1 and 1.5% (w/w) Tarragon (T) essential oil mix were applied on beef slices to control the growth of pathogenic microorganisms. Microbiological (total viable count, psychrotrophic count, Escherichia coli, Staphylococcus aureus and fungi), chemical (thiobarbituric acid, peroxide value and pH) and sensory characteristics (odor, color and overall acceptability) analysis measurements were made during the storage periodically. PCA was employed to examine the effect of the exerted treatments on the beef shelf life as well as discovering the correlations between the studied responses. Considering the variability of the dimensions of the responses, correlation coefficients were applied to form the matrix and extract the eigenvalue. The PCA showed that the properties of the uncoated meat samples on the 9th, 12th, 15th and 18th days of storage are continuously changing independent of the exerted treatments on the other samples. This reveals the effect of the exerted treatments on the samples. Copyright © 2017 Elsevier Ltd. All rights reserved.

Inactivation of Geobacillus stearothermophilus Spores by High-Pressure Carbon Dioxide Treatment

PubMed Central

Watanabe, Taisuke; Furukawa, Soichi; Hirata, Junichi; Koyama, Tetsuya; Ogihara, Hirokazu; Yamasaki, Makari

2003-01-01

High-pressure CO2 treatment has been studied as a promising method for inactivating bacterial spores. In the present study, we compared this method with other sterilization techniques, including heat and pressure treatment. Spores of Bacillus coagulans, Bacillus subtilis, Bacillus cereus, Bacillus licheniformis, and Geobacillus stearothermophilus were subjected to CO2 treatment at 30 MPa and 35°C, to high-hydrostatic-pressure treatment at 200 MPa and 65°C, or to heat treatment at 0.1 MPa and 85°C. All of the bacterial spores except the G. stearothermophilus spores were easily inactivated by the heat treatment. The highly heat- and pressure-resistant spores of G. stearothermophilus were not the most resistant to CO2 treatment. We also investigated the influence of temperature on CO2 inactivation of G. stearothermophilus. Treatment with CO2 and 30 MPa of pressure at 95°C for 120 min resulted in 5-log-order spore inactivation, whereas heat treatment at 95°C for 120 min and high-hydrostatic-pressure treatment at 30 MPa and 95°C for 120 min had little effect. The activation energy required for CO2 treatment of G. stearothermophilus spores was lower than the activation energy for heat or pressure treatment. Although heat was not necessary for inactivationby CO2 treatment of G. stearothermophilus spores, CO2 treatment at 95°C was more effective than treatment at 95°C alone. PMID:14660357

Inactivation of Geobacillus stearothermophilus spores by high-pressure carbon dioxide treatment.

PubMed

Watanabe, Taisuke; Furukawa, Soichi; Hirata, Junichi; Koyama, Tetsuya; Ogihara, Hirokazu; Yamasaki, Makari

2003-12-01

High-pressure CO2 treatment has been studied as a promising method for inactivating bacterial spores. In the present study, we compared this method with other sterilization techniques, including heat and pressure treatment. Spores of Bacillus coagulans, Bacillus subtilis, Bacillus cereus, Bacillus licheniformis, and Geobacillus stearothermophilus were subjected to CO2 treatment at 30 MPa and 35 degrees C, to high-hydrostatic-pressure treatment at 200 MPa and 65 degrees C, or to heat treatment at 0.1 MPa and 85 degrees C. All of the bacterial spores except the G. stearothermophilus spores were easily inactivated by the heat treatment. The highly heat- and pressure-resistant spores of G. stearothermophilus were not the most resistant to CO2 treatment. We also investigated the influence of temperature on CO2 inactivation of G. stearothermophilus. Treatment with CO2 and 30 MPa of pressure at 95 degrees C for 120 min resulted in 5-log-order spore inactivation, whereas heat treatment at 95 degrees C for 120 min and high-hydrostatic-pressure treatment at 30 MPa and 95 degrees C for 120 min had little effect. The activation energy required for CO2 treatment of G. stearothermophilus spores was lower than the activation energy for heat or pressure treatment. Although heat was not necessary for inactivationby CO2 treatment of G. stearothermophilus spores, CO2 treatment at 95 degrees C was more effective than treatment at 95 degrees C alone.

Effectiveness and cost-effectiveness of salicylic acid and cryotherapy for cutaneous warts. An economic decision model.

PubMed

Thomas, K S; Keogh-Brown, M R; Chalmers, J R; Fordham, R J; Holland, R C; Armstrong, S J; Bachmann, M O; Howe, A H; Rodgers, S; Avery, A J; Harvey, I; Williams, H C

2006-08-01

To estimate the costs of commonly used treatments for cutaneous warts, as well as their health benefits and risk. To create an economic decision model to evaluate the cost-effectiveness of these treatments, and, as a result, assess whether a randomised controlled trial (RCT) would be feasible and cost-effective. Focus groups, structured interviews and observation of practice. Postal survey sent to 723 patients. A recently updated Cochrane systematic review and published cost and prescribing data. Primary and secondary data collection methods were used to inform the development of an economic decision model. Data from the postal survey provided estimates of the effectiveness of wart treatments in a primary care setting. These estimates were compared with outcomes reported in the Cochrane review of wart treatment, which were largely obtained from RCTs conducted in secondary care. A decision model was developed including a variety of over-the-counter (OTC) and GP-prescribed treatments. The model simulated 10,000 patients and adopted a societal perspective. OTC treatments were used by a substantial number of patients (57%) before attending the GP surgery. By far the most commonly used OTC preparation was salicylic acid (SA). The results of the economic model suggested that of the treatments prescribed by a GP, the most cost-effective treatment was SA, with an incremental cost-effectiveness ratio (ICER) of 2.20 pound/% cured. The ICERs for cryotherapy varied widely (from 1.95 to 7.06 pound/% cured) depending on the frequency of applications and the mode of delivery. The most cost-effective mode of delivery was through nurse-led cryotherapy clinics (ICER = 1.95 pound/% cured) and this could be a cost-effective alternative to GP-prescribed SA. Overall, the OTC therapies were the most cost-effective treatment options. ICERs ranged from 0.22 pound/% cured for OTC duct tape and 0.76 pound/% cured for OTC cryotherapy to 1.12 pound/% cured for OTC SA. However, evidence in support of OTC duct tape and OTC cryotherapy is very limited. Side-effects were commonly reported for both SA and cryotherapy, particularly a burning sensation, pain and blistering. Cryotherapy delivered by a doctor is an expensive option for the treatment of warts in primary care. Alternative options such as GP-prescribed SA and nurse-led cryotherapy clinics provide more cost-effective alternatives, but are still expensive compared with self-treatment. Given the minor nature of most cutaneous warts, coupled with the fact that the majority spontaneously resolve in time, it may be concluded that a shift towards self-treatment is warranted. Although both duct tape and OTC cryotherapy appear promising new self-treatment options from both a cost and an effectiveness perspective, more research is required to confirm the efficacy of these two methods of wart treatment. If these treatments are shown to be as cost-effective as or more cost-effective than conventional treatments, then a shift in service delivery away from primary care towards more OTC treatment is likely. A public awareness campaign would be useful to educate patients about the self-limiting nature of warts and the possible alternative OTC treatment options available. Two future RCTs are recommended for consideration: a trial of SA compared with nurse-led cryotherapy in primary care, and a trial of home treatments. Greater understanding of the efficacy of these home treatments will give doctors a wider choice of treatment options, and may help to reduce the overall demand for cryotherapy in primary care.

Adjusting for treatment effects in studies of quantitative traits: antihypertensive therapy and systolic blood pressure.

PubMed

Tobin, Martin D; Sheehan, Nuala A; Scurrah, Katrina J; Burton, Paul R

2005-10-15

A population-based study of a quantitative trait may be seriously compromised when the trait is subject to the effects of a treatment. For example, in a typical study of quantitative blood pressure (BP) 15 per cent or more of middle-aged subjects may take antihypertensive treatment. Without appropriate correction, this can lead to substantial shrinkage in the estimated effect of aetiological determinants of scientific interest and a marked reduction in statistical power. Correction relies upon imputation, in treated subjects, of the underlying BP from the observed BP having invoked one or more assumptions about the bioclinical setting. There is a range of different assumptions that may be made, and a number of different analytical models that may be used. In this paper, we motivate an approach based on a censored normal regression model and compare it with a range of other methods that are currently used or advocated. We compare these methods in simulated data sets and assess the estimation bias and the loss of power that ensue when treatment effects are not appropriately addressed. We also apply the same methods to real data and demonstrate a pattern of behaviour that is consistent with that in the simulation studies. Although all approaches to analysis are necessarily approximations, we conclude that two of the adjustment methods appear to perform well across a range of realistic settings. These are: (1) the addition of a sensible constant to the observed BP in treated subjects; and (2) the censored normal regression model. A third, non-parametric, method based on averaging ordered residuals may also be advocated in some settings. On the other hand, three approaches that are used relatively commonly are fundamentally flawed and should not be used at all. These are: (i) ignoring the problem altogether and analysing observed BP in treated subjects as if it was underlying BP; (ii) fitting a conventional regression model with treatment as a binary covariate; and (iii) excluding treated subjects from the analysis. Given that the more effective methods are straightforward to implement, there is no argument for undertaking a flawed analysis that wastes power and results in excessive bias. Copyright (c) 2005 John Wiley & Sons, Ltd.

A solvent induced crystallisation method to imbue bioactive ingredients of neem oil into the compact structure of poly (ethylene terephthalate) polyester.

PubMed

Ali, Wazed; Sultana, Parveen; Joshi, Mangala; Rajendran, Subbiyan

2016-07-01

Neem oil, a natural antibacterial agent from neem tree (Azadarichtaindica) has been used to impart antibacterial activity to polyester fabrics. Solvent induced polymer modification method was used and that facilitated the easy entry of neem molecules into the compact structure of polyethylene terephthalate (PET) polyester. The polyester fabric was treated with trichloroacetic acid-methylene chloride (TCAMC) solvent system at room temperature prior to treatment with neem oil. The concentration of TCAMC and the treatment time were optimised. XRD and SEM results showed that the TCAMC treatment causes polymer modification and morphological changes in the PET polyester. Antibacterial activity of TCAMC pre-treated and neem-oil-treated polyester fabric was tested using AATCC qualitative and quantitative methods. Both Gram-positive and Gram-negative organisms were used to determine the antimicrobial activity. It was observed that the treated fabric registers substantial antimicrobial activity against both the Staphylococcus aureus (Gram-positive) and the Escherichia coli (Gram-negative) and the effect increases with the increase in concentration of TCAMC treatment. The antibacterial effect remains substantial even after 25 launderings. A kinetic growth study involving the effect of antibacterial activity at various incubation times was carried out. Copyright © 2016 Elsevier B.V. All rights reserved.

Evaluating the Effects of Gamma-Irradiation for Decontamination of Medicinal Cannabis.

PubMed

Hazekamp, Arno

2016-01-01

In several countries with a National medicinal cannabis program, pharmaceutical regulations specify that herbal cannabis products must adhere to strict safety standards regarding microbial contamination. Treatment by gamma irradiation currently seems the only method available to meet these requirements. We evaluated the effects of irradiation treatment of four different cannabis varieties covering different chemical compositions. Samples were compared before and after standard gamma-irradiation treatment by performing quantitative UPLC analysis of major cannabinoids, as well as qualitative GC analysis of full cannabinoid and terpene profiles. In addition, water content and microscopic appearance of the cannabis flowers was evaluated. This study found that treatment did not cause changes in the content of THC and CBD, generally considered as the most important therapeutically active components of medicinal cannabis. Likewise, the water content and the microscopic structure of the dried cannabis flowers were not altered by standard irradiation protocol in the cannabis varieties studied. The effect of gamma-irradiation was limited to a reduction of some terpenes present in the cannabis, but keeping the terpene profile qualitatively the same. Based on the results presented in this report, gamma irradiation of herbal cannabis remains the recommended method of decontamination, at least until other more generally accepted methods have been developed and validated.

Evaluating the Effects of Gamma-Irradiation for Decontamination of Medicinal Cannabis

PubMed Central

Hazekamp, Arno

2016-01-01

In several countries with a National medicinal cannabis program, pharmaceutical regulations specify that herbal cannabis products must adhere to strict safety standards regarding microbial contamination. Treatment by gamma irradiation currently seems the only method available to meet these requirements. We evaluated the effects of irradiation treatment of four different cannabis varieties covering different chemical compositions. Samples were compared before and after standard gamma-irradiation treatment by performing quantitative UPLC analysis of major cannabinoids, as well as qualitative GC analysis of full cannabinoid and terpene profiles. In addition, water content and microscopic appearance of the cannabis flowers was evaluated. This study found that treatment did not cause changes in the content of THC and CBD, generally considered as the most important therapeutically active components of medicinal cannabis. Likewise, the water content and the microscopic structure of the dried cannabis flowers were not altered by standard irradiation protocol in the cannabis varieties studied. The effect of gamma-irradiation was limited to a reduction of some terpenes present in the cannabis, but keeping the terpene profile qualitatively the same. Based on the results presented in this report, gamma irradiation of herbal cannabis remains the recommended method of decontamination, at least until other more generally accepted methods have been developed and validated. PMID:27199751

Modified Ponseti method of treatment for correction of neglected clubfoot in older children and adolescents--a preliminary report.

PubMed

Bashi, Ramin Haj Zargar; Baghdadi, Taghi; Shirazi, Mehdi Ramezan; Abdi, Reza; Aslani, Hossein

2016-03-01

Congenital talipes equinovarus may be the most common congenital orthopedic condition requiring treatment. Nonoperative treatment including different methods is generally accepted as the first step in the deformity correction. Ignacio Ponseti introduced his nonsurgical approach to the treatment of clubfoot in the early 1940s. The method is reportedly successful in treating clubfoot in patients up to 9 years of age. However, whether age at the beginning of treatment affects the rate of effective correction and relapse is unknown. We have applied the Ponseti method successfully with some modifications for 11 patients with a mean age of 11.2 years (range, 6 to 19 years) with neglected and untreated clubbed feet. The mean follow-up was 15 months (12 to 36 months). Correction was achieved with a mean of nine casts (six to 13). Clinically, 17 out of 18 feet (94.4%) were considered to achieve a good result with no need for further surgery. The application of this method of treatment is very simple and also cheap in developing countries with limited financial and social resources for health service. To the best of the authors' knowledge, such a modified method as a correction method for clubfoot in older children and adolescents has not been applied previously for neglected clubfeet in older children in the literature.

Subthreshold Diode Micropulse Laser Photocoagulation (SDM) as Invisible Retinal Phototherapy for Diabetic Macular Edema: A Review

PubMed Central

Luttrull, Jeffrey K; Dorin, Giorgio

2012-01-01

Purpose: To present the state-of-the-art of subthreshold diode laser micropulse photocoagulation (SDM) as invisible retinal phototherapy for diabetic macular edema (DME). Method: To review the role and evolution of retinal laser treatment for DME. Results: Thermal laser retinal photocoagulation has been the cornerstone of treatment for diabetic macular edema for over four decades. Throughout, laser induced retinal damage produced by conventional photocoagulation has been universally accepted as necessary to produce a therapeutic benefit, despite the inherent risks, adverse effects and limitations of thermally destructive treatment. Recently, SDM, performed as invisible retinal phototherapy for DME, has been found to be effective in the absence of any retinal damage or adverse effect, fundamentally altering our understanding of laser treatment for retinal disease. Summary: The discovery of clinically effective and harmless SDM treatment for DME offers exciting new information that will improve our understanding of laser treatment for retinal disease, expand treatment indications, and improve patient outcomes. PMID:22587512

Treatment of petroleum hydrocarbon polluted environment through bioremediation: a review.

PubMed

Singh, Kriti; Chandra, Subhash

2014-01-01

Bioremediation play key role in the treatment of petroleum hydrocarbon contaminated environment. Exposure of petroleum hydrocarbon into the environment occurs either due to human activities or accidentally and cause environmental pollution. Petroleum hydrocarbon cause many toxic compounds which are potent immunotoxicants and carcinogenic to human being. Remedial methods for the treatment of petroleum contaminated environment include various physiochemical and biological methods. Due to the negative consequences caused by the physiochemical methods, the bioremediation technology is widely adapted and considered as one of the best technology for the treatment of petroleum contaminated environment. Bioremediation utilizes the natural ability of microorganism to degrade the hazardous compound into simpler and non hazardous form. This paper provides a review on the role of bioremediation in the treatment of petroleum contaminated environment, discuss various hazardous effects of petroleum hydrocarbon, various factors influencing biodegradation, role of various enzymes in biodegradation and genetic engineering in bioremediation.

Regeneration and reuse of iron catalyst for Fenton-like reactions.

PubMed

Cao, Guo-min; Sheng, Mei; Niu, Wen-feng; Fei, Yu-lei; Li, Dong

2009-12-30

Fenton and Fenton-like reactions employed for oxidative treatment of a typical industrial wastewater generate a large amount of ferric hydroxide sludge which has to be properly disposed at a high cost. This paper presents a simple and cost-effective method for recovering the iron catalyst from the iron hydroxide sludge for oxidative treatment of industrial wastewaters. The sludge was dewatered, dried and baked at 350-400 degrees C for 20-30 min; the residual solids were dissolved in sulfuric acid to form the reusable catalyst for Fenton and Fenton-like reactions. The recovered catalyst was highly effective for the oxidative pretreatment of a fine chemical wastewater to improve its biodegradability; the resulting COD removal and BOD(5)/COD ratio of the treated stream remained nearly unchanged during the time period when the regenerated catalyst was reused six times. The simple and effective catalyst regeneration method will make Fenton and Fenton-like oxidation a more cost-effective wastewater treatment alternative.

[Current status and prospect of photodynamic therapy in laryngeal diseases].

PubMed

Zhang, C; Jiang, J Q

2018-04-07

Laryngeal diseases are closely related to the swallowing and speech function of the patients.Protecting and restoring laryngeal function, while curing lesions, is vital to patients' quality of life.Photodynamic therapy (PDT) is a minimally invasive method which is widely used in the treatment of tumor, precancerous lesions, and inflammatory diseases.In recent years, it has been shown to have a protective effect on normal structures. This article reviews the clinical outcomes of laryngeal diseases treated with PDT since 1990 in order to evaluate its efficacy and significance. The complete remission rate of early-stage laryngeal tumors and precancerous lesions after PDT is 77.6%(249/321), and a promising effect on recurrent laryngeal papillomatosis has been observed thus far. The prolonged adverse effects of the first-generation photosensitizers have limited the application of PDT. With the improvement of photosensitizers and treatment strategies, PDT promises to be a safe, effective, and minimally invasive treatment method for laryngeal diseases.

Recent advances for the treatment of cocaine abuse: central nervous system immunopharmacotherapy.

PubMed

Dickerson, Tobin J; Janda, Kim D

2005-10-19

Cocaine addiction continues to be a major health and societal problem in spite of governmental efforts devoted toward educating the public of the dangers of illicit drug use. A variety of pharmacotherapies and psychosocial programs have been proposed in an effort to provide a method for alleviation of the physical and psychological symptoms of cocaine abuse. Unfortunately, these methods have been met with limited success, illustrating a critical need for new effective approaches for the treatment of cocaine addiction. Recently an alternative cocaine abuse treatment strategy was proposed using intranasal administration of an engineered filamentous bacteriophage displaying cocaine-sequestering antibodies on its surface. These phage particles are an effective vector for CNS penetration and are capable of binding cocaine, thereby blocking its behavioral effects in a rodent model. The convergence of phage display and immunopharmacotherapy has allowed for an investigation of the efficacy of protein-based therapeutics acting within the CNS on the effects of cocaine in animal models and has uncovered a new tool in the battle against cocaine addiction.

Influence of euthanasia method on blood and gill variables in normoxic and hypoxic Gulf killifish Fundulus grandis.

PubMed

Larter, K F; Rees, B B

2017-06-01

In many experiments, euthanasia, or humane killing, of animals is necessary. Some methods of euthanasia cause death through cessation of respiratory or cardiovascular systems, causing oxygen levels of blood and tissues to drop. For experiments where the goal is to measure the effects of environmental low oxygen (hypoxia), the choice of euthanasia technique, therefore, may confound the results. This study examined the effects of four euthanasia methods commonly used in fish biology (overdose of MS-222, overdose of clove oil, rapid cooling and blunt trauma to the head) on variables known to be altered during hypoxia (haematocrit, plasma cortisol, blood lactate and blood glucose) or reflecting gill damage (trypan blue exclusion) and energetic status (ATP, ADP and ATP:ADP) in Gulf killifish Fundulus grandis after 24 h exposure to well-aerated conditions (normoxia, 7·93 mg O 2  l -1 , c. 150 mm Hg or c. 20 kPa) or reduced oxygen levels (0·86 mg O 2  l -1 , c. 17 mm Hg or c. 2·2 kPa). Regardless of oxygen treatment, fish euthanized by an overdose of MS-222 had higher haematocrit and lower gill ATP:ADP than fish euthanized by other methods. The effects of 24 h hypoxic exposure on these and other variables, however, were equivalent among methods of euthanasia (i.e. there were no significant interactions between euthanasia method and oxygen treatment). The choice of an appropriate euthanasia method, therefore, will depend upon the magnitude of the treatment effects (e.g. hypoxia) relative to potential artefacts caused by euthanasia on the variables of interest. © 2017 The Fisheries Society of the British Isles.

Czechoslovak Journal of Physics (selected articles)

NASA Astrophysics Data System (ADS)

Hermoch, V.; Zitka, B. H.

1983-01-01

One of the most widely used methods of electroerosion treatment is the so called anode mechanical method, which uses an electrolyte rather than a dielectric medium. The effect of the short term pulsed discharge, the effect of the surrounding electrolyte on the behavior of the discharge, and the effect of electromechanical changes on the surface of the electrode on the discharge mechanism were studied.

Music therapy as a non-pharmacological treatment for epilepsy.

PubMed

Liao, Huan; Jiang, Guohui; Wang, Xuefeng

2015-01-01

Epilepsy is one of the most common neurological diseases. Currently, the primary methods of treatment include pharmacological and surgical treatment. However, approximately one-third of patients exhibit refractory epilepsy. Therefore, a novel approach to epilepsy treatment is necessary. Several studies have confirmed that music therapy can be effective at reducing seizures and epileptiform discharges, thus providing a new option for clinicians in the treatment of epilepsy. Although the underlying mechanism of music therapy is unknown, it may be related to resonance, mirror neurons, dopamine pathways and parasympathetic activation. Large sample, multicenter, randomized double-blind and more effectively designed studies are needed for future music therapy studies.

Screening, diagnosis, and treatment of post-traumatic stress disorder.

PubMed

Wisco, Blair E; Marx, Brian P; Keane, Terence M

2012-08-01

Post-traumatic stress disorder (PTSD) is a prevalent problem among military personnel and veterans. Identification of effective screening tools, diagnostic technologies, and treatments for PTSD is essential to ensure that all individuals in need of treatment are offered interventions with proven efficacy. Well-validated methods for screening and diagnosing PTSD are now available, and effective pharmacological and psychological treatments can be offered. Despite these advances, many military personnel and veterans do not receive evidence-based care. We review the literature on screening, diagnosis, and treatment of PTSD in military populations, and discuss the challenges to implementing the best evidence-based practices in clinical settings.

[Onyx embolization for treatment of dural arteriovenous fistula: comparison of long- distance versus routine injection method].

PubMed

He, Xiao-Yan; Zhang, Guo-Zhong; Li, Ming-Zhou; Wang, Gang; Liu, Dan; Qi, Song-Tao; Li, Wei-Guang; Feng, Wen-Feng

2016-03-01

To compare the efficacy, clinical characteristics, safety, injection time and radiation exposure of Onyx embolization using a long-distance injection method and routine injection method for management of dural arteriovenous fistula (DAVF). The clinical data were retrospectively analyzed in 59 patients with DAVF treated with Onyx embolization using long-distance injection method (28 patients) and routine injection method (31 patients). The efficacy, safety, injection time and radiation exposure during Onyx embolization were compared between the two injections methods. The average radiation dose exposure to the surgeon per procedure was significantly lower in the long-distance injection group than in the routine group. The injection time (P=0.53), injection volume (P=0.78), number of supply arteries (P=0.80), Cognard types (P=0.67), and effect of embolization (P=0.88) were all similar between the two groups. Endovaseular treatment of intracranial DAVF with Onyx embolization using the long-distance injection method is feasible, safe and effective and can reduce the radiation exposure to the surgeon.

Attendance and Substance Use Outcomes for the Seeking Safety Program: Sometimes Less Is More

ERIC Educational Resources Information Center

Hien, Denise A.; Morgan-Lopez, Antonio A.; Campbell, Aimee N. C.; Saavedra, Lissette M.; Wu, Elwin; Cohen, Lisa; Ruglass, Lesia; Nunes, Edward V.

2012-01-01

Objective: This study uses data from the largest effectiveness trial to date on treatment of co-occurring posttraumatic stress and substance use disorders, using advances in statistical methodology for modeling treatment attendance and membership turnover in rolling groups. Method: Women receiving outpatient substance abuse treatment (N = 353)…

Randomized Controlled Trial of Video Self-Modeling Following Speech Restructuring Treatment for Stuttering

ERIC Educational Resources Information Center

Cream, Angela; O'Brian, Sue; Jones, Mark; Block, Susan; Harrison, Elisabeth; Lincoln, Michelle; Hewat, Sally; Packman, Ann; Menzies, Ross; Onslow, Mark

2010-01-01

Purpose: In this study, the authors investigated the efficacy of video self-modeling (VSM) following speech restructuring treatment to improve the maintenance of treatment effects. Method: The design was an open-plan, parallel-group, randomized controlled trial. Participants were 89 adults and adolescents who undertook intensive speech…

Comparing Voice-Therapy and Vocal-Hygiene Treatments in Dysphonia Using a Limited Multidimensional Evaluation Protocol

ERIC Educational Resources Information Center

Rodriguez-Parra, Maria J.; Adrian, Jose A.; Casado, Juan C.

2011-01-01

Purpose: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation. Method: Forty-two participants with voice disorders were…

Behavioral Treatment of Menopausal Hot Flashes: Evaluation by Objective Methods.

ERIC Educational Resources Information Center

Germaine, Leonard M.; Freedman, Robert R.

1984-01-01

Used latency to hot flash onset under heat stress to evaluate the effects of relaxation treatment or a control procedure in 14 menopausal women. Following treatment, the latency to hot flash onset during heat stress was increased in relaxation subjects. Reported symptom frequency was significantly reduced in relaxation subjects. (BH)

Evaluation of two years of mass chemotherapy against ascariasis in Hamadan, Islamic Republic of Iran.

PubMed Central

Fallah, Mohammad; Mirarab, Akbar; Jamalian, Farzad; Ghaderi, Ahmad

2002-01-01

OBJECTIVE: To evaluate the mass treatment of ascariasis in rural areas of Hamadan Province, Islamic Republic of Iran. METHODS: A control programme in rural areas of Hamadan Province, which began in November 1997, involved giving all persons a single dose of 400 mg albendazole at intervals of three months. The efficacy of the treatment was evaluated by the formalin-ether concentration technique for stool examination and by the Stoll quantitative method. FINDINGS: The average rate of infection with Ascaris before treatment was 53.3%, ranging from 40% in Hamadan district to 75% in Toysercan. Two areas, Malayer and Nahavand, were excluded from the programme because the infection rates were only 13% and 4%, respectively. After two years of mass treatment the infection rate had decreased to 6%. The proportion of positive cases excreting only unfertilized eggs increased to 32%. No side-effects of mass treatment were observed. CONCLUSION: Systematic mass treatment giving high coverage proved to be very effective in the control of ascariasis, notwithstanding a lack of other preventive measures. PMID:12077616

Anthropometric and quantitative EMG status of femoral quadriceps before and after conventional kinesitherapy with and without magnetotherapy.

PubMed

Graberski Matasović, M; Matasović, T; Markovac, Z

1997-06-01

The frequency of femoral quadriceps muscle hypotrophy has become a significant therapeutic problem. Efforts are being made to improve the standard scheme of kinesitherapeutic treatment by using additional more effective therapeutic methods. Beside kinesitherapy, the authors have used magnetotherapy in 30 of the 60 patients. The total of 60 patients, both sexes, similar age groups and intensity of hypotrophy, were included in the study. They were divided into groups A and B, the experimental and the control one (30 patients each). The treatment was scheduled for the usual 5-6 weeks. Electromyographic quantitative analysis was used to check-up the treatment results achieved after 5 and 6 weeks of treatment period. Analysis of results has confirmed the assumption that magnetotherapy may yield better and faster treatment results, disappearance of pain and decreased risk of complications. The same results were obtained in the experimental group, only one week earlier than in the control group. The EMG quantitative analysis has not proved sufficiently reliable and objective method in the assessment of real condition of the muscle and effects of treatment.

A Review of Propensity-Score Methods and Their Use in Cardiovascular Research.

PubMed

Deb, Saswata; Austin, Peter C; Tu, Jack V; Ko, Dennis T; Mazer, C David; Kiss, Alex; Fremes, Stephen E

2016-02-01

Observational studies using propensity-score methods have been increasing in the cardiovascular literature because randomized controlled trials are not always feasible or ethical. However, propensity-score methods can be confusing, and the general audience may not fully understand the importance of this technique. The objectives of this review are to describe (1) the fundamentals of propensity score methods, (2) the techniques to assess for propensity-score model adequacy, (3) the 4 major methods for using the propensity score (matching, stratification, covariate adjustment, and inverse probability of treatment weighting [IPTW]) using examples from previously published cardiovascular studies, and (4) the strengths and weaknesses of these 4 techniques. Our review suggests that matching or IPTW using the propensity score have shown to be most effective in reducing bias of the treatment effect. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Multicellular Tumour Spheroid as a model for evaluation of [18F]FDG as biomarker for breast cancer treatment monitoring

PubMed Central

Monazzam, Azita; Razifar, Pasha; Simonsson, Martin; Qvarnström, Fredrik; Josephsson, Raymond; Blomqvist, Carl; Långström, Bengt; Bergström, Mats

2006-01-01

Background In order to explore a pre-clinical method to evaluate if [18F]FDG is valid for monitoring early response, we investigated the uptake of FDG in Multicellular tumour spheroids (MTS) without and with treatment with five routinely used chemotherapy agents in breast cancer. Methods The response to each anticancer treatment was evaluated by measurement of the [18F]FDG uptake and viable volume of the MTSs after 2 and 3 days of treatment. Results The effect of Paclitaxel and Docetaxel on [18F]FDG uptake per viable volume was more evident in BT474 (up to 55% decrease) than in MCF-7 (up to 25% decrease). Doxorubicin reduced the [18F]FDG uptake per viable volume more noticeable in MCF-7 (25%) than in BT474 MTSs. Tamoxifen reduced the [18F]FDG uptake per viable volume only in MCF-7 at the highest dose of 1 μM. No effect of Imatinib was observed. Conclusion MTS was shown to be appropriate to investigate the potential of FDG-PET for early breast cancer treatment monitoring; the treatment effect can be observed before any tumour size changes occur. The combination of PET radiotracers and image analysis in MTS provides a good model to evaluate the relationship between tumour volume and the uptake of metabolic tracer before and after chemotherapy. This feature could be used for screening and selecting PET-tracers for early assessment of treatment response. In addition, this new method gives a possibility to assess quickly, and in vitro, a good preclinical profile of existing and newly developed anti-cancer drugs. PMID:16556298