An Advanced Multiple Alternatives Modeling Formulation for Determining Graduated Fiscal Support Strategies for Operational and Planned Educational Programs.

ERIC Educational Resources Information Center

Wholeben, Brent Edward

A rationale is presented for viewing the decision-making process inherent in determining budget reductions for educational programs as most effectively modeled by a graduated funding approach. The major tenets of the graduated budget reduction approach to educational fiscal policy include the development of multiple alternative reduction plans, or…

A reanalysis of a behavioral intervention to prevent incident HIV infections: Including indirect effects in modeling outcomes of Project EXPLORE

PubMed Central

Eaton, Lisa A.; Kalichman, Seth C.; Kenny, David A.; Harel, Ofer

2013-01-01

Background Project EXPLORE -- a large-scale, behavioral intervention tested among men who have sex with men (MSM) at-risk for HIV infection --was generally deemed as ineffective in reducing HIV incidence. Using novel and more precise data analytic techniques we reanalyzed Project EXPLORE by including both direct and indirect paths of intervention effects. Methods Data from 4,296 HIV negative MSM who participated in Project EXPLORE, which included ten sessions of behavioral risk reduction counseling completed from 1999-2005, were included in the analysis. We reanalyzed the data to include parameters that estimate the overtime effects of the intervention on unprotected anal sex and the over-time effects of the intervention on HIV status mediated by unprotected anal sex simultaneously in a single model. Results We found the indirect effect of intervention on HIV infection through unprotected anal sex to be statistically significant up through 12 months post-intervention, OR=.83, 95% CI=.72-.95. Furthermore, the intervention significantly reduced unprotected anal sex up through 18 months post-intervention, OR=.79, 95% CI=.63-.99. Discussion Our results reveal effects not tested in the original model that offer new insight into the effectiveness of a behavioral intervention for reducing HIV incidence. Project EXPLORE demonstrated that when tested against an evidence-based, effective control condition can result in reductions in rates of HIV acquisition at one year follow-up. Findings highlight the critical role of addressing behavioral risk reduction counseling in HIV prevention. PMID:23245226

Consideration of permanent tidal deformation in the orbit determination and data analysis for the Topex/Poseidon mission

NASA Technical Reports Server (NTRS)

Rapp, Richard H.; Nerem, R. Steven; Shum, C. K.; Klosko, Steven M.; Williamson, Ronald G.

1991-01-01

The effects of the permanent tidal effects of the Sun and Moon with specific applications to satellite altimeter data reduction are reviewed in the context of a consistent definition of geoid undulations. Three situations are applicable not only for altimeter reduction and geoid definition, but also for the second degree zonal harmonic of the geopotential and the equatorial radius. A recommendation is made that sea surface heights and geoid undulations placed on the Topex/Poseidon geophysical data record should be referred to the mean Earth case (i.e., with the permanent effects of the Sun and Moon included). Numerical constants for a number of parameters, including a flattening and geoid geopotential, are included.

Impact of clay minerals on sulfate-reducing activity in aquifers

USGS Publications Warehouse

Wong, D.; Suflita, J.M.; McKinley, J.P.; Krumholz, L.R.

2004-01-01

Previous studies have shown that sulfate-reduction activity occurs in a heterogeneous manner throughout the terrestrial subsurface. Low-activity regions are often observed in the presence of clay minerals. Here we report that clays inhibit sulfate reduction activity in sediments and in a pure culture of Desulfovibriovulgaris. Clay minerals including bentonite and kaolinite inhibited sulfate reduction by 70–90% in sediments. Intact clays and clay colloids or soluble components, capable of passing through a 0.2-µm filter, were also inhibitory to sulfate-reducing bacteria. Other adsorbent materials, including anion or cation exchangers and a zeolite, did not inhibit sulfate reduction in sediments, suggesting that the effect of clays was not due to their cation-exchange capacity. We observed a strong correlation between the Al2O3content of clays and their relative ability to inhibit sulfate reduction in sediments (r2 = 0.82). This suggested that inhibition might be a direct effect of Al3+ (aq) on the bacteria. We then tested pure aluminum oxide (Al2O3) and showed it to act in a similar manner to clay. As dissolved aluminum is known to be toxic to a variety of organisms at low concentrations, our results suggest that the effects of clay on sulfate-reducing bacteria may be directly due to aluminum. Thus, our experiments provide an explanation for the lack of sulfate-reduction activity in clay-rich regions and presents a mechanism for the effect.

The Community-based Participatory Intervention Effect of “HIV-RAAP”

PubMed Central

Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

2012-01-01

Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

The community-based participatory intervention effect of "HIV-RAAP".

PubMed

Yancey, Elleen M; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H; Yuan, Keming

2012-07-01

To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission.

Effects of Na2SO4 on iron and nickel reduction in a high-iron and low-nickel laterite ore

NASA Astrophysics Data System (ADS)

Wang, Xiao-ping; Sun, Ti-chang; Chen, Chao; Kou, Jue

2018-04-01

This study investigates the reactions of Na2SO4 and its effects on iron and nickel reduction in the roasting of a high-iron and low-nickel laterite ore through gas composition, X-ray diffraction, and scanning electron microscope analyses. Results showed that a reduction reaction of Na2SO4 to SO2 was performed with roasting up to 600°C. However, no clear influence on iron and nickel reductions appeared, because only a small amount of Na2SO4 reacted to produce SO2. Na2SO4 reacted completely at 1000°C, mainly producing troilite and nepheline, which remarkably improves selective reduction of nickel. Furthermore, the production of low-melting-point minerals, including troilite and nepheline, accelerated nickel reduction and delayed iron reduction, which is attributed to the concurrent production of magnesium magnetite, whose structure is more stable than the structure of magnetite. Reduction reactions of Na2SO4 resulted in weakening of the reduction atmosphere, and the main product of Na2SO4 changed and delayed the reduction of iron. Eventually, iron metallization was effectively controlled during laterite ore reduction roasting, leading to iron mainly being found in wustite and high iron-containing olivine.

Stability of mycotoxins during food processing.

PubMed

Bullerman, Lloyd B; Bianchini, Andreia

2007-10-20

The mycotoxins that commonly occur in cereal grains and other products are not completely destroyed during food processing operations and can contaminate finished processed foods. The mycotoxins most commonly associated with cereal grains are aflatoxins, ochratoxin A, fumonisins, deoxynivalenol and zearalenone. The various food processes that may have effects on mycotoxins include sorting, trimming, cleaning, milling, brewing, cooking, baking, frying, roasting, canning, flaking, alkaline cooking, nixtamalization, and extrusion. Most of the food processes have variable effects on mycotoxins, with those that utilize the highest temperatures having greatest effects. In general the processes reduce mycotoxin concentrations significantly, but do not eliminate them completely. However, roasting and extrusion processing show promise for lowering mycotoxin concentrations, though very high temperatures are needed to bring about much of a reduction in mycotoxin concentrations. Extrusion processing at temperatures greater than 150 degrees C are needed to give good reduction of zearalenone, moderate reduction of alfatoxins, variable to low reduction of deoxynivalenol and good reduction of fumonisins. The greatest reductions of fumonisins occur at extrusion temperatures of 160 degrees C or higher and in the presence of glucose. Extrusion of fumonisin contaminated corn grits with 10% added glucose resulted in 75-85% reduction in Fumonisin B(1) levels. Some fumonisin degredation products are formed during extrusion, including small amounts of hydrolyzed Fumonisin B(1) and N-(Carboxymethyl) - Fumonisin B(1) and somewhat higher amounts of N-(1-deoxy-d-fructos-1-yl) Fumonisin B(1) in extruded grits containing added glucose. Feeding trial toxicity tests in rats with extruded fumonisin contaminated corn grits show some reduction in toxicity of grits extruded with glucose.

Potential biomass and logs from fire-hazard-reduction treatments in Southwest Oregon and Northern California

Treesearch

R. James Barbour; Jeremy Fried; Peter J. Daugherty; Glenn Christensen; Roger. Fight

2008-01-01

The FIA BioSum model was used to simulate three fire-hazard-reduction policies in an area comprising northern California, southwestern Oregon, and the east slopes of the Cascade Mountains in Oregon. The policy scenarios, all subject to a stand-scale fire-hazard-reduction effectiveness constraint, included maximize torching index improvement (Max TI), maximize net...

Summary of noise reduction characteristics of typical general aviation materials

NASA Technical Reports Server (NTRS)

Roskam, J.; Grosveld, F.; Van Aken, J.

1979-01-01

The paper presents the results of a large number of systematic tests to determine noise reduction characteristics of general aviation materials. Effects of material type (metallic and composite), thickness, panel stiffening, vibration damping materials, sound absorption materials and pressurization on noise reduction are included. Several promising methods for reducing cabin interior noise in light airplanes are discussed based on the results.

"Effect of Anxiety Reduction on Children's School Performance and Social Adjustment": Correction to Wood (2006)

ERIC Educational Resources Information Center

Wood, Jeffrey J.

2007-01-01

Reports an error in "Effect of anxiety reduction on children's school performance and social adjustment" by Jeffrey Wood (Developmental Psychology, 2006[Mar], Vol 42[2], 345-349). The byline and author note should have included the author's middle initial, J. Thus, the byline and author note should refer to "Jeffrey J. Wood." The correction is…

SGLT2 inhibitors in the management of type 2 diabetes.

PubMed

Monica Reddy, R P; Inzucchi, Silvio E

2016-08-01

The glucose-lowering pharmacopeia continues to grow for patients with type 2 diabetes. The latest drug category, the SGLT2 inhibitors reduce glycated hemoglobin concentrations by increasing urinary excretion of glucose. They are used mainly in combination with metformin and other antihyperglycemic agents, including insulin. Their glucose-lowering potency is modest. Advantages include lack of hypoglycemia as a side effect, and mild reduction in blood pressure and body weight. Side effects include increased urinary frequency, owing to their mild diuretic action, symptoms of hypovolemia, genitourinary infections. There are also recent reports of rare cases of diabetic ketoacidosis occurring in insulin-treated patients. Recently, a large cardiovascular outcome trial reported that a specific SGLT2 inhibitor, empagliflozin, led to a reduction in the primary endpoint of major cardiovascular events. This effect was mainly the result of a surprising 38 % reduction in cardiovascular death, and the drug was also associated with nearly as large a reduction in heart failure hospitalization. These findings were notable because most drugs used in type 2 diabetes have not been shown to improve cardiovascular outcomes. Accordingly, there is growing interest in empagliflozin and the entire SGLT2 inhibitor class as drugs that could potentially change the manner in which we approach the management of hyperglycemia in patients with type 2 diabetes.

The Motivating Influence of Retest and Repeated Dietary Counseling on Cholesterol Reduction

NASA Technical Reports Server (NTRS)

Taylor, P.; Townsend, J. C.; Villafana, C.; Arnoldi, L. B.

1971-01-01

An analysis was made of retest and followup counselling effects on the reduction of hypercholesterolemia levels in NASA employees. Criteria used to measure such control include motivation, age of patient, personality of patient, job stress, and physical exercise.

Effects of various pretreatments on biological sulfate reduction with waste activated sludge as electron donor and waste activated sludge diminution under biosulfidogenic condition.

PubMed

Sheng, Yuxing; Cao, Hongbin; Li, Yuping; Zhang, Yi

2010-07-15

The current study focused on the influences of various pretreatments, including alkaline, ultrasonic and thermal pretreatments on biological sulfate reduction with waste activated sludge (WAS) as sole electron donor. Our results showed that thermal and ultrasonic pretreatments increased the sulfate reduction percentage by 14.8% and 7.1%, respectively, compared with experiment with raw WAS, while alkaline pretreatment decreased the sulfate reduction percentage by 46%. By analyzing the WAS structure, particle size distribution, organic component, and enzyme activity after different pretreatments, we studied the effects of these pretreatments on WAS as well as on the mechanisms of how biological sulfate reduction was affected. The reduction of WAS and variation of WAS structure in the process of sulfate reduction were investigated. Our results showed that biosulfidogenesis was an efficient method of diminishing WAS, and various pretreatments could enhance the reduction efficiency of volatile solid in the WAS. 2010 Elsevier B.V. All rights reserved.

Linking sensory biology and fisheries bycatch reduction in elasmobranch fishes: a review with new directions for research

PubMed Central

Jordan, Laura K.; Mandelman, John W.; McComb, D. Michelle; Fordham, Sonja V.; Carlson, John K.; Werner, Timothy B.

2013-01-01

Incidental capture, or bycatch, in fisheries represents a substantial threat to the sustainability of elasmobranch populations worldwide. Consequently, researchers are increasingly investigating elasmobranch bycatch reduction methods, including some focused on these species' sensory capabilities, particularly their electrosensory systems. To guide this research, we review current knowledge of elasmobranch sensory biology and feeding ecology with respect to fishing gear interactions and include examples of bycatch reduction methods used for elasmobranchs as well as other taxonomic groups. We discuss potential elasmobranch bycatch reduction strategies for various fishing gear types based on the morphological, physiological, and behavioural characteristics of species within this diverse group. In select examples, we indicate how an understanding of the physiology and sensory biology of vulnerable, bycatch-prone, non-target elasmobranch species can help in the identification of promising options for bycatch reduction. We encourage collaboration among researchers studying bycatch reduction across taxa to provide better understanding of the broad effects of bycatch reduction methods. PMID:27293586

First-line treatment for elevated intraocular pressure (IOP) associated with open-angle glaucoma or ocular hypertension: focus on bimatoprost

PubMed Central

Law, Simon K

2007-01-01

The goal of treatment for open-angle glaucoma or ocular hypertension is to improve quality of life through reduction of intraocular pressure (IOP) to preserve visual function. Prostaglandins, as a newer class of ocular hypotensive agents, have been shown to be effective in IOP reduction by the primary mechanism of action of increase the uveoscleral outflow. Bimatoprost is a member this class, but different from the other members by having an ethyl amide group rather than an isopropyl ester at the C-1 carbon of the alpha chain. Bimatoprost used once daily has been shown to be more effect in IOP reduction than other classes of topical ocular hypotensive agents including beta-blockers, carbonic anhydrase inhibitors, and alpha agonists. Comparing with other topical prostaglandins, bimatoprost may be slightly more effective in IOP reduction, but the clinical significance is uncertain. The commonly reported adverse events associated with bimatoprost are localized to the eye and include conjunctival hyperemia, changes in the pigmentation of the periocular skin and iris, and eyelash darkening and growth. It is currently approved by the Food and Drug Administration (FDA) and the European Commission (EC) for first-line therapy for the reduction of elevated IOP in patients with open-angle glaucoma or ocular hypertension. PMID:19668476

Plug Load Behavioral Change Demonstration Project

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

Metzger, I.; Kandt, A.; VanGeet, O.

2011-08-01

This report documents the methods and results of a plug load study of the Environmental Protection Agency's Region 8 Headquarters in Denver, Colorado, conducted by the National Renewable Energy Laboratory. The study quantified the effect of mechanical and behavioral change approaches on plug load energy reduction and identified effective ways to reduce plug load energy. Load reduction approaches included automated energy management systems and behavioral change strategies.

A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come?

PubMed Central

Stangl, Anne L; Lloyd, Jennifer K; Brady, Laura M; Holland, Claire E; Baral, Stefan

2013-01-01

Introduction HIV-related stigma and discrimination continue to hamper efforts to prevent new infections and engage people in HIV treatment, care and support programmes. The identification of effective interventions to reduce stigma and discrimination that can be integrated into national responses is crucial to the success of the global AIDS response. Methods We conducted a systematic review of studies and reports that assessed the effectiveness of interventions to reduce HIV stigma and discrimination between 1 January 2002 and 1 March 2013. Databases searched for peer-reviewed articles included PubMed, Scopus, EBSCO Host –CINAHL Plus, Psycinfo, Ovid, Sociofile and Popline. Reports were obtained from the www.HIVAIDSClearinghouse.eu, USAID Development Experience Clearinghouse, UNESCO HIV and AIDS Education Clearinghouse, Google, WHO and UNAIDS. Ancestry searches for articles included in the systematic review were also conducted. Studies of any design that sought to reduce stigma as a primary or secondary objective and included pre- and post-intervention measures of stigma were included. Results Of 2368 peer-reviewed articles and reports identified, 48 were included in our review representing 14 different target populations in 28 countries. The majority of interventions utilized two or more strategies to reduce stigma and discrimination, and ten included structural or biomedical components. However, most interventions targeted a single socio-ecological level and a single domain of stigma. Outcome measures lacked uniformity and validity, making both interpretation and comparison of study results difficult. While the majority of studies were effective at reducing the aspects of stigma they measured, none assessed the influence of stigma or discrimination reduction on HIV-related health outcomes. Conclusions Our review revealed considerable progress in the stigma-reduction field. However, critical challenges and gaps remain which are impeding the identification of effective stigma-reduction strategies that can be implemented by national governments on a larger scale. The development, validation, and consistent use of globally relevant scales of stigma and discrimination are a critical next step for advancing the field of research in this area. Studies comparing the effectiveness of different stigma-reduction strategies and studies assessing the influence of stigma reduction on key behavioural and biomedical outcomes are also needed to maximize biomedical prevention efforts. PMID:24242268

A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come?

PubMed

Stangl, Anne L; Lloyd, Jennifer K; Brady, Laura M; Holland, Claire E; Baral, Stefan

2013-11-13

HIV-related stigma and discrimination continue to hamper efforts to prevent new infections and engage people in HIV treatment, care and support programmes. The identification of effective interventions to reduce stigma and discrimination that can be integrated into national responses is crucial to the success of the global AIDS response. We conducted a systematic review of studies and reports that assessed the effectiveness of interventions to reduce HIV stigma and discrimination between 1 January 2002 and 1 March 2013. Databases searched for peer-reviewed articles included PubMed, Scopus, EBSCO Host -CINAHL Plus, Psycinfo, Ovid, Sociofile and Popline. Reports were obtained from the www.HIVAIDSClearinghouse.eu, USAID Development Experience Clearinghouse, UNESCO HIV and AIDS Education Clearinghouse, Google, WHO and UNAIDS. Ancestry searches for articles included in the systematic review were also conducted. Studies of any design that sought to reduce stigma as a primary or secondary objective and included pre- and post-intervention measures of stigma were included. Of 2368 peer-reviewed articles and reports identified, 48 were included in our review representing 14 different target populations in 28 countries. The majority of interventions utilized two or more strategies to reduce stigma and discrimination, and ten included structural or biomedical components. However, most interventions targeted a single socio-ecological level and a single domain of stigma. Outcome measures lacked uniformity and validity, making both interpretation and comparison of study results difficult. While the majority of studies were effective at reducing the aspects of stigma they measured, none assessed the influence of stigma or discrimination reduction on HIV-related health outcomes. Our review revealed considerable progress in the stigma-reduction field. However, critical challenges and gaps remain which are impeding the identification of effective stigma-reduction strategies that can be implemented by national governments on a larger scale. The development, validation, and consistent use of globally relevant scales of stigma and discrimination are a critical next step for advancing the field of research in this area. Studies comparing the effectiveness of different stigma-reduction strategies and studies assessing the influence of stigma reduction on key behavioural and biomedical outcomes are also needed to maximize biomedical prevention efforts.

Displaced intra-articular calcaneal fractures.

PubMed

Bajammal, Sohail; Tornetta, Paul; Sanders, David; Bhandari, Mohit

2005-01-01

Calcaneal fractures comprise 1 to 2 percent of all fractures. Approximately 75% of calcaneal fractures are intra-articular. The management of intra-articular calcaneal fractures remains controversial. Nonoperative treatment options include elevation, ice, early mobilization, and cyclic compression of the plantar arch. Operative treatment options include closed reduction and percutaneous pin fixation, open reduction and internal fixation, and arthrodesis. The effect of operative versus nonoperative treatment has been the focus of several comparative studies. This study was designed to determine the effect of operative treatment compared with nonoperative treatment on the rate of union, complications, and functional outcome after intra-articular calcaneal fracture in adults.

Hybrid Wing Body Aircraft System Noise Assessment with Propulsion Airframe Aeroacoustic Experiments

NASA Technical Reports Server (NTRS)

Thomas, Russell H.; Burley, Casey L.; Olson, Erik D.

2010-01-01

A system noise assessment of a hybrid wing body configuration was performed using NASA s best available aircraft models, engine model, and system noise assessment method. A propulsion airframe aeroacoustic effects experimental database for key noise sources and interaction effects was used to provide data directly in the noise assessment where prediction methods are inadequate. NASA engine and aircraft system models were created to define the hybrid wing body aircraft concept as a twin engine aircraft with a 7500 nautical mile mission. The engines were modeled as existing technology high bypass ratio turbofans. The baseline hybrid wing body aircraft was assessed at 22 dB cumulative below the FAA Stage 4 certification level. To determine the potential for noise reduction with relatively near term technologies, seven other configurations were assessed beginning with moving the engines two fan nozzle diameters upstream of the trailing edge and then adding technologies for reduction of the highest noise sources. Aft radiated noise was expected to be the most challenging to reduce and, therefore, the experimental database focused on jet nozzle and pylon configurations that could reduce jet noise through a combination of source reduction and shielding effectiveness. The best configuration for reduction of jet noise used state-of-the-art technology chevrons with a pylon above the engine in the crown position. This configuration resulted in jet source noise reduction, favorable azimuthal directivity, and noise source relocation upstream where it is more effectively shielded by the limited airframe surface, and additional fan noise attenuation from acoustic liner on the crown pylon internal surfaces. Vertical and elevon surfaces were also assessed to add shielding area. The elevon deflection above the trailing edge showed some small additional noise reduction whereas vertical surfaces resulted in a slight noise increase. With the effects of the configurations from the database included, the best available noise reduction was 40 dB cumulative. Projected effects from additional technologies were assessed for an advanced noise reduction configuration including landing gear fairings and advanced pylon and chevron nozzles. Incorporating the three additional technology improvements, an aircraft noise is projected of 42.4 dB cumulative below the Stage 4 level.

E-cigarettes and smoking cessation: evidence from a systematic review and meta-analysis.

PubMed

Rahman, Muhammad Aziz; Hann, Nicholas; Wilson, Andrew; Mnatzaganian, George; Worrall-Carter, Linda

2015-01-01

E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation. To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation. A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases. Published studies, those reported smoking abstinence or reduction in cigarette consumption after the use of e-cigarettes, were included. Studies were systematically reviewed, and meta-analyses were conducted using Mantel-Haenszel fixed-effect and random-effects models. Degree of heterogeneity among studies and quality of the selected studies were evaluated. Six studies were included involving 7,551 participants. Meta-analyses included 1,242 participants who had complete data on smoking cessation. Nicotine filled e-cigarettes were more effective for cessation than those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Amongst 1,242 smokers, 224 (18%) reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28). Use of e-cigarettes was also associated with a reduction in the number of cigarettes used. Included studies were heterogeneous, due to different study designs and gender variation. Whilst we were able to comment on the efficacy of nicotine vs. non-nicotine e-cigarettes for smoking cessation, we were unable to comment on the efficacy of e-cigarettes vs. other interventions for cessation, given the lack of comparator groups in the studies included in this meta-analysis. Use of e-cigarettes is associated with smoking cessation and reduction. More randomised controlled trials are needed to assess effectiveness against other cessation methods.

A randomized-controlled trial examining the effects of reflexology on anxiety of patients undergoing coronary angiography.

PubMed

Molavi Vardanjani, Mehdi; Masoudi Alavi, Negin; Razavi, Narges Sadat; Aghajani, Mohammad; Azizi-Fini, Esmail; Vaghefi, Seied Morteza

2013-09-01

The anxiety reduction before coronary angiography has clinical advantages and is one of the objectives of nursing. Reflexology is a non-invasive method that has been used in several clinical situations. Applying reflexology might have effect on the reduction of anxiety before coronary angiography. The aim of this randomized clinical trial was to investigate the effect of reflexology on anxiety among patients undergoing coronary angiography. This trial was conducted in Shahid Beheshti Hospital, in Kashan, Iran. One hundred male patients who were undergoing coronary angiography were randomly enrolled into intervention and placebo groups. The intervention protocol was included 30 minutes of general foot massage and the stimulation of three reflex points including solar plexus, pituitary gland, and heart. The placebo group only received the general foot massage. Spielbergers state trait anxiety inventory was used to assess the anxiety experienced by patients. Data was analyzed using Man-Witney, Wilcoxon and Chi-square tests. The stepwise multiple regressions used to analyze the variables that are involved in anxiety reduction. The mean range of anxiety decreased from 53.24 to 45.24 in reflexology group which represented 8 score reduction (P = 0.0001). The reduction in anxiety was 5.9 score in placebo group which was also significant (P = 0.0001). The anxiety reduction was significantly higher in reflexology group (P = 0.014). The stepwise multiple regression analysis showed that doing reflexology can explain the 7.5% of anxiety reduction which made a significant model. Reflexology can decrease the anxiety level before coronary angiography. Therefore, reflexology before coronary angiography is recommended.

High Bypass Ratio Jet Noise Reduction and Installation Effects Including Shielding Effectiveness

NASA Technical Reports Server (NTRS)

Thomas, Russell H.; Czech, Michael J.; Doty, Michael J.

2013-01-01

An experimental investigation was performed to study the propulsion airframe aeroacoustic installation effects of a separate flow jet nozzle with a Hybrid Wing Body aircraft configuration where the engine is installed above the wing. Prior understanding of the jet noise shielding effectiveness was extended to a bypass ratio ten application as a function of nozzle configuration, chevron type, axial spacing, and installation effects from additional airframe components. Chevron types included fan chevrons that are uniform circumferentially around the fan nozzle and T-fan type chevrons that are asymmetrical circumferentially. In isolated testing without a pylon, uniform chevrons compared to T-fan chevrons showed slightly more low frequency reduction offset by more high frequency increase. Phased array localization shows that at this bypass ratio chevrons still move peak jet noise source locations upstream but not to nearly the extent, as a function of frequency, as for lower bypass ratio jets. For baseline nozzles without chevrons, the basic pylon effect has been greatly reduced compared to that seen for lower bypass ratio jets. Compared to Tfan chevrons without a pylon, the combination with a standard pylon results in more high frequency noise increase and an overall higher noise level. Shielded by an airframe surface 2.17 fan diameters from nozzle to airframe trailing edge, the T-fan chevron nozzle can produce reductions in jet noise of as much as 8 dB at high frequencies and upstream angles. Noise reduction from shielding decreases with decreasing frequency and with increasing angle from the jet inlet. Beyond an angle of 130 degrees there is almost no noise reduction from shielding. Increasing chevron immersion more than what is already an aggressive design is not advantageous for noise reduction. The addition of airframe control surfaces, including vertical stabilizers and elevon deflection, showed only a small overall impact. Based on the test results, the best overall nozzle configuration design was selected for application to the N2A Hybrid Wing Body concept that will be the subject of the NASA Langley 14 by 22 Foot Subsonic Tunnel high fidelity aeroacoustic characterization experiment. The best overall nozzle selected includes T-fan type chevrons, uniform chevrons on the core nozzle, and no additional pylon of the type that created a strong acoustic effect at lower bypass ratios. The T-fan chevrons are oriented azimuthally away from the ground observer locations. This best overall nozzle compared to the baseline nozzle was assessed, at equal thrust, to produce sufficient installed noise reduction of the jet noise component to enable the N2A HWB to meet NASA s noise goal of 42 dB cumulative below Stage 4.

Conservation voltage regulation (CVR) applied to energy savings by voltage-adjusting equipment through AMI

NASA Astrophysics Data System (ADS)

Lan, B.-R.; Chang, C.-A.; Huang, P.-Y.; Kuo, C.-H.; Ye, Z.-J.; Shen, B.-C.; Chen, B.-K.

2017-11-01

Conservation voltage reduction (CVR) includes peak demand reduction, energy conservation, carbon emission reduction, and electricity bill reduction. This paper analyzes the energy-reduction of Siwei Feeders with applying CVR, which are situated in Penghu region and equipped with smart meters. Furthermore, the applicable voltage reduction range for the feeders will be explored. This study will also investigate how the CVR effect and energy conservation are improved with the voltage control devices integrated. The results of this study can serve as a reference for the Taiwan Power Company to promote and implement voltage reduction and energy conservation techniques. This study is expected to enhance the energy-reduction performance of the Penghu Low Carbon Island Project.

Monoclonal antibody disulfide reduction during manufacturing

PubMed Central

Hutterer, Katariina M.; Hong, Robert W.; Lull, Jonathon; Zhao, Xiaoyang; Wang, Tian; Pei, Rex; Le, M. Eleanor; Borisov, Oleg; Piper, Rob; Liu, Yaoqing Diana; Petty, Krista; Apostol, Izydor; Flynn, Gregory C.

2013-01-01

Manufacturing-induced disulfide reduction has recently been reported for monoclonal human immunoglobulin gamma (IgG) antibodies, a widely used modality in the biopharmaceutical industry. This effect has been tied to components of the intracellular thioredoxin reduction system that are released upon cell breakage. Here, we describe the effect of process parameters and intrinsic molecule properties on the extent of reduction. Material taken from cell cultures at the end of production displayed large variations in the extent of antibody reduction between different products, including no reduction, when subjected to the same reduction-promoting harvest conditions. Additionally, in a reconstituted model in which process variables could be isolated from product properties, we found that antibody reduction was dependent on the cell line (clone) and cell culture process. A bench-scale model using a thioredoxin/thioredoxin reductase regeneration system revealed that reduction susceptibility depended on not only antibody class but also light chain type; the model further demonstrates that the trend in reducibility was identical to DTT reduction sensitivity following the order IgG1λ > IgG1κ > IgG2λ > IgG2κ. Thus, both product attributes and process parameters contribute to the extent of antibody reduction during production. PMID:23751615

Hypnosis in patients with perceived stress - a systematic review.

PubMed

Fisch, S; Brinkhaus, B; Teut, M

2017-06-19

Although hypnosis and hypnotherapy have become more popular in recent years, the evidence for hypnosis to influence perceived stress is unclear. In this systematic review we searched and evaluated randomized clinical studies investigating the effect of hypnosis on perceived stress reduction and coping. The Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, the Database of Abstracts of Review of Effects, EMBASE, Medline, PsycINFO, PSYNDEX and PubMed were systematically screened from their inception until December 2015 for randomized controlled trials (RCTs) reporting about hypnosis or hypnotherapy for stress reduction in healthy participants. Risk of Bias was assessed according the Cochrane Collaboration recommendations. Nine RCTs with a total of 365 participants met the inclusion criteria and were included in this review. Most included participants were medical students, predominantly female (n = 211). Mean age of participants ranged in most studies between 20 and 25 years, in three studies the mean ages were between 30 and 42 years. Perceived stress was measured by a wide range of psychological questionnaires including Face Valid Stress Test, Stress Thermometer, and immunological data was collected. All nine included studies used explorative designs and showed a high risk of bias. Six out of nine studies reported significant positive effects of hypnosis for stress reduction in the main outcome parameter compared to control groups (3 active controls, 3 no therapy controls). Immunological outcomes were assessed in six studies, the results were inconclusive. Due to exploratory designs and high risk of bias, the effectiveness of hypnosis or hypnotherapy in stress reduction remains still unclear. More high quality clinical research is urgently needed.

[Manipulative reduction and external fixation with cardboard splint for the treatment of calcaneal fractures: a 60-case report].

PubMed

Hao, Bo-Chuan; Xie, Ke-Bo

2014-07-01

To investigate the therapeutic effects of manipulative reduction for calcaneal fractures. From January 2009 to June 2012, 53 cases (60 affected feet) of Sanders type I-IV calcaneal fractures were treated by manipulative reduction and external fixation with cardboard splint,including 45 males and 8 females with an average age of (33.5 +/- 1.54) years old ranging from 18 to 65. The course of disease ranged 0.5 h to 7 d. Before treatment the feet were swelling, ache and activity limitation in evidence, some feet were wide flat deformity, the cortical bone was broken in the imaging examination. All selected cases were evaluated using Creighton-Nebraska health foundation assessment scale for fractures of calcaneus. All cases were followed up at 12 months after treatment, 13 feet got excellent curative effect, 34 good, 11 moderate and 2 poor. Manipulative reduction for Sanders type I-IV calcaneal fractures could get excellent curative effect. Manipulative reduction for calcaneal fractures could avoid surgical trauma while assure high curative effects. Manipulative reduction is not only economical and easy therapy, but also can restore maximum function of the calcaneus with few complications and facilitate early rehabilitation of ankle and joint function.

Climate effects of reducing black carbon emissions: Dependence on location of emission

NASA Astrophysics Data System (ADS)

Fuglestvedt, J.; Berntsen, T.; Myhre, G.; Rive, N. A.; Rypdal, K.; Gerland, S.; Pedersen, C.; Strøm, J.

2006-12-01

The role played by emissions of black carbon aerosols (BC) on the Earth's climate is diverse and the overall effect is still quite uncertain: Black carbon not only absorbs sunlight (direct effect), but it also has a semi- direct effect on clouds, and when deposited on snow and ice it changes the reflectivity (albedo) of the ground surface. These mechanisms generally have a warming effect on the climate. This poster presents a Norwegian project that focus on the net effect of current BC emissions and future possible reductions in emissions of BC aerosols, taking into account scientific, economic, and political perspectives on the inclusion of BC in climate policies. Thus, the scope of the project is interdisciplinary and includes observations in the Arctic, model simulations of dispersion of BC aerosols, its radiative forcing and climate effects. Some initial results from measurements of BC content in snow from the Norwegian Arctic and corresponding measurements for surface reflectance will be presented. The radiative forcing of BC emissions from different geographical regions differs due to differences in the removal processes (i.e. the lifetime) and the amount of solar radiation available for absorption (depends on latitude, clouds, and surface albedo). The atmospheric burdens and RF (of the direct effect) of regional BC emissions from fossil fuel sources have been calculated by the global chemical transport model Oslo-CTM2 and a radiative transfer model, and first results of time-integrated RF per unit of emission (equivalent to absolute GWPs) are presented. Future plans including i) analysis of cost effective emission reduction strategies, taking into account regional differences the forcing efficiencies, but also cost estimates for BC reductions in the different regions, and ii) an evaluation of the climate effects of the emission reductions through model simulations, including climatic, economic and political perspectives exploring obstacles and opportunities will also be presented.

Comparison of four different reduction methods for anterior dislocation of the shoulder.

PubMed

Guler, Olcay; Ekinci, Safak; Akyildiz, Faruk; Tirmik, Uzeyir; Cakmak, Selami; Ugras, Akin; Piskin, Ahmet; Mahirogullari, Mahir

2015-05-28

Shoulder dislocations account for almost 50% of all major joint dislocations and are mainly anterior. The aim is a comparative retrospective study of different reduction maneuvers without anesthesia to reduce the dislocated shoulder. Patients were treated with different reduction maneuvers, including various forms of traction and external rotation, in the emergency departments of four training hospitals between 2009 and 2012. Each of the four hospitals had different treatment protocols for reduction and applying one of four maneuvers: Spaso, Chair, Kocher, and Matsen methods. Thirty-nine patients were treated by the Spaso method, 47 by the Chair reduction method, 40 by the Kocher method, and 27 patients by Matsen's traction-countertraction method. All patients' demographic data were recorded. Dislocation number, reduction time, time interval between dislocation and reduction, and associated complications, pre- and post-reduction period, were recorded prospectively. No anesthetic method was used for the reduction. All of the methods used included traction and some external rotation. The Chair method had the shortest reduction time. All surgeons involved in the study agreed that the Kocher and Matsen methods needed more force for the reduction. Patients could contract their muscles because of the pain in these two methods. The Spaso method includes flexion of the shoulder and blocks muscle contraction somewhat. The Chair method was found to be the easiest because the patients could not contract their muscles while sitting on a chair with the affected arm at their side. We suggest that the Chair method is an effective and fast reduction maneuver that may be an alternative for the treatment of anterior shoulder dislocations. Further prospective studies with larger sample size are needed to compare safety of different reduction techniques.

76 FR 7841 - Agency Information Collection Activities; Proposed Collections; Toxic Chemical Release Reporting...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

... prevention and waste management data, including recycling information, for such chemicals. 42 U.S.C. 13106... reporting forms and associated instructions, but these changes are estimated to have a negligible effect on... source reduction activities, and provide additional optional information on source reduction, recycling...

Systematic review of dietary trans-fat reduction interventions

PubMed Central

Bromley, Helen; Kypridemos, Chris; O’Flaherty, Martin; Lloyd-Williams, Ffion; Guzman-Castillo, Maria; Pearson-Stuttard, Jonathan; Capewell, Simon

2017-01-01

Abstract Objective To systematically review published studies of interventions to reduce people’s intake of dietary trans-fatty acids (TFAs). Methods We searched online databases (CINAHL, the CRD Wider Public Health database, Cochrane Database of Systematic Reviews, Ovid®, MEDLINE®, Science Citation Index and Scopus) for studies evaluating TFA interventions between 1986 and 2017. Absolute decrease in TFA consumption (g/day) was the main outcome measure. We excluded studies reporting only on the TFA content in food products without a link to intake. We included trials, observational studies, meta-analyses and modelling studies. We conducted a narrative synthesis to interpret the data, grouping studies on a continuum ranging from interventions targeting individuals to population-wide, structural changes. Results After screening 1084 candidate papers, we included 23 papers: 12 empirical and 11 modelling studies. Multiple interventions in Denmark achieved a reduction in TFA consumption from 4.5 g/day in 1976 to 1.5 g/day in 1995 and then virtual elimination after legislation banning TFAs in manufactured food in 2004. Elsewhere, regulations mandating reformulation of food reduced TFA content by about 2.4 g/day. Worksite interventions achieved reductions averaging 1.2 g/day. Food labelling and individual dietary counselling both showed reductions of around 0.8 g/day. Conclusion Multicomponent interventions including legislation to eliminate TFAs from food products were the most effective strategy. Reformulation of food products and other multicomponent interventions also achieved useful reductions in TFA intake. By contrast, interventions targeted at individuals consistently achieved smaller reductions. Future prevention strategies should consider this effectiveness hierarchy to achieve the largest reductions in TFA consumption. PMID:29200523

Reducing Fatal Opioid Overdose: Prevention, Treatment and Harm Reduction Strategies

PubMed Central

Hawk, Kathryn F.; Vaca, Federico E.; D’Onofrio, Gail

2015-01-01

The opioid overdose epidemic is a major threat to the public’s health, resulting in the development and implementation of a variety of strategies to reduce fatal overdose [1-3]. Many strategies are focused on primary prevention and increased access to effective treatment, although the past decade has seen an exponential increase in harm reduction initiatives. To maximize identification of opportunities for intervention, initiatives focusing on prevention, access to effective treatment, and harm reduction are examined independently, although considerable overlap exists. Particular attention is given to harm reduction approaches, as increased public and political will have facilitated widespread implementation of several initiatives, including increased distribution of naloxone and policy changes designed to increase bystander assistance during a witnessed overdose [4-7]. PMID:26339206

Effect of pH, temperature, humic acid and coexisting anions on reduction of Cr(Ⅵ) in the soil leachate by nZVI/Ni bimetal material.

PubMed

Zhu, Fang; Li, Luwei; Ren, Wentao; Deng, Xiaoqiang; Liu, Tao

2017-08-01

Nano zero valent iron/Ni bimetal materials (nZVI/Ni) were prepared by borohydride reduction method to remediate toxic Cr(Ⅵ) contaminated in soil leachate. nZVI/Ni was characterized using scanning electron microscopy (SEM), X-ray diffraction (XRD) and X-ray Photoelectron Spectroscopy (XPS). Different factors including pH value of soil leachate, reaction time, temperature, humic acid and coexisting anions (SO 4 2- , NO 3 - , HCO 3 - , CO 3 2- ) were studied to analyze the reduction rate. Results showed that the reduction rate of Cr(Ⅵ) could reach 99.84% under the condition of pH of 5 and temperature of 303 K. pH values and temperature of soil leachate had a significant effect on the reduction efficiency, while humic acid had inhibition effect for the reduction reaction. SO 4 2- , HCO 3 - and CO 3 2- had inhibition effect for reduction rate, while NO 3 - barely influenced the reduction process of nZVI/Ni. Moreover, Langumir-Hinshelwood first order kinetic model was studied and could describe the reduction process well. The thermodynamic studies indicated that the reaction process was endothermic and spontaneous. Activation energy was 143.80 kJ mol -1 , showing that the reaction occurred easily. Therefore, the study provides an idea for nZVI/Ni further research and practical application of nZVI/Ni in soil remediation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Does integrated care reduce hospital activity for patients with chronic diseases? An umbrella review of systematic reviews

PubMed Central

Damery, Sarah; Flanagan, Sarah; Combes, Gill

2016-01-01

Objective To summarise the evidence regarding the effectiveness of integrated care interventions in reducing hospital activity. Design Umbrella review of systematic reviews and meta-analyses. Setting Interventions must have delivered care crossing the boundary between at least two health and/or social care settings. Participants Adult patients with one or more chronic diseases. Data sources MEDLINE, Embase, ASSIA, PsycINFO, HMIC, CINAHL, Cochrane Library (HTA database, DARE, Cochrane Database of Systematic Reviews), EPPI-Centre, TRIP, HEED, manual screening of references. Outcome measures Any measure of hospital admission or readmission, length of stay (LoS), accident and emergency use, healthcare costs. Results 50 reviews were included. Interventions focused on case management (n=8), chronic care model (CCM) (n=9), discharge management (n=15), complex interventions (n=3), multidisciplinary teams (MDT) (n=10) and self-management (n=5). 29 reviews reported statistically significant improvements in at least one outcome. 11/21 reviews reported significantly reduced emergency admissions (15–50%); 11/24 showed significant reductions in all-cause (10–30%) or condition-specific (15–50%) readmissions; 9/16 reported LoS reductions of 1–7 days and 4/9 showed significantly lower A&E use (30–40%). 10/25 reviews reported significant cost reductions but provided little robust evidence. Effective interventions included discharge management with postdischarge support, MDT care with teams that include condition-specific expertise, specialist nurses and/or pharmacists and self-management as an adjunct to broader interventions. Interventions were most effective when targeting single conditions such as heart failure, and when care was provided in patients’ homes. Conclusions Although all outcomes showed some significant reductions, and a number of potentially effective interventions were found, interventions rarely demonstrated unequivocally positive effects. Despite the centrality of integrated care to current policy, questions remain about whether the magnitude of potentially achievable gains is enough to satisfy national targets for reductions in hospital activity. Trial registration number CRD42015016458. PMID:27872113

Meta-analysis and systematic review of studies on the effectiveness of HIV stigma reduction programs.

PubMed

Mak, Winnie W S; Mo, Phoenix K H; Ma, Gloria Y K; Lam, Maggie Y Y

2017-09-01

The present study conducted a meta-analysis and systematic review on studies evaluating the effectiveness of stigma reduction programs in improving knowledge and reducing negative attitudes towards people living with HIV (PLHIV). Meta-analysis (k = 42 studies) found significant and small effect sizes in the improvement of the participants' knowledge of HIV/AIDS from interventions with (Cohen's d = 0.48, 95% CI [0.30, 0.66]) and without control groups (Cohen's d = 0.42, 95% CI [0.28, 0.57]). Significant and small effect sizes were found in the improvement of the participants' attitudes toward PLHIV from interventions with (Cohen's d = 0.39, 95% CI [0.23, 0.55]) and without control groups (Cohen's d = 0.25, 95% CI [0.11, 0.39]). Significant and small effect sizes were sustained at the follow-up assessments. Subgroup analysis showed that number of intervention sessions, intervention settings, and sample type significantly moderated the effect sizes in the meta-analysis. Findings from the systematic review of 35 studies indicated that most of the included studies showed positive results in reducing negative attitudes toward PLHIV and improving HIV-related knowledge. Most of the included studies tended to have low methodological quality. The present meta-analysis and systematic review indicated that the studies generally found small improvement in HIV-related knowledge and reduction in negative attitudes towards PLHIV among the stigma reduction programs being evaluated. High-quality stigma reduction programs with multidimensional stigma indicators and psychometrically sound outcome measures are highly warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

Working Alliance, Interpersonal Problems, and Depressive Symptoms in Tele-Interpersonal Psychotherapy for HIV-infected Rural Persons: Evidence for Indirect Effects.

PubMed

Anderson, Timothy; McClintock, Andrew S; McCarrick, Shannon S; Heckman, Timothy G; Heckman, Bernadette D; Markowitz, John C; Sutton, Mark

2018-03-01

Interpersonal psychotherapy (IPT) has demonstrated efficacy for the treatment of depression, yet little is known about its therapeutic mechanisms. As a specific treatment, IPT has been shown to directly reduce depressive symptoms, although it is unclear whether these reductions occur via interpersonal changes. Within IPT, the potential role of the working alliance, a common factor, as a predictor of depression and interpersonal changes is also unclear. Participants were 147 depressed persons living with HIV in rural communities of 28 U.S. states enrolled in a randomized clinical trial. Seventy-five patients received up to 9 sessions of telephone-administered IPT (tele-IPT) plus standard care and 72 patients received standard care only. Two models were tested; one included treatment condition (tele-IPT vs. control) and another included the working alliance as independent variables. The first model found an indirect effect whereby tele-IPT reduced depression via decreased social avoidance. There was a direct effect between tele-IPT and reduced depression. In the second model, the working alliance influenced depressive symptom relief via reductions in social avoidance. Both goal and task working alliance subscales were indirectly associated with reductions in depressive symptoms, also through reductions in social avoidance. There were no direct effects involving the working alliance. Tele-IPT's influence on depressive symptom reduction was primarily through a direct effect, whereas the influence of working alliance depression was almost entirely via an indirect effect through interpersonal problems. Study findings have implications for IPT when intervening with depressed rural people living with HIV/AIDS over the telephone. © 2017 Wiley Periodicals, Inc.

Advances in reduction techniques for tire contact problems

NASA Technical Reports Server (NTRS)

Noor, Ahmed K.

1995-01-01

Some recent developments in reduction techniques, as applied to predicting the tire contact response and evaluating the sensitivity coefficients of the different response quantities, are reviewed. The sensitivity coefficients measure the sensitivity of the contact response to variations in the geometric and material parameters of the tire. The tire is modeled using a two-dimensional laminated anisotropic shell theory with the effects of variation in geometric and material parameters, transverse shear deformation, and geometric nonlinearities included. The contact conditions are incorporated into the formulation by using a perturbed Lagrangian approach with the fundamental unknowns consisting of the stress resultants, the generalized displacements, and the Lagrange multipliers associated with the contact conditions. The elemental arrays are obtained by using a modified two-field, mixed variational principle. For the application of reduction techniques, the tire finite element model is partitioned into two regions. The first region consists of the nodes that are likely to come in contact with the pavement, and the second region includes all the remaining nodes. The reduction technique is used to significantly reduce the degrees of freedom in the second region. The effectiveness of the computational procedure is demonstrated by a numerical example of the frictionless contact response of the space shuttle nose-gear tire, inflated and pressed against a rigid flat surface. Also, the research topics which have high potential for enhancing the effectiveness of reduction techniques are outlined.

Nonsteroidal Anti-inflammatory Drugs for Sciatica: An Updated Cochrane Review.

PubMed

Rasmussen-Barr, Eva; Held, Ulrike; Grooten, Wilhelmus J A; Roelofs, Pepijn D D M; Koes, Bart W; van Tulder, Maurits W; Wertli, Maria M

2017-04-15

Systematic review and meta-analysis. To determine the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) on pain reduction, overall improvement, and reported adverse effects in people with sciatica. NSAIDs are one of the most frequently prescribed drugs for sciatica. We updated a 2008 Cochrane Review through June 2015. Randomized controlled trials that compared NSAIDs with placebo, with other NSAIDs, or with other medication were included. Outcomes included pain using mean difference (MD, 95% confidence intervals [95% CI]). For global improvement and adverse effects risk ratios (RR, 95% CI) were used. We assessed level of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach. Ten trials were included (N = 1651). Nine out of 10 trials were assessed at high risk of bias. For pain reduction (visual analog scale, 0 to 100) NSAIDs were no more effective than placebo (MD -4.56, 95% CI -11.11 to 1.99, quality of evidence: very low). For global improvement NSAIDs were more effective than placebo (RR 1.14 [95% CI 1.03 to 1.27], low quality of evidence). One trial reported the effect of NSAIDs on disability with very low-quality evidence that NSAIDs are no more effective than placebo. There was low-quality evidence that the risk for adverse effects is higher for NSAID than placebo (RR 1.40, 95% CI 1.02 to 1.93). Our findings show very low-quality evidence that the efficacy of NSAIDs for pain reduction is comparable with that of placebo, low-quality evidence that NSAIDs is better than placebo for global improvement and low-quality evidence for higher risk of adverse effects using NSAIDs compared with placebo. The findings must be interpreted with caution, due to small study samples, inconsistent results, and a high risk of bias in the included trials. 1.

Beneficial effects of a woman-focused development programme on child survival: evidence from rural Bangladesh.

PubMed

Bhuiya, Abbas; Chowdhury, Mushtaque

2002-11-01

This paper reports results from a prospective study of the impact of a woman-focused development programme on child survival in Matlab, a rural area of Bangladesh. The programme was targeted to households owning less than 50 decimals of land and members selling more than 100 days of labour for living in a year. Programme components included formation of women's groups for saving and credit, training on skill development, functional literacy including legal and social awareness, and technical and marketing support to projects undertaken with the loan money from the organization. A total of 13,549 children born alive during 1988-97 in the study area were included in the study. Hazards of mortality during pre- and post-intervention periods were compared among the programme participants and non-participants controlling the effects of other relevant variables. There has been a substantial reduction in mortality during the post-intervention period; however, the reduction was much greater for infants whose mothers participated in the development programme compared to infants of non-participant mothers from similar socioeconomic background. In a relative sense, there has been a 52% reduction of the pre-intervention level hazard of death of children during infancy of participant mothers compared to 31% reduction for the infants of non-participant mothers from similar socioeconomic background. There had also been a substantial reduction in hazard of death during childhood (1-4 year age group), however, the reduction was statistically similar for all groups of children irrespective of their mothers' participation in the development programmes.

A Randomized-Controlled Trial Examining the Effects of Reflexology on Anxiety of Patients Undergoing Coronary Angiography

PubMed Central

Molavi Vardanjani, Mehdi; Masoudi Alavi, Negin; Razavi, Narges Sadat; Aghajani, Mohammad; Azizi-Fini, Esmail; Vaghefi, Seied Morteza

2013-01-01

Background: The anxiety reduction before coronary angiography has clinical advantages and is one of the objectives of nursing. Reflexology is a non-invasive method that has been used in several clinical situations. Applying reflexology might have effect on the reduction of anxiety before coronary angiography. Objectives: The aim of this randomized clinical trial was to investigate the effect of reflexology on anxiety among patients undergoing coronary angiography. Patients and Methods: This trial was conducted in Shahid Beheshti Hospital, in Kashan, Iran. One hundred male patients who were undergoing coronary angiography were randomly enrolled into intervention and placebo groups. The intervention protocol was included 30 minutes of general foot massage and the stimulation of three reflex points including solar plexus, pituitary gland, and heart. The placebo group only received the general foot massage. Spielbergers state trait anxiety inventory was used to assess the anxiety experienced by patients. Data was analyzed using Man-Witney, Wilcoxon and Chi-square tests. The stepwise multiple regressions used to analyze the variables that are involved in anxiety reduction. Results: The mean range of anxiety decreased from 53.24 to 45.24 in reflexology group which represented 8 score reduction (P = 0.0001). The reduction in anxiety was 5.9 score in placebo group which was also significant (P = 0.0001). The anxiety reduction was significantly higher in reflexology group (P = 0.014). The stepwise multiple regression analysis showed that doing reflexology can explain the 7.5% of anxiety reduction which made a significant model. Conclusions: Reflexology can decrease the anxiety level before coronary angiography. Therefore, reflexology before coronary angiography is recommended. PMID:25414869

Effect of the bread-making process on zearalenone levels.

PubMed

Heidari, Sara; Milani, Jafar; Nazari, Seyed Saman Seyed Jafar

2014-01-01

The effects of the bread-making process including fermentation with Saccharomyces cerevisiae and lactic acid bacteria (Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus acidophilus and Lactobacillus fermentum) and baking at 200°C on zearalenone (ZEA) levels were investigated. Standard solutions of ZEA were added to flour and then loaves of bread were prepared. Sourdough and three types of yeast including active dry yeast, instant dry yeast and compressed yeast were used for the fermentation of dough. ZEA levels in flour, dough and bread were determined by HPLC with fluorescence detection after extraction and clean-up on an immunoaffinity column. The highest reduction in levels of ZEA was found in the first fermentation (first proof), while the lowest reduction was observed in the baking stage. In addition, the results showed that compressed yeast had the maximum reduction potential on ZEA levels even at the baking stage.

Outcomes of a pilot hand hygiene randomized cluster trial to reduce communicable infections among US office-based employees.

PubMed

Stedman-Smith, Maggie; DuBois, Cathy L Z; Grey, Scott F; Kingsbury, Diana M; Shakya, Sunita; Scofield, Jennifer; Slenkovich, Ken

2015-04-01

To determine the effectiveness of an office-based multimodal hand hygiene improvement intervention in reducing self-reported communicable infections and work-related absence. A randomized cluster trial including an electronic training video, hand sanitizer, and educational posters (n = 131, intervention; n = 193, control). Primary outcomes include (1) self-reported acute respiratory infections (ARIs)/influenza-like illness (ILI) and/or gastrointestinal (GI) infections during the prior 30 days; and (2) related lost work days. Incidence rate ratios calculated using generalized linear mixed models with a Poisson distribution, adjusted for confounders and random cluster effects. A 31% relative reduction in self-reported combined ARI-ILI/GI infections (incidence rate ratio: 0.69; 95% confidence interval, 0.49 to 0.98). A 21% nonsignificant relative reduction in lost work days. An office-based multimodal hand hygiene improvement intervention demonstrated a substantive reduction in self-reported combined ARI-ILI/GI infections.

Reduction in Force: Is Your Board Prepared?

ERIC Educational Resources Information Center

Stanley, William L., Jr.

A reduction in force (RIF), coupled with today's inflation and cost of living increases, impacts on school systems. This paper discusses the effects on an urban school system--the Atlanta Public Schools--and offers suggestions to school administrators on moves to make and pitfalls to avoid when faced with RIF. Some topics covered include legal…

The impact of parent involvement in an effective adolescent risk reduction intervention on sexual risk communication and adolescent outcomes

PubMed Central

Wang, Bo; Stanton, Bonita; Deveaux, Lynette; Li, Xiaoming; Koci, Veronica; Lunn, Sonja

2014-01-01

Parent involvement in prevention efforts targeting adolescents increases the impact of such programs. However, the majority of risk-reduction intervention programs that are implemented through schools do not include parents, in part because most existing parental interventions require significant time commitment by parents. We designed a brief parent-adolescent sexual risk communication intervention to be delivered with an effective HIV prevention intervention as part of a randomized, controlled trial among 2564 grade 10 students and their parents in The Bahamas. Mixed effects modeling analysis was conducted to evaluate the effect of the brief parent-adolescent communication intervention using four waves of longitudinal data. Results indicate that a brief parent-adolescent communication intervention is effective in improving parent-adolescent communication on sex-related issues and perceived parental monitoring as well as the youth's condom use skills and self-efficacy. There is a marginal effect on consistent condom use. In addition, there is an apparent dose effect of the brief parent intervention on perceived parent-adolescent sexual risk communication and adolescent outcomes. These findings suggest that adolescent risk reduction interventions should include a brief parent-adolescent communication intervention which should be reinforced by periodic boosters in order to enhance the impact of adolescent HIV prevention programs. PMID:25490732

The impact of parent involvement in an effective adolescent risk reduction intervention on sexual risk communication and adolescent outcomes.

PubMed

Wang, Bo; Stanton, Bonita; Deveaux, Lynette; Li, Xiaoming; Koci, Veronica; Lunn, Sonja

2014-12-01

Parent involvement in prevention efforts targeting adolescents increases the impact of such programs. However, the majority of risk-reduction intervention programs that are implemented through schools do not include parents, in part because most existing parental interventions require significant time commitment by parents. We designed a brief parent-adolescent sexual risk communication intervention to be delivered with an effective HIV prevention intervention as part of a randomized, controlled trial among 2,564 grade 10 students and their parents in the Bahamas. Mixed effects modeling analysis was conducted to evaluate the effect of the brief parent-adolescent communication intervention using four waves of longitudinal data. Results indicate that a brief parent-adolescent communication intervention is effective in improving parent-adolescent communication on sex-related issues and perceived parental monitoring as well as the youth's condom use skills and self-efficacy. There is a marginal effect on consistent condom use. In addition, there is an apparent dose effect of the brief parent intervention on perceived parent-adolescent sexual risk communication and adolescent outcomes. These findings suggest that adolescent risk reduction interventions should include a brief parent-adolescent communication intervention that should be reinforced by periodic boosters in order to enhance the impact of adolescent HIV prevention programs.

Reduced or modified dietary fat for preventing cardiovascular disease

PubMed Central

Hooper, Lee; Summerbell, Carolyn D; Thompson, Rachel; Sills, Deirdre; Roberts, Felicia G; Moore, Helen; Smith, George Davey

2014-01-01

Background Reduction and modification of dietary fats have differing effects on cardiovascular risk factors (such as serum cholesterol), but their effects on important health outcomes are less clear. Objectives To assess the effect of reduction and/or modification of dietary fats on mortality, cardiovascular mortality, cardiovascular morbidity and individual outcomes including myocardial infarction, stroke and cancer diagnoses in randomised clinical trials of at least 6 months duration. Search methods For this review update, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE, were searched through to June 2010. References of Included studies and reviews were also checked. Selection criteria Trials fulfilled the following criteria: 1) randomised with appropriate control group, 2) intention to reduce or modify fat or cholesterol intake (excluding exclusively omega-3 fat interventions), 3) not multi factorial, 4) adult humans with or without cardiovascular disease, 5) intervention at least six months, 6) mortality or cardiovascular morbidity data available. Data collection and analysis Participant numbers experiencing health outcomes in each arm were extracted independently in duplicate and random effects meta-analyses, meta-regression, sub-grouping, sensitivity analyses and funnel plots were performed. Main results This updated review suggested that reducing saturated fat by reducing and/or modifying dietary fat reduced the risk of cardiovascular events by 14% (RR 0.86, 95% CI 0.77 to 0.96, 24 comparisons, 65,508 participants of whom 7% had a cardiovascular event, I2 50%). Subgrouping suggested that this reduction in cardiovascular events was seen in studies of fat modification (not reduction - which related directly to the degree of effect on serum total and LDL cholesterol and triglycerides), of at least two years duration and in studies of men (not of women). There were no clear effects of dietary fat changes on total mortality (RR 0.98, 95% CI 0.93 to 1.04, 71,790 participants) or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants). This did not alter with sub-grouping or sensitivity analysis. Few studies compared reduced with modified fat diets, so direct comparison was not possible. Authors’ conclusions The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear. PMID:21735388

Fast track pathway reduces sight loss in giant cell arteritis: results of a longitudinal observational cohort study.

PubMed

Patil, P; Williams, M; Maw, W W; Achilleos, K; Elsideeg, S; Dejaco, C; Borg, F; Gupta, S; Dasgupta, B

2015-01-01

To investigate the effectiveness of a fast track pathway (FTP) on sight loss in patients with suspected giant cell arteritis (GCA). A longitudinal observational cohort study was conducted in the secondary care rheumatology department. One hundred and thirty-five newly referred suspected GCA patients seen via the FTP (Jan. 2012-Dec. 2013) were compared to 81 patients seen through the conventional referral and review system (Jan. 2009-Dec. 2011). The FTP resulted in significant reduction in irreversible sight loss from 37.0% (as seen in the historical cohort 2009-2011) to 9.0 % (2012-2013, OR 0.17, p=0.001). Adjustment for clinical and demographic parameters including known risk factors for GCA associated blindness did not significantly change the primary result (OR 0.08, p=0.001). FTP resulted in a reduction of time from symptom onset to diagnosis, particularly by reduction of time from general practitioner's (GP) referral to the rheumatology review (79% of FTP patients were seen within one working day compared to 64.6 % in the conventional pathway, p=0.023). The FTP has seen a reduction in number of GP appointments. There was a significant reduction of permanent sight loss with a fast track GCA pathway. The effect may be due to multiple factors including better GP education and reduction in delayed diagnosis. These results need verification at other sites.

The Effect of a Self-Monitored Relaxation Breathing Exercise on Male Adolescent Aggressive Behavior

ERIC Educational Resources Information Center

Gaines, Trudi; Barry, Leasha M.

2008-01-01

This study sought to contribute to the identification of effective interventions in the area of male adolescent aggressive behavior. Existing research includes both group- and single-case studies implementing treatments which typically include an anger-management component and its attendant relaxation and stress-reduction techniques. The design of…

Effectiveness of individualized, integrative outpatient treatment for females with anorexia nervosa and bulimia nervosa.

PubMed

Freudenberg, Cara; Jones, Rebecca A; Livingston, Genvieve; Goetsch, Virginia; Schaffner, Angela; Buchanan, Linda

2016-01-01

The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups. This study provides preliminary support for the efficacy of a multimodal program for the treatment of both anorexia nervosa and bulimia nervosa.

Complementary and Alternative Therapies as Treatment Approaches for Interstitial Cystitis

PubMed Central

Whitmore, Kristene E

2002-01-01

The management of interstitial cystitis (IC) is predominantly the reduction of the symptoms of frequency, urgency, and pain. Multimodal treatment approaches for IC are helpful in customizing therapy for individual patients. Complementary and alternative therapies are a quintessential addition to the therapeutic armamentarium and frequently include dietary modification, nutraceuticals, bladder training, neuromodulation, stress reduction, and sex therapy. Dietary modification involves elimination of bladder irritants, fluid regulation, and a bowel regimen. Nutraceuticals studied for the treatment of IC include calcium glycerophosphate, L-arginine, mucopolysaccharides, bioflavinoids, and Chinese herbs. Bladder training is effective after pain reduction. The neuromodulation of high-tone pelvic-floor muscle dysfunction is achieved with physical therapy and acupuncture. Stress reduction and sex therapy are best administered by a qualified stress manager and sex therapist. Multimodal, nonconventional management may add efficacy to the treatment of IC. PMID:16986031

Use of organic acids to inactivate Escherichia coli O157:H7, Salmonella Typhimurium, and Listeria monocytogenes on organic fresh apples and lettuce.

PubMed

Park, Sang-Hyun; Choi, Mi-Ran; Park, Jeong-Woong; Park, Ki-Hwan; Chung, Myung-Sub; Ryu, Sangryeol; Kang, Dong-Hyun

2011-08-01

This study was undertaken to investigate the antimicrobial effect of organic acids against Escherichia coli O157:H7, Salmonella Typhimurium, and Listeria monocytogenes on whole red organic apples and lettuce. Several studies have been conducted to evaluate organic acids as sanitizers. However, no studies have compared antimicrobial effects of various organic acids on organic fresh produce, including evaluation of color changes of produce. Apples and lettuce were inoculated with a cocktail of 3 strains each of 3 foodborne pathogens provided above and treated with 1% and 2% organic acids (propionic, acetic, lactic, malic, and citric acid) for 0, 0.5, 1, 5, and 10 min. With increasing treatment time and acid concentration, organic acid treatments showed significant reduction compared to the control treatment (distilled water), and differences in antimicrobial effects between organic acids were observed. After 10 min of treatment with 1% and 2% organic acids in apples, propionic (0.92 to 2.75 log reduction), acetic (0.52 to 2.78 log reduction), lactic (1.69 to >3.42 log reduction), malic (1.48 to >3.42 log reduction), and citric acid (1.52 to >3.42 log reduction) exhibited significant (P < 0.05) antibacterial effects against 3 foodborne pathogens compared to the control treatment. In lettuce, propionic (0.93 to 1.52 log reduction), acetic (1.13 to 1.74 log reduction), lactic (1.87 to 2.54 log reduction), malic (2.32 to 2.98 log reduction), and citric acid (1.85 to 2.86 log reduction) showed significant (P < 0.05) effects compared to the control treatment. Changes in sample color subjected to organic acids treatment were not significant during storage. It is suggested that organic acids have a potential as sanitizers for organic fresh produce. These data may help the organic produce industry provide safe fresh produce for consumers. © 2011 Institute of Food Technologists®

Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic

PubMed Central

Schmidt, Norman B.; Raines, Amanda M.; Allan, Nicholas P.; Zvolensky, Michael J.

2016-01-01

Empirical evidence has identified several risk factors for panic psychopathology, including smoking and anxiety sensitivity (AS; the fear of anxiety-related sensations). Smokers with elevated AS are therefore a particularly vulnerable population for panic. Yet, there is little knowledge about how to reduce risk of panic among high AS smokers. The present study prospectively evaluated panic outcomes within the context of a controlled randomized risk reduction program for smokers. Participants (N = 526) included current smokers who all received a state-of-the-art smoking cessation intervention with approximately half randomized to the AS reduction intervention termed Panic-smoking Program (PSP). The primary hypotheses focus on examining the effects of a PSP on panic symptoms in the context of this vulnerable population. Consistent with prediction, there was a significant effect of treatment condition on AS, such that individuals in the PSP condition, compared to those in the control condition, demonstrated greater decreases in AS throughout treatment and the follow-up period. In addition, PSP treatment resulted in lower rates of panic-related symptomatology. Moreover, mediation analyses indicated that reductions in AS resulted in lower panic symptoms. The present study provides the first empirical evidence that brief, targeted psychoeducational interventions can mitigate panic risk among smokers. PMID:26752327

Anxiety sensitivity risk reduction in smokers: A randomized control trial examining effects on panic.

PubMed

Schmidt, Norman B; Raines, Amanda M; Allan, Nicholas P; Zvolensky, Michael J

2016-02-01

Empirical evidence has identified several risk factors for panic psychopathology, including smoking and anxiety sensitivity (AS; the fear of anxiety-related sensations). Smokers with elevated AS are therefore a particularly vulnerable population for panic. Yet, there is little knowledge about how to reduce risk of panic among high AS smokers. The present study prospectively evaluated panic outcomes within the context of a controlled randomized risk reduction program for smokers. Participants (N = 526) included current smokers who all received a state-of-the-art smoking cessation intervention with approximately half randomized to the AS reduction intervention termed Panic-smoking Program (PSP). The primary hypotheses focus on examining the effects of a PSP on panic symptoms in the context of this vulnerable population. Consistent with prediction, there was a significant effect of treatment condition on AS, such that individuals in the PSP condition, compared to those in the control condition, demonstrated greater decreases in AS throughout treatment and the follow-up period. In addition, PSP treatment resulted in lower rates of panic-related symptomatology. Moreover, mediation analyses indicated that reductions in AS resulted in lower panic symptoms. The present study provides the first empirical evidence that brief, targeted psychoeducational interventions can mitigate panic risk among smokers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of the effects of Korean mindfulness-based stress reduction, walking, and patient education in diabetes mellitus.

PubMed

Jung, Hee Young; Lee, Haejung; Park, Jina

2015-12-01

The purpose of this study was to compare the effects of Korean mindfulness-based stress reduction (K-MBSR), walking, and patient education regarding diabetes mellitus (DM) on stress response, glycemic control, and vascular inflammation in patients with diabetes mellitus. A cluster randomized trial including 56 adults with diabetes mellitus (K-MBSR group = 21, walking group = 18, patient education group = 17) was conducted between 13 July and 14 September 2012. The questionnaire included the Diabetes Distress Scale and Perceived Stress Response Inventory. Fasting blood samples were used to measure levels of cortisol, blood glucose, plasminogen activator inhibitor-1 (PAI-1), and tissue plasminogen activator (t-PA). There were no statistically significant differences between the effects of K-MBSR, walking, and patient education on stress, glycemic control, or vascular inflammation. However, in the K-MBSR and walking groups, significant reductions in the levels of serum cortisol and PAI-1 were observed. A significant reduction in psychological responses to stress was observed in the walking and patient education groups. Longitudinal studies could provide better insight into the impact of K-MBSR, walking, and patient education on health outcomes in adults with diabetes mellitus. © 2015 Wiley Publishing Asia Pty Ltd.

The development of peer educator-based harm reduction programmes in Northern Vietnam.

PubMed

Walsh, Nick; Gibbie, Tania M; Higgs, Peter

2008-03-01

Injecting drug use remains an important risk factor for transmission in Vietnam, with an estimated 50% of the 290 000 people living with HIV/AIDS reporting injecting drug use as a risk factor. Despite this, effective harm reduction interventions are generally lacking. This paper describes the implementation of peer-based harm reduction programmes in two rural provinces of Vietnam. Peer educators were trained in basic HIV prevention, including harm reduction. After significant preparation work with the Provincial AIDS Committees of Bac Giang and Thanh Hoa and other relevant national, provincial and local authorities, the interventions were commenced. Harm reduction interventions were delivered through outreach as well as on-site. This included needle and syringe distribution and collection. Community advocacy occurred throughout the life of the project. Local authorities and peers believed that while there was a general reduction in stigma and discrimination, legal barriers associated particularly with the carrying of injecting equipment remained. This impacted upon the ability of peer educators to work with their clients. Peer-based delivery of harm reduction intervention is acceptable. Harm reduction interventions, including needle and syringe programmes, are feasible and acceptable in these two rural Vietnamese provinces. Community acceptance and uptake of these interventions is key to successful expansion across the region. Active participation by families of drug users seems crucial. This initiative demonstrates that despite a difficult policy environment, peer-delivered needle and syringe programmes are feasible within a rural Asian environment as long as there is adequate local political and community support.

Cost assessment and ecological effectiveness of nutrient reduction options for mitigating Phaeocystis colony blooms in the Southern North Sea: an integrated modeling approach.

PubMed

Lancelot, Christiane; Thieu, Vincent; Polard, Audrey; Garnier, Josette; Billen, Gilles; Hecq, Walter; Gypens, Nathalie

2011-05-01

Nutrient reduction measures have been already taken by wealthier countries to decrease nutrient loads to coastal waters, in most cases however, prior to having properly assessed their ecological effectiveness and their economic costs. In this paper we describe an original integrated impact assessment methodology to estimate the direct cost and the ecological performance of realistic nutrient reduction options to be applied in the Southern North Sea watershed to decrease eutrophication, visible as Phaeocystis blooms and foam deposits on the beaches. The mathematical tool couples the idealized biogeochemical GIS-based model of the river system (SENEQUE-RIVERSTRAHLER) implemented in the Eastern Channel/Southern North Sea watershed to the biogeochemical MIRO model describing Phaeocystis blooms in the marine domain. Model simulations explore how nutrient reduction options regarding diffuse and/or point sources in the watershed would affect the Phaeocystis colony spreading in the coastal area. The reference and prospective simulations are performed for the year 2000 characterized by mean meteorological conditions, and nutrient reduction scenarios include and compare upgrading of wastewater treatment plants and changes in agricultural practices including an idealized shift towards organic farming. A direct cost assessment is performed for each realistic nutrient reduction scenario. Further the reduction obtained for Phaeocystis blooms is assessed by comparison with ecological indicators (bloom magnitude and duration) and the cost for reducing foam events on the beaches is estimated. Uncertainty brought by the added effect of meteorological conditions (rainfall) on coastal eutrophication is discussed. It is concluded that the reduction obtained by implementing realistic environmental measures on the short-term is costly and insufficient to restore well-balanced nutrient conditions in the coastal area while the replacement of conventional agriculture by organic farming might be an option to consider in the nearby future. Copyright © 2011 Elsevier B.V. All rights reserved.

The cost-effectiveness of harm reduction.

PubMed

Wilson, David P; Donald, Braedon; Shattock, Andrew J; Wilson, David; Fraser-Hurt, Nicole

2015-02-01

HIV prevalence worldwide among people who inject drugs (PWID) is around 19%. Harm reduction for PWID includes needle-syringe programs (NSPs) and opioid substitution therapy (OST) but often coupled with antiretroviral therapy (ART) for people living with HIV. Numerous studies have examined the effectiveness of each harm reduction strategy. This commentary discusses the evidence of effectiveness of the packages of harm reduction services and their cost-effectiveness with respect to HIV-related outcomes as well as estimate resources required to meet global and regional coverage targets. NSPs have been shown to be safe and very effective in reducing HIV transmission in diverse settings; there are many historical and very recent examples in diverse settings where the absence of, or reduction in, NSPs have resulted in exploding HIV epidemics compared to controlled epidemics with NSP implementation. NSPs are relatively inexpensive to implement and highly cost-effective according to commonly used willingness-to-pay thresholds. There is strong evidence that substitution therapy is effective, reducing the risk of HIV acquisition by 54% on average among PWID. OST is relatively expensive to implement when only HIV outcomes are considered; other societal benefits substantially improve the cost-effectiveness ratios to be highly favourable. Many studies have shown that ART is cost-effective for keeping people alive but there is only weak supportive, but growing evidence, of the additional effectiveness and cost-effectiveness of ART as prevention among PWID. Packages of combined harm reduction approaches are highly likely to be more effective and cost-effective than partial approaches. The coverage of harm reduction programs remains extremely low across the world. The total annual costs of scaling up each of the harm reduction strategies from current coverage levels, by region, to meet WHO guideline coverage targets are high with ART greatest, followed by OST and then NSPs. But scale-up of all three approaches is essential. These interventions can be cost-effective by most thresholds in the short-term and cost-saving in the long-term. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis

PubMed Central

Rahman, Muhammad Aziz; Hann, Nicholas; Wilson, Andrew; Mnatzaganian, George; Worrall-Carter, Linda

2015-01-01

Background E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation. Objectives To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation. Data Sources A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases. Methods Published studies, those reported smoking abstinence or reduction in cigarette consumption after the use of e-cigarettes, were included. Studies were systematically reviewed, and meta-analyses were conducted using Mantel-Haenszel fixed-effect and random-effects models. Degree of heterogeneity among studies and quality of the selected studies were evaluated. Results Six studies were included involving 7,551 participants. Meta-analyses included 1,242 participants who had complete data on smoking cessation. Nicotine filled e-cigarettes were more effective for cessation than those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Amongst 1,242 smokers, 224 (18%) reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28). Use of e-cigarettes was also associated with a reduction in the number of cigarettes used. Limitations Included studies were heterogeneous, due to different study designs and gender variation. Whilst we were able to comment on the efficacy of nicotine vs. non-nicotine e-cigarettes for smoking cessation, we were unable to comment on the efficacy of e-cigarettes vs. other interventions for cessation, given the lack of comparator groups in the studies included in this meta-analysis. Conclusions Use of e-cigarettes is associated with smoking cessation and reduction. More randomised controlled trials are needed to assess effectiveness against other cessation methods. PMID:25822251

Efficacy of Ginseng Supplements on Fatigue and Physical Performance: a Meta-analysis

PubMed Central

2016-01-01

We conducted a meta-analysis to investigate the efficacy of ginseng supplements on fatigue reduction and physical performance enhancement as reported by randomized controlled trials (RCTs). RCTs that investigated the efficacy of ginseng supplements on fatigue reduction and physical performance enhancement compared with placebos were included. The main outcome measures were fatigue reduction and physical performance enhancement. Out of 155 articles meeting initial criteria, 12 RCTs involving 630 participants (311 participants in the intervention group and 319 participants in the placebo group) were included in the final analysis. In the fixed-effect meta-analysis of four RCTs, there was a statistically significant efficacy of ginseng supplements on fatigue reduction (standardized mean difference, SMD = 0.34; 95% confidence interval [CI] = 0.16 to 0.52). However, ginseng supplements were not associated with physical performance enhancement in the fixed-effect meta-analysis of eight RCTs (SMD = −0.01; 95% CI = −0.29 to 0.27). We found that there was insufficient clinical evidence to support the use of ginseng supplements on reducing fatigue and enhancing physical performance because only few RCTs with a small sample size have been published so far. Further lager RCTs are required to confirm the efficacy of ginseng supplements on fatigue reduction. PMID:27822924

Effects of alcohol tax increases on alcohol-related disease mortality in Alaska: time-series analyses from 1976 to 2004.

PubMed

Wagenaar, Alexander C; Maldonado-Molina, Mildred M; Wagenaar, Bradley H

2009-08-01

We evaluated the effects of tax increases on alcoholic beverages in 1983 and 2002 on alcohol-related disease mortality in Alaska. We used a quasi-experimental design with quarterly measures of mortality from 1976 though 2004, and we included other states for comparison. Our statistical approach combined an autoregressive integrated moving average model with structural parameters in interrupted time-series models. We observed statistically significant reductions in the numbers and rates of deaths caused by alcohol-related disease beginning immediately after the 1983 and 2002 alcohol tax increases in Alaska. In terms of effect size, the reductions were -29% (Cohen's d = -0.57) and -11% (Cohen's d = -0.52) for the 2 tax increases. Statistical tests of temporary-effect models versus long-term-effect models showed little dissipation of the effect over time. Increases in alcohol excise tax rates were associated with immediate and sustained reductions in alcohol-related disease mortality in Alaska. Reductions in mortality occurred after 2 tax increases almost 20 years apart. Taxing alcoholic beverages is an effective public health strategy for reducing the burden of alcohol-related disease.

Effects of a cardiovascular risk reduction intervention with psychobehavioral strategies for Korean adults with type 2 diabetes and metabolic syndrome.

PubMed

Kim, Chun-Ja; Kim, Dae-Jung; Park, Hyung-Ran

2011-01-01

Type 2 diabetes mellitus (DM) and metabolic syndrome are associated with high risk of cardiovascular disease (CVD) and depression. Although lifestyle modifications including regular exercise and weight control are recommended as a primary approach to glycemic control and CVD risk reduction for people with DM and/or metabolic syndrome, little is known concerning the effects of CVD risk reduction interventions using psychobehavioral strategies in this population. This pilot study investigated the effects of a 16-week CVD risk reduction intervention in Korean adults with type 2 DM and metabolic syndrome. A prospective, pretest and posttest, controlled, quasi-experimental design enrolled a convenience sample of 43 Korean adults with type 2 DM and metabolic syndrome at a university hospital. The adults in the intervention group participated in a 16-week CVD risk reduction intervention consisting of 150 minutes of regular exercise per week; 200- to 300-kcal reduced daily diet for weight control; one-on-one psychobehavioral counseling based on constructs from the Transtheoretical Model such as processes of change, self-efficacy, and decisional balance; and telephone coaching for behavioral modification. Participants in the control group received a booklet with basic diabetic education as part of their routine care. Repeated-measures analysis of variance was used for analyzing the effects of the CVD risk reduction intervention on cardiometabolic risk factors including the UK Prospective Diabetes Study score for 10-year CVD risk, glycated hemoglobin (HbA1c), and depression. The intervention group showed significant reductions (P < .05) at 16 weeks, compared with the control group on the UK Prospective Diabetes Study fatal risk scale (-1.73% vs -0.04%), triglycerides (-38.5 vs -15.1 mg/dL), fasting plasma glucose (-29.24 vs +1.77 mg/dL), HbA1c (-0.37% vs +0.17%), and depression (score, -3.24 vs 1.40) measurements. This pilot study yielded evidence for the beneficial impact of the CVD risk reduction intervention for Korean adults with type 2 DM and metabolic syndrome on improved glycemic control, reduced CVD risk, and depression.

Risk factors of chronic periodontitis on healing response: a multilevel modelling analysis.

PubMed

Song, J; Zhao, H; Pan, C; Li, C; Liu, J; Pan, Y

2017-09-15

Chronic periodontitis is a multifactorial polygenetic disease with an increasing number of associated factors that have been identified over recent decades. Longitudinal epidemiologic studies have demonstrated that the risk factors were related to the progression of the disease. A traditional multivariate regression model was used to find risk factors associated with chronic periodontitis. However, the approach requirement of standard statistical procedures demands individual independence. Multilevel modelling (MLM) data analysis has widely been used in recent years, regarding thorough hierarchical structuring of the data, decomposing the error terms into different levels, and providing a new analytic method and framework for solving this problem. The purpose of our study is to investigate the relationship of clinical periodontal index and the risk factors in chronic periodontitis through MLM analysis and to identify high-risk individuals in the clinical setting. Fifty-four patients with moderate to severe periodontitis were included. They were treated by means of non-surgical periodontal therapy, and then made follow-up visits regularly at 3, 6, and 12 months after therapy. Each patient answered a questionnaire survey and underwent measurement of clinical periodontal parameters. Compared with baseline, probing depth (PD) and clinical attachment loss (CAL) improved significantly after non-surgical periodontal therapy with regular follow-up visits at 3, 6, and 12 months after therapy. The null model and variance component models with no independent variables included were initially obtained to investigate the variance of the PD and CAL reductions across all three levels, and they showed a statistically significant difference (P < 0.001), thus establishing that MLM data analysis was necessary. Site-level had effects on PD and CAL reduction; those variables could explain 77-78% of PD reduction and 70-80% of CAL reduction at 3, 6, and 12 months. Other levels only explain 20-30% of PD and CAL reductions. Site-level had the greatest effect on PD and CAL reduction. Non-surgical periodontal therapy with regular follow-up visits had a remarkable curative effect. All three levels had a substantial influence on the reduction of PD and CAL. Site-level had the largest effect on PD and CAL reductions.

The estimated effect of mass or footprint reduction in recent light-duty vehicles on U.S. societal fatality risk per vehicle mile traveled.

PubMed

Wenzel, Tom

2013-10-01

The National Highway Traffic Safety Administration (NHTSA) recently updated its 2003 and 2010 logistic regression analyses of the effect of a reduction in light-duty vehicle mass on US societal fatality risk per vehicle mile traveled (VMT; Kahane, 2012). Societal fatality risk includes the risk to both the occupants of the case vehicle as well as any crash partner or pedestrians. The current analysis is the most thorough investigation of this issue to date. This paper replicates the Kahane analysis and extends it by testing the sensitivity of his results to changes in the definition of risk, and the data and control variables used in the regression models. An assessment by Lawrence Berkeley National Laboratory (LBNL) indicates that the estimated effect of mass reduction on risk is smaller than in Kahane's previous studies, and is statistically non-significant for all but the lightest cars (Wenzel, 2012a). The estimated effects of a reduction in mass or footprint (i.e. wheelbase times track width) are small relative to other vehicle, driver, and crash variables used in the regression models. The recent historical correlation between mass and footprint is not so large to prohibit including both variables in the same regression model; excluding footprint from the model, i.e. allowing footprint to decrease with mass, increases the estimated detrimental effect of mass reduction on risk in cars and crossover utility vehicles (CUVs)/minivans, but has virtually no effect on light trucks. Analysis by footprint deciles indicates that risk does not consistently increase with reduced mass for vehicles of similar footprint. Finally, the estimated effects of mass and footprint reduction are sensitive to the measure of exposure used (fatalities per induced exposure crash, rather than per VMT), as well as other changes in the data or control variables used. It appears that the safety penalty from lower mass can be mitigated with careful vehicle design, and that manufacturers can reduce mass as a strategy to increase their vehicles' fuel economy and reduce greenhouse gas emissions without necessarily compromising societal safety. Published by Elsevier Ltd.

A Plan for the Evaluation of California's Class Size Reduction Initiative.

ERIC Educational Resources Information Center

Kirst, Michael; Bomstedt, George; Stecher, Brian

In July 1996, California began its Class Size Reduction (CSR) Initiative. To gauge the effectiveness of this initiative, an analysis of its objectives and an overview of proposed strategies for evaluating CSR are presented here. An outline of the major challenges that stand between CSR and its mission are provided. These include logistical…

Toxicity of iron overload and iron overload reduction in the setting of hematopoietic stem cell transplantation for hematologic malignancies.

PubMed

Leitch, Heather A; Fibach, Eitan; Rachmilewitz, Eliezer

2017-05-01

Iron is an essential element for key cellular metabolic processes. However, transfusional iron overload (IOL) may result in significant cellular toxicity. IOL occurs in transfusion dependent hematologic malignancies (HM), may lead to pathological clinical outcomes, and IOL reduction may improve outcomes. In hematopoietic stem cell transplantation (SCT) for HM, IOL may have clinical importance; endpoints examined regarding an impact of IOL and IOL reduction include transplant-related mortality, organ function, infection, relapse risk, and survival. Here we review the clinical consequences of IOL and effects of IOL reduction before, during and following SCT for HM. IOL pathophysiology is discussed as well as available tests for IOL quantification including transfusion history, serum ferritin level, transferrin saturation, hepcidin, labile plasma iron and other parameters of iron-catalyzed oxygen free radicals, and organ IOL by imaging. Data-based recommendations for IOL measurement, monitoring and reduction before, during and following SCT for HM are made. Copyright © 2017 Elsevier B.V. All rights reserved.

Possible rainfall reduction through reduced surface temperatures due to overgrazing

NASA Technical Reports Server (NTRS)

Otterman, J.

1975-01-01

Surface temperature reduction in terrain denuded of vegetation (as by overgrazing) is postulated to decrease air convection, reducing cloudiness and rainfall probability during weak meteorological disturbances. By reducing land-sea daytime temperature differences, the surface temperature reduction decreases daytime circulation of thermally driven local winds. The described desertification mechanism, even when limited to arid regions, high albedo soils, and weak meteorological disturbances, can be an effective rainfall reducing process in many areas including most of the Mediterranean lands.

The Effect of a Coronary Artery Risk Evaluation Program on the Serum Lipid Values of a Selected Military Population

DTIC Science & Technology

1991-05-01

interventions reduced low density lipoproteins and serum cholesterol levels. The goals of risk factor reduction are disease prevention , delay of disease... preventing CAD (Lipid Research Clinics Program, 1984). A 1% reduction in cholesterol was associated with a 2 % reduction in risk (NIH, 1984). This includes...heart attack before age 65? Yes No 2 . Do you have Diabetes Mellitus ? Yes No 3. Do you have uncontrolled hypertension? (Blood Pressure consistently

Magnitudes of biomarker reductions in response to controlled reductions in cigarettes smoked per day: a one-week clinical confinement study.

PubMed

Theophilus, Eugenia H; Coggins, Christopher R E; Chen, Peter; Schmidt, Eckhardt; Borgerding, Michael F

2015-03-01

Tobacco toxicant-related exposure reduction is an important tool in harm reduction. Cigarette per day reduction (CPDR) occurs as smokers migrate from smoking cigarettes to using alternative tobacco/nicotine products, or quit smoking. Few reports characterize the dose-response relationships between CPDR and effects on exposure biomarkers, especially at the low end of CPD exposure (e.g., 5 CPD). We present data on CPDR by characterizing magnitudes of biomarker reductions. We present data from a well-controlled, one-week clinical confinement study in healthy smokers who were switched from smoking 19-25 CPD to smoking 20, 10, 5 or 0 CPD. Biomarkers were measured in blood, plasma, urine, and breath, and included smoke-related toxicants, urine mutagenicity, smoked cigarette filter analyses (mouth level exposure), and vital signs. Many of the biomarkers (e.g., plasma nicotine) showed strong CPDR dose-response reductions, while others (e.g., plasma thiocyanate) showed weaker dose-response reductions. Factors that lead to lower biomarker reductions include non-CPD related contributors to the measured response (e.g., other exposure sources from environment, life style, occupation; inter-individual variability). This study confirms CPDR dose-responsive biomarkers and suggests that a one-week design is appropriate for characterizing exposure reductions when smokers switch from cigarettes to new tobacco products. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Effectiveness of an occupational health intervention program to reduce whole body vibration exposure: an evaluation study with a controlled pretest-post-test design.

PubMed

Tiemessen, Ivo J H; Hulshof, Carel T J; Frings-Dresen, Monique H W

2009-12-01

An effective intervention program aiming to reduce whole body vibration (WBV) exposure at work will reduce the number of low back complaints in the near future. An evaluation study with a controlled pretest-post-test design. Nine companies and 126 drivers were included in the study. Cluster randomization on company level divided the drivers and their employers in an intervention group and a "care-as-usual" group. At baseline (T0) and intervention program was implemented and evaluated after 7 months (T1). The main outcome measure was WBV exposure. Process measures included knowledge, attitude, and (intended) behavior towards reduction of WBV exposure for the drivers and knowledge and WBV policy for the employers. At T1, no significant reduction was found in WBV exposure within both groups compared with T0. Probably due to poor to moderate compliance, the intervention program was not effective in reducing the WBV exposure on group level but small reductions in WBV exposure are possible when intervention compliance is high. Copyright 2009 Wiley-Liss, Inc.

Gonadotrophin-releasing hormone agonist treatment for sexual offenders: A systematic review.

PubMed

Lewis, Alexandra; Grubin, Don; Ross, Callum C; Das, Mrigendra

2017-10-01

Sexual offending is a significant international issue causing long-term consequences for victims, perpetrators and society. The purpose of this study was to review the existing research data assessing the efficacy of gonadotrophin-releasing hormone agonists for treating adult, male, sexual offenders. The method of this review involved the examination of studies involving participants prescribed at least one month of a gonadotrophin-releasing hormone agonist for the purposes of reducing sexual drive related to offending. The primary outcome measures were recidivism rates and sexual functioning. Secondary outcome measures included assessment of side effects and effects on interpersonal/psychiatric functioning. Studies in the English language that were dated 1969-2015 were included. Twelve eligible studies (323 participants) were identified. A reduction in a variety of measures of sexual functioning and/or risk was found in all studies. Robust recidivism data was limited. Medication was rarely described as ineffectual. All studies reported side effects. Reduction in bone density and potential long-term reduction in fertility in some subjects were issues of concern. Whilst identified studies showed promising results with respect to sexual functioning, challenges in performing randomised control trials in this subject group meant that included studies were methodologically limited. This review recommends that future research must be performed before the effectiveness and tolerability of gonadotrophin-releasing hormone agonists in this population can be confirmed.

The effects of health care-based violence intervention programs on injury recidivism and costs: A systematic review.

PubMed

Strong, Bethany L; Shipper, Andrea G; Downton, Katherine D; Lane, Wendy G

2016-11-01

Youth violence affects thousands annually, with homicide being the third leading cause of death for those aged 10 to 24 years. This systematic review aims to evaluate the published evidence for the effects of health care-based violence intervention programs (VIPs), which focus on reducing recurrent presentations for injury due to youth violence ("recidivism"). Health literature databases were searched. Studies were retained if peer reviewed and if programs were health care based, focused on intentional injury, addressed secondary or tertiary prevention (i.e., preventing recidivism and reducing complications), included participants aged 14 to 25 years, had greater than 1-month follow-up, and evaluated outcomes. Studies of child and sexual abuse and workplace, intimate partner, and self-inflicted violence were excluded. Extracted data subject to qualitative analysis included enrollment and retention, duration of follow-up, services provided, statistical analysis, and primary and intermediate outcomes. Of the 2,144 citations identified, 22 studies were included in the final sample. Twelve studies were randomized controlled trials representing eight VIPs. Injury recidivism was assessed in six (75%) of eight programs with a significant reduction in one (17%) of six programs. Of the randomized controlled trials showing no difference in recidivism, all were either underpowered or did not include a power analysis. Two observational studies also showed significant reduction in recidivism. Significant intermediate outcomes included increased service use, attitude change, and decreases in violence-related behavior. Reductions in injury recidivism led to reductions in health care and criminal justice system costs. Three studies showing reduced injury recidivism and several studies showing positive intermediate outcomes identify VIPs as a promising practice. Many studies were limited by poor methodological quality, including high losses to follow-up. Systematic review, level III.

Are Electronic Cigarettes an Effective Aid to Smoking Cessation or Reduction Among Vulnerable Groups? A Systematic Review of Quantitative and Qualitative Evidence.

PubMed

Gentry, Sarah; Forouhi, Nita; Notley, Caitlin

2018-03-28

Smoking prevalence remains high in some vulnerable groups, including those who misuse substances, have a mental illness, are homeless or are involved with the criminal justice system. E-cigarette use is increasing and may support smoking cessation/reduction. Systematic review of quantitative and qualitative data on the effectiveness of e-cigarettes for smoking cessation/reduction among vulnerable groups. Databases searched were MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, ProQuest Dissertations and Theses and Open Grey. Narrative synthesis of quantitative data and thematic synthesis of qualitative data. 2628 records and 46 full texts were screened; 9 studies were identified for inclusion. Due to low quality of evidence, it is uncertain whether e-cigarettes are effective for smoking cessation in vulnerable populations. A moderate quality study suggested e-cigarettes were as effective as nicotine replacement therapy. Four studies suggested significant smoking reduction, however three were uncontrolled and had sample sizes below 30. A prospective cohort study found no differences between e-cigarette users and non-users. No significant adverse events and minimal side effects were identified. Qualitative thematic synthesis revealed barriers and facilitators associated with each component of the COM-B (capability, opportunity, motivation, behaviour) model, including practical barriers; perceptions of effectiveness for cessation/reduction; design features contributing to automatic and reflective motivation; smoking bans facilitating practical opportunity; and social connectedness increasing social opportunity. Further research is needed to identify the most appropriate device types for practicality and safety, level of support required in e-cigarette interventions, and to compare e-cigarettes with current best practice smoking cessation support among vulnerable groups. Smoking prevalence among people with mental illness, substance misuse, homelessness or criminal justice system involvement remains high. E-cigarettes could support cessation. This systematic review found limited quantitative evidence assessing effectiveness. No serious adverse events were identified. Qualitative thematic synthesis revealed barriers and facilitators mapping to each component of the COM-B (capability, opportunity, motivation, behaviour) model, including practical barriers; perceived effectiveness; design features contributing to automatic and reflective motivation; smoking bans facilitating practical opportunity; and social connectedness increasing social opportunity. Further research should consider appropriate devices for practicality and safety, concurrent support, and comparison with best practice smoking cessation support.

Minimizing AED adverse effects: improving quality of life in the interictal state in epilepsy care.

PubMed

St Louis, Erik K; Louis, Erik K

2009-06-01

The goals of epilepsy therapy are to achieve seizure freedom while minimizing adverse effects of treatment. However, producing seizure-freedom is often overemphasized, at the expense of inducing adverse effects of treatment. All antiepileptic drugs (AEDs) have the potential to cause dose-related, "neurotoxic" adverse effects (i.e., drowsiness, fatigue, dizziness, blurry vision, and incoordination). Such adverse effects are common, especially when initiating AED therapy and with polytherapy. Dose-related adverse effects may be obviated in most patients by dose reduction of monotherapy, reduction or elimination of polytherapy, or substituting for a better tolerated AED. Additionally, all older and several newer AEDs have idiosyncratic adverse effects which usually require withdrawal in an affected patient, including serious rash (i.e., Stevens-Johnson Syndrome, toxic epidermal necrolysis), hematologic dyscrasias, hepatotoxicity, teratogenesis in women of child bearing potential, bone density loss, neuropathy, and severe gingival hyperplasia. Unfortunately, occurrence of idiosyncratic AED adverse effects cannot be predicted or, in most cases, prevented in susceptible patients. This article reviews a practical approach for the definition and identification of adverse effects of epilepsy therapies, and reviews the literature demonstrating that adverse effects result in detrimental quality of life in epilepsy patients. Strategies for minimizing AED adverse effects by reduction or elimination of AED polytherapy, appropriately employing drug-sparing therapies, and optimally administering AEDs are outlined, including tenets of AED selection, titration, therapeutic AED laboratory monitoring, and avoidance of chronic idiosyncratic adverse effects.

Yoga clinical research review.

PubMed

Field, Tiffany

2011-02-01

In this paper recent research is reviewed on the effects of yoga poses on psychological conditions including anxiety and depression, on pain syndromes, cardiovascular, autoimmune and immune conditions and on pregnancy. Further, the physiological effects of yoga including decreased heartrate and blood pressure and the physical effects including weight loss and increased muscle strength are reviewed. Finally, potential underlying mechanisms are proposed including the stimulation of pressure receptors leading to enhanced vagal activity and reduced cortisol. The reduction in cortisol, in turn, may contribute to positive effects such as enhanced immune function and a lower prematurity rate. Copyright © 2010 Elsevier Ltd. All rights reserved.

Engine-propeller power plant aircraft community noise reduction key methods

NASA Astrophysics Data System (ADS)

Moshkov P., A.; Samokhin V., F.; Yakovlev A., A.

2018-04-01

Basic methods of aircraft-type flying vehicle engine-propeller power plant noise reduction were considered including single different-structure-and-arrangement propellers and piston engines. On the basis of a semiempirical model the expressions for blade diameter and number effect evaluation upon propeller noise tone components under thrust constancy condition were proposed. Acoustic tests performed at Moscow Aviation institute airfield on the whole qualitatively proved the obtained ratios. As an example of noise and detectability reduction provision a design-and-experimental estimation of propeller diameter effect upon unmanned aircraft audibility boundaries was performed. Future investigation ways were stated to solve a low-noise power plant design problem for light aircraft and unmanned aerial vehicles.

[Relevance of MRI After Closed Reduction of Traumatic Hip Dislocation in Children].

PubMed

Strüwind, Christoph Mauritz; von Rüden, Christian; Thannheimer, Andreas; Bühren, Volker; Schneidmueller, Dorien

2018-05-14

Traumatic hip dislocation in children and adolescents is a rare entity that typically results from high-energy trauma. After closed joint reduction, further treatment depends on the specific pattern of the lesion as identified using cross sectional imaging. The aim of this retrospective analysis was to evaluate relevant side effects after traumatic hip dislocation in children and adolescents in order to examine the need for focused diagnostics. This retrospective analysis covered 8 adolescents under 18 years suffering isolated traumatic hip joint dislocation between 2001 and 2017. In all patients, closed joint reduction was performed immediately after admission to the emergency room. In order to evaluate the complete extent of the injury, 5 patients received an MRI and 3 patients a CT scan following closed joint reduction. Two female and 6 male patients with a median age of 11 (range 5 - 16) years were included. In 2 cases, a free joint body was detected in the posterior joint gap in the posttraumatic CT scan after closed joint reduction. Interposition of the labrum into the joint gap was detected intraoperatively in both cases. In one patient who received posttraumatic MRI, labral interposition into the joint gap was observed after closed reduction. These findings were confirmed intraoperatively. In 4 other patients, no posttraumatic labral lesion was detected in the MRI after closed reduction. The reported side effects included ruptured anterior inferior iliac spine and ruptured femoral head ligament. MRI is gaining increasing importance following traumatic hip dislocation in children and adolescents. A missing chondral or osteochondral fragment in the CT scan does not exclude a labral lesion or interposition. Therefore, MRI following closed reduction is mandatory in any case. Georg Thieme Verlag KG Stuttgart · New York.

Effects of Mitral Annulus Remodeling Following MitraClip Procedure on Reduction of Functional Mitral Regurgitation.

PubMed

Hidalgo, Francisco; Mesa, Dolores; Ruiz, Martín; Delgado, Mónica; Rodríguez, Sara; Pardo, Laura; Pan, Manuel; López, Amador; Romero, Miguel A; Suárez de Lezo, José

2016-11-01

The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diameter in patients with functional mitral regurgitation, but the relationship between this and regurgitation severity has not been demonstrated. The aim of this study was to determine the effect of mitral annulus remodeling on the reduction of mitral regurgitation in patients with functional etiology. The study included all patients with functional mitral regurgitation treated with MitraClip at our hospital until January 2015. Echocardiogram (iE33 model, Philips) was performed in all patients immediately after device positioning. Changes in the mitral annulus correlated with mitral regurgitation severity, as assessed using the effective regurgitant orifice area. The study included 23 patients (age, 65±14 years; 74% men; left ventricular ejection fraction, 31%±13%; systolic pulmonary artery pressure, 47±10 mmHg). After the procedure, the regurgitant orifice area decreased by 0.30 cm 2 ±0.04 cm 2 (P<.0005), from a baseline of 0.49 cm 2 ±0.09 cm 2 . Anteroposterior diameter decreased by 3.14 mm±1.01 mm (P<.0005) from a baseline of 28.27 mm±4.9 mm, with no changes in the intercommissural diameter (0.50 mm±0.91 mm vs 40.68 mm±4.7 mm; P=.26). A significant association was seen between anteroposterior diameter reduction and regurgitant orifice area reduction (r=.49; P=.020). In patients with functional mitral regurgitation, the MitraClip device produces an immediate reduction in the anteroposterior diameter. This remodeling may be related to the reduction in mitral regurgitation. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Biology Notes.

ERIC Educational Resources Information Center

School Science Review, 1982

1982-01-01

Describes laboratory procedures, demonstrations, and classroom activities/materials, including use of dwarf cichlids (fishes) in secondary school biology, teaching edge effects on stomatal diffusion, computer program on effects of selection on gene frequencies, biological oxidation/reduction reactions, short cuts with Drosophila, computer program…

Acoustic analysis of aft noise reduction techniques measured on a subsonic tip speed 50.8 cm (twenty inch) diameter fan. [quiet engine program

NASA Technical Reports Server (NTRS)

Stimpert, D. L.; Clemons, A.

1977-01-01

Sound data which were obtained during tests of a 50.8 cm diameter, subsonic tip speed, low pressure ratio fan were analyzed. The test matrix was divided into two major investigations: (1) source noise reduction techniques; and (2) aft duct noise reduction with acoustic treatment. Source noise reduction techniques were investigated which include minimizing second harmonic noise by varying vane/blade ratio, variation in spacing, and lowering the Mach number through the vane row to lower fan broadband noise. Treatment in the aft duct which includes flow noise effects, faceplate porosity, rotor OGV treatment, slant cell treatment, and splitter simulation with variable depth on the outer wall and constant thickness treatment on the inner wall was investigated. Variable boundary conditions such as variation in treatment panel thickness and orientation, and mixed porosity combined with variable thickness were examined. Significant results are reported.

Effects of drug price reduction and prescribing restrictions on expenditures and utilisation of antihypertensive drugs in Korea

PubMed Central

Yoo, Ki-Bong; Lee, Sang Gyu; Park, Sohee; Kim, Tae Hyun; Ahn, Jeonghoon; Cho, Mee-Hyun; Park, Eun-Cheol

2015-01-01

Objectives To evaluate the quantitative effects of the drug price reduction on pharmaceutical expenditures and the new guidelines to restrict prescribing on drug utilisation for antihypertensive drugs. Design We used an interrupted time series design with the National patient sample data of Health Insurance Review and Assessment Service in South Korea. Methods 54 295 participants who were with primary hypertension from the National patient sample data of Health Insurance Review and Assessment Service were included. The study period was from March 2011 to December 2013. The dependent variables were antihypertensive drug costs, antihypertensive drug cost per prescribing day, daily drug utilisation, average number of drugs per month, percentage of original drugs per prescription, drug overutilisation and prohibited combinations. Segmented regression analysis was used. Results The drug price reduction reduced expenditure (US$−1.51, −10.2%), and the new guidelines reduced expenditures even more (US$−2.13; −16.2%). These policies saved US$4.22 (28%) of antihypertensive drug costs per patient in December 2013 compared to March 2012. Drug price reduction policy was introduced in April 2012. We established the policy effect by comparing it before (March 2012) with after(21 months later-December 2012). The effects of the guidelines decreased expenditures, daily drug utilisation and the average number of drugs per month more than did the drug price reduction. Conclusions Both policies saved money. The guidelines were more effective over time and had fewer side effects such as increasing daily drug utilisation and number of drugs than the effects of drug price reduction. PMID:26179644

Does integrated care reduce hospital activity for patients with chronic diseases? An umbrella review of systematic reviews.

PubMed

Damery, Sarah; Flanagan, Sarah; Combes, Gill

2016-11-21

To summarise the evidence regarding the effectiveness of integrated care interventions in reducing hospital activity. Umbrella review of systematic reviews and meta-analyses. Interventions must have delivered care crossing the boundary between at least two health and/or social care settings. Adult patients with one or more chronic diseases. MEDLINE, Embase, ASSIA, PsycINFO, HMIC, CINAHL, Cochrane Library (HTA database, DARE, Cochrane Database of Systematic Reviews), EPPI-Centre, TRIP, HEED, manual screening of references. Any measure of hospital admission or readmission, length of stay (LoS), accident and emergency use, healthcare costs. 50 reviews were included. Interventions focused on case management (n=8), chronic care model (CCM) (n=9), discharge management (n=15), complex interventions (n=3), multidisciplinary teams (MDT) (n=10) and self-management (n=5). 29 reviews reported statistically significant improvements in at least one outcome. 11/21 reviews reported significantly reduced emergency admissions (15-50%); 11/24 showed significant reductions in all-cause (10-30%) or condition-specific (15-50%) readmissions; 9/16 reported LoS reductions of 1-7 days and 4/9 showed significantly lower A&E use (30-40%). 10/25 reviews reported significant cost reductions but provided little robust evidence. Effective interventions included discharge management with postdischarge support, MDT care with teams that include condition-specific expertise, specialist nurses and/or pharmacists and self-management as an adjunct to broader interventions. Interventions were most effective when targeting single conditions such as heart failure, and when care was provided in patients' homes. Although all outcomes showed some significant reductions, and a number of potentially effective interventions were found, interventions rarely demonstrated unequivocally positive effects. Despite the centrality of integrated care to current policy, questions remain about whether the magnitude of potentially achievable gains is enough to satisfy national targets for reductions in hospital activity. CRD42015016458. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A randomized trial of pneumatic reduction versus hydrostatic reduction for intussusception in pediatric patients.

PubMed

Xie, Xiaolong; Wu, Yang; Wang, Qi; Zhao, Yiyang; Chen, Guobin; Xiang, Bo

2017-08-08

Data of randomly controlled trials comparing the hydrostatic and pneumatic reduction for intussusception in pediatric patients as initial therapy are lacking. The aim of this study was to conduct a randomly controlled trial to compare the effectiveness and safety of the hydrostatic and pneumatic reduction techniques. All intussusception patients who visited West China Hospital of Sichuan University from January 2014 to December 2015 were enrolled in this study in which they underwent pneumatic reduction or hydrostatic reduction. Patients were randomized into ultrasound-guided hydrostatic or X-ray-guided pneumatic reduction group. The data collected includes demographic data, symptoms, signs, and investigations. The primary outcome of the study was the success rate of reduction. And the secondary outcomes of the study were the rates of intestinal perforations and recurrence. A total of 124 children with intussusception who had met the inclusion criteria were enrolled. The overall success rate of this study was 90.32%. Univariable analysis showed that the success rate of hydrostatic reduction with normal saline (96.77%) was significantly higher than that of pneumatic reduction with air (83.87%) (p=0.015). Perforation after reduction was found in only one of the pneumatic reduction group. The recurrence rate of intussusception in the hydrostatic reduction group was 4.84% compared with 3.23% of pneumatic reduction group. Our study found that ultrasound-guided hydrostatic reduction is a simple, safe and effective nonoperative treatment for pediatric patients suffering from intussusceptions, and should be firstly adopted in the treatment of qualified patients. Therapeutic study TYPE OF STUDY: Prospective study. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of Exposure on the Mechanical Properties of Gamma MET PX

NASA Technical Reports Server (NTRS)

Draper, S. L.; Lerch, B. A.; Locci, I. E.; Shazly, M.; Prakash, V.

2004-01-01

The effect of a service environment exposure on the mechanical properties of a high Nb content TiAl alloy, Gamma MET PX , was assessed. Gamma MET PX, like other TiAl alloys, experiences a reduction of ductility following high temperature exposure. Exposure in Ar, air, and high-purity oxygen all resulted in a loss of ductility with the ductility reduction increasing with oxygen content in the exposure atmosphere. Embrittling mechanisms, including bulk microstructural changes, moisture induced environmental embrittlement, and near surface effects were investigated. The embrittlement has been shown to be a near-surface effect, most likely due to the diffusion of oxygen into the alloy.

Aeroacoustics of Propulsion Airframe Integration: Overview of NASA's Research

NASA Technical Reports Server (NTRS)

Thomas, Russell H.

2003-01-01

The integration of propulsion and airframe is fundamental to the design of an aircraft system. Many considerations influence the integration, such as structural, aerodynamic, and maintenance factors. In regard to the acoustics of an aircraft, the integration can have significant effects on the net radiated noise. Whether an engine is mounted above a wing or below can have a significant effect on noise that reaches communities below because of shielding or reflection of engine noise. This is an obvious example of the acoustic effects of propulsion airframe installation. Another example could be the effect of the pylon on the development of the exhaust plume and on the resulting jet noise. In addition, for effective system noise reduction the impact that installation has on noise reduction devices developed on isolated components must be understood. In the future, a focus on the aerodynamic and acoustic interaction effects of installation, propulsion airframe aeroacoustics, will become more important as noise reduction targets become more difficult to achieve. In addition to continued fundamental component reduction efforts, a system level approach that includes propulsion airframe aeroacoustics will be required in order to achieve the 20 dB of perceived noise reduction envisioned by the long-range NASA goals. This emphasis on the aeroacoustics of propulsion airframe integration is a new part of NASA s noise research. The following paper will review current efforts and highlight technical challenges and approaches.

First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents.

PubMed

Letourneau, Elizabeth J; McCart, Michael R; Sheidow, Ashli J; Mauro, Pia M

2017-01-01

There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N=45) or usual services (US; N=60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

First Evaluation of a Contingency Management Intervention Addressing Adolescent Substance Use and Sexual Risk Behaviors: Risk Reduction Therapy for Adolescents

PubMed Central

Letourneau, Elizabeth J.; McCart, Michael R.; Sheidow, Ashli J.; Mauro, Pia M.

2016-01-01

There is a need for interventions that comprehensively address youth substance use disorders (SUD) and sexual risk behaviors. Risk Reduction Therapy for Adolescents (RRTA) adapts a validated family-focused intervention for youth SUD to include sexual risk reduction components in a single intervention. In this first evaluation of RRTA, drug court involved youth were randomly assigned to RRTA (N = 45) or usual services (US; N = 60) and followed through 12-months post-baseline. RRTA included weekly cognitive behavior therapy and behavior management training and contingency-contracting with a point earning system managed by caregivers targeting drug use and sexual risk antecedents. Longitudinal models estimated within-group change and between-group differences through 6- and 12-month follow-up on outcomes for substance use, sexual risk behaviors, and protective HIV behaviors. Robust effects of the intervention were not detected under conditions of the study that included potent background interventions by the juvenile drug court. Considerations about future development and testing of sexual risk reduction therapy for youth are discussed, including the potential role of contingency management in future interventions. PMID:27629581

Viscosity induced non-uniform flow in laminar flow heat exchangers

NASA Astrophysics Data System (ADS)

Putnam, G. R.; Rohsenow, W. M.

1985-05-01

Laminar flow heat exchangers which cool oil in noninterconnected parallel passages can experience nonuniform flows and a reduction in the effective heat exchanger coefficient in a range of Reynolds number which varies with tube length and diameter, tube wall temperature and fluid inlet temperature. The method of predicting the reduction in effective heat transfer coefficient and the range of Reynolds number over which these instabilities exist is presented for a particular oil, Mobil aviation oil 120. Included, also, is the prediction of the effect of radial viscosity variation on the constant property magnitudes of friction and heat transfer coefficient.

A Comparison between Users and Non-Users of Devereux's Safe and Positive Approaches Training Curricula in the Reduction of Injury and Restraint

ERIC Educational Resources Information Center

Russell, Megan; Maher, Catherine; Dorrell, Mandi; Pitcher, Christianna; Henderson, Lorrie

2009-01-01

This study examined the effectiveness of Devereux's Safe and Positive Approaches training curricula (SPA) in the reduction of injury and restraint. Several data points were collected including utilization rates of restrictive interventions, number of youth injuries, number of staff injuries, and whether the program/organization is a user or…

A meta-analysis of overall effects of weight loss interventions delivered via mobile phones and effect size differences according to delivery mode, personal contact, and intervention intensity and duration.

PubMed

Schippers, M; Adam, P C G; Smolenski, D J; Wong, H T H; de Wit, J B F

2017-04-01

Weight loss interventions are delivered through various mediums including, increasingly, mobile phones. This systematic review and meta-analysis assesses whether interventions delivered via mobile phones reduce body weight and which intervention characteristics are associated with efficacy. The study included randomised controlled trials assessing the efficacy of weight loss interventions delivered via mobile phones. A meta-analysis to test intervention efficacy was performed, and subgroup analyses were conducted to determine whether interventions' delivery mode(s), inclusion of personal contact, duration and interaction frequency improve efficacy. Pooled body weight reduction (d = -0.23; 95% confidence interval = -0.38, -0.08) was significant. Interventions delivered via other modes in addition to the mobile phone were associated with weight reduction. Personal contact and more frequent interactions in interventions were also associated with greater weight reduction. In conclusion, the current body of evidence shows that interventions delivered via mobile phones produce a modest reduction in body weight when combined with other delivery modes. Delivering interventions with frequent and personal interactions may in particular benefit weight loss results. © 2017 World Obesity Federation.

Baseline Serum Estradiol and Fracture Reduction During Treatment With Hormone Therapy: The Women’s Health Initiative Randomized Trial

PubMed Central

Cauley, Jane A.; LaCroix, Andrea Z.; Robbins, John A.; Larson, Joseph; Wallace, Robert; Wactawski-Wende, Jean; Chen, Zhao; Bauer, Douglas C.; Cummings, Steven R.; Jackson, Rebecca

2009-01-01

Purpose To test the hypothesis that the reduction in fractures with hormone therapy (HT) is greater in women with lower estradiol levels. Methods We conducted a nested case-control study within the Women’s Health Initiative HT Trials. The sample included 231 hip fracture case-control pairs and a random sample of 519 all fracture case-control pairs. Cases and controls were matched for age, ethnicity, randomization date, fracture history and hysterectomy status. Hormones were measured prior to randomization. Incident cases of fracture identified over an average follow-up of 6.53 years. Results There was no evidence that the effect of HT on fracture differed by baseline estradiol (E2) or sex hormone binding globulin (SHBG). Across all quartiles of E2 and SHBG, women randomized to HT had about a 50% lower risk of fracture including hip fracture, compared to placebo. Conclusion The effect of HT on fracture reduction is independent of estradiol and SHBG levels. PMID:19436934

Outcomes of a Pilot Hand Hygiene Randomized Cluster Trial to Reduce Communicable Infections Among US Office-Based Employees

PubMed Central

DuBois, Cathy L.Z.; Grey, Scott F.; Kingsbury, Diana M.; Shakya, Sunita; Scofield, Jennifer; Slenkovich, Ken

2015-01-01

Objective: To determine the effectiveness of an office-based multimodal hand hygiene improvement intervention in reducing self-reported communicable infections and work-related absence. Methods: A randomized cluster trial including an electronic training video, hand sanitizer, and educational posters (n = 131, intervention; n = 193, control). Primary outcomes include (1) self-reported acute respiratory infections (ARIs)/influenza-like illness (ILI) and/or gastrointestinal (GI) infections during the prior 30 days; and (2) related lost work days. Incidence rate ratios calculated using generalized linear mixed models with a Poisson distribution, adjusted for confounders and random cluster effects. Results: A 31% relative reduction in self-reported combined ARI-ILI/GI infections (incidence rate ratio: 0.69; 95% confidence interval, 0.49 to 0.98). A 21% nonsignificant relative reduction in lost work days. Conclusions: An office-based multimodal hand hygiene improvement intervention demonstrated a substantive reduction in self-reported combined ARI-ILI/GI infections. PMID:25719534

Effect of Intravenous Mannitol on Intraocular Pressure in Vitrectomized Silicone-Oil-Filled Eyes.

PubMed

Takkar, Brijesh; Chandra, Parijat; Shah, Ritu; Bhatia, Indrish; Roy, Sangeeta; Sihota, Ramanjit

2017-01-01

To evaluate the effect of intravenous mannitol (IVM) on intraocular pressure (IOP) in vitrectomized eyes. Thirty-one patients with raised IOP after retinal surgery with silicone oil injection were included. Patients were administered IVM (20% solution, 1g/Kg, over 30 minutes) and IOP was noted at regular intervals. IOP reduction in vitrectomized eyes (Group 1) was compared with the normal eyes (Group 2). Percentage IOP reduction was higher in Group 1 than in Group 2 at all time intervals, 24.5% vs. 19.2% at 15 minutes (p=0.34), 22.6% vs. 9.8% at 45 minutes (p=0.003), 19.1% vs. 9.9% at two hours (p=0.023), and 16.1% vs. 7.8% at four hours (p=0.04), respectively. In Group 1, 40% eyes had an IOP reduction of 2-6 mmHg while 30% eyes had IOP reduction >6 mmHg at four hours post-IVM. IVM is useful for short-term IOP reduction in vitrectomized eyes. IOP reduction is independent of baseline IOP, and sustained and higher as compared to normal eyes.

Experiences with three different fiber supplements in weight reduction.

PubMed

Birketvedt, Grethe Støa; Shimshi, Mona; Erling, Thom; Florholmen, Jon

2005-01-01

Fiber supplements added to a caloric diet have additional effects on weight reduction in overweight subjects. The aim of this study was to compare the effect of various commercial fiber supplements (glucomannan, guar gum and alginate) on weight reduction in healthy overweight subjects. One hundred and seventy six men and women were included to receive either active fiber substance or placebo in randomized placebo-controlled studies. The fiber supplements consisted of the viscous fibers glucomannan (Chrombalance), glucomannan and guar gum (Appe-Trim) and glucomannan, guar gum and alginat (Glucosahl). All fiber supplements plus a balanced 1200 kcal diet induced significantly weight reduction more than placebo and diet alone, during a five week observation period. However, there were no significant differences between the different fibers in their ability to induce weight reduction, which was approximately 0.8 kg/week (3.8 +/- 0.9, 4.4 +/- 2.0, 4.1 +/- 0.6 in the Chrombalance, Appe-Trim and Glucosahl group, respectively). Glucomannan induced body weight reduction in healthy overweight subjects, whereas the addition of guar gum and alginate did not seem to cause additional loss of weight.

The complexity of 'harm reduction' with smokeless tobacco as an approach to tobacco control in low-income and middle-income countries.

PubMed

Ayo-Yusuf, Olalekan A; Burns, David M

2012-03-01

To review the implications of recommending smokeless tobacco (ST) use as a harm reduction approach for low-income and middle-income countries (LMICs). Narrative review of published papers and other data sources (including conference abstracts and internet-based information) on the health risks posed by the use of ST products for individual smokers and for the population with a focus on their implications for LMICs. Swedish snus has a relatively lower toxicity profile than ST products available in other markets, including older products used in the US and products used in Africa and Asia. The experience with snus in Sweden provides information on the effects of snus use in a population where cigarette smoking was already culturally ingrained. However, population effects are likely to be different in those LMICs where smoking is not yet the dominant culturally accepted form of tobacco use. The total effect may be negative in countries where locally-popular ST products have substantially higher disease risks than Swedish snus and where there is limited regulatory and tobacco use surveillance capacity. Issues relating to how populations in LMICs respond to marketing efforts, the risks of the dual use of ST and smoking, and the capacity to regulate ST products need to be considered in making decisions about harm reduction strategies in LMICs. The public health effects of supporting ST as a harm reduction strategy may vary substantively in countries with different pre-existing tobacco use patterns.

The current status of artisanal cannabis for the treatment of epilepsy in the United States.

PubMed

Sulak, Dustin; Saneto, Russell; Goldstein, Bonni

2017-05-01

The widespread patient use of artisanal cannabis preparations has preceded quality validation of cannabis use for epilepsy. Neurologists and cannabinoid specialists are increasingly in a position to monitor and guide the use of herbal cannabis in epilepsy patients. We report the retrospective data on efficacy and adverse effects of artisanal cannabis in Patients with medically refractory epilepsy with mixed etiologies in Washington State, California, and Maine. Clinical considerations, including potential risks and benefits, challenges related to artisanal preparations, and cannabinoid dosing, are discussed. Of 272 combined patients from Washington State and California, 37 (14%) found cannabis ineffective at reducing seizures, 29 (15%) experienced a 1-25% reduction in seizures, 60 (18%) experienced a 26-50% reduction in seizures, 45 (17%) experienced a 51-75% reduction in seizures, 75 (28%) experienced a 76-99% reduction in seizures, and 26 (10%) experienced a complete clinical response. Overall, adverse effects were mild and infrequent, and beneficial side effects such as increased alertness were reported. The majority of patients used cannabidiol (CBD)-enriched artisanal formulas, some with the addition of delta-9-tetrahydrocannabinol (THC) and tetrahydrocannabinolic acid (THCA). Four case reports are included that illustrate clinical responses at doses <0.1mg/kg/day, biphasic dose-response effects, the use of THCA for seizure prevention, the use of THC for seizure rescue, and the synergy of cannabinoids and terpenoids in artisanal preparations. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy". Copyright © 2017 Elsevier Inc. All rights reserved.

The effect of chlorogenic acid on blood pressure: a systematic review and meta-analysis of randomized clinical trials.

PubMed

Onakpoya, I J; Spencer, E A; Thompson, M J; Heneghan, C J

2015-02-01

Several dietary supplements are currently marketed for management of hypertension, but the evidence for effectiveness is conflicting. Our objective was to critically appraise and evaluate the evidence for the effectiveness of chlorogenic acids (CGAs) on blood pressure, using data from published randomized clinical trials (RCTs). Electronic searches were conducted in Medline, Embase, Amed, Cinahl and The Cochrane Library. We also hand-searched the bibliographies of all retrieved articles. Two reviewers independently determined the eligibility of studies and extracted the data. The reporting quality of all included studies was assessed by the use of a quality assessment checklist adapted from the Consolidated Standard of Reporting Trials Statement. Disagreements were resolved through discussion. Seven eligible studies were identified, and five including 364 participants were included. There were variations in the reporting quality of the included RCTs. Meta-analysis revealed a statistically significant reduction in systolic blood pressure in favour of CGA (mean difference (MD): -4.31 mm Hg; 95% confidence interval (CI): -5.60 to -3.01; I(2)=65%; P<0.00001). Meta-analysis also showed a significant reduction in diastolic blood pressure favouring CGA (MD: -3.68 mm Hg; 95% CI: -3.91 to -3.45; I(2)=97%; P<0.00001). All studies reported no adverse events. In conclusion, the evidence from published RCTs suggests that CGA intake causes statistically significant reductions in systolic and diastolic blood pressures. The size of the effect is moderate. Few clinical trials have been conducted; they vary in design and methodology and are confined to Asian populations and funded by CGA manufacturers. Large independent trials evaluating the effects of CGA on blood pressure are warranted.

Further Examination of the Vibratory Loads Reduction Results from the NASA/ARMY/MIT Active Twist Rotor Test

NASA Technical Reports Server (NTRS)

Wilbur, Matthew L.; Yeager, William T., Jr.; Sekula, Martin K.

2002-01-01

The vibration reduction capabilities of a model rotor system utilizing controlled, strain-induced blade twisting are examined. The model rotor blades, which utilize piezoelectric active fiber composite actuators, were tested in the NASA Langley Transonic Dynamics Tunnel using open-loop control to determine the effect of active-twist on rotor vibratory loads. The results of this testing have been encouraging, and have demonstrated that active-twist rotor designs offer the potential for significant load reductions in future helicopter rotor systems. Active twist control was found to use less than 1% of the power necessary to operate the rotor system and had a pronounced effect on both rotating- and fixed-system loads, offering reductions in individual harmonic loads of up to 100%. A review of the vibration reduction results obtained is presented, which includes a limited set of comparisons with results generated using the second-generation version of the Comprehensive Analytical Model of Rotorcraft Aerodynamics and Dynamics (CAMRAD II) rotorcraft comprehensive analysis.

Direct printing and reduction of graphite oxide for flexible supercapacitors

NASA Astrophysics Data System (ADS)

Jung, Hanyung; Ve Cheah, Chang; Jeong, Namjo; Lee, Junghoon

2014-08-01

We report direct printing and photo-thermal reduction of graphite oxide (GO) to obtain a highly porous pattern of interdigitated electrodes, leading to a supercapacitor on a flexible substrate. Key parameters optimized include the amount of GO delivered, the suitable photo-thermal energy level for effective flash reduction, and the substrate properties for appropriate adhesion after reduction. Tests with supercapacitors based on the printed-reduced GO showed performance comparable with commercial supercapacitors: the energy densities were 1.06 and 0.87 mWh/cm3 in ionic and organic electrolytes, respectively. The versatility in the architecture and choice of substrate makes this material promising for smart power applications.

Comparison of sidestream treatment technologies: post aerobic digestion and Anammox.

PubMed

Bauer, Heidi; Johnson, Thomas D; Johnson, Bruce R; Oerke, David; Graziano, Steven

2016-01-01

Post aerobic digestion (PAD) and anaerobic ammonium oxidation (Anammox) are sidestream treatment technologies which are both excellent options for the reduction of nitrogen recycled back to the liquid stream without the need for supplemental carbon or alkalinity. However, the achievement of this goal is where the similarities between the two technologies end. PAD is an advanced digestion process where aerobic digestion is designed to follow anaerobic digestion. Other benefits of PAD include volatile solids reduction, odor reduction, and struvite formation reduction. Anammox harnesses a specific species of autotrophic bacteria that can help achieve partial nitritation/deammonification. Other benefits of Anammox include lower energy consumption due to requiring less oxygen compared with conventional nitrification. This manuscript describes the unique benefits and challenges of each technology. Example installations are presented with a narrative of how and why the technology was selected. A whole plant simulator is used to compare and contrast the mass balances and net present value costs on an 'apples to apples' basis. The discussion includes descriptions of conditions under which each technology would potentially be the most beneficial and cost-effective against a baseline facility without sidestream treatment.

Noise analysis for near field 3-D FM-CW radar imaging systems

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

Sheen, David M.

2015-06-19

Near field radar imaging systems are used for several applications including concealed weapon detection in airports and other high-security venues. Despite the near-field operation, phase noise and thermal noise can limit the performance in several ways including reduction in system sensitivity and reduction of image dynamic range. In this paper, the effects of thermal noise, phase noise, and processing gain are analyzed in the context of a near field 3-D FM-CW imaging radar as might be used for concealed weapon detection. In addition to traditional frequency domain analysis, a time-domain simulation is employed to graphically demonstrate the effect of thesemore » noise sources on a fast-chirping FM-CW system.« less

The combined effects of noncontingent reinforcement and punishment on the reduction of rumination.

PubMed

DeRosa, Nicole M; Roane, Henry S; Bishop, Jamie R; Silkowski, Erica L

2016-09-01

The current study extends the literature on the assessment and treatment of rumination through the evaluation of a combined reinforcement- and punishment-based intervention. The study included a single participant with a history of rumination maintained by automatic reinforcement, as identified via a functional analysis. Both noncontingent reinforcement (NCR) with preferred edible items and punishment, in the form of a facial screen, were implemented separately to evaluate their independent effects on the occurrence of rumination. The final treatment package included both NCR and punishment procedures. Implementation of the combined treatment resulted in a 96.5% reduction in rumination relative to baseline. Procedural modifications and integrity errors also were evaluated. © 2016 Society for the Experimental Analysis of Behavior.

Experience with Sonogram-guided hydrostatic reduction of Intussusception in Children in South-West Nigeria.

PubMed

Ogundoyin, Oo; Lawal, Ta; Olulana, DI; Atalabi, Om

2013-04-01

Intussusception is a common cause of intestinal obstruction in young children. The diagnosis and treatment of intussusception has evolved over the years with ultrasound being the first choice imaging technique and a major player in the non-operative reduction of intussusception owing to its advantage of reduced morbidity and non-exposure to ionizing radiation when compared to other modalities of treatment. Aim & Objectives: The aim of this study was to evaluate the efficiency of ultrasound guided hydrostatic reduction in the management of intussusception in children and assess the predictors of reducibility. A prospective study of all infants and children who presented with uncomplicated intussusception was conducted between January, 2005 and September, 2013. The diagnosis of intussusception was made clinically and this was confirmed by an abdominal ultrasonography. Ultrasound guided hydrostatic reduction of intussusception was performed on the selected patients after they were adequately resuscitated. Failed reduction was abandoned in favour of operative reduction in some patients. Data collected included the age of the patients, duration of symptoms and the outcomes of the procedure and these were analyzed. Eighty-four patients with intussusception were treated over this period, 36(42.9%) patients were found suitable for hydrostatic reduction of intussusception. Twenty-four(66.7%) patients presented within 48 hours of onset of symptoms. Twenty-one(58.3%) patients had successful hydrostatic reduction of intussusception while 15(41.7%) patients had failed reduction. The procedure was successful in majority (58%) of the patients under the age of 1 year and one of the three (33%) patients older than one year. Hydrostatic reduction of intussusception was successful in 14 out of 24 patients (58.3%) who presented within 48 hours of onset of symptoms. Hydrostatic reduction of intussusception under ultrasound guidance is an effective and useful conservative method of management in carefully selected children with intussusception. Overall, this modality of treatment is cost effective and could readily be used for patients in resource poor environment. It also monitors the reduction process and visualizes the components of the intussusception including the lead points.

A Pilot Study of Skin Resurfacing Using the 2,790-nm Erbium:YSGG Laser System.

PubMed

Rhie, Jong Won; Shim, Jeong Su; Choi, Won Seok

2015-01-01

The erbium:yttrium scandium gallium garnet (Er:YSGG) laser differs from other laser techniques by having a faster and higher cure rate. Since the Er:YSGG laser causes an appropriate proportion of ablation and coagulation, it has advantages over the conventional carbon dioxide (CO2) laser and the erbium-doped yttrium aluminum garnet (Er:YAG) laser, including heating tendencies and explosive vaporization. This research was conducted to explore the effects and safety of the Er:YSGG laser. Twenty patients participated in the pilot study of a resurfacing system using a 2,790-nm Er:YSGG laser. All patients received facial treatment by the 2,790-nm Er:YSGG laser system (Cutera) twice with a 4-week interval. Wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture were measured. Study subjects included 15 women and five men. Re-epithelization occurred in all subjects 3 to 4 days after treatment, and wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture within 6 months of treatment. The 2,790-nm YSGG laser technique had fewer complications and was effective in the improvement of scars, pores, wrinkles, and skin tone and color with one or two treatments. We expect this method to be effective for people with acne scars, pore scars, deep wrinkles, and uneven skin texture and color.

A Pilot Study of Skin Resurfacing Using the 2,790-nm Erbium:YSGG Laser System

PubMed Central

Rhie, Jong Won; Choi, Won Seok

2015-01-01

Background The erbium:yttrium scandium gallium garnet (Er:YSGG) laser differs from other laser techniques by having a faster and higher cure rate. Since the Er:YSGG laser causes an appropriate proportion of ablation and coagulation, it has advantages over the conventional carbon dioxide (CO2) laser and the erbium-doped yttrium aluminum garnet (Er:YAG) laser, including heating tendencies and explosive vaporization. This research was conducted to explore the effects and safety of the Er:YSGG laser. Methods Twenty patients participated in the pilot study of a resurfacing system using a 2,790-nm Er:YSGG laser. All patients received facial treatment by the 2,790-nm Er:YSGG laser system (Cutera) twice with a 4-week interval. Wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture were measured. Results Study subjects included 15 women and five men. Re-epithelization occurred in all subjects 3 to 4 days after treatment, and wrinkle reduction, reduction in pigment inhomogeneity, and improvement in tone and texture within 6 months of treatment. Conclusions The 2,790-nm YSGG laser technique had fewer complications and was effective in the improvement of scars, pores, wrinkles, and skin tone and color with one or two treatments. We expect this method to be effective for people with acne scars, pore scars, deep wrinkles, and uneven skin texture and color. PMID:25606490

The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services.

PubMed

Chin, Helen B; Sipe, Theresa Ann; Elder, Randy; Mercer, Shawna L; Chattopadhyay, Sajal K; Jacob, Verughese; Wethington, Holly R; Kirby, Doug; Elliston, Donna B; Griffith, Matt; Chuke, Stella O; Briss, Susan C; Ericksen, Irene; Galbraith, Jennifer S; Herbst, Jeffrey H; Johnson, Robert L; Kraft, Joan M; Noar, Seth M; Romero, Lisa M; Santelli, John

2012-03-01

Adolescent pregnancy, HIV, and other sexually transmitted infections (STIs) are major public health problems in the U.S. Implementing group-based interventions that address the sexual behavior of adolescents may reduce the incidence of pregnancy, HIV, and other STIs in this group. Methods for conducting systematic reviews from the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of two strategies for group-based behavioral interventions for adolescents: (1) comprehensive risk reduction and (2) abstinence education on preventing pregnancy, HIV, and other STIs. Effectiveness of these interventions was determined by reductions in sexual risk behaviors, pregnancy, HIV, and other STIs and increases in protective sexual behaviors. The literature search identified 6579 citations for comprehensive risk reduction and abstinence education. Of these, 66 studies of comprehensive risk reduction and 23 studies of abstinence education assessed the effects of group-based interventions that address the sexual behavior of adolescents, and were included in the respective reviews. Meta-analyses were conducted for each strategy on the seven key outcomes identified by the coordination team-current sexual activity; frequency of sexual activity; number of sex partners; frequency of unprotected sexual activity; use of protection (condoms and/or hormonal contraception); pregnancy; and STIs. The results of these meta-analyses for comprehensive risk reduction showed favorable effects for all of the outcomes reviewed. For abstinence education, the meta-analysis showed a small number of studies, with inconsistent findings across studies that varied by study design and follow-up time, leading to considerable uncertainty around effect estimates. Based on these findings, group-based comprehensive risk reduction was found to be an effective strategy to reduce adolescent pregnancy, HIV, and STIs. No conclusions could be drawn on the effectiveness of group-based abstinence education. Published by Elsevier Inc.

Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication.

PubMed

Keyworth, C; Nelson, P A; Bundy, C; Pye, S R; Griffiths, C E M; Cordingley, L

2018-08-01

Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain- or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor  of increased BI for both alcohol reduction (β = .290, p < .01) and increased physical activity (β = -.231, p < .001). Message framing may be an important factor to consider depending on the health benefit emphasised (disease symptom reduction or CVD risk reduction) and patient-stated priorities. Condition-specific health messages in psoriasis populations may increase the likelihood of message effectiveness for alcohol reduction.

Identifying external nutrient reduction requirements and potential in the hypereutrophic Lake Taihu Basin, China.

PubMed

Peng, Jiao-Ting; Zhu, Xiao-Dong; Sun, Xiang; Song, Xiao-Wei

2018-04-01

Reducing external nutrient loads is the first step for controlling eutrophication. Here, we identified external nutrient reduction requirements and potential of strategies for achieving reductions to remediate a eutrophic water body, Lake Taihu, China. A mass balance approach based on the entire lake was used to identify nutrient reduction requirements; an empirical export coefficient approach was introduced to estimate the nutrient reduction potential of the overall program on integrated regulation of Taihu Lake Basin (hereafter referred to as the "Guideline"). Reduction requirements included external total nitrogen (TN) and total phosphorus (TP) loads, which should be reduced by 41-55 and 25-50%, respectively, to prevent nutrient accumulation in Lake Taihu and to meet the planned water quality targets. In 2010, which is the most seriously polluted calendar year during the 2008-2014 period, the nutrient reduction requirements were estimated to be 36,819 tons of N and 2442 tons of P, and the potential nutrient reduction strategies would reduce approximately 25,821 tons of N and 3024 tons of P. Since there is a net N remaining in the reduction requirements, it should be the focus and deserves more attention in identifying external nutrient reduction strategies. Moreover, abatement measures outlined in the Guideline with high P reduction potential required large monetary investments. Achieving TP reduction requirement using the cost-effective strategy costs about 80.24 million USD. The design of nutrient reduction strategies should be enacted according to regional and sectoral differences and the cost-effectiveness of abatement measures.

The Cost-Effectiveness of NBPTS Teacher Certification

ERIC Educational Resources Information Center

Yeh, Stuart S.

2010-01-01

A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of…

Population Modeling of Modified Risk Tobacco Products Accounting for Smoking Reduction and Gradual Transitions of Relative Risk.

PubMed

Poland, Bill; Teischinger, Florian

2017-11-01

As suggested by the Food and Drug Administration (FDA) Modified Risk Tobacco Product (MRTP) Applications Draft Guidance, we developed a statistical model based on public data to explore the effect on population mortality of an MRTP resulting in reduced conventional cigarette smoking. Many cigarette smokers who try an MRTP persist as dual users while smoking fewer conventional cigarettes per day (CPD). Lower-CPD smokers have lower mortality risk based on large cohort studies. However, with little data on the effect of smoking reduction on mortality, predictive modeling is needed. We generalize prior assumptions of gradual, exponential decay of Excess Risk (ER) of death, relative to never-smokers, after quitting or reducing CPD. The same age-dependent slopes are applied to all transitions, including initiation to conventional cigarettes and to a second product (MRTP). A Monte Carlo simulation model generates random individual product use histories, including CPD, to project cumulative deaths through 2060 in a population with versus without the MRTP. Transitions are modeled to and from dual use, which affects CPD and cigarette quit rates, and to MRTP use only. Results in a hypothetical scenario showed high sensitivity of long-run mortality to CPD reduction levels and moderate sensitivity to ER transition rates. Models to project population effects of an MRTP should account for possible mortality effects of reduced smoking among dual users. In addition, studies should follow dual-user CPD histories and quit rates over long time periods to clarify long-term usage patterns and thereby improve health impact projections. We simulated mortality effects of a hypothetical MRTP accounting for cigarette smoking reduction by smokers who add MRTP use. Data on relative mortality risk versus CPD suggest that this reduction may have a substantial effect on mortality rates, unaccounted for in other models. This effect is weighed with additional hypothetical effects in an example. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

40 CFR 35.360 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., demonstrations, surveys, and studies relating to the causes, effects, extent, prevention, reduction, and... appropriate priorities for funding for this program. This guidance may include such focus areas as National...

Food Reduction in Avicenna's View and Related Principles in Classical Medicine.

PubMed

Nozad, Aisan; Naseri, Mohsen; Safari, Mir Bahram; Abd Al Ahadi, Azam; Ghaffari, Farzaneh

2016-06-01

Traditional Iranian medicine (TIM) is a rich and valuable school of thought that believes medications are not the only effective approach for the treatment of diseases but that nutrition is also important. Our study includes two parts; the first is a book review of the Canon of Medicine by Avicenna (10th and 11th centuries), in which we focus on finding and understanding Avicenna's point of view. In the second part, we searched for "food reduction" as a key word from 2000 to 2015 in databases such as Google Scholar, PubMed, Copernicus, DOAJ, EBSCO-CINAHL, and the Iranian search database Iranmedex for principles of food reduction in classical medicine. The main methods of treatment in traditional medicine include changes in lifestyle, especially diet, the use of medications, and the use of manipulation methods. For diet, the individual may be prohibited from eating or food amounts may be decreased or increased. Centuries ago, Avicenna was making use of methods of food reduction as an important therapeutic approach in the treatment of diseases. According to him, food reduction, to the extent that it does not cause energy loss helps to cure disease. Avicenna has proposed food reduction as an aid to treating a variety of ailments such as headaches and reflux. Today, a variety of basic and clinical research has shown that food reduction or calorie restriction to a standard level can effectively prevent and treat a variety of diseases such as neoplasms, diabetes, and kidney disease. Practical principles explained by traditional Iranian medicine, in particular Avicenna, could open important and quite uncomplicated strategies for the prevention and treatment of diseases.

Acceptability of mental health stigma-reduction training and initial effects on awareness among military personnel.

PubMed

Hurtado, Suzanne L; Simon-Arndt, Cynthia M; McAnany, Jennifer; Crain, Jenny A

2015-01-01

The purpose of this paper is to report on the development of a mental health stigma reduction toolkit and training, and the acceptability and level of stigma awareness following the stigma-reduction training for military personnel. The overall aims of the training were to provide discussion tools highlighting the experiences of Marines seeking help for stress concerns, improve communication between leaders and their Marines around the issue of help seeking, and familiarize Marines with behavioral health treatment. Senior enlisted leaders and officers (N = 52) from a Marine Corps battalion participated in a pretest, 2-h stigma-reduction training and immediate posttest. Acceptability of the training was measured by querying participants about the usefulness and helpfulness of the training among other factors, and stigma awareness was measured with 10 items about mental health stigma. The stigma-reduction training and materials were well accepted by participants. In addition, there was a significant improvement in four of ten stigma-reduction awareness concepts measured before and immediately after the training, which included an increase in agreement that mental health treatments are usually effective in reducing stress reactions [t(51) = -3.35, p = 0.002], and an increase in disagreement that seeking counseling after a deployment will jeopardize future deployments [t(51) = -3.05, p = 0.004]. Level of agreement with several statements including those regarding perceptions of invincibility, and malingering, among others, did not change significantly after the training. The stigma-reduction training containing educational and contact strategies was highly acceptable to the leaders and may have promise for initially dispelling myths associated with seeking help for stress concerns among military service members; however, results indicate that there is clearly more work to be done in combatting stigma.

Reduction-Responsive Polymeric Micelles and Vesicles for Triggered Intracellular Drug Release

PubMed Central

Sun, Huanli; Cheng, Ru; Deng, Chao

2014-01-01

Abstract Significance: The therapeutic effects of current micellar and vesicular drug formulations are restricted by slow and inefficient drug release at the pathological site. The development of smart polymeric nanocarriers that release drugs upon arriving at the target site has received a tremendous amount of attention for cancer therapy. Recent Advances: Taking advantage of a high reducing potential in the tumor tissues and in particular inside the tumor cells, various reduction-sensitive polymeric micelles and vesicles have been designed and explored for triggered anticancer drug release. These reduction-responsive nanosystems have demonstrated several unique features, such as good stability under physiological conditions, fast response to intracellular reducing environment, triggering drug release right in the cytosol and cell nucleus, and significantly improved antitumor activity, compared to traditional reduction-insensitive counterparts. Critical Issues: Although reduction-sensitive micelles and polymersomes have accomplished rapid intracellular drug release and enhanced in vitro antitumor effect, their fate inside the cells including the mechanism, site, and rate of reduction reaction remains unclear. Moreover, the systemic fate and performance of reduction-sensitive polymeric drug formulations have to be investigated. Future Directions: Biophysical studies should be carried out to gain insight into the degradation and drug release behaviors of reduction-responsive nanocarriers inside the tumor cells. Furthermore, novel ligand-decorated reduction-sensitive nanoparticulate drug formulations should be designed and explored for targeted cancer therapy in vivo. Antioxid. Redox Signal. 21, 755–767. PMID:24279980

Invariant Type-B characteristics of drag-reducing microalgal biopolymer solutions

NASA Astrophysics Data System (ADS)

Gasljevic, K.; Hall, K.; Chapman, D.; Matthys, E. F.

2017-05-01

The drag-reducing properties of polysaccharides from marine microalgae were investigated. They were compared to two drag-reducing additives studied extensively in the past, synthetic poly(ethylene) oxide, one of the most effective drag-reducing additives; and Xanthan Gum, another biopolymer often considered a model polymer for chemical and rheological research. Compared to Xanthan Gum, the most effective polymers from our microalgae show a higher drag-reducing efficiency in terms of necessary concentration to achieve a given level of drag reduction. In addition, they show a striking Type-B drag reduction behavior, which may be a very useful quality in most drag reduction applications, thanks to the independence of the drag reduction level on flow conditions such as velocity, shear stress, and tube diameter. With these polymers from microalgae we did not see evidence of Type-A behavior over the wide range of conditions studied (including pipe diameters up to 52 mm). Importantly, this suggests that the Drag Reduction coefficient in pipe flow for ideal drag-reducing solutions such as the polysaccharides investigated here is invariant at a given additive concentration of flow or solution parameters like ionic strength and can be used as a solution property to predict its drag reduction effectiveness over a wide range of conditions. On the contrary, Xanthan Gum showed evidence of both Type-A behavior in large diameter pipes and Type-B behavior in smaller ones. The polymers from microalgae also showed high resistance to degradation. Considering that these microalgae are very effective producers of polysaccharides (both extracellular and intracellular), they appear to be very promising additives for drag reduction applications.

Harm reduction and law enforcement in Vietnam: influences on street policing

PubMed Central

2012-01-01

Background and rationale The HIV epidemic in Vietnam has from its start been concentrated among injecting drug users. Vietnam instituted the 2006 HIV/AIDS Law which includes comprehensive harm reduction measures, but these are unevenly accepted and inadequately implemented. Ward police are a major determinant of risk for IDUs, required to participate in drug control practices (especially meeting quotas for detention centres) which impede support for harm reduction. We studied influences on ward level police regarding harm reduction in Hanoi to learn how to better target education and structural change. Methods After document review, we interviewed informants from government, NGOs, INGOs, multilateral agencies, and police, using semi-structured guides. Topics covered included perceptions of harm reduction and the police role in drug law enforcement, and harm reduction training and advocacy among police. Results Police perceive conflicting responsibilities, but overwhelmingly see their responsibility as enforcing drug laws, identifying and knowing drug users, and selecting those for compulsory detention. Harm reduction training was very patchy, ward police not being seen as important to it; and understanding of harm reduction was limited, tending to reflect drug control priorities. Justification for methadone was as much crime prevention as HIV prevention. Competing pressures on ward police create much anxiety, with performance measures based around drug control; recourse to detention resolves competing pressures more safely. There is much recognition of the importance of discretion, and much use of it to maintain good social order. Policy dissemination approaches within the law enforcement sector were inconsistent, with little communication about harm reduction programs or approaches, and an unfounded assumption that training at senior levels would naturally reach to the street. Discussion Ward police have not been systematically included in harm reduction advocacy or training strategies to support or operationalise legalised harm reduction interventions. The practices of street police challenge harm reduction policies, entirely understandably given the competing pressures on them. For harm reduction to be effective in Vietnam, it is essential that the ambiguities and contradictions between laws to control HIV and to control drugs be resolved for the street-level police. PMID:22769590

Antiinflammatory actions of inorganic nitrate stabilize the atherosclerotic plaque

PubMed Central

Khambata, Rayomand S.; Ghosh, Suborno M.; Rathod, Krishnaraj S.; Thevathasan, Tharssana; Filomena, Federica; Xiao, Qingzhong; Ahluwalia, Amrita

2017-01-01

Reduced bioavailable nitric oxide (NO) plays a key role in the enhanced leukocyte recruitment reflective of systemic inflammation thought to precede and underlie atherosclerotic plaque formation and instability. Recent evidence demonstrates that inorganic nitrate (NO3−) through sequential chemical reduction in vivo provides a source of NO that exerts beneficial effects upon the cardiovascular system, including reductions in inflammatory responses. We tested whether the antiinflammatory effects of inorganic nitrate might prove useful in ameliorating atherosclerotic disease in Apolipoprotein (Apo)E knockout (KO) mice. We show that dietary nitrate treatment, although having no effect upon total plaque area, caused a reduction in macrophage accumulation and an elevation in smooth muscle accumulation within atherosclerotic plaques of ApoE KO mice, suggesting plaque stabilization. We also show that in nitrate-fed mice there is reduced systemic leukocyte rolling and adherence, circulating neutrophil numbers, neutrophil CD11b expression, and myeloperoxidase activity compared with wild-type littermates. Moreover, we show in both the ApoE KO mice and using an acute model of inflammation that this effect upon neutrophils results in consequent reductions in inflammatory monocyte expression that is associated with elevations of the antiinflammatory cytokine interleukin (IL)-10. In summary, we demonstrate that inorganic nitrate suppresses acute and chronic inflammation by targeting neutrophil recruitment and that this effect, at least in part, results in consequent reductions in the inflammatory status of atheromatous plaque, and suggest that this effect may have clinical utility in the prophylaxis of inflammatory atherosclerotic disease. PMID:28057862

'Social evils' and harm reduction: the evolving policy environment for human immunodeficiency virus prevention among injection drug users in China and Vietnam.

PubMed

Hammett, Theodore M; Wu, Zunyou; Duc, Tran Tien; Stephens, David; Sullivan, Sheena; Liu, Wei; Chen, Yi; Ngu, Doan; Des Jarlais, Don C

2008-01-01

This paper reviews the evolution of government policies in China and Vietnam regarding harm reduction interventions for human immunodeficiency virus (HIV) prevention, such as needle/syringe provision and opioid substitution treatment. The work is based upon the authors' experiences in and observations of these policy developments, as well as relevant government policy documents and legislation. Both countries are experiencing HIV epidemics driven by injection drug use and have maintained generally severe policies towards injection drug users (IDUs). In recent years, however, they have also officially endorsed harm reduction. We sought to understand how and why this apparently surprising policy evolution took place. Factors associated with growing support for harm reduction were similar but not identical in China and Vietnam. These included the emergence of effective 'champions' for such policies, an ethos of pragmatism and receptivity to evidence, growing collaboration across public health, police and other sectors, the influence of contingent events such as the severe acute respiratory syndrome (SARS) epidemic and pressure from donors and international organizations to adopt best practice in HIV prevention. Ongoing challenges and lessons learned include the persistence of tensions between drug control and harm reduction that may have negative effects on programs until a fully harmonized policy environment is established. Excessive reliance on law enforcement and forced detoxification will not solve the problems of substance abuse or of HIV among drug users. Ongoing evaluation of harm reduction programs, as well as increased levels of multi-sectoral training, collaboration and support are also needed.

Assessing Community Coalition Capacity and its Association with Underage Drinking Prevention Effectiveness in the Context of the SPF SIG.

PubMed

Flewelling, Robert L; Hanley, Sean M

2016-10-01

Community coalitions are a prominent organizational structure through which community-based substance abuse prevention efforts are implemented. There is little empirical evidence, however, regarding the association between coalition attributes and success in achieving community-level reductions in substance abuse behaviors. In this study, we assessed the relationship between coalition capacity, based on coalition coordinator responses to 16 survey items, and reductions in underage drinking prevalence rates. The coalitions were funded through the federally sponsored Strategic Prevention Framework State Incentive Grant (SPF SIG). We first examined whether coalition capacity increased over the life of the projects. Mean capacity scores increased for all 16 capacity items examined (N = 318 coalitions), the majority of which were statistically significant. Analysis of the associations between capacity and reductions in underage drinking was limited to coalitions that targeted underage drinking and provided usable outcome measures based on student survey data for either past 30-day alcohol use (N = 129) or binge drinking (N = 100). Bivariate associations between the capacity items and prevalence reductions for each outcome were consistently positive, although many were not statistically significant. Composite measures of correlated items were then created to represent six different capacity constructs, and included in multivariate models to predict reductions in the targeted outcomes. Constructs that significantly predicted reductions in one or both outcome measures included internal organization and structure, community connections and outreach, and funding from multiple sources. The findings provide support for the expectation that high functioning community coalitions can be effective agents for producing desirable community-level changes in targeted substance abuse behaviors.

Cannabis and schizophrenia.

PubMed

Pushpa-Rajah, Jonathan A; McLoughlin, Benjamin C; Gillies, Donna; Rathbone, John; Variend, Hannele; Kalakouti, Eliana; Kyprianou, Katerina

2015-03-01

Many people with schizophrenia smoke cannabis, and it is unclear why a large proportion do so and if the effects are harmful or beneficial. It is also unclear what the best method is to allow people with schizophrenia to alter their cannabis intake. To assess the effects of specific psychological treatments for cannabis reduction in people with schizophrenia. To assess the effects of antipsychotics for cannabis reduction in people with schizophrenia. To assess the effects of cannabinoids (cannabis-related chemical compounds derived from cannabis or manufactured) for symptom reduction in people with schizophrenia. We searched the Cochrane Schizophrenia Group Trials Register (August 2013) and all references of articles selected for further relevant trials. We contacted the first author of included studies for unpublished trials or data. We included all randomized controlled trials involving cannabinoids and schizophrenia/schizophrenia-like illnesses, which assessed: (1) treatments to reduce cannabis use in people with schizophrenia and (2) the effects of cannabinoids on people with schizophrenia. Results are limited and inconclusive due to the small number and size of randomized controlled trials available and quality of data reporting within these trials. Currently, there is no evidence to demonstrate that one type of adjunct psychological therapy or one type of drug therapy is more effective than another. There is also insufficient evidence to show that cannabidiol has an antipsychotic effect. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Direct printing and reduction of graphite oxide for flexible supercapacitors

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

Jung, Hanyung; Ve Cheah, Chang; Jeong, Namjo

2014-08-04

We report direct printing and photo-thermal reduction of graphite oxide (GO) to obtain a highly porous pattern of interdigitated electrodes, leading to a supercapacitor on a flexible substrate. Key parameters optimized include the amount of GO delivered, the suitable photo-thermal energy level for effective flash reduction, and the substrate properties for appropriate adhesion after reduction. Tests with supercapacitors based on the printed-reduced GO showed performance comparable with commercial supercapacitors: the energy densities were 1.06 and 0.87 mWh/cm{sup 3} in ionic and organic electrolytes, respectively. The versatility in the architecture and choice of substrate makes this material promising for smart powermore » applications.« less

Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs.

PubMed

Goodman, Patrick; Agnew, Michelle; McCaffrey, Marie; Paul, Gillian; Clancy, Luke

2007-04-15

Environmental tobacco smoke (ETS) causes disease in nonsmokers. Workplace bans on smoking are interventions to reduce exposure to ETS to try to prevent harmful health effects. On March 29, 2004, the Irish government introduced the first national comprehensive legislation banning smoking in all workplaces, including bars and restaurants. This study examines the impact of this legislation on air quality in pubs and on respiratory health effects in bar workers in Dublin. Exposure study. Concentrations of particulate matter 2.5 microm or smaller (PM(2.5)) and particulate matter 10 microm or smaller (PM(10)) in 42 pubs were measured and compared before and after the ban. Benzene concentrations were also measured in 26 of the pubs. Health effects study. Eighty-one barmen volunteered to have full pulmonary function studies, exhaled breath carbon monoxide, and salivary cotinine levels performed before the ban and repeated 1 year after the ban. They also completed questionnaires on exposure to ETS and respiratory symptoms on both occasions. Exposure study. There was an 83% reduction in PM(2.5) and an 80.2% reduction in benzene concentration in the bars. Health effects study. There was a 79% reduction in exhaled breath carbon monoxide and an 81% reduction in salivary cotinine. There were statistically significant improvements in measured pulmonary function tests and significant reductions in self-reported symptoms and exposure levels in nonsmoking barmen volunteers after the ban. A total workplace smoking ban results in a significant reduction in air pollution in pubs and an improvement in respiratory health in barmen.

[Effectiveness of School-based Interventions for the Prevention and/or Reduction of Psychosocial Problems among Children and Adolescents: A Review of Reviews].

PubMed

Muellmann, S; Landgraf-Rauf, K; Brand, T; Zeeb, H; Pischke, C R

2017-04-01

Objective: To summarize the current evidence on the effectiveness of school-based interventions for the maintenance of mental health and the prevention of psychosocial problems among pupils. Methods: A systematic literature search of reviews published between 2007 and 2015 was carried out. Databases searched included Medline, PsycINFO, Campbell Library, Cochrane Library, NICE, ERIC, and Web of Science. Study selection, data extraction, and quality assessment (using AMSTAR criteria) were performed by 2 independent reviewers. Results: 6 reviews covering 331 primary studies were included in this review of reviews. Findings of three reviews with a focus on the maintenance and/or promotion of mental health and general well-being suggested that interventions aimed at changes in the social and the school environment were more effective than those that only targeted individual behavior change among pupils. Interventions for the reduction of mobbing/bullying were most effective if they comprised organizational changes at schools, such as playground and schoolyard supervision, and disciplinary measures. One review suggested strong evidence for the effectiveness of classroom management to reduce violent behavior among pupils. Conclusions: Participation in interventions promoting changes in the school environment, in addition to individual behavior change, appears to be associated with improved mental health among pupils and reductions in mobbing/bullying and violent behavior at schools. © Georg Thieme Verlag KG Stuttgart · New York.

Car free cities: Pathway to healthy urban living.

PubMed

Nieuwenhuijsen, Mark J; Khreis, Haneen

2016-09-01

Many cities across the world are beginning to shift their mobility solution away from the private cars and towards more environmentally friendly and citizen-focused means. Hamburg, Oslo, Helsinki, and Madrid have recently announced their plans to become (partly) private car free cities. Other cities like Paris, Milan, Chengdu, Masdar, Dublin, Brussels, Copenhagen, Bogota, and Hyderabad have measures that aim at reducing motorized traffic including implementing car free days, investing in cycling infrastructure and pedestrianization, restricting parking spaces and considerable increases in public transport provision. Such plans and measures are particularly implemented with the declared aim of reducing greenhouse gas emissions. These reductions are also likely to benefit public health. We aimed to describe the plans for private car free cities and its likely effects on public health. We reviewed the grey and scientific literature on plans for private car free cities, restricted car use, related exposures and health. An increasing number of cities are planning to become (partly) private car free. They mainly focus on the reduction of private car use in city centers. The likely effects of such policies are significant reductions in traffic-related air pollution, noise, and temperature in city centers. For example, up to a 40% reduction in NO2 levels has been reported on car free days. These reductions are likely to lead to a reduction in premature mortality and morbidity. Furthermore the reduction in the number of cars, and therefore a reduction in the need for parking places and road space, provides opportunities to increase green space and green networks in cities, which in turn can lead to many beneficial health effects. All these measures are likely to lead to higher levels of active mobility and physical activity which may improve public health the most and also provide more opportunities for people to interact with each other in public space. Furthermore, such initiatives, if undertaken at a sufficiently large scale can result in positive distal effects and climate change mitigation through CO2 reductions. The potential negative effects which may arise due to motorized traffic detouring around car free zone into their destinations also need further evaluation and the areas in which car free zones are introduced need to be given sufficient attention so as not to become an additional way to exacerbate socioeconomic divides. The extent and magnitude of all the above effects is still unclear and needs further research, including full chain health impact assessment modeling to quantify the potential health benefits of such schemes, and exposure and epidemiological studies to measure any changes when such interventions take place. The introduction of private car free cities is likely to have direct and indirect health benefits, but the exact magnitude and potential conflicting effects are as yet unclear. This paper has overviewed the expected health impacts, which can be useful to underpin policies to reduce car use in cities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Field Test Evaluation of Conservation Retrofits of Low-Income, Single-Family Buildings in Wisconsin: Blower-Door-Directed Infiltration Reduction Procedure, Field Test Implementation and Results

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

Gettings, M.B.

A blower-door-directed infiltration retrofit procedure was field tested on 18 homes in south central Wisconsin. The procedure, developed by the Wisconsin Energy Conservation Corporation, includes recommended retrofit techniques as well as criteria for estimating the amount of cost-effective work to be performed on a house. A recommended expenditure level and target air leakage reduction, in air changes per hour at 50 Pascal (ACH50), are determined from the initial leakage rate measured. The procedure produced an average 16% reduction in air leakage rate. For the 7 houses recommended for retrofit, 89% of the targeted reductions were accomplished with 76% of themore » recommended expenditures. The average cost of retrofits per house was reduced by a factor of four compared with previous programs. The average payback period for recommended retrofits was 4.4 years, based on predicted energy savings computed from achieved air leakage reductions. Although exceptions occurred, the procedure's 8 ACH50 minimum initial leakage rate for advising retrofits to be performed appeared a good choice, based on cost-effective air leakage reduction. Houses with initial rates of 7 ACH50 or below consistently required substantially higher costs to achieve significant air leakage reductions. No statistically significant average annual energy savings was detected as a result of the infiltration retrofits. Average measured savings were -27 therm per year, indicating an increase in energy use, with a 90% confidence interval of 36 therm. Measured savings for individual houses varied widely in both positive and negative directions, indicating that factors not considered affected the results. Large individual confidence intervals indicate a need to increase the accuracy of such measurements as well as understand the factors which may cause such disparity. Recommendations for the procedure include more extensive training of retrofit crews, checks for minimum air exchange rates to insure air quality, and addition of the basic cost of determining the initial leakage rate to the recommended expenditure level. Recommendations for the field test of the procedure include increasing the number of houses in the sample, more timely examination of metered data to detect anomalies, and the monitoring of indoor air temperature. Though not appropriate in a field test of a procedure, further investigation into the effects of air leakage rate reductions on heating loads needs to be performed.« less

Mindfulness-based stress reduction: an intervention to enhance the effectiveness of nurses' coping with work-related stress.

PubMed

Smith, Sarah A

2014-06-01

This critical literature review explored the current state of the science regarding mindfulness-based stress reduction (MBSR) as a potential intervention to improve the ability of nurses to effectively cope with stress. Literature sources include searches from EBSCOhost, Gale PowerSearch, ProQuest, PubMed Medline, Google Scholar, Online Journal of Issues in Nursing, and reference lists from relevant articles. Empirical evidence regarding utilizing MBSR with nurses and other healthcare professionals suggests several positive benefits including decreased stress, burnout, and anxiety; and increased empathy, focus, and mood. Nurse use of MBSR may be a key intervention to help improve nurses' ability to cope with stress and ultimately improve the quality of patient care provided. © 2014 NANDA International, Inc.

Gamma model and its analysis for phase measuring profilometry.

PubMed

Liu, Kai; Wang, Yongchang; Lau, Daniel L; Hao, Qi; Hassebrook, Laurence G

2010-03-01

Phase measuring profilometry is a method of structured light illumination whose three-dimensional reconstructions are susceptible to error from nonunitary gamma in the associated optical devices. While the effects of this distortion diminish with an increasing number of employed phase-shifted patterns, gamma distortion may be unavoidable in real-time systems where the number of projected patterns is limited by the presence of target motion. A mathematical model is developed for predicting the effects of nonunitary gamma on phase measuring profilometry, while also introducing an accurate gamma calibration method and two strategies for minimizing gamma's effect on phase determination. These phase correction strategies include phase corrections with and without gamma calibration. With the reduction in noise, for three-step phase measuring profilometry, analysis of the root mean squared error of the corrected phase will show a 60x reduction in phase error when the proposed gamma calibration is performed versus 33x reduction without calibration.

Aerosol effect on climate extremes in Europe under different future scenarios

NASA Astrophysics Data System (ADS)

Sillmann, J.; Pozzoli, L.; Vignati, E.; Kloster, S.; Feichter, J.

2013-05-01

This study investigates changes in extreme temperature and precipitation events under different future scenarios of anthropogenic aerosol emissions (i.e., SO2 and black and organic carbon) simulated with an aerosol-climate model (ECHAM5-HAM) with focus on Europe. The simulations include a maximum feasible aerosol reduction (MFR) scenario and a current legislation emission (CLEmod) scenario where Europe implements the MFR scenario, but the rest of the world follows the current legislation scenario and a greenhouse gas scenario. The strongest changes relative to the year 2000 are projected for the MFR scenario, in which the global aerosol reduction greatly enforces the general warming effect due to greenhouse gases and results in significant increases of temperature and precipitation extremes in Europe. Regional warming effects can also be identified from aerosol reductions under the CLEmodscenario. This becomes most obvious in the increase of the hottest summer daytime temperatures in Northern Europe.

A multifaceted community-based asthma intervention in Chicago: effects of trigger reduction and self-management education on asthma morbidity.

PubMed

Turyk, Mary; Banda, Elizabeth; Chisum, Gay; Weems, Dolores; Liu, Yangyang; Damitz, Maureen; Williams, Rhonda; Persky, Victoria

2013-09-01

Home-based, multifaceted interventions have been effective in reducing asthma morbidity in children. However, identification of independent components that contribute to outcomes and delineating effectiveness by level of asthma symptoms would help to refine the intervention and target appropriate populations. A community health educator led asthma intervention implemented in a low-income African-American neighborhood included asthma management education, individually tailored low-cost asthma home trigger remediation, and referrals to social and medical agencies, when appropriate. Changes in asthma morbidity measures were assessed in relation to implementation of individual intervention components using multivariable logistic regression. Among the 218 children who completed the year-long program, there were significant reductions in measures of asthma morbidity, including symptoms, urgent care visits, emergency department (ED) visits, hospitalizations, missed school days, and missed work days for caretakers. We also found significant decreases in the prevalence of many home asthma triggers and improvements in asthma management practices. Improvement in caretaker's ability to manage the child's asthma was associated with reduction in ED visits for asthma and uncontrolled asthma. Specific home interventions, such as repair of water leaks and reduced exposure to plants, dust, clutter and stuffed toys, may be related to reduction in asthma morbidity. This program was effective in reducing asthma morbidity in low-income African-American children and identified specific interventions as possible areas to target in future projects. Furthermore, the intervention was useful in children with persistent asthma symptoms as well as those with less frequent asthma exacerbations.

Reduction in saturated fat intake for cardiovascular disease.

PubMed

Hooper, Lee; Martin, Nicole; Abdelhamid, Asmaa; Davey Smith, George

2015-06-10

Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally it is unclear whether the energy from saturated fats that are lost in the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. This review is part of a series split from and updating an overarching review. To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA) or monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and EMBASE (Ovid) on 5 March 2014. We also checked references of included studies and reviews. Trials fulfilled the following criteria: 1) randomised with appropriate control group; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) not multifactorial; 4) adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 5) intervention at least 24 months; 6) mortality or cardiovascular morbidity data available. Two review authors working independently extracted participant numbers experiencing health outcomes in each arm, and we performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses and funnel plots. We include 15 randomised controlled trials (RCTs) (17 comparisons, ˜59,000 participants), which used a variety of interventions from providing all food to advice on how to reduce saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of cardiovascular events by 17% (risk ratio (RR) 0.83; 95% confidence interval (CI) 0.72 to 0.96, 13 comparisons, 53,300 participants of whom 8% had a cardiovascular event, I² 65%, GRADE moderate quality of evidence), but effects on all-cause mortality (RR 0.97; 95% CI 0.90 to 1.05; 12 trials, 55,858 participants) and cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 12 trials, 53,421 participants) were less clear (both GRADE moderate quality of evidence). There was some evidence that reducing saturated fats reduced the risk of myocardial infarction (fatal and non-fatal, RR 0.90; 95% CI 0.80 to 1.01; 11 trials, 53,167 participants), but evidence for non-fatal myocardial infarction (RR 0.95; 95% CI 0.80 to 1.13; 9 trials, 52,834 participants) was unclear and there were no clear effects on stroke (any stroke, RR 1.00; 95% CI 0.89 to 1.12; 8 trials, 50,952 participants). These relationships did not alter with sensitivity analysis. Subgrouping suggested that the reduction in cardiovascular events was seen in studies that primarily replaced saturated fat calories with polyunsaturated fat, and no effects were seen in studies replacing saturated fat with carbohydrate or protein, but effects in studies replacing with monounsaturated fats were unclear (as we located only one small trial). Subgrouping and meta-regression suggested that the degree of reduction in cardiovascular events was related to the degree of reduction of serum total cholesterol, and there were suggestions of greater protection with greater saturated fat reduction or greater increase in polyunsaturated and monounsaturated fats. There was no evidence of harmful effects of reducing saturated fat intakes on cancer mortality, cancer diagnoses or blood pressure, while there was some evidence of improvements in weight and BMI. The findings of this updated review are suggestive of a small but potentially important reduction in cardiovascular risk on reduction of saturated fat intake. Replacing the energy from saturated fat with polyunsaturated fat appears to be a useful strategy, and replacement with carbohydrate appears less useful, but effects of replacement with monounsaturated fat were unclear due to inclusion of only one small trial. This effect did not appear to alter by study duration, sex or baseline level of cardiovascular risk. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturated fats. The ideal type of unsaturated fat is unclear.

A project-based system for including farmers in the EU ETS.

PubMed

Brandt, Urs Steiner; Svendsen, Gert Tinggaard

2011-04-01

Farmers in the EU do not trade greenhouse gases under the Kyoto agreement. This is an empirical puzzle because agriculture is a significant contributor of greenhouse gases (GHG) in the EU and may harvest private net gains from trade. Furthermore, the US has strongly advocated land-use practices as 'the missing link' in past climate negotiations. We argue that farmers have relatively low marginal reduction costs and that consequences in terms of the effect on permit price and technology are overall positive in the EU Emission Trading System (ETS). Thus, we propose a project-based system for including the farming practices in the EU ETS that reduces the uncertainty from measuring emission reduction in this sector. The system encourages GHG reduction either by introducing a new and less polluting practice or by reducing the polluting activity. When doing so, farmers will receive GHG permits corresponding to the amount of reduction which can be stored for later use or sold in the EU ETS. Copyright © 2010 Elsevier Ltd. All rights reserved.

The relative impact of harvest and fire upon landscape-level dynamics of older forests: lessons from the Northwest Forest Plan

Treesearch

Sean Healey; Warren Cohen; Thomas A. Spies; Melinda Moeur; Dirk Pflugmacher; M. German Whitley; Michael. Lefsky

2008-01-01

Interest in preserving older forests at the landscape level has increased in many regions, including the Pacific Northwest of the United States. The Northwest Forest Plan (NWFP) of 1994 initiated a significant reduction in the harvesting of older forests on federal land. We used historical satellite imagery to assess the effect of this reduction in relation to: past...

The relative impact of harvest and fire upon landscape-level dynamics of older forests: Lessons from the Northwest Forest Plan

Treesearch

Sean P. Healey; Warren B. Cohen; Thomas A. Spies; Melinda Moeur; Dirk Pflungmacher; M. German Whitley; Michael Lefsky

2008-01-01

Interest in preserving older forests at the landscape level has increased in many regions, including the Pacific Northwest of the United States. The Northwest Forest Plan (NWFP) of 1994 initiated a significant reduction in the harvesting of older forests on federal land. We used historical satellite imagery to assess the effect of this reduction in relation to: past...

Vagus Nerve Stimulation in Intractable Childhood Epilepsy: a Korean Multicenter Experience

PubMed Central

You, Su Jeong; Kang, Hoon-Chul; Kim, Heung Dong; Kim, Deok-Soo; Hwang, Yong Soon; Kim, Dong Suk; Lee, Jung-Kyo; Park, Sang Keun

2007-01-01

We evaluated the long-term outcome of vagus nerve stimulation (VNS) in 28 children with refractory epilepsy. Of these 28 children, 15 (53.6%) showed a >50% reduction in seizure frequency and 9 (32.1%) had a >75% reduction. When we compared seizure reduction rates according to seizure types (generalized vs. partial) and etiologies (symptomatic vs. cryptogenic), we found no significant differences. In addition, there was no correlation between the length of the stimulation period and treatment effect. The seizure reduction rate, however, tended to be inversely related to the seizure duration before VNS implantation and age at the time of VNS therapy. VNS also improved quality of life in this group of patients, including improved memory in 9 (32.1%), improved mood in 12 (42.9%), improved behavior in 11 (39.3%), improved altertness in 12 (42.9%), improved achievement in 6 (21.4%), and improved verbal skills in 8 (28.6%). Adverse events included hoarseness in 7 patients, dyspnea at sleep in 2 patients, and wound infection in 1 patient, but all were transient and successfully managed by careful follow-up and adjustment of parameters. These results indicate that VNS is a safe and effective alternative therapy for pediatric refractory epilepsy, without significant adverse events. PMID:17596651

Technologies for reducing sludge production in wastewater treatment plants: State of the art.

PubMed

Wang, Qilin; Wei, Wei; Gong, Yanyan; Yu, Qiming; Li, Qin; Sun, Jing; Yuan, Zhiguo

2017-06-01

This review presents the state-of-the-art sludge reduction technologies applied in both wastewater and sludge treatment lines. They include chemical, mechanical, thermal, electrical treatment, addition of chemical un-coupler, and predation of protozoa/metazoa in wastewater treatment line, and physical, chemical and biological pretreatment in sludge treatment line. Emphasis was put on their effect on sludge reduction performance, with 10% sludge reduction to zero sludge production in wastewater treatment line and enhanced TS (total solids) or volatile solids removal of 5-40% in sludge treatment line. Free nitrous acid (FNA) technology seems good in wastewater treatment line but it is only under the lab-scale trial. In sludge treatment line, thermal, ultrasonic (<4400kJ/kg TS), FNA pretreatment and temperature-phased anaerobic digestion (TPAD) are promising if pathogen inactivation is not a concern. However, thermal pretreatment and TPAD are superior to other pretreatment technologies when pathogen inactivation is required. The new wastewater treatment processes including SANI®, high-rate activated sludge coupled autotrophic nitrogen removal and anaerobic membrane bioreactor coupled autotrophic nitrogen removal also have a great potential to reduce sludge production. In the future, an effort should be put on the effect of sludge reduction technologies on the removal of organic micropollutants and heavy metals. Copyright © 2017 Elsevier B.V. All rights reserved.

Reduction technique for tire contact problems

NASA Technical Reports Server (NTRS)

Noor, Ahmed K.; Peters, Jeanne M.

1995-01-01

A reduction technique and a computational procedure are presented for predicting the tire contact response and evaluating the sensitivity coefficients of the different response quantities. The sensitivity coefficients measure the sensitivity of the contact response to variations in the geometric and material parameters of the tire. The tire is modeled using a two-dimensional laminated anisotropic shell theory with the effects of variation in geometric and material parameters, transverse shear deformation, and geometric nonlinearities included. The contact conditions are incorporated into the formulation by using a perturbed Lagrangian approach with the fundamental unknowns consisting of the stress resultants, the generalized displacements, and the Lagrange multipliers associated with the contact conditions. The elemental arrays are obtained by using a modified two-field, mixed variational principle. For the application of the reduction technique, the tire finite element model is partitioned into two regions. The first region consists of the nodes that are likely to come in contact with the pavement, and the second region includes all the remaining nodes. The reduction technique is used to significantly reduce the degrees of freedom in the second region. The effectiveness of the computational procedure is demonstrated by a numerical example of the frictionless contact response of the space shuttle nose-gear tire, inflated and pressed against a rigid flat surface.

Influences of synthesis methods and modifier addition on the properties of Ni-based catalysts supported on reticulated ceramic foams

NASA Astrophysics Data System (ADS)

Nikolić, Vesna; Kamberović, Željko; Anđić, Zoran; Korać, Marija; Sokić, Miroslav; Maksimović, Vesna

2014-08-01

A method of synthesizing Ni-based catalysts supported on α-Al2O3-based foams was developed. The foams were impregnated with aqueous solutions of metal chlorides under an air atmosphere using an aerosol route. Separate procedures involved calcination to form oxides and drying to obtain chlorides on the foam surface. The synthesized samples were subsequently reduced with hydrogen. With respect to the Ni/Al2O3 catalysts, the chloride reduction route enabled the formation of a Ni coating without agglomerates or cracks. Further research included catalyst modification by the addition of Pd, Cu, and Fe. The influences of the additives on the degree of reduction and on the low-temperature reduction effectiveness (533 and 633 K) were examined and compared for the catalysts obtained from oxides and chlorides. Greater degrees of reduction were achieved with chlorides, whereas Pd was the most effective modifier among those investigated. The reduction process was nearly complete at 533 K in the sample that contained 0.1wt% Pd. A lower reduction temperature was utilized, and the calcination step was avoided, which may enhance the economical and technological aspects of the developed catalyst production method.

Meta-analysis of the Effects of Sanitizing Treatments on Salmonella, Escherichia coli O157:H7, and Listeria monocytogenes Inactivation in Fresh Produce

PubMed Central

Prado-Silva, Leonardo; Cadavez, Vasco; Gonzales-Barron, Ursula; Rezende, Ana Carolina B.

2015-01-01

The aim of this study was to perform a meta-analysis of the effects of sanitizing treatments of fresh produce on Salmonella spp., Escherichia coli O157:H7, and Listeria monocytogenes. From 55 primary studies found to report on such effects, 40 were selected based on specific criteria, leading to more than 1,000 data on mean log reductions of these three bacterial pathogens impairing the safety of fresh produce. Data were partitioned to build three meta-analytical models that could allow the assessment of differences in mean log reductions among pathogens, fresh produce, and sanitizers. Moderating variables assessed in the meta-analytical models included type of fresh produce, type of sanitizer, concentration, and treatment time and temperature. Further, a proposal was done to classify the sanitizers according to bactericidal efficacy by means of a meta-analytical dendrogram. The results indicated that both time and temperature significantly affected the mean log reductions of the sanitizing treatment (P < 0.0001). In general, sanitizer treatments led to lower mean log reductions when applied to leafy greens (for example, 0.68 log reductions [0.00 to 1.37] achieved in lettuce) compared to other, nonleafy vegetables (for example, 3.04 mean log reductions [2.32 to 3.76] obtained for carrots). Among the pathogens, E. coli O157:H7 was more resistant to ozone (1.6 mean log reductions), while L. monocytogenes and Salmonella presented high resistance to organic acids, such as citric acid, acetic acid, and lactic acid (∼3.0 mean log reductions). With regard to the sanitizers, it has been found that slightly acidic electrolyzed water, acidified sodium chlorite, and the gaseous chlorine dioxide clustered together, indicating that they possessed the strongest bactericidal effect. The results reported seem to be an important achievement for advancing the global understanding of the effectiveness of sanitizers for microbial safety of fresh produce. PMID:26362982

Mindfulness-Based Stress Reduction for lung cancer patients and their partners: Results of a mixed methods pilot study.

PubMed

van den Hurk, Desiree G M; Schellekens, Melanie P J; Molema, Johan; Speckens, Anne E M; van der Drift, Miep A

2015-07-01

Lung cancer patients and partners show high rates of impaired quality of life and heightened distress levels. Mindfulness-Based Stress Reduction has proven to be effective in reducing psychological distress in cancer patients. However, studies barely included lung cancer patients. We examined whether Mindfulness-Based Stress Reduction might be a feasible and effective intervention for patients with lung cancer and partners. Mindfulness-Based Stress Reduction is a training in which mindfulness practices are combined with psycho-education to help participants cope with distress. In this mixed methods pilot study, questionnaires on psychological distress and quality of life were administered before, directly after and 3 months after the Mindfulness-Based Stress Reduction training, in combination with semi-structured interviews. Patients with lung cancer and partners were recruited at one tertiary care academic medical centre. A total of 19 lung cancer patients and 16 partners participated in the Mindfulness-Based Stress Reduction training. Most patients were diagnosed with advanced stage lung cancer. Vast majority completed the training. Those receiving anti-cancer treatment did not miss more sessions than patients who were not currently treated. Patients and partners felt positive about participating in a peer group and with their partner. Among participants no significant changes were found in psychological distress. Caregiver burden in partners decreased significantly after following Mindfulness-Based Stress Reduction. The qualitative analysis showed that the training seemed to instigate a process of change in participants. The Mindfulness-Based Stress Reduction training seemed to be feasible for patients with lung cancer and their partners. A randomized controlled trial is needed to examine the effectiveness of Mindfulness-Based Stress Reduction in reducing psychological distress in lung cancer patients and partners. © The Author(s) 2015.

Multiple effects of probiotics on different types of diabetes: a systematic review and meta-analysis of randomized, placebo-controlled trials.

PubMed

Wang, Xia; Juan, Qi-Fang; He, Yu-Wei; Zhuang, Li; Fang, Yuan-Yuan; Wang, Yong-Hong

2017-05-24

A systematic review and meta-analysis was designed to evaluate the effect of probiotics on diabetes and its associated risk factors. We systematically searched the Cochrane Library, PubMed, EMBASE and Web of Science to June 2016. We also hand-searched the citation lists of included studies and previously identified systematic reviews to identify further relevant trials. Our primary outcome variables included glucose, glycated hemoglobin (HbA1c) and insulin. The pooled standardized mean difference was used to compare the effect between the probiotics and controlled groups, and the pooled standardized mean difference effect size with a 95% confidence interval (CI) was estimated using a random-effect model. Heterogeneity was assessed with Cochran's Q and Higgins I2 tests. Two reviewers assessed trial quality and extracted data independently. The analysis and bias for each included study was performed and assessed using Review Manager 5.2. Eighteen randomized, placebo-controlled studies (n=1056 participants, 527 consuming probiotics, 529 not consuming probiotics) were included for analysis. Comparing the probiotics groups with the control groups, there were statistically significant pooled standardized mean differences on the reduction of glucose (-0.61, 95% CI -0.98, -0.24; p=0.001), insulin (-0.49, 95% CI -0.93, -0.04; p=0.03) and HbA1c (-0.39, 95% CI -0.60, -0.19%; p=0.0001). Subgroup analysis also indicated statistical significance on the reduction of low-density lipoprotein cholesterol (LDL-C) in non-type 2 diabetes (non-T2DM) mellitus patients with diabetes, for the pooled standardized mean difference was -0.29 (95% CI -0.54, -0.04; p=0.02). Probiotics may have beneficial effects on the reduction of glucose, insulin and HbA1c for diabetes, especially for T2DM mellitus patients.

Successful weight reduction and maintenance by using a smartphone application in those with overweight and obesity.

PubMed

Chin, Sang Ouk; Keum, Changwon; Woo, Junghoon; Park, Jehwan; Choi, Hyung Jin; Woo, Jeong-Taek; Rhee, Sang Youl

2016-11-07

A discrepancy exists with regard to the effect of smartphone applications (apps) on weight reduction due to the several limitations of previous studies. This is a retrospective cohort study, aimed to investigate the effectiveness of a smartphone app on weight reduction in obese or overweight individuals, based on the complete enumeration study that utilized the clinical and logging data entered by Noom Coach app users between October 2012 and April 2014. A total of 35,921 participants were included in the analysis, of whom 77.9% reported a decrease in body weight while they were using the app (median 267 days; interquartile range = 182). Dinner input frequency was the most important factor for successful weight loss (OR = 10.69; 95% CI = 6.20-19.53; p < 0.001), and more frequent input of weight significantly decreased the possibility of experiencing the yo-yo effect (OR = 0.59, 95% CI = 0.39-0.89; p < 0.001). This study demonstrated the clinical utility of an app for successful weight reduction in the majority of the app users; the effects were more significant for individuals who monitored their weight and diet more frequently.

Nuclear Quantum Effects on Aqueous Electron Attachment and Redox Properties.

PubMed

Rybkin, Vladimir V; VandeVondele, Joost

2017-04-06

Nuclear quantum effects (NQEs) on the reduction and oxidation properties of small aqueous species (CO 2 , HO 2 , and O 2 ) are quantified and rationalized by first-principles molecular dynamics and thermodynamic integration. Vertical electron attachment, or electron affinity, and detachment energies (VEA and VDE) are strongly affected by NQEs, decreasing in absolute value by 0.3 eV going from a classical to a quantum description of the nuclei. The effect is attributed to NQEs that lessen the solvent response upon oxidation/reduction. The reduction of solvent reorganization energy is expected to be general for small solutes in water. In the thermodynamic integral that yields the free energy of oxidation/reduction, these large changes enter with opposite sign, and only a small net effect (0.1 eV) remains. This is not obvious for CO 2 , where the integrand is strongly influenced by NQEs due to the onset of interaction of the reduced orbital with the conduction band of the liquid during thermodynamic integration. We conclude that NQEs might not have to be included in the computation of redox potentials, unless high accuracy is needed, but are important for VEA and VDE calculations.

Effects of grassland restoration efforts on mound-building ants in the Chihuahuan Desert

USDA-ARS?s Scientific Manuscript database

Shrub encroachment is a serious problem in arid environments worldwide because of potential reductions in ecosystem services and negative effects on biodiversity. In southwestern USA, Chihuahuan Desert grasslands have experienced long-term encroachment by shrubs including creosotebush (Larrea triden...

Year-Round Daylight Saving Time Study : Volume 1. Interim Report on the Operation and Effects of Daylight Saving Time

DOT National Transportation Integrated Search

1975-06-01

The analyses of the effects of Year-Round Daylight Saving Time were not conslusive because they could not be reliablyseparated from other changes occuring simultaneously including fuel availability constraints, speed limit reductions, Sunday gasoline...

Web-Based Positive Psychology Interventions: A Reexamination of Effectiveness.

PubMed

Woodworth, Rosalind J; O'Brien-Malone, Angela; Diamond, Mark R; Schüz, Benjamin

2017-03-01

Seligman, Steen, Park, and Peterson (2005) suggested that positive psychology interventions (PPIs) contain specific, powerful, therapeutic ingredients that effect greater increases in happiness and reductions in depression than a placebo control. This study reexamined the three PPIs that Seligman et al. found to be most effective when delivered over the internet. Three PPIs and a placebo control, identical with the interventions used by Seligman et al., were examined in a web-based, randomized assignment design. Mixed-design analysis of variance and multilevel modeling showed that all interventions, including the placebo, led to significant increases in happiness and reductions in depression. The effects of PPIs were indistinguishable from those of the placebo control. Using web-based delivery, both PPIs and theoretically neutral placebos can increase happiness and reduce depression in self-selected populations. Possible explanations include that non-specific factors common to most therapeutic treatments are responsible for the observed changes, or that cultural or other context-related variables operate to account for the divergent findings. © 2016 Wiley Periodicals, Inc.

Circumference reduction and cellulite treatment with a TriPollar radiofrequency device: a pilot study.

PubMed

Manuskiatti, W; Wachirakaphan, C; Lektrakul, N; Varothai, S

2009-07-01

A wide variety of treatments for circumference reduction and cellulite are available, but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome. Objective To determine the safety and efficacy of the TriPollar radiofrequency device for cellulite treatment and circumference reduction. Thirty-nine females with cellulite received eight weekly TriPollar treatments. Treatment areas included the abdomen, thighs, buttocks and arms. Subjects were evaluated using standardized photographs and measurements of body weight, circumference, subcutaneous thickness, and skin elasticity of the treatment sites at baseline, immediately after and 4 weeks after the final treatment. Physicians' evaluation of clinical improvement scores using a quartile grading scale was recorded. Thirty-seven patients (95%) completed the treatment protocol. There was significant circumference reduction of 3.5 and 1.7 cm at the abdomen (P = 0.002) and thigh (P = 0.002) regions, respectively. At 4 weeks after the last treatment, the average circumferential reductions of the abdomen and thighs were sustained. No significant circumferential reductions of the buttocks and arms at the last treatment visit compared to baseline were demonstrated (P = 0.138 and 0.152, respectively). Quartile grading scores correlating to approximately 50% improvement in cellulite appearance were noted. Tripollar radiofrequency provided beneficial effects on the reduction of abdomen and thigh circumference and cellulite appearance.

Double stellate tongue reduction: a new method of treatment for macroglossia in patients with Beckwith-wiedemann syndrome.

PubMed

Hettinger, Patrick C; Denny, Arlen D

2011-09-01

Although multiple methods of tongue reduction have been described, recent literature suggests that the central reductions may be more favorable in patients with Beckwith-Wiedemann syndrome (BWS). In this case series, we review our experience with macroglossia associated with BWS, and we offer a new technique of central tongue reduction. Between 1993 and 2007, a retrospective chart review was conducted to include all patients with a diagnosis of BWS who have undergone stellate or double stellate tongue reduction at the Children's Hospital of Wisconsin. A total of 7 patients met all inclusion criteria. All patients had good tongue mobility at 1-year follow-up. One patient required speech therapy for persistent articulation errors postoperatively. A total of 2 patients required secondary procedures for recurrent macroglossia. There were no complaints of abnormal taste or sensation. The stellate and double stellate tongue reductions provide effective treatment in macroglossia associated with BWS.

Accounting for nonmonotonic precursor duration effects with gain reduction in the temporal window model.

PubMed

Roverud, Elin; Strickland, Elizabeth A

2014-03-01

The mechanisms of forward masking are not clearly understood. The temporal window model (TWM) proposes that masking occurs via a neural mechanism that integrates within a temporal window. The medial olivocochlear reflex (MOCR), a sound-evoked reflex that reduces cochlear amplifier gain, may also contribute to forward masking if the preceding sound reduces gain for the signal. Psychophysical evidence of gain reduction can be observed using a growth of masking (GOM) paradigm with an off-frequency forward masker and a precursor. The basilar membrane input/output (I/O) function is estimated from the GOM function, and the I/O function gain is reduced by the precursor. In this study, the effect of precursor duration on this gain reduction effect was examined for on- and off-frequency precursors. With on-frequency precursors, thresholds increased with increasing precursor duration, then decreased (rolled over) for longer durations. Thresholds with off-frequency precursors continued to increase with increasing precursor duration. These results are not consistent with solely neural masking, but may reflect gain reduction that selectively affects on-frequency stimuli. The TWM was modified to include history-dependent gain reduction to simulate the MOCR, called the temporal window model-gain reduction (TWM-GR). The TWM-GR predicted rollover and the differences with on- and off-frequency precursors whereas the TWM did not.

Mediation Analysis of the Efficacy of the Eban HIV/STD Risk-Reduction Intervention for African American HIV Serodiscordant Couples.

PubMed

El-Bassel, Nabila; Jemmott, John B; Bellamy, Scarlett L; Pequegnat, Willo; Wingood, Gina M; Wyatt, Gail E; Landis, J Richard; Remien, Robert H

2016-06-01

Targeting couples is a promising behavioral HIV risk-reduction strategy, but the mechanisms underlying the effects of such interventions are unknown. We report secondary analyses testing whether Social-Cognitive-Theory variables mediated the Eban HIV-risk-reduction intervention's effects on condom-use outcomes. In a multisite randomized controlled trial conducted in four US cities, 535 African American HIV-serodiscordant couples were randomized to the Eban HIV risk-reduction intervention or attention-matched control intervention. Outcomes were proportion condom-protected sex, consistent condom use, and frequency of unprotected sex measured pre-, immediately post-, and 6 and 12 months post-intervention. Potential mediators included Social-Cognitive-Theory variables: outcome expectancies and self-efficacy. Mediation analyses using the product-of-coefficients approach in a generalized-estimating-equations framework revealed that condom-use outcome expectancy, partner-reaction outcome expectancy, intention, self-efficacy, and safer-sex communication improved post-intervention and mediated intervention-induced improvements in condom-use outcomes. These findings underscore the importance of targeting outcome expectancies, self-efficacy, and safer-sex communication in couples-level HIV risk-reduction interventions.

Long-term results of a smoking reduction program.

PubMed

Glasgow, Russell E; Gaglio, Bridget; Estabrooks, Paul A; Marcus, Alfred C; Ritzwoller, Debra P; Smith, Tammy L; Levinson, Arnold H; Sukhanova, Anna; O'Donnell, Colin; Ferro, Erica F; France, Eric K

2009-01-01

There have been few comprehensive evaluations of smoking reduction, especially in health care delivery systems, and little is known about its cost, maintenance of reduced smoking, or robustness across patient subgroups. A generally representative sample of 320 adult smokers from an HMO scheduled for outpatient surgery or a diagnostic procedure was randomized to enhanced usual care or a theory-based smoking reduction intervention that combined telephone counseling and tailored newsletters. Outcomes included cigarettes smoked, carbon monoxide levels, and costs. Both intervention and control conditions continued to improve from 3- to 12-month assessments. Between-condition differences using intent-to-treat analyses on both self-report and carbon monoxide measures were nonsignificant by the 12-month follow-up (25% vs. 19% achieved 50% or greater reductions in cigarettes smoked). The intervention was implemented consistently despite logistical constraints and was generally robust across patient characteristics (eg, education, ethnicity, health literacy, dependence). In the absence of nicotine replacement therapy, the long-term effects of this smoking reduction intervention seem modest and nonsignificant. Future research is indicated to enhance intervention effects and conduct more comprehensive economic analyses of program variations.

An elaborated feeding cycle model for reductions in vectorial capacity of night-biting mosquitoes by insecticide-treated nets.

PubMed

Le Menach, Arnaud; Takala, Shannon; McKenzie, F Ellis; Perisse, Andre; Harris, Anthony; Flahault, Antoine; Smith, David L

2007-01-25

Insecticide Treated Nets (ITNs) are an important tool for malaria control. ITNs are effective because they work on several parts of the mosquito feeding cycle, including both adult killing and repelling effects. Using an elaborated description of the classic feeding cycle model, simple formulas have been derived to describe how ITNs change mosquito behaviour and the intensity of malaria transmission, as summarized by vectorial capacity and EIR. The predicted changes are illustrated as a function of the frequency of ITN use for four different vector populations using parameter estimates from the literature. The model demonstrates that ITNs simultaneously reduce mosquitoes' lifespans, lengthen the feeding cycle, and by discouraging human biting divert more bites onto non-human hosts. ITNs can substantially reduce vectorial capacity through small changes to all of these quantities. The total reductions in vectorial capacity differ, moreover, depending on baseline behavior in the absence of ITNs. Reductions in lifespan and vectorial capacity are strongest for vector species with high baseline survival. Anthropophilic and zoophilic species are affected differently by ITNs; the feeding cycle is lengthened more for anthrophilic species, and the proportion of bites that are diverted onto non-human hosts is higher for zoophilic species. This model suggests that the efficacy of ITNs should be measured as a total reduction in transmission intensity, and that the quantitative effects will differ by species and by transmission intensity. At very high rates of ITN use, ITNs can generate large reductions in transmission intensity that could provide very large reductions in transmission intensity, and effective malaria control in some areas, especially when used in combination with other control measures. At high EIR, ITNs will probably not substantially reduce the parasite rate, but when transmission intensity is low, reductions in vectorial capacity combine with reductions in the parasite rate to generate very large reductions in EIR.

Effects of a radiation dose reduction strategy for computed tomography in severely injured trauma patients in the emergency department: an observational study.

PubMed

Kim, Soo Hyun; Jung, Seung Eun; Oh, Sang Hoon; Park, Kyu Nam; Youn, Chun Song

2011-11-03

Severely injured trauma patients are exposed to clinically significant radiation doses from computed tomography (CT) imaging in the emergency department. Moreover, this radiation exposure is associated with an increased risk of cancer. The purpose of this study was to determine some effects of a radiation dose reduction strategy for CT in severely injured trauma patients in the emergency department. We implemented the radiation dose reduction strategy in May 2009. A prospective observational study design was used to collect data from patients who met the inclusion criteria during this one year study (intervention group) from May 2009 to April 2010. The prospective data were compared with data collected retrospectively for one year prior to the implementation of the radiation dose reduction strategy (control group). By comparison of the cumulative effective dose and the number of CT examinations in the two groups, we evaluated effects of a radiation dose reduction strategy. All the patients met the institutional adult trauma team activation criteria. The radiation doses calculated by the CT scanner were converted to effective doses by multiplication by a conversion coefficient. A total of 118 patients were included in this study. Among them, 33 were admitted before May 2009 (control group), and 85 were admitted after May 2009 (intervention group). There were no significant differences between the two groups regarding baseline characteristics, such as injury severity and mortality. Additionally, there was no difference between the two groups in the mean number of total CT examinations per patient (4.8 vs. 4.5, respectively; p = 0.227). However, the mean effective dose of the total CT examinations per patient significantly decreased from 78.71 mSv to 29.50 mSv (p < 0.001). The radiation dose reduction strategy for CT in severely injured trauma patients effectively decreased the cumulative effective dose of the total CT examinations in the emergency department. But not effectively decreased the number of CT examinations.

Directions of the US Geological Survey Landslide Hazards Reduction Program

USGS Publications Warehouse

Wieczorek, G.F.

1993-01-01

The US Geological Survey (USGS) Landslide Hazards Reduction Program includes studies of landslide process and prediction, landslide susceptibility and risk mapping, landslide recurrence and slope evolution, and research application and technology transfer. Studies of landslide processes have been recently conducted in Virginia, Utah, California, Alaska, and Hawaii, Landslide susceptibility maps provide a very important tool for landslide hazard reduction. The effects of engineering-geologic characteristics of rocks, seismic activity, short and long-term climatic change on landslide recurrence are under study. Detailed measurement of movement and deformation has begun on some active landslides. -from Author

Microfinance and poverty reduction: evidence from a village study in Bangladesh.

PubMed

Nawaz, Shah

2010-01-01

To evaluate the competing claims on the impact of microfinance programs on multidimensional poverty, a village study in Bangladesh was conducted where three microfinance programs had been operating for more than five years. The study found that microfinance has resulted in a moderate reduction in the poverty of borrowers, as measured by a variety of socio-economic indicators, but has not reached many of the poorest in the village. To make microfinance a more effective means of poverty reduction other services such as skills training, technological support, education and health related strategies should be included with microfinance.

The Nature of Reduction in Space Weathering

NASA Astrophysics Data System (ADS)

McKay, D. S.; Allen, C. C.

1993-07-01

Space weathering is a broad term that includes a number of complex effects of the exposure of materials to the environment of space. The processes that drive space weathering include micrometeorite impact, radiation from the Sun and cosmic rays, and exposure to the vacuum of space. One of the important effects caused by these processes is the tendency for chemical reduction of oxide and silicate materials (including glasses), with accompanying loss of oxygen and production of reduced metal. Such chemical reduction and accompanying metal production may have an important influence on the chemistry of the outermost volume of individual grains as well as on the optical properties of this material. Hapke [1] discussed five processes that have been suggested for producing submicroscopic iron metal in the lunar soil: (1) shock reduction, (2) heating in a thermal blanket in vacuum, (3) shock heating of solar-wind-impregnated grains, (4) coatings deposited by solar wind sputtering, and (5) coatings deposited by impact vaporization. As noted by Hapke, "Processes (1) and (2) have been refuted by laboratory experiments. Processes (4) and (5) have produced submicroscopic iron metal in laboratory simulations. Although no experiments have been done to simulate process (3), it is widely accepted." We have been performing experimental reduction of simulated and actual lunar materials [2-5] and have shown that, under conditions of exposure to hydrogen at elevated temperatures, reduction of FeO readily occurs in ilmenite and lunar composition glass, and occurs at a slower rate in pyroxene and olivine. Even plagioclase feldspar containing minor FeO is readily reduced with formation of metallic iron blebs on surfaces [4]. A comparison of natural lunar samples to hydrogen-reduced samples or simulants in which we are searching for reduction evidence in various soil phases is underway. Preliminary data for mature soils show, in agreement with earlier results, that reduced iron produced in the regolith is most commonly formed in agglutinitic glass rather than in minerals including ilmenite, even though experimental reduction of ilmenite occurs as rapidly, if not more so, than reduction of FeO in glass. Several explanations are possible. Ilmenite may melt and dissolve readily into the impact-formed melt, providing FeO to the glass. Then the reduced iron is derived from the melt rather than from the mineral. Relic reduced ilmenite grains, similar to experimentally reduced ilmenites, therefore may not normally be formed. Second, similar to the process for making impact breccias as proposed by Simonds et al. [6], the impact process may tend to completely melt everything within a small volume, including iron-bearing minerals such as ilmenite and pyroxene. This superheated volume is partially reduced almost instantly by included solar wind hydrogen or carbon as summarized in Hapke [1], forming abundant metallic iron blebs. Then this melted volume encounters cold mineral and lithic grains and incorporates them as clasts, chilling rapidly without heating the clasts sufficiently to produce significant reduction. This explanation seems to better fit the observation that apparently totally unreduced ilmenite clasts are found in glass containing abundant reduced iron. Implications for space weathering are that reduction mainly occurs in melting processes (and also in vaporization processes [7]), but that solid-state reduction may be rare in micrometeorite impact-driven processes. However, impact-driven reduction from events larger than micrometeorite impacts may still provide elevated temperatures over a long enough time span to drive solid-state reduction. Solid-state reduction produced by shock effects has also been proposed to explain metal blebs in plagioclase [8]. While hydrogen is usually cited as the main reducing agent in the lunar regolith, we note that recent analyses of interplanetary dust particles show carbon contents of up to 40% by weight [9]; such particles added to the regolith may supply abundant carbon for supporting space weathering reduction processes during impacts. References: [1] Hapke B. (1993) LPI Tech. Rpt. 93-01, 8-9. [2] Allen C. C. et al. (1992) In Engineering, Construction, and Operations in Space III, 629-640, Am. Soc. Civil Engineers, New York. [3] Allen C. C. et al. (1992) LPS XXIII, 21-22. [4] Allen C. C. et al. (1993) Icarus, submitted. [5] Allen C. C. et al. (1993) LPS XXIV, 19-20. [6] Simonds C. H. et al. (1976) Proc. LSC 7th, 2509-2528. [7] Keller L. P. and McKay D. S. (1992) LPS XXIll, 673-674. [8] Sclar C. B. and Bauer J. F. (1976) Proc. LSC 7th, 2493-2508. [9] Thomas K. L. et al. (1993) GCA, in press.

Variability and dilemmas in harm reduction for anabolic steroid users in the UK: a multi-area interview study

PubMed Central

2014-01-01

Background The UK continues to experience a rise in the number of anabolic steroid-using clients attending harm reduction services such as needle and syringe programmes. Methods The present study uses interviews conducted with harm reduction service providers as well as illicit users of anabolic steroids from different areas of England and Wales to explore harm reduction for this group of drug users, focussing on needle distribution policies and harm reduction interventions developed specifically for this population of drug users. Results The article addresses the complexity of harm reduction service delivery, highlighting different models of needle distribution, such as peer-led distribution networks, as well as interventions available in steroid clinics, including liver function testing of anabolic steroid users. Aside from providing insights into the function of interventions available to steroid users, along with principles adopted by service providers, the study found significant tensions and dilemmas in policy implementation due to differing perspectives between service providers and service users relating to practices, risks and effective interventions. Conclusion The overarching finding of the study was the tremendous variability across harm reduction delivery sites in terms of available measures and mode of operation. Further research into the effectiveness of different policies directed towards people who use anabolic steroids is critical to the development of harm reduction. PMID:24986546

Effects of low carbohydrate diets on weight and glycemic control among type 2 diabetes individuals: a systemic review of RCT greater than 12 weeks.

PubMed

Castañeda-González, L M; Bacardí Gascón, M; Jiménez Cruz, A

2011-01-01

Low carbohydrate diets (LCD) have shown beneficial effects on short-term weight reduction programs for obese individuals without diabetes, but the long-term evidence of efficacy on individuals with type 2 diabetes is not conclusive. To evaluate, the effectiveness of 12 or more weeks of LCD compared to Low Fat Diet (LFD), Usual Care Diet (UCD) or Low Glycemic Index Diet (LGID) on weight reduction and AIC on type 2 diabetes individuals. A systematic review was conducted on randomized trials registered in PubMed, Cochrane and EBSCOhost from January 1st 2000 to January 1st 2010 including those with an intervention program with LCD in type 2 diabetes subjects and a follow-up ≥ 12 weeks. Available data on study design; carbohydrate composition of diet; duration of diet; and the outcomes of weight, lipid levels (total, low density lipoprotein and high-density lipoprotein cholesterol, and triglycerides), hemoglobin A1C percent and/or fasting glucose were extracted. Five studies showed greater weight reduction with LCD, of which four demonstrated no significant difference. The longest trial intervention studies did not show a difference in weight change. Only two studies showed greater reduction of A1C with LCD, including the longest intervention trial with a low carbohydrate Mediterranean diet. This review shows that there are no consistent differences in weight and A1C changes over the long-term treatment with LCD and LFD, UCD or LGID.

Transport-related measures to mitigate climate change in Basel, Switzerland: A health-effectiveness comparison study.

PubMed

Perez, L; Trüeb, S; Cowie, H; Keuken, M P; Mudu, P; Ragettli, M S; Sarigiannis, D A; Tobollik, M; Tuomisto, J; Vienneau, D; Sabel, C; Künzli, N

2015-12-01

Local strategies to reduce green-house gases (GHG) imply changes of non-climatic exposure patterns. To assess the health impacts of locally relevant transport-related climate change policies in Basel, Switzerland. We modelled change in mortality and morbidity for the year 2020 based on several locally relevant transport scenarios including all decided transport policies up to 2020, additional realistic and hypothesized traffic reductions, as well as ambitious diffusion levels of electric cars. The scenarios were compared to the reference condition in 2010 assumed as status quo. The changes in non-climatic population exposure included ambient air pollution, physical activity, and noise. As secondary outcome, changes in Disability-Adjusted Life Years (DALYs) were put into perspective with predicted changes of CO2 emissions and fuel consumption. Under the scenario that assumed a strict particle emissions standard in diesel cars and all planned transport measures, 3% of premature deaths could be prevented from projected PM2.5 exposure reduction. A traffic reduction scenario assuming more active trips provided only minor added health benefits for any of the changes in exposure considered. A hypothetical strong support to electric vehicles diffusion would have the largest health effectiveness given that the energy production in Basel comes from renewable sources. The planned local transport related GHG emission reduction policies in Basel are sensible for mitigating climate change and improving public health. In this context, the most effective policy remains increasing zero-emission vehicles. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effectiveness of regionalization of trauma care services: a systematic review.

PubMed

Vali, Y; Rashidian, A; Jalili, M; Omidvari, A H; Jeddian, A

2017-05-01

Improving trauma systems in various forms has always been an important aspect of health policy. While several papers have reported the implementation of a structured trauma system of care, research evidence on the effectiveness of such regionalization for improvement in trauma outcome is limited. Systematic review. Medline, EMbase, EconLit and Health Management Information Consortium were searched, using sensitive search terms, for interventional studies that reported a trauma regionalization system as their intervention, and compared important outcomes such as mortality and preventable deaths. At least two authors assessed eligibility for inclusion and risk of bias, and extracted data from the included studies. As meta-analysis was not possible for all studies, two controlled before-after studies were included in the meta-analysis, and a narrative analysis was conducted for the other studies. After title and abstract sifting, 66 papers were retrieved. After reading the full texts, a total of 24 studies from the USA, UK, Canada, Australia, and the Netherlands were included in this review. In spite of variation in study specifications, most were before-after studies with a high risk of bias. Although a reduction in mortality was shown in most studies, only two studies were eligible for meta-analysis, and the results showed a significant reduction in mortality after implementation of an organized trauma system (odds ratio 0.840, 95% confidence interval 0.756-0.924; P = 0.00). Correlation was found between a regionalized network of trauma care and a reduction in trauma-related mortality, based on studies that did not exclude the effects of other concurrent changes on observed reductions. It is recommended that more studies with robust research designs should be conducted in a more diverse range of countries to assess the effectiveness of regionalization. Despite this limitation, the present findings support the regionalization of trauma care services. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Effects of Mindfulness-Based Stress Reduction Intervention on Psychological Well-being and Quality of Life: Is Increased Mindfulness Indeed the Mechanism?

PubMed Central

Kuijpers, Karlijn F.

2008-01-01

Background Although several studies have reported positive effects of mindfulness-based stress reduction (MBSR) intervention on psychological well-being, it is not known whether these effects are attributable to a change in mindfulness. Purpose The aim of this study is to compare the effects of MBSR to a waiting-list control condition in a randomized controlled trial while examining potentially mediating effects of mindfulness. Methods Forty women and 20 men from the community with symptoms of distress (mean age 43.6 years, SD = 10.1) were randomized into a group receiving MBSR or a waiting-list control group. Before and after the intervention period, questionnaires were completed on psychological well-being, quality of life, and mindfulness. Results Repeated measures multiple analysis of variance (MANCOVAs) showed that, compared with the control group, the intervention resulted in significantly stronger reductions of perceived stress (p = 0.016) and vital exhaustion (p = 0.001) and stronger elevations of positive affect (p = 0.006), quality of life (p = .009), as well as mindfulness (p = 0.001). When mindfulness was included as a covariate in the MANCOVA, the group effects on perceived stress and quality of life were reduced to nonsignificance. Conclusion Increased mindfulness may, at least partially, mediate the positive effects of mindfulness-based stress reduction intervention. PMID:18535870

Organizational downsizing: a review of literature for planning and research.

PubMed

Davis, Jullet A; Savage, Grant; Stewart, R Thomas

2003-01-01

The use of downsizing as management's strategic response to environmental and institutional changes is prevalent in all U.S. industries, including healthcare. The popular and research literature is inundated with reports on companies undergoing various stages of restructuring, which often include one or more staff reductions. This article provides a review of downsizing literature published from 1985 to 2002. Although the findings and conclusions of these articles are generally inconsistent, the prevailing opinion is that for downsizing to be successful, effective planning must occur long before, during, and after downsizing. Additionally, a downsizing plan should be included in the strategic management plan of all organizations, regardless of whether they plan to downsize or not. By including such a plan, the organization will be better prepared to begin the staff-reduction process should it be forced to do so in response to environmental changes. Finally, providing ample support and protection for staff is key to the organization's recovery and growth. The lessons provided in this literature review should assist healthcare managers in deciding how to plan and structure potential staff reductions.

Proximate and Ultimate Limiting Nutrients in the Mississippi River Plume: Implications for Hypoxia Reduction Through Nutrient Management

NASA Astrophysics Data System (ADS)

Fennel, K.; Laurent, A.

2016-02-01

A large hypoxic area (15,000 km2 on average) forms every summer over the Texas-Louisiana shelf in the northern Gulf of Mexico due to decay of organic matter that is primarily derived from nutrient inputs from the Mississippi/Atchafalaya River System. Efforts are underway to reduce the extent of hypoxic conditions through nutrient management in the watershed; for example, an interagency Hypoxia Task Force is developing Action Plans with input from various stakeholders that set out targets for hypoxia reduction. An open question is by how much nutrient loads would have to be decreased in order to produce the desired reductions in hypoxia and when these would be measurable over natural variability. We have performed a large number of multi-year nutrient load reduction scenarios with a regional biogeochemical model for the region. The model is based on the Regional Ocean Modeling System (ROMS), explicitly includes nitrogen (N) and phosphorus (P) species as inorganic nutrients, and has been shown to realistically reproduce the key processes responsible for hypoxia generation. We have quantified the effects of differential reductions in river N and P loads on hypoxic extent. An assessment of the effects of N versus P reductions is important because, thus far, nutrient management efforts have focused on N, yet P is known to limit primary production in spring and early summer. A debate is ongoing as to whether targets for P reductions should be set and whether nutrient reduction efforts should focus solely on P, which results primarily from urban and industrial point sources and is uncoupled from agricultural fertilizer application. Our results strongly indicate that N is the `ultimate' limiting nutrient to primary production determining the areal extent and duration of hypoxic conditions in a cumulative sense, while P is temporarily limiting in spring. Although reductions in river P load would decrease hypoxic extent in early summer, they would have a much smaller effect than N reductions on the cumulative extent and duration of hypoxic conditions. Combined reductions of N and P have the greatest effect.

Proximate versus ultimate limiting nutrients in the Mississippi River Plume and Implications for Hypoxia Reductions through Nutrient Management

NASA Astrophysics Data System (ADS)

Fennel, Katja; Laurent, Arnaud

2016-04-01

A large hypoxic area (15,000 km2 on average) forms every summer over the Texas-Louisiana shelf in the northern Gulf of Mexico due to decay of organic matter that is primarily derived from nutrient inputs from the Mississippi/Atchafalaya River System. Efforts are underway to reduce the extent of hypoxic conditions through nutrient management in the watershed; for example, an interagency Hypoxia Task Force is developing Action Plans with input from various stakeholders that set out targets for hypoxia reduction. An open question is how far nutrient loads would have to be decreased in order to produce the desired reductions in hypoxia and when these would be measurable given significant natural variability. We have simulated a large number of multi-year nutrient load reduction scenarios with a regional biogeochemical model for the region. The model is based on the Regional Ocean Modeling System (ROMS), explicitly includes nitrogen (N) and phosphorus (P) species as inorganic nutrients, and has been shown to realistically reproduce the key processes responsible for hypoxia generation. We have quantified the effects of differential reductions in river N and P loads on hypoxic extent. An assessment of the effects of N versus P reductions is important because, thus far, nutrient management efforts have focused on N, yet P is known to limit primary production in spring and early summer. A debate is ongoing as to whether targets for P reductions should be set and whether nutrient reduction efforts should focus solely on P, which results primarily from urban and industrial point sources and is uncoupled from agricultural fertilizer application. Our results strongly indicate that N is the 'ultimate' limiting nutrient to primary production determining the areal extent and duration of hypoxic conditions in a cumulative sense, while P is temporarily limiting in spring. Although reductions in river P load would decrease hypoxic extent in early summer, they would have a much smaller effect than N reductions on the cumulative extent and duration of hypoxic conditions. Combined reductions of N and P have the greatest effect.

Moderators of the Intervention Effects for a Dissonance-Based Eating Disorder Prevention Program; Results from an Amalgam of Three Randomized Trials

PubMed Central

Müller, Sina; Stice, Eric

2013-01-01

Objective To investigate factors hypothesized to moderate the effects of a dissonance-based eating disorder prevention program, including initial elevations in thin-ideal internalization, body dissatisfaction, eating disorder symptoms, and older participant age. Method Adolescent female high school and college students with body image concerns (N = 977; M age = 18.6) were randomized to a dissonance-based thin-ideal internalization reduction program or an assessment-only control condition in three prevention trials. Results The intervention produced (a) significantly stronger reductions in thin-ideal internalization for participants with initial elevations in thin-ideal internalization and a threshold/subthreshold DSM-5 eating disorder at baseline, (b) significantly greater reductions in eating disorder symptoms for participants with versus without a DSM-5 eating disorder at baseline, and (c) significantly stronger reductions in body dissatisfaction for late adolescence/young adulthood versus mid-adolescent participants. Baseline body dissatisfaction did not moderate the intervention effects. Conclusion Overall, intervention effects tended to be amplified for individuals with initial elevations in risk factors and a DSM-5 eating disorder at baseline. Results suggest that this prevention program is effective for a broad range of individuals, but is somewhat more beneficial for the subgroups identified in the moderation analyses. PMID:23337181

The effectiveness of measures to reduce the man-made greenhouse effect. The application of a Climate-policy Model

NASA Astrophysics Data System (ADS)

Jain, A. K.; Bach, W.

1994-06-01

In this paper we briefly describe the characteristics and the performance of our 1-D Muenster Climate Model. The model system consists of coupled models including gas cycle models, an energy balance model and a sea level rise model. The chemical feedback mechanisms among greenhouse gases are not included. This model, which is a scientifically-based parameterized simulation model, is used here primarily to help assess the effectiveness of various plausible policy options in mitigating the additional man-made greenhouse warming and the resulting sea level rise. For setting priorities it is important to assess the effectiveness of the various measures by which the greenhouse effect can be reduced. To this end we take a Scenario Business-as-Usual as a reference case (Leggett et al., 1992) and study the mitigating effects of the following four packages of measures: The Copenhagen Agreements on CFC, HCFC, and halon reduction (GECR, 1992), the Tropical Forest Preservation Plan of the Climate Enquete-Commission of the German Parliament on CO2 reduction (ECGP, 1990), a detailed reduction scheme for energy-related CO2 (ECGP, 1990), and a preliminary scheme for CH4, CO, and N2O reduction (Bach and Jain, 1992 1993). The required reduction depends, among others, on the desired climate and ecosystem protection. This is defined by the Enquete-Commission and others as a mean global rate of surface temperature change of ca. 0.1 °C per decade — assumed to be critical to many ecosystems — and a mean global warming ceiling of ca. 2 °C in 2100 relative to 1860. Our results show that the Copenhagen Agreements, the Tropical Forest Preservation Plan, the energy-related CO2 reduction scheme, and the CH4 and N2O reduction schemes could mitigate the anthropogenic greenhouse warming by ca. 12%, 6%, 35%, and 9% respectively. Taken together, all four packages of measures could reduce the man-made greenhouse effect by more than 60% until 2100; i.e. over the climate sensitivity range 2.5 °C (1.5 to 4.5) for 2 × CO2, the warming could be reduced from 3.5 °C (2.4 to 5.0) without specific measures to 1.3 °C (0.9 to 2.0) with the above packages of measures; and likewise, the mean global sea level rise could be reduced from 65 cm (46 to 88) without specific measures to 32 cm (22 to 47) with the above measures. Finally, the model results also emphasize the importance of trace gases other than CO2 in mitigating additional man-made greenhouse warming. According to our preliminary estimates, CH4 could in the short term make a sizable contribution to the reduction of the greenhouse effect (because of its relatively short lifetime of 10 yr), as could N2O in the medium and long term (with a relatively long lifetime of 150 yr).

Landscape planning for agricultural nonpoint source pollution reduction III: Assessing phosphorus and sediment reduction potential

USGS Publications Warehouse

Diebel, M.W.; Maxted, J.T.; Robertson, Dale M.; Han, S.; Vander Zanden, M. J.

2009-01-01

Riparian buffers have the potential to improve stream water quality in agricultural landscapes. This potential may vary in response to landscape characteristics such as soils, topography, land use, and human activities, including legacies of historical land management. We built a predictive model to estimate the sediment and phosphorus load reduction that should be achievable following the implementation of riparian buffers; then we estimated load reduction potential for a set of 1598 watersheds (average 54 km2) in Wisconsin. Our results indicate that land cover is generally the most important driver of constituent loads in Wisconsin streams, but its influence varies among pollutants and according to the scale at which it is measured. Physiographic (drainage density) variation also influenced sediment and phosphorus loads. The effect of historical land use on present-day channel erosion and variation in soil texture are the most important sources of phosphorus and sediment that riparian buffers cannot attenuate. However, in most watersheds, a large proportion (approximately 70%) of these pollutants can be eliminated from streams with buffers. Cumulative frequency distributions of load reduction potential indicate that targeting pollution reduction in the highest 10% of Wisconsin watersheds would reduce total phosphorus and sediment loads in the entire state by approximately 20%. These results support our approach of geographically targeting nonpoint source pollution reduction at multiple scales, including the watershed scale. ?? 2008 Springer Science+Business Media, LLC.

Potassium permanganate cleansing is an effective sanitary method for the reduction of bacterial bioload on raw Coriandrum sativum.

PubMed

Subramanya, Supram Hosuru; Pai, Vasudha; Bairy, Indira; Nayak, Niranjan; Gokhale, Shishir; Sathian, Brijesh

2018-02-13

Raw vegetables including flowers, leaves, stems, and roots are important carriers of food borne pathogens. We evaluated the bacteriological contamination of unwashed coriander leaves, and effectiveness of cleansing with 0.1% potassium permanganate solution as decontamination method. Significant bacterial contamination including pathogens like Salmonella species and Aeromonas species were isolated from unwashed coriander leaves. Decontamination with 0.1% potassium permanganate was found to be more effective than three steps wash with sterile water.

Impact of wastewater derived dissolved organic carbon on reduction, mobility, and bioavailability of As(V) and Cr(VI) in contaminated soils.

PubMed

Kunhikrishnan, Anitha; Choppala, Girish; Seshadri, Balaji; Wijesekara, Hasintha; Bolan, Nanthi S; Mbene, Kenneth; Kim, Won-Il

2017-01-15

In this work, the effects of various wastewater sources (storm water, sewage effluent, piggery effluent, and dairy effluent) on the reduction, and subsequent mobility and bioavailability of arsenate [As(V)] and chromate [Cr(VI)] were compared using both spiked and field contaminated soils. Wastewater addition to soil can increase the supply of carbon, nutrients, and stimulation of microorganisms which are considered to be important factors enhancing the reduction of metal(loid)s including As and Cr. The wastewater-induced mobility and bioavailability of As(V) and Cr(VI) were examined using leaching, earthworm, and soil microbial activity tests. The rate of reduction of As(V) was much less than that of Cr(VI) both in the presence and absence of wastewater addition. Wastewater addition increased the reduction of both As(V) and Cr(VI) compared to the control (Milli-Q water) and the effect was more pronounced in the case of Cr(VI). The leaching experiment indicated that Cr(VI) was more mobile than As(V). Wastewater addition increased the mobility and bioavailability of As(V), but had an opposite effect on Cr(VI). The difference in the mobility and bioavailability of Cr(VI) and As(V) between wastewater sources can be attributed to the difference in their dissolved organic carbon (DOC) content. The DOC provides carbon as an electron donor for the reduction of As(V) and Cr(VI) and also serves as a complexing agent thereby impacting their mobility and bioavailability. The DOC-induced reduction increased both the mobility and bioavailability of As, but it caused an opposite effect in the case of Cr. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison between the weightlessness syndrome and aging

NASA Technical Reports Server (NTRS)

Miquel, J.

1982-01-01

The similarity of detrimental effects of normal aging and of exposure to space weightlessness is discussed. The effects include: the reduction in cardiac output, increase in blood pressure, decrease in respiratory vital capacity, decrease in lean body weight and muscle mass, collagen and fat infiltration of muscle, bone demineralization, and a decrease in urinary excretion of total 17-hydroxicorticosteroids. It is also noted that dispite the accelerated aging of organisms, if animals or human subjects were to spend their entire lives in weightlessness, their lifespans might be significantly increased because of a reduction in metabolic rate. Experimental results are cited.

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.

Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation

PubMed Central

Brown, Tamara J; Todd, Adam; O'Malley, Claire; Moore, Helen J; Husband, Andrew K; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F; Steed, Liz; Smith, Sarah; Nield, Lucie; Summerbell, Carolyn D

2016-01-01

Objectives To systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management. Design Systematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014. Eligibility criteria for selecting studies Study design: randomised and non-randomised controlled trials; controlled before/after studies, interrupted times series. Intervention: any relevant intervention set in a community pharmacy, delivered by the pharmacy team. No restrictions on duration, country, age, or language. Results 19 studies were included: 2 alcohol reduction, 12 smoking cessation and 5 weight management. Study quality rating: 6 ‘strong’, 4 ‘moderate’ and 9 ‘weak’. 8 studies were conducted in the UK, 4 in the USA, 2 in Australia, 1 each in 5 other countries. Evidence from 2 alcohol-reduction interventions was limited. Behavioural support and/or nicotine replacement therapy are effective and cost-effective for smoking cessation: pooled OR was 2.56 (95% CI 1.45 to 4.53) for active intervention vs usual care. Pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control. Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations. Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions. Conclusions Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services. PMID:26928025

Development and validation of a ten-item questionnaire with explanatory illustrations to assess upper extremity disorders: favorable effect of illustrations in the item reduction process.

PubMed

Kurimoto, Shigeru; Suzuki, Mikako; Yamamoto, Michiro; Okui, Nobuyuki; Imaeda, Toshihiko; Hirata, Hitoshi

2011-11-01

The purpose of this study is to develop a short and valid measure for upper extremity disorders and to assess the effect of attached illustrations in item reduction of a self-administered disability questionnaire while retaining psychometric properties. A validated questionnaire used to assess upper extremity disorders, the Hand20, was reduced to ten items using two item-reduction techniques. The psychometric properties of the abbreviated form, the Hand10, were evaluated on an independent sample that was used for the shortening process. Validity, reliability, and responsiveness of the Hand10 were retained in the item reduction process. It was possible that the use of explanatory illustrations attached to the Hand10 helped with its reproducibility. The illustrations for the Hand10 promoted text comprehension and motivation to answer the items. These changes resulted in high acceptability; more than 99.3% of patients, including 98.5% of elderly patients, could complete the Hand10 properly. The illustrations had favorable effects on the item reduction process and made it possible to retain precision of the instrument. The Hand10 is a reliable and valid instrument for individual-level applications with the advantage of being compact and broadly applicable, even in elderly individuals.

Effectiveness of a self-administered intervention for criminal thinking: Taking a Chance on Change.

PubMed

Folk, Johanna B; Disabato, David J; Daylor, Jordan M; Tangney, June P; Barboza, Sharen; Wilson, John S; Bonieskie, Lynda; Holwager, James

2016-08-01

The current study tested the effectiveness of a self-administered, cognitive-behavioral intervention targeting criminal thinking for inmates in segregated housing: Taking a Chance on Change (TCC). Participants included 273 inmates in segregated housing at state correctional institutions. Reductions in criminal thinking, as assessed by the Psychological Inventory of Criminal Styles-Simplified Version, were found in the general criminal thinking score as well as the proactive and reactive composite scores. Examination of demographic predictors of change (i.e., age, years of education, length of sentence) revealed older and more educated participants decreased in criminal thinking more than younger and less educated participants. For a subset of 48 inmates, completion of TCC was associated with significant reduction of disciplinary infractions. Reductions in reactive criminal thinking predicted reductions in disciplinary infractions. Although further research is needed to determine the effectiveness of TCC in reducing recidivism, the reductions in criminal thinking and disordered conduct suggest this is a promising intervention and mode of treatment delivery. By utilizing self-directed study at an accessible reading level, the intervention is uniquely suited to a correctional setting where staff and monetary resources are limited and security and operational issues limit the feasibility of traditional cognitive-behavioral group treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Effectiveness of a self-administered intervention for criminal thinking: Taking a chance on change

PubMed Central

Folk, Johanna B.; Disabato, David J.; Daylor, Jordan M.; Tangney, June P.; Barboza, Sharen; Wilson, John S.; Bonieskie, Lynda; Holwager, James

2016-01-01

The current study tested the effectiveness of a self-administered, cognitive-behavioral intervention targeting criminal thinking for inmates in segregated housing: Taking a Chance on Change (TCC). Participants included 273 inmates in segregated housing at state correctional institutions. Reductions in criminal thinking, as assessed by the Psychological Inventory of Criminal Styles-Simplified Version, were found in the general criminal thinking score as well as the proactive and reactive composite scores. Examination of demographic predictors of change (i.e., age, years of education, length of sentence) revealed older and more educated participants decreased in criminal thinking more than younger and less educated participants. For a subset of 48 inmates, completion of TCC was associated with significant reduction of disciplinary infractions. Reductions in reactive criminal thinking predicted reductions in disciplinary infractions. Although further research is needed to determine the effectiveness of TCC in reducing recidivism, the reductions in criminal thinking and disordered conduct suggest this is a promising intervention and mode of treatment delivery. By utilizing self-directed study at an accessible reading level, the intervention is uniquely suited to a correctional setting where staff and monetary resources are limited and security and operational issues limit the feasibility of traditional cognitive-behavioral group treatment. PMID:27243111

The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: a randomized trial.

PubMed

Henderson, Virginia P; Clemow, Lynn; Massion, Ann O; Hurley, Thomas G; Druker, Susan; Hébert, James R

2012-01-01

The aim of this study was determine the effectiveness of a mindfulness-based stress-reduction (MBSR) program on quality of life (QOL) and psychosocial outcomes in women with early-stage breast cancer, using a three-arm randomized controlled clinical trial (RCT). This RCT consisting of 172 women, aged 20-65 with stage I or II breast cancer consisted of the 8-week MBSR, which was compared to a nutrition education program (NEP) and usual supportive care (UC). Follow-up was performed at three post-intervention points: 4 months, 1, and 2 years. Standardized, validated self-administered questionnaires were adopted to assess psychosocial variables. Statistical analysis included descriptive and regression analyses incorporating both intention-to-treat and post hoc multivariable approaches of the 163 women with complete data at baseline, those who were randomized to MBSR experienced a significant improvement in the primary measures of QOL and coping outcomes compared to the NEP, UC, or both, including the spirituality subscale of the FACT-B as well as dealing with illness scale increases in active behavioral coping and active cognitive coping. Secondary outcome improvements resulting in significant between-group contrasts favoring the MBSR group at 4 months included meaningfulness, depression, paranoid ideation, hostility, anxiety, unhappiness, and emotional control. Results tended to decline at 12 months and even more at 24 months, though at all times, they were as robust in women with lower expectation of effect as in those with higher expectation. The MBSR intervention appears to benefit psychosocial adjustment in cancer patients, over and above the effects of usual care or a credible control condition. The universality of effects across levels of expectation indicates a potential to utilize this stress reduction approach as complementary therapy in oncologic practice.

Evaluating the impact of prioritization of antiretroviral pre-exposure prophylaxis (PrEP) in New York City

PubMed Central

Kessler, Jason; Myers, Julie E.; Nucifora, Kimberly A.; Mensah, Nana; Toohey, Christopher; Khademi, Amin; Cutler, Blayne; Braithwaite, R. Scott

2015-01-01

Objective To compare the value and effectiveness of different prioritization strategies of pre-exposure prophylaxis (PrEP) in New York City (NYC). Design Mathematical modeling utilized as clinical trial is not feasible. Methods Using a model accounting for both sexual and parenteral transmission of HIV we compare different prioritization strategies (PPS) for PrEP to two scenarios—no PrEP and PrEP for all susceptible at-risk individuals. The PPS included PrEP for all MSM, only high-risk MSM, high-risk heterosexuals, and injection drug users, and all combinations of these four strategies. Outcomes included HIV infections averted, and incremental cost effectiveness (per-infection averted) ratios. Initial assumptions regarding PrEP included a 44% reduction in HIV transmission, 50% uptake in the prioritized population and an annual cost per person of $9,762. Sensitivity analyses on key parameters were conducted. Results Prioritization to all MSM results in a 19% reduction in new HIV infections. Compared to PrEP for all persons at-risk this PPS retains 79% of the preventative effect at 15% of the total cost. PrEP prioritized to only high-risk MSM results in a reduction in new HIV infections of 15%. This PPS retains 60% of the preventative effect at 6% of the total cost. There are diminishing returns when PrEP utilization is expanded beyond this group. Conclusions PrEP implementation is relatively cost-inefficient under our initial assumptions. Our results suggest that PrEP should first be promoted among MSM who are at particularly high-risk of HIV acquisition. Further expansion beyond this group may be cost-effective, but is unlikely to be cost-saving. PMID:25493594

Experimental investigations on the damping effect due to passengers on flexural vibrations of railway vehicle carbody and basic studies on the mimicry of the effect with simple substitutions

NASA Astrophysics Data System (ADS)

Tomioka, T.; Takigami, T.; Aida, K.

2017-07-01

The effect of passengers on a railway vehicle is usually considered as additional mass in designing a carbody. However, previous studies by means of stationary excitation tests or running tests using actual vehicles indicate that passengers behave not as mass but as damping. In this paper, the authors examined the passengers' damping effect under controlled excitation conditions on a roller rig through a series of excitation tests using a commuter-type vehicle. Large and multi-modal reductions of flexural vibrations of the carbody were observed when passengers existed. Influences of the number of passengers, distributions and postures of passengers were investigated. The authors also tried to mimic the damping effect by passengers using flexible tanks filled with fluids. Three kinds of fluids which have different viscosities have been tested. As a result of the excitation tests, good vibration reduction effects were observed by applying those tanks, and it has been found that the flexible tanks filled with fluids bring about vibration reduction effect (including multi-modal reduction) which is equal to or rather better than the case of similar mass of passengers in the carbody; the difference of viscosity gave little affect on the damping abilities. From these measurement results, a possibility of realising effective damping devices against flexural vibrations of railway vehicle carbodies representing passengers damping effect, in a simple, economical and environmental friendly way, has been demonstrated.

Impact of programming strategies aimed at reducing nonessential implantable cardioverter defibrillator therapies on mortality: a systematic review and meta-analysis.

PubMed

Tan, Vern Hsen; Wilton, Stephen B; Kuriachan, Vikas; Sumner, Glen L; Exner, Derek V

2014-02-01

Patients who receive implantable cardioverter defibrillator therapies are at higher risk of death versus those who do not. Programmed settings to reduce nonessential implantable cardioverter defibrillator therapies (therapy reduction programming) have been developed but may have adverse effects. This systematic review and meta-analysis assessed the relationship between therapy reduction programming with the risks of death from any cause, implantable cardioverter defibrillator shocks, and syncope. MEDLINE, EMBASE, and clinicaltrials.gov databases were searched to identify relevant studies. Those that followed patients for ≥6 months and reported mortality were included. Six met the inclusion criteria; 4 randomized (Comparison of Empiric to Physician-Tailored Programming of ICDs [EMPIRIC], Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy [MADIT-RIT], Avoid Delivering Therapies for Non-sustained Arrhythmias in ICD Patients III [ADVANCE III], and Programming Implantable Cardioverter-Defibrillators in Patients with Primary Prevention Indication to Prolong Time to First Shock [PROVIDE]) and 2 prospective studies (Role of Long Detection Window Programming in Patients With Left Ventricular Dysfunction, Non-ischemic Etiology in Primary Prevention Treated with a Biventricular ICD [RELEVANT] and Primary Prevention Parameters Evaluation [PREPARE]). These 6 studies included 7687 (3598 conventional and 4089 therapy reduction programming) patients. Most (77%) participants were men, had a history of ischemic heart disease (56%), and were prescribed β-blockers (84%). Therapy reduction programming was associated with a 30% relative reduction in mortality (95% confidence interval, 16%-41%; P<0.001). No significant heterogeneity among studies was observed (P=0.6). A similar 26% reduction in mortality was observed when only the 4 randomized trials were included (95% confidence interval, 11%-40%; P=0.002). These results were not significantly altered after adjustment for baseline characteristics. No significant difference in the risk of syncope was observed with conventional versus therapy reduction programming (P=0.5). Therapy reduction programming results in a large, significant, and consistent reduction in mortality, with no apparent increase in the risk of syncope.

Cost-Effectiveness of Tramadol and Oxycodone in the Treatment of Knee Osteoarthritis.

PubMed

Smith, Savannah R; Katz, Jeffrey N; Collins, Jamie E; Solomon, Daniel H; Jordan, Joanne M; Suter, Lisa G; Yelin, Edward H; David Paltiel, A; Losina, Elena

2017-02-01

To evaluate the cost-effectiveness of incorporating tramadol or oxycodone into knee osteoarthritis (OA) treatment. We used the Osteoarthritis Policy Model to evaluate long-term clinical and economic outcomes of knee OA patients with a mean age of 60 years with persistent pain despite conservative treatment. We evaluated 3 strategies: opioid-sparing (OS), tramadol (T), and tramadol followed by oxycodone (T+O). We obtained estimates of pain reduction and toxicity from published literature and annual costs for tramadol ($600) and oxycodone ($2,300) from Red Book Online. Based on published data, in the base case, we assumed a 10% reduction in total knee arthroplasty (TKA) effectiveness in opioid-based strategies. Outcomes included quality-adjusted life years (QALYs), lifetime cost, and incremental cost-effectiveness ratios (ICERs) and were discounted at 3% per year. In the base case, T and T+O strategies delayed TKA by 7 and 9 years, respectively, and led to reduction in TKA utilization by 4% and 10%, respectively. Both opioid-based strategies increased cost and decreased QALYs compared to the OS strategy. Tramadol's ICER was highly sensitive to its effect on TKA outcomes. Reduction in TKA effectiveness by 5% (compared to base case 10%) resulted in an ICER for the T strategy of $110,600 per QALY; with no reduction in TKA effectiveness, the ICER was $26,900 per QALY. When TKA was not considered a treatment option, the ICER for T was $39,600 per QALY. Opioids do not appear to be cost-effective in OA patients without comorbidities, principally because of their negative impact on pain relief after TKA. The influence of opioids on TKA outcomes should be a research priority. © 2016, American College of Rheumatology.

NOx reduction through combustion optimization at PEPCO`s Potomac River Station

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

Cramer, D.S.; Williams, S.E.; Watkins, J.T.

1995-06-01

This paper describes the work done under EPRI Project RP 3383 at Potomac River Station to reduce NOx emissions by adjusting boiler controls. it details the method followed by PEPCO and Lehigh engineers to achieve a 35% reduction in average NOx emissions over a one-month extended test. Parameters that had the largest effect on NOx are discussed. A description of instruments installed to better monitor and control combustion is included.

DoD Role in Counterdrug Operations - Can We Achieve Better Results?

DTIC Science & Technology

1999-04-01

drug detection 34 requirement. Tests showed fully loaded containers can be effectively screened for narcotics with high energy X - ray technologies...The DOD and the U.S. Customs Service are procuring X - ray systems with higher energy level, mobile X - ray systems, and even more advanced handheld...reduction in domestic marijuana cultivation and methamphetamine production by the year 2002. Long term objectives include a 30 percent reduction in the flow

The effect of chemical treatment on reduction of aflatoxins and ochratoxin A in black and white pepper during washing.

PubMed

Jalili, M; Jinap, S; Son, R

2011-04-01

The effect of 18 different chemicals, which included acidic compounds (sulfuric acid, chloridric acid, phosphoric acid, benzoic acid, citric acid, acetic acid), alkaline compounds (ammonia, sodium bicarbonate, sodium hydroxide, potassium hydroxide, calcium hydroxide), salts (acetate ammonium, sodium bisulfite, sodium hydrosulfite, sodium chloride, sodium sulfate) and oxidising agents (hydrogen peroxide, sodium hypochlorite), on the reduction of aflatoxins B(1), B(2), G(1) and G(2) and ochratoxin A (OTA) was investigated in black and white pepper. OTA and aflatoxins were determined using HPLC after immunoaffinity column clean-up. Almost all of the applied chemicals showed a significant degree of reduction on mycotoxins (p < 0.05). The lowest and highest reduction of aflatoxin B(1), which is the most dangerous aflatoxin, was 20.5% ± 2.7% using benzoic acid and 54.5% ± 2.7% using sodium hydroxide. There was no significant difference between black and white peppers (p < 0.05).

A dose ranging study of ibuprofen suspension as an antipyretic.

PubMed Central

Marriott, S C; Stephenson, T J; Hull, D; Pownall, R; Smith, C M; Butler, A

1991-01-01

A double blind trial was conducted to determine the dose of ibuprofen suspension, which is effective in reducing the body temperature. The principal measure of efficacy was a reduction in axillary temperature of 1 degree C or more three hours after dosing. A second objective of the trial was to compare the incidence and severity of side effects and the palatability of a range of ibuprofen doses. Ninety three children were included in the analysis. All four doses of ibuprofen studied (0.625 mg/kg-5 mg/kg) were associated with temperature reduction and only the lowest dose failed to satisfy the principal measure of efficacy. The influence of dose on the magnitude of the body temperature reduction was significant and the 5 mg/kg dose achieved the largest mean reduction in body temperature (2 degrees C). The tolerability and palatability of all doses studied were excellent. These findings suggest that ibuprofen is a good alternative to paracetamol as an antipyretic. PMID:1929509

The societal benefits of reducing six behavioural risk factors: an economic modelling study from Australia

PubMed Central

2011-01-01

Background A large proportion of disease burden is attributed to behavioural risk factors. However, funding for public health programs in Australia remains limited. Government and non-government organisations are interested in the productivity effects on society from reducing chronic diseases. We aimed to estimate the potential health status and economic benefits to society following a feasible reduction in the prevalence of six behavioural risk factors: tobacco smoking; inadequate fruit and vegetable consumption; high risk alcohol consumption; high body mass index; physical inactivity; and intimate partner violence. Methods Simulation models were developed for the 2008 Australian population. A realistic reduction in current risk factor prevalence using best available evidence with expert consensus was determined. Avoidable disease, deaths, Disability Adjusted Life Years (DALYs) and health sector costs were estimated. Productivity gains included workforce (friction cost method), household production and leisure time. Multivariable uncertainty analyses and correction for the joint effects of risk factors on health status were undertaken. Consistent methods and data sources were used. Results Over the lifetime of the 2008 Australian adult population, total opportunity cost savings of AUD2,334 million (95% Uncertainty Interval AUD1,395 to AUD3,347; 64% in the health sector) were found if feasible reductions in the risk factors were achieved. There would be 95,000 fewer DALYs (a reduction of about 3.6% in total DALYs for Australia); 161,000 less new cases of disease; 6,000 fewer deaths; a reduction of 5 million days in workforce absenteeism; and 529,000 increased days of leisure time. Conclusions Reductions in common behavioural risk factors may provide substantial benefits to society. For example, the total potential annual cost savings in the health sector represent approximately 2% of total annual health expenditure in Australia. Our findings contribute important new knowledge about productivity effects, including the potential for increased household and leisure activities, associated with chronic disease prevention. The selection of targets for risk factor prevalence reduction is an important policy decision and a useful approach for future analyses. Similar approaches could be applied in other countries if the data are available. PMID:21689461

[Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation].

PubMed

Zhang, Xin; Wei, Qiang; Ji, Fang; Tong, Da-Ke; Tang, Hao; Zhang, Hao; Yu, Jin-Guo; Yang, Ji-Dong; Cui, Rui; Huo, Ning-Ning

2018-05-25

To investigate the efficacy and complications of manual reduction and external fixation for the treatment of scaphoid fractures and perilunate dislocations. From January 2009 to January 2013, 43 patients suffered from scaphoid fractures and perilunate dislocations were retrospective analyzed. Among them, 17 cases were treated with manipulative reduction and plaster external fixation as conservation group including 10 males and 7 females, the other 26 cases were treated with application of surgical as operation group including 15 males and 11 females. The clinical effects were assessed by Cooney function score, radiological analysis and observation of complications. All patients were followed up for(45.00±8.72) months ranging from 36 to 60 months. At the final follow-up, the Cooney score of wrist function was 88.53±4.24 in conservation group and 89.58±4.59in operation group( t= 0.455, P >0.05). During the follow-up, 4 patients were found scaphoid avascular necrosis in the imaging performance in the conservation group(χ²=4.32, P <0.05). The difference of other complications between two groups was not statistically significant( P >0.05). For patients suffered from the scaphoid fractures and perilunate dislocation, the early manipulative reduction and plaster external fixation after injury as soon as possible is necessary. Maintaining a satisfactory reduction and reliable fixation at the same time can lead to good treatment effect and there's no weakness compared to surgical treatment. But there was an increase in danger of complications. The key of conservative treatment lies in early diagnosis and maintenance of reduction, reliable fixation, and timely and appropriate functional exercise. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

Food Reduction in Avicenna’s View and Related Principles in Classical Medicine

PubMed Central

Nozad, Aisan; Naseri, Mohsen; Safari, Mir Bahram; Abd Al Ahadi, Azam; Ghaffari, Farzaneh

2016-01-01

Context Traditional Iranian medicine (TIM) is a rich and valuable school of thought that believes medications are not the only effective approach for the treatment of diseases but that nutrition is also important. Evidence Acquisition Our study includes two parts; the first is a book review of the Canon of Medicine by Avicenna (10th and 11th centuries), in which we focus on finding and understanding Avicenna’s point of view. In the second part, we searched for “food reduction” as a key word from 2000 to 2015 in databases such as Google Scholar, PubMed, Copernicus, DOAJ, EBSCO-CINAHL, and the Iranian search database Iranmedex for principles of food reduction in classical medicine. Results The main methods of treatment in traditional medicine include changes in lifestyle, especially diet, the use of medications, and the use of manipulation methods. For diet, the individual may be prohibited from eating or food amounts may be decreased or increased. Centuries ago, Avicenna was making use of methods of food reduction as an important therapeutic approach in the treatment of diseases. According to him, food reduction, to the extent that it does not cause energy loss helps to cure disease. Avicenna has proposed food reduction as an aid to treating a variety of ailments such as headaches and reflux. Conclusions Today, a variety of basic and clinical research has shown that food reduction or calorie restriction to a standard level can effectively prevent and treat a variety of diseases such as neoplasms, diabetes, and kidney disease. Practical principles explained by traditional Iranian medicine, in particular Avicenna, could open important and quite uncomplicated strategies for the prevention and treatment of diseases. PMID:27621927

c-Type Cytochrome-Dependent Formation of U(IV) Nanoparticles by Shewanella oneidensis

PubMed Central

Marshall, Matthew J; Dohnalkova, Alice C; Kennedy, David W; Shi, Liang; Wang, Zheming; Boyanov, Maxim I; Lai, Barry; Kemner, Kenneth M; McLean, Jeffrey S; Reed, Samantha B; Culley, David E; Bailey, Vanessa L; Simonson, Cody J; Saffarini, Daad A; Romine, Margaret F; Zachara, John M

2006-01-01

Modern approaches for bioremediation of radionuclide contaminated environments are based on the ability of microorganisms to effectively catalyze changes in the oxidation states of metals that in turn influence their solubility. Although microbial metal reduction has been identified as an effective means for immobilizing highly-soluble uranium(VI) complexes in situ, the biomolecular mechanisms of U(VI) reduction are not well understood. Here, we show that c-type cytochromes of a dissimilatory metal-reducing bacterium, Shewanella oneidensis MR-1, are essential for the reduction of U(VI) and formation of extracelluar UO 2 nanoparticles. In particular, the outer membrane (OM) decaheme cytochrome MtrC (metal reduction), previously implicated in Mn(IV) and Fe(III) reduction, directly transferred electrons to U(VI). Additionally, deletions of mtrC and/or omcA significantly affected the in vivo U(VI) reduction rate relative to wild-type MR-1. Similar to the wild-type, the mutants accumulated UO 2 nanoparticles extracellularly to high densities in association with an extracellular polymeric substance (EPS). In wild-type cells, this UO 2-EPS matrix exhibited glycocalyx-like properties and contained multiple elements of the OM, polysaccharide, and heme-containing proteins. Using a novel combination of methods including synchrotron-based X-ray fluorescence microscopy and high-resolution immune-electron microscopy, we demonstrate a close association of the extracellular UO 2 nanoparticles with MtrC and OmcA (outer membrane cytochrome). This is the first study to our knowledge to directly localize the OM-associated cytochromes with EPS, which contains biogenic UO 2 nanoparticles. In the environment, such association of UO 2 nanoparticles with biopolymers may exert a strong influence on subsequent behavior including susceptibility to oxidation by O 2 or transport in soils and sediments. PMID:16875436

Insurance, Public Assistance, and Household Flood Risk Reduction: A Comparative Study of Austria, England, and Romania.

PubMed

Hanger, Susanne; Linnerooth-Bayer, Joanne; Surminski, Swenja; Nenciu-Posner, Cristina; Lorant, Anna; Ionescu, Radu; Patt, Anthony

2018-04-01

In light of increasing losses from floods, many researchers and policymakers are looking for ways to encourage flood risk reduction among communities, business, and households. In this study, we investigate risk-reduction behavior at the household level in three European Union Member States with fundamentally different insurance and compensation schemes. We try to understand if and how insurance and public assistance influence private risk-reduction behavior. Data were collected using a telephone survey (n = 1,849) of household decisionmakers in flood-prone areas. We show that insurance overall is positively associated with private risk-reduction behavior. Warranties, premium discounts, and information provision with respect to risk reduction may be an explanation for this positive relationship in the case of structural measures. Public incentives for risk-reduction measures by means of financial and in-kind support, and particularly through the provision of information, are also associated with enhancing risk reduction. In this study, public compensation is not negatively associated with private risk-reduction behavior. This does not disprove such a relationship, but the negative effect may be mitigated by factors related to respondents' capacity to implement measures or social norms that were not included in the analysis. The data suggest that large-scale flood protection infrastructure creates a sense of security that is associated with a lower level of preparedness. Across the board there is ample room to improve both public and private policies to provide effective incentives for household-level risk reduction. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

Healthy Sleep Habits

MedlinePlus

... effective long-term treatment for people with chronic insomnia . CBT can help you address the thoughts and behaviors that prevent you from sleeping well. It also includes techniques for stress reduction, relaxation and sleep schedule management. If you ...

The clinical effect and tolerability of ezetimibe in high-risk patients managed in a specialty cardiovascular risk reduction clinic

PubMed Central

Pearson, Glen J; Francis, Gordon A; Romney, Jacques S; Gilchrist, Dawna M; Opgenorth, Andrea; Gyenes, Gabor T

2006-01-01

INTRODUCTION Ezetimibe (EZ) is a selective cholesterol absorption inhibitor approved for use in Canada. The effect and tolerability of EZ among patients was evaluated in the clinical setting of a specialty cardiovascular risk reduction clinic at the University of Alberta Hospital, Edmonton, Alberta. PATIENTS AND METHODS All patients 18 years of age or older who were prescribed EZ were included, unless they failed to take EZ for a minimum of two weeks, did not have baseline and on-EZ low-density lipoprotein cholesterol (LDL-C) levels, or had concomitant lipid-lowering drugs or dosages changed within one month of starting EZ. RESULTS Eighty-four patients (mean age 57.9 years) were included. By Framingham risk calculation, 71.4% were found to be high-risk patients, 13.1% moderate-risk patients and 15.5% low-risk patients; 66.7% of patients had prior cardiovascular events. On EZ, the mean reductions were: total cholesterol level 1.11 mmol/L (16.5%); LDL-C level 1.01 mmol/L (22.3%); high-density lipoprotein cholesterol level 0.06 mmol/L (4.6%); and ratio of total cholesterol level to high-density lipoprotein cholesterol level 0.68 mmol/L (12.8%); all were statistically significant (P<0.001). Results were similar when stratified by primary (n=28) versus secondary (n=56) prevention. Patients on EZ monotherapy (n=34) had mean LDL-C reductions of 1.03 mmol/L (20.5%) compared with 1.19 mmol/L (30.1%) or 0.95 mmol/L (22.5%), where EZ was added to low-dose or high-dose statins (P<0.01 for all). On EZ, 30 patients (35.7%) achieved previously unattainable target LDL-C levels. Four patients discontinued the drug due to side effects. CONCLUSIONS EZ is safe and effective in high-risk patients treated in the clinical setting of a cardiovascular risk reduction clinic. A mean LDL-C reduction of 1 mmol/L (20% to 30%) in all patient subgroups is consistent with previous clinical trial results. The significant reduction in LDL-C (mean 22.5%) observed in the EZ plus high-dose statin subgroup provides clinical evidence for use of this medication beyond published studies. PMID:16971979

Impacts of licensed premises trading hour policies on alcohol-related harms.

PubMed

Atkinson, Jo-An; Prodan, Ante; Livingston, Michael; Knowles, Dylan; O'Donnell, Eloise; Room, Robin; Indig, Devon; Page, Andrew; McDonnell, Geoff; Wiggers, John

2018-07-01

Evaluations of alcohol policy changes demonstrate that restriction of trading hours of both 'on'- and 'off'-licence venues can be an effective means of reducing rates of alcohol-related harm. Despite this, the effects of different trading hour policy options over time, accounting for different contexts and demographic characteristics, and the common co-occurrence of other harm reduction strategies in trading hour policy initiatives, are difficult to estimate. The aim of this study was to use dynamic simulation modelling to compare estimated impacts over time of a range of trading hour policy options on various indicators of acute alcohol-related harm. An agent-based model of alcohol consumption in New South Wales, Australia was developed using existing research evidence, analysis of available data and a structured approach to incorporating expert opinion. Five policy scenarios were simulated, including restrictions to trading hours of on-licence venues and extensions to trading hours of bottle shops. The impact of the scenarios on four measures of alcohol-related harm were considered: total acute harms, alcohol-related violence, emergency department (ED) presentations and hospitalizations. Simulation of a 3 a.m. (rather than 5 a.m.) closing time resulted in an estimated 12.3 ± 2.4% reduction in total acute alcohol-related harms, a 7.9 ± 0.8% reduction in violence, an 11.9 ± 2.1% reduction in ED presentations and a 9.5 ± 1.8% reduction in hospitalizations. Further reductions were achieved simulating a 1 a.m. closing time, including a 17.5 ± 1.1% reduction in alcohol-related violence. Simulated extensions to bottle shop trading hours resulted in increases in rates of all four measures of harm, although most of the effects came from increasing operating hours from 10 p.m. to 11 p.m. An agent-based simulation model suggests that restricting trading hours of licensed venues reduces rates of alcohol-related harm and extending trading hours of bottle shops increases rates of alcohol-related harm. The model can estimate the effects of a range of policy options. © 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Effectiveness of Morinda citrifolia juice as an intracanal irrigant in deciduous molars: An in vivo study

PubMed Central

Chandwani, Manisha; Mittal, Rakesh; Chandak, Shweta; Pimpale, Jitesh

2017-01-01

Background: The purpose of this study was to evaluate the microbial reduction in deciduous molars using Morinda citrifolia juice (MCJ) as irrigating solution. Materials and Methods: This was a randomized comparative study including 60 deciduous molars chosen among the patients belonging to the age group of 6–9 years based on the inclusion or exclusion criteria. The selected teeth were divided randomly into two groups based on irrigation solution used, that was, Group I (1% NaOCl) and Group II (MCJ). The microbial samples were collected both pre- and post-irrigation and were transferred for microbial assay. Paired t-test was used for intragroup analysis of pre- and post-operative mean reduction of bacterial colony forming unit (CFU)/ml, whereas Independent t-test was used to assess the intergroup, pre- and post-operative mean reduction of bacterial CFU/ml. Results: In the intragroup comparison, both of the groups showed statistically significant (P < 0.001) reduction in the mean CFU/ml; however, it did not show statistically significant reduction when intergroup comparison was carried out between the two groups. Both the study materials had clinically revealed decrease in the microbial count postirrigation. Conclusion: Both the irrigants, 1% NaOCl and MCJ, were significantly effective in the reduction of mean CFUs/ml postoperatively. The results of this study have confirmed the antibacterial effectiveness of MCJ in the root canals of deciduous teeth. Considering the low toxicity and antibacterial effectiveness of MCJ, it can be advocated as a root canal irrigant in endodontic treatment of primary teeth. PMID:28928778

Absolute cerebral blood flow quantification with pulsed arterial spin labeling during hyperoxia corrected with the simultaneous measurement of the longitudinal relaxation time of arterial blood.

PubMed

Pilkinton, David T; Hiraki, Teruyuki; Detre, John A; Greenberg, Joel H; Reddy, Ravinder

2012-06-01

Quantitative arterial spin labeling (ASL) estimates of cerebral blood flow (CBF) during oxygen inhalation are important in several contexts, including functional experiments calibrated with hyperoxia and studies investigating the effect of hyperoxia on regional CBF. However, ASL measurements of CBF during hyperoxia are confounded by the reduction in the longitudinal relaxation time of arterial blood (T(1a) ) from paramagnetic molecular oxygen dissolved in blood plasma. The aim of this study is to accurately quantify the effect of arbitrary levels of hyperoxia on T(1a) and correct ASL measurements of CBF during hyperoxia on a per-subject basis. To mitigate artifacts, including the inflow of fresh spins, partial voluming, pulsatility, and motion, a pulsed ASL approach was implemented for in vivo measurements of T(1a) in the rat brain at 3 Tesla. After accounting for the effect of deoxyhemoglobin dilution, the relaxivity of oxygen on blood was found to closely match phantom measurements. The results of this study suggest that the measured ASL signal changes are dominated by reductions in T(1a) for brief hyperoxic inhalation epochs, while the physiologic effects of oxygen on the vasculature account for most of the measured reduction in CBF for longer hyperoxic exposures. Copyright © 2011 Wiley-Liss, Inc.

Error reduction and parameter optimization of the TAPIR method for fast T1 mapping.

PubMed

Zaitsev, M; Steinhoff, S; Shah, N J

2003-06-01

A methodology is presented for the reduction of both systematic and random errors in T(1) determination using TAPIR, a Look-Locker-based fast T(1) mapping technique. The relations between various sequence parameters were carefully investigated in order to develop recipes for choosing optimal sequence parameters. Theoretical predictions for the optimal flip angle were verified experimentally. Inversion pulse imperfections were identified as the main source of systematic errors in T(1) determination with TAPIR. An effective remedy is demonstrated which includes extension of the measurement protocol to include a special sequence for mapping the inversion efficiency itself. Copyright 2003 Wiley-Liss, Inc.

Rye cover crop effects on soil properties in no-till corn silage/soybean agroecosystems

USDA-ARS?s Scientific Manuscript database

Farmers in the U.S. Corn Belt are showing increasing interest in winter cover crops. Known benefits of winter cover crops include reductions in nutrient leaching, erosion mitigation, and weed suppression, however little research has investigated the effects of winter cover crops on soil properties. ...

75 FR 30897 - Agency Information Collection Activities: Proposed Request and Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-02

... appropriate steps to ensure effective communication with applicants, participants, personnel of other Federal... (Pub. L.) 104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. This notice includes...-0454 or by writing to the above e-mail address. 1. Request for Accommodation in Communication Method...

The Impact and Cost of Scaling up Midwifery and Obstetrics in 58 Low- and Middle-Income Countries

PubMed Central

Bartlett, Linda; Weissman, Eva; Gubin, Rehana; Patton-Molitors, Rachel; Friberg, Ingrid K.

2014-01-01

Background and Methods To guide achievement of the Millennium Development Goals, we used the Lives Saved Tool to provide a novel simulation of potential maternal, fetal, and newborn lives and costs saved by scaling up midwifery and obstetrics services, including family planning, in 58 low- and middle-income countries. Typical midwifery and obstetrics interventions were scaled to either 60% of the national population (modest coverage) or 99% (universal coverage). Findings Under even a modest scale-up, midwifery services including family planning reduce maternal, fetal, and neonatal deaths by 34%. Increasing midwifery alone or integrated with obstetrics is more cost-effective than scaling up obstetrics alone; when family planning was included, the midwifery model was almost twice as cost-effective as the obstetrics model, at $2,200 versus $4,200 per death averted. The most effective strategy was the most comprehensive: increasing midwives, obstetricians, and family planning could prevent 69% of total deaths under universal scale-up, yielding a cost per death prevented of just $2,100. Within this analysis, the interventions which midwifery and obstetrics are poised to deliver most effectively are different, with midwifery benefits delivered across the continuum of pre-pregnancy, prenatal, labor and delivery, and postpartum-postnatal care, and obstetrics benefits focused mostly on delivery. Including family planning within each scope of practice reduced the number of likely births, and thus deaths, and increased the cost-effectiveness of the entire package (e.g., a 52% reduction in deaths with midwifery and obstetrics increased to 69% when family planning was added; cost decreased from $4,000 to $2,100 per death averted). Conclusions This analysis suggests that scaling up midwifery and obstetrics could bring many countries closer to achieving mortality reductions. Midwives alone can achieve remarkable mortality reductions, particularly when they also perform family planning services - the greatest return on investment occurs with the scale-up of midwives and obstetricians together. PMID:24941336

Assessing the impact of harm reduction programs on law enforcement in Southeast Asia: a description of a regional research methodology.

PubMed

Thomson, Nick; Moore, Tim; Crofts, Nick

2012-07-09

For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HIV/AIDS Asia Regional Program (HAARP), from 2007 until 2015.2 Both projects included in their design specific strategies for engaging with law enforcement agencies at country level. The main focus of these strategies has been to develop law enforcement harm reduction policy and curriculum, and the design and implementation of specific harm reduction training for law enforcement officers.In July 2008, the Australian Development Research Awards (ADRA) funded the Nossal Institute for Global Health at the University of Melbourne to establish a research project created to assess the influence of harm reduction programs on the policy and operational practices of law enforcement agencies in Southeast Asia, known as the LEHRN Project (Law Enforcement, Harm Reduction, Nossal Institute Project). The ADRA is a unique grant research mechanism that specifically funds development research to improve the understanding and informed decision making of the implementation of Australian aid effectiveness.While the need to engage law enforcement when establishing harm reduction programs was well documented, little was known about the impact or influence of harm reduction programs on policy and practices of law enforcement agencies. The LEHRN Project provided the opportunity to assess the impact of harm reduction programs on law enforcement in Southeast Asia, with a focus on Vietnam, Cambodia and Lao PDR.

Assessing the impact of harm reduction programs on law enforcement in Southeast Asia: a description of a regional research methodology

PubMed Central

2012-01-01

For over 15 years the Australian Agency for International Development (AusAID) has been a leading donor for harm reduction projects in Southeast Asia. The recent AusAID-supported harm reduction projects of greatest significance have included the Asia Regional HIV/AIDS Project (AHRP), from 2002 until 2007,1 and the HIV/AIDS Asia Regional Program (HAARP), from 2007 until 2015.2 Both projects included in their design specific strategies for engaging with law enforcement agencies at country level. The main focus of these strategies has been to develop law enforcement harm reduction policy and curriculum, and the design and implementation of specific harm reduction training for law enforcement officers. In July 2008, the Australian Development Research Awards (ADRA) funded the Nossal Institute for Global Health at the University of Melbourne to establish a research project created to assess the influence of harm reduction programs on the policy and operational practices of law enforcement agencies in Southeast Asia, known as the LEHRN Project (Law Enforcement, Harm Reduction, Nossal Institute Project). The ADRA is a unique grant research mechanism that specifically funds development research to improve the understanding and informed decision making of the implementation of Australian aid effectiveness. While the need to engage law enforcement when establishing harm reduction programs was well documented, little was known about the impact or influence of harm reduction programs on policy and practices of law enforcement agencies. The LEHRN Project provided the opportunity to assess the impact of harm reduction programs on law enforcement in Southeast Asia, with a focus on Vietnam, Cambodia and Lao PDR. PMID:22769050

Framing and the marginalisation of evidence in media reportage of policy debate about alcopops, Australia 2008-2009: implications for advocacy.

PubMed

Fogarty, Andrea S; Chapman, Simon

2011-11-01

We aimed to investigate news reportage of the contested Australian 2008 'alcopop tax' on ready-to-drink spirits, with an emphasis on the treatment of evidence of the tax's effect on consumption rates. The tax was associated with both and overall net reduction in alcohol consumption (2.7%) and reduction specifically in ready-to-drink spirits (26.1%). We conducted content analyses of 536 articles from Australian newspapers and 33 Sydney television news items. All items were coded for the presence of rhetorical frames, the total number of statements per item that corresponded with each frame and the group identity of news-actors making the statements. Four principal frames were identified: consumption reduction, substitution effects, revenue raising and closing a tax loophole. Only 22.2% of statements included evidence regarding the tax's effect on sales and consumption. A significantly higher proportion of statements supporting the tax included evidence (29%) compared with statements opposing the tax (15%). Public health advocates should be mindful of how evidence can be marginalised in contested policy debates. The direction and rhetorical appeal of counterargument needs to be anticipated in strategic planning of the communication of alcohol control policies. © 2010 Australasian Professional Society on Alcohol and other Drugs.

A Summary of the Experimental Results for a Generic Tractor-Trailer in the Ames Research Center 7- by 10-Foot and 12-Foot Wind Tunnels

NASA Technical Reports Server (NTRS)

Storms, Bruce L.; Satran, Dale R.; Heineck, James T.; Walker, Stephen M.

2006-01-01

Experimental measurements of a generic tractor-trailer were obtained in two wind tunnels at Ames Research Center. After a preliminary study at atmospheric conditions in the 7- by 10-Foot Wind Tunnel, additional testing was conducted at Reynolds numbers corresponding to full-scale highway speeds in the 12-Foot Pressure Wind Tunnel. To facilitate computational modeling, the 1:8-scale geometry, designated the Generic Conventional Model, included a simplified underbody and omitted many small-scale details. The measurements included overall and component forces and moments, static and dynamic surface pressures, and three-component particle image velocimetry. This summary report highlights the effects of numerous drag reduction concepts and provides details of the model installation in both wind tunnels. To provide a basis for comparison, the wind-averaged drag coefficient was tabulated for all configurations tested. Relative to the baseline configuration representative of a modern class-8 tractor-trailer, the most effective concepts were the trailer base flaps and trailer belly box providing a drag-coefficient reduction of 0.0855 and 0.0494, respectively. Trailer side skirts were less effective yielding a drag reduction of 0.0260. The database of this experimental effort is publicly available for further analysis.

Assessment of the effect of probiotic curd consumption on salivary pH and streptococcus mutans counts.

PubMed

Sudhir, R; Praveen, P; Anantharaj, A; Venkataraghavan, Karthik

2012-07-01

Antimicrobial methods of controlling dental caries that include probiotic agents can play a valuable role in establishing caries control in children at moderate to high risk for developing dental caries. Several studies have demonstrated the beneficial effects of use of various Probiotic products including curd. The objective of this study was to compare the effect of short-term consumption of probiotic curd containing Lactobacillus acidophilus and normal curd on salivary Streptococcus Mutans counts, as well as salivary pH. Forty, caries-free, 10-12 years old children were selected and randomly allocated to two groups. Test Group consisted of 20 children who consumed 200ml of probiotic curd daily for 30 days. Control Group consisted of 20 children who were given 200ml of regular curd for 30 days. Salivary pH and salivary Streptococcus Mutans counts were recorded at baseline and after 30 days and statistically compared using the Student's t-test. Consumption of probiotic curd resulted in a statistically significant reduction in S. Mutans colony counts (P<0.001) as compared to regular curd. However, there was a slight reduction in pH (P>0.05) in both the groups. Short-term consumption of probiotic curds can reduce oral S. Mutans counts. However, this caused a slight reduction in salivary pH.

Surgical decompression for space-occupying cerebral infarction: outcomes at 3 years in the randomized HAMLET trial.

PubMed

Geurts, Marjolein; van der Worp, H Bart; Kappelle, L Jaap; Amelink, G Johan; Algra, Ale; Hofmeijer, Jeannette

2013-09-01

We assessed whether the effects of surgical decompression for space-occupying hemispheric infarction, observed at 1 year, are sustained at 3 years. Patients with space-occupying hemispheric infarction, who were enrolled in the Hemicraniectomy After Middle cerebral artery infarction with Life-threatening Edema Trial within 4 days after stroke onset, were followed up at 3 years. Outcome measures included functional outcome (modified Rankin Scale), death, quality of life, and place of residence. Poor functional outcome was defined as modified Rankin Scale >3. Of 64 included patients, 32 were randomized to decompressive surgery and 32 to best medical treatment. Just as at 1 year, surgery had no effect on the risk of poor functional outcome at 3 years (absolute risk reduction, 1%; 95% confidence interval, -21 to 22), but it reduced case fatality (absolute risk reduction, 37%; 95% confidence interval, 14-60). Sixteen surgically treated patients and 8 controls lived at home (absolute risk reduction, 27%; 95% confidence interval, 4-50). Quality of life improved between 1 and 3 years in patients treated with surgery. In patients with space-occupying hemispheric infarction, the effects of decompressive surgery on case fatality and functional outcome observed at 1 year are sustained at 3 years. http://www.controlled-trials.com. Unique identifier: ISRCTN94237756.

Technologies for Aircraft Noise Reduction

NASA Technical Reports Server (NTRS)

Huff, Dennis L.

2006-01-01

Technologies for aircraft noise reduction have been developed by NASA over the past 15 years through the Advanced Subsonic Technology (AST) Noise Reduction Program and the Quiet Aircraft Technology (QAT) project. This presentation summarizes highlights from these programs and anticipated noise reduction benefits for communities surrounding airports. Historical progress in noise reduction and technologies available for future aircraft/engine development are identified. Technologies address aircraft/engine components including fans, exhaust nozzles, landing gear, and flap systems. New "chevron" nozzles have been developed and implemented on several aircraft in production today that provide significant jet noise reduction. New engines using Ultra-High Bypass (UHB) ratios are projected to provide about 10 EPNdB (Effective Perceived Noise Level in decibels) engine noise reduction relative to the average fleet that was flying in 1997. Audio files are embedded in the presentation that estimate the sound levels for a 35,000 pound thrust engine for takeoff and approach power conditions. The predictions are based on actual model scale data that was obtained by NASA. Finally, conceptual pictures are shown that look toward future aircraft/propulsion systems that might be used to obtain further noise reduction.

Meta-analysis of medical intervention for normal tension glaucoma.

PubMed

Cheng, Jin-Wei; Cai, Ji-Ping; Wei, Rui-Li

2009-07-01

To evaluate the intraocular pressure (IOP) reduction achieved by the most frequently prescribed antiglaucoma drugs in patients with normal tension glaucoma (NTG). Systematic review and meta-analysis. Fifteen randomized clinical trials reported 25 arms for peak IOP reduction, 16 arms for trough IOP reduction, and 13 arms for diurnal curve IOP reduction. Pertinent publications were identified through systematic searches of PubMed, EMBASE, and the Cochrane Controlled Trials Register. The patients had to be diagnosed as having NTG. Methodological quality was assessed by the Delphi list on a scale from 0 to 18. The pooled 1-month IOP-lowering effects were calculated using the 2-step DerSimonian and Laird estimate method of the random effects model. Absolute and relative reductions in IOP from baseline for peak and trough moments. Quality scores of included studies were generally high, with a mean quality score of 12.7 (range, 9-16). Relative IOP reductions were peak, 15% (12%-18%), and trough, 18% (8%-27%) for timolol; peak, 14% (8%-19%), and trough, 12% (-7% to 31%) for dorzolamide; peak, 24% (17%-31%), and trough, 11% (7%-14%) for brimonidine; peak, 20% (17%-24%), and trough, 20% (18%-23%) for latanoprost; peak, 21% (16%-25%), and trough, 18% (14%-22%) for bimatoprost. The differences in absolute IOP reductions between prostaglandin analogues and timolol varied from 0.9 to 1.0 mmHg at peak and -0.1 to 0.2 mmHg at trough. Latanoprost, bimatoprost, and timolol are the most effective IOP-lowering agents in patients with NTG.

Effects of Specific Alcohol Control Policy Measures on Alcohol-Related Mortality in Russia from 1998 to 2013.

PubMed

Khaltourina, Daria; Korotayev, Andrey

2015-09-01

To elucidate the possible effects of alcohol control policy measures on alcohol-related mortality in Russia between 1998 and 2013. Trends in mortality, alcohol production and sales were analyzed in conjunction with alcohol control legislative measures. Correlation analysis of health and alcohol market indicators was performed. Ethyl alcohol production was the strongest correlate of alcohol-related mortality, which is probably due to the fact that ethyl alcohol is used for both recorded and unrecorded alcohol production. Measures producing greatest mortality reduction effect included provisions which reduced ethyl alcohol production (introduction of minimum authorized capital for ethyl alcohol and liquor producers in 2006 and the requirement for distillery dreg processing), as well as measures to tax and denaturize ethanol-containing liquids in 2006. Liquor tax decrease in real terms was associated with rising mortality in 1998-1999, while excise tax increase was associated with mortality reduction in 2004 and since 2012. Conventional alcohol control measures may also have played a moderately positive role. Countries with high alcohol-related mortality should aim for a reduction in spirits consumption as a major health policy. Alcohol market centralization and reduction of the number of producers can have immediate strong effects on mortality. These measures should be combined with an increase in alcohol taxes and prices, as well as other established alcohol policy measures. In 2015 in Russia, this is not being implemented. In Russia, legislation enforcement including excise tax collection remains the major challenge. Another challenge will be the integration into the Eurasian Economic Union. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Reduction of chronic abdominal pain in patients with inflammatory bowel disease through transcranial direct current stimulation: a randomized controlled trial.

PubMed

Volz, Magdalena S; Farmer, Annabelle; Siegmund, Britta

2016-02-01

Inflammatory bowel disease (IBD) is frequently associated with chronic abdominal pain (CAP). Transcranial direct current stimulation (tDCS) has been proven to reduce chronic pain. This study aimed to investigate the effects of tDCS in patients with CAP due to IBD. This randomized, sham-controlled, double blind, parallel-designed study included 20 patients with either Crohn disease or ulcerative colitis with CAP (≥3/10 on the visual analog scale (VAS) in 3/6 months). Anodal or sham tDCS was applied over the primary motor cortex for 5 consecutive days (2 mA, 20 minutes). Assessments included VAS, pressure pain threshold, inflammatory markers, and questionnaires on quality of life, functional and disease specific symptoms (Irritable Bowel Syndrome-Severity Scoring System [IBS-SSS]), disease activity, and pain catastrophizing. Follow-up data were collected 1 week after the end of the stimulation. Statistical analyses were performed using analysis of variance and t tests. There was a significant reduction of abdominal pain in the anodal tDCS group compared with sham tDCS. This effect was evident in changes in VAS and pressure pain threshold on the left and right sides of the abdomen. In addition, 1 week after stimulation, pain reduction remained significantly decreased in the right side of the abdomen. There was also a significant reduction in scores on pain catastrophizing and on IBS-SSS when comparing both groups. Inflammatory markers and disease activity did not differ significantly between groups throughout the experiment. Transcranial direct current stimulation proved to be an effective and clinically relevant therapeutic strategy for CAP in IBD. The analgesic effects observed are unrelated to inflammation and disease activity, which emphasizes central pain mechanisms in CAP.

Long-Haul Truck Sleeper Heating Load Reduction Package for Rest Period Idling

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

Lustbader, Jason Aaron; Kekelia, Bidzina; Tomerlin, Jeff

Annual fuel use for sleeper cab truck rest period idling is estimated at 667 million gallons in the United States, or 6.8% of long-haul truck fuel use. Truck idling during a rest period represents zero freight efficiency and is largely done to supply accessory power for climate conditioning of the cab. The National Renewable Energy Laboratory's CoolCab project aims to reduce heating, ventilating, and air conditioning (HVAC) loads and resulting fuel use from rest period idling by working closely with industry to design efficient long-haul truck thermal management systems while maintaining occupant comfort. Enhancing the thermal performance of cab/sleepers willmore » enable smaller, lighter, and more cost-effective idle reduction solutions. In addition, if the fuel savings provide a one- to three-year payback period, fleet owners will be economically motivated to incorporate them. For candidate idle reduction technologies to be implemented by original equipment manufacturers and fleets, their effectiveness must be quantified. To address this need, several promising candidate technologies were evaluated through experimentation and modeling to determine their effectiveness in reducing rest period HVAC loads. Load reduction strategies were grouped into the focus areas of solar envelope, occupant environment, conductive pathways, and efficient equipment. Technologies in each of these focus areas were investigated in collaboration with industry partners. The most promising of these technologies were then combined with the goal of exceeding a 30% reduction in HVAC loads. These technologies included 'ultra-white' paint, advanced insulation, and advanced curtain design. Previous testing showed more than a 35.7% reduction in air conditioning loads. This paper describes the overall heat transfer coefficient testing of this advanced load reduction technology package that showed more than a 43% reduction in heating load. Adding an additional layer of advanced insulation with a reflective barrier to the thermal load reduction package resulted in a 53.3% reduction in the overall heat transfer coefficient.« less

Long-Haul Truck Sleeper Heating Load Reduction Package for Rest Period Idling: Preprint

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

Lustbader, Jason; Kekelia, Bidzina; Tomerlin, Jeff

Annual fuel use for sleeper cab truck rest period idling is estimated at 667 million gallons in the United States, or 6.8% of long-haul truck fuel use. Truck idling during a rest period represents zero freight efficiency and is largely done to supply accessory power for climate conditioning of the cab. The National Renewable Energy Laboratory's CoolCab project aims to reduce heating, ventilating, and air conditioning (HVAC) loads and resulting fuel use from rest period idling by working closely with industry to design efficient long-haul truck thermal management systems while maintaining occupant comfort. Enhancing the thermal performance of cab/sleepers willmore » enable smaller, lighter, and more cost-effective idle reduction solutions. In addition, if the fuel savings provide a one- to three-year payback period, fleet owners will be economically motivated to incorporate them. For candidate idle reduction technologies to be implemented by original equipment manufacturers and fleets, their effectiveness must be quantified. To address this need, several promising candidate technologies were evaluated through experimentation and modeling to determine their effectiveness in reducing rest period HVAC loads. Load reduction strategies were grouped into the focus areas of solar envelope, occupant environment, conductive pathways, and efficient equipment. Technologies in each of these focus areas were investigated in collaboration with industry partners. The most promising of these technologies were then combined with the goal of exceeding a 30% reduction in HVAC loads. These technologies included 'ultra-white' paint, advanced insulation, and advanced curtain design. Previous testing showed more than a 35.7% reduction in air conditioning loads. This paper describes the overall heat transfer coefficient testing of this advanced load reduction technology package that showed more than a 43% reduction in heating load. Adding an additional layer of advanced insulation with a reflective barrier to the thermal load reduction package resulted in a 53.3% reduction in the overall heat transfer coefficient.« less

Comparing effectiveness of mass media campaigns with price reductions targeting fruit and vegetable intake on US cardiovascular disease mortality and race disparities.

PubMed

Pearson-Stuttard, Jonathan; Bandosz, Piotr; Rehm, Colin D; Afshin, Ashkan; Peñalvo, Jose L; Whitsel, Laurie; Danaei, Goodarz; Micha, Renata; Gaziano, Tom; Lloyd-Williams, Ffion; Capewell, Simon; Mozaffarian, Dariush; O'Flaherty, Martin

2017-07-01

Background: A low intake of fruits and vegetables (F&Vs) is a major risk factor for cardiovascular disease (CVD) in the United States. Both mass media campaigns (MMCs) and economic incentives may increase F&V consumption. Few data exist on their comparative effectiveness. Objective: We estimated CVD mortality reductions potentially achievable by price reductions and MMC interventions targeting F&V intake in the US population. Design: We developed a US IMPACT Food Policy Model to compare 3 policies targeting F&V intake across US adults from 2015 to 2030: national MMCs and national F&V price reductions of 10% and 30%. We accounted for differences in baseline diets, CVD rates, MMC coverage, MMC duration, and declining effects over time. Outcomes included cumulative CVD (coronary heart disease and stroke) deaths prevented or postponed and life-years gained (LYGs) over the study period, stratified by age, sex, and race. Results: A 1-y MMC in 2015 would increase the average national F&V consumption by 7% for 1 y and prevent ∼18,600 CVD deaths (95% CI: 17,600, 19,500), gaining ∼280,100 LYGs by 2030. With a 15-y MMC, increased F&V consumption would be sustained, yielding a 3-fold larger reduction (56,100; 95% CI: 52,400, 57,700) in CVD deaths. In comparison, a 10% decrease in F&V prices would increase F&V consumption by ∼14%. This would prevent ∼153,300 deaths (95% CI: 146,400, 159,200), gaining ∼2.51 million LYGs. For a 30% price decrease, resulting in a 42% increase in F&V consumption, corresponding values would be 451,900 CVD deaths prevented or postponed (95% CI: 433,100, 467,500) and 7.3 million LYGs gained. Effects were similar by sex, with a smaller proportional effect and larger absolute effects at older ages. A 1-y MMC would be 35% less effective in preventing CVD deaths in non-Hispanic blacks than in whites. In comparison, price-reduction policies would have equitable proportional effects. Conclusion: Both national MMCs and price-reduction policies could reduce US CVD mortality, with price reduction being more powerful and sustainable. © 2017 American Society for Nutrition.

Effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries: a realist review protocol.

PubMed

Thapa, Subash; Hannes, Karin; Cargo, Margaret; Buve, Anne; Mathei, Catharina

2015-11-02

Several stigma reduction intervention strategies have been developed and tested for effectiveness in terms of increasing human immunodeficiency virus (HIV) test uptake. These strategies have been more effective in some contexts and less effective in others. Individual factors, such as lack of knowledge and fear of disclosure, and social-contextual factors, such as poverty and illiteracy, might influence the effect of stigma reduction intervention strategies on HIV test uptake in low- and middle-income countries. So far, it is not clearly known how the stigma reduction intervention strategies interact with these contextual factors to increase HIV test uptake. Therefore, we will conduct a review that will synthesize existing studies on stigma reduction intervention strategies to increase HIV test uptake to better understand the mechanisms underlying this process in low- and middle-income countries. A realist review will be conducted to unpack context-mechanism-outcome configurations of the effect of stigma reduction intervention strategies on HIV test uptake. Based on a scoping review, we developed a preliminary theoretical framework outlining a potential mechanism of how the intervention strategies influence HIV test uptake. Our realist synthesis will be used to refine the preliminary theoretical framework to better reflect mechanisms that are supported by existing evidence. Journal articles and grey literature will be searched following a purposeful sampling strategy. Data will be extracted and tested against the preliminary theoretical framework. Data synthesis and analysis will be performed in five steps: organizing extracted data into evidence tables, theming, formulating chains of inference from the identified themes, linking the chains of inference and developing generative mechanisms, and refining the framework. This will be the first realist review that offers both a quantitative and a qualitative exploration of the available evidence to develop and propose a theoretical framework that explains why and how HIV stigma reduction intervention strategies influence HIV test uptake in low- and middle-income countries. Our theoretical framework is meant to provide guidance to program managers on identifying the most effective stigma reduction intervention strategies to increase HIV test uptake. We also include advice on how to effectively implement these strategies to reduce the rate of HIV transmission. PROSPERO CRD42015023687.

Effectiveness of urine surveillance as an adjunct to outpatient psychotherapy for drug abusers.

PubMed

Milby, J B; Clarke, C; Toro, C; Thornton, S; Rickert, D

1980-10-01

Twenty-nine polydrug abusers were randomly assigned to three out-patient treatment groups after inpatient detoxification. The groups were outpatient psychotherapy (1) with urine surveillance, (2) without surveillance, and (3) waiting list control. Tests were administered before and 3 months after outpatient treatment began. All groups made positive changes during treatment including significant reduction in drugs abused and numbers of subjects reporting less time spent in illegal activity. Notable significant differences were Group 3's reduction in social introversion vs Groups 1 and 2, and Group 1's retaining fewer drug-using friends and showing greatest reduction in barbiturate use frequency vs Groups 2 and 3. Experimenters concluded urine surveillance was somewhat helpful as an adjunct to outpatient psychotherapy but suggested its effect could be amplified by employing more rigorous surveillance procedures, especially if contingency contracting were utilized.

Introduction of Energy and Climate Mitigation Policy Issues in Energy - Environment Model of Latvia

NASA Astrophysics Data System (ADS)

Klavs, G.; Rekis, J.

2016-12-01

The present research is aimed at contributing to the Latvian national climate policy development by projecting total GHG emissions up to 2030, by evaluating the GHG emission reduction path in the non-ETS sector at different targets set for emissions reduction and by evaluating the obtained results within the context of the obligations defined by the EU 2030 policy framework for climate and energy. The method used in the research was bottom-up, linear programming optimisation model MARKAL code adapted as the MARKAL-Latvia model with improvements for perfecting the integrated assessment of climate policy. The modelling results in the baseline scenario, reflecting national economic development forecasts and comprising the existing GHG emissions reduction policies and measures, show that in 2030 emissions will increase by 19.1 % compared to 2005. GHG emissions stabilisation and reduction in 2030, compared to 2005, were researched in respective alternative scenarios. Detailed modelling and analysis of the Latvian situation according to the scenario of non-ETS sector GHG emissions stabilisation and reduction in 2030 compared to 2005 have revealed that to implement a cost effective strategy of GHG emissions reduction first of all a policy should be developed that ensures effective absorption of the available energy efficiency potential in all consumer sectors. The next group of emissions reduction measures includes all non-ETS sectors (industry, services, agriculture, transport, and waste management).

Inelastic losses in X-ray absorption theory

NASA Astrophysics Data System (ADS)

Campbell, Luke Whalin

There is a surprising lack of many body effects observed in XAS (X-ray Absorption Spectroscopy) experiments. While collective excitations and other satellite effects account for between 20% and 40% of the spectral weight of the core hole and photoelectron excitation spectrum, the only commonly observed many body effect is a relatively structureless amplitude reduction to the fine structure, typically no more than a 10% effect. As a result, many particle effects are typically neglected in the XAS codes used to predict and interpret modern experiments. To compensate, the amplitude reduction factor is simply fitted to experimental data. In this work, a quasi-boson model is developed to treat the case of XAS, when the system has both a photoelectron and a core hole. We find that there is a strong interference between the extrinsic and intrinsic losses. The interference reduces the excitation amplitudes at low energies where the core hole and photo electron induced excitations tend to cancel. At high energies, the interference vanishes, and the theory reduces to the sudden approximation. The x-ray absorption spectrum including many-body excitations is represented by a convolution of the one-electron absorption spectrum with an energy dependent spectral function. The latter has an asymmetric quasiparticle peak and broad satellite structure. The net result is a phasor sum, which yields the many body amplitude reduction and phase shift of the fine structure oscillations (EXAFS), and possibly additional satellite structure. Calculations for several cases of interest are found to be in reasonable agreement with experiment. Edge singularity effects and deviations from the final state rule arising from this theory are also discussed. The ab initio XAS code FEFF has been extended for calculations of the many body amplitude reduction and phase shift in x-ray spectroscopies. A new broadened plasmon pole self energy is added. The dipole matrix elements are modified to include a projection operator to calculate deviations from the final state rule and edge singularities.

Food decontamination using nanomaterials

USDA-ARS?s Scientific Manuscript database

The research indicates that nanomaterials including nanoemulsions are promising decontamination media for the reduction of food contaminating pathogens. The inhibitory effect of nanoparticles for pathogens could be due to deactivate cellular enzymes and DNA; disrupting of membrane permeability; and/...

Upper atmosphere pollution measurements (GASP)

NASA Technical Reports Server (NTRS)

Rudey, R. A.; Holdeman, J. D.

1975-01-01

The environmental effects are discussed of engine effluents of future large fleets of aircraft operating in the stratosphere. Topics discussed include: atmospheric properties, aircraft engine effluents, upper atmospheric measurements, global air sampling, and data reduction and analysis

Sepiapterin Reductase Mediates Chemical Redox Cycling in Lung Epithelial Cells*

PubMed Central

Yang, Shaojun; Jan, Yi-Hua; Gray, Joshua P.; Mishin, Vladimir; Heck, Diane E.; Laskin, Debra L.; Laskin, Jeffrey D.

2013-01-01

In the lung, chemical redox cycling generates highly toxic reactive oxygen species that can cause alveolar inflammation and damage to the epithelium, as well as fibrosis. In this study, we identified a cytosolic NADPH-dependent redox cycling activity in mouse lung epithelial cells as sepiapterin reductase (SPR), an enzyme important for the biosynthesis of tetrahydrobiopterin. Human SPR was cloned and characterized. In addition to reducing sepiapterin, SPR mediated chemical redox cycling of bipyridinium herbicides and various quinones; this activity was greatest for 1,2-naphthoquinone followed by 9,10-phenanthrenequinone, 1,4-naphthoquinone, menadione, and 2,3-dimethyl-1,4-naphthoquinone. Whereas redox cycling chemicals inhibited sepiapterin reduction, sepiapterin had no effect on redox cycling. Additionally, inhibitors such as dicoumarol, N-acetylserotonin, and indomethacin blocked sepiapterin reduction, with no effect on redox cycling. Non-redox cycling quinones, including benzoquinone and phenylquinone, were competitive inhibitors of sepiapterin reduction but noncompetitive redox cycling inhibitors. Site-directed mutagenesis of the SPR C-terminal substrate-binding site (D257H) completely inhibited sepiapterin reduction but had minimal effects on redox cycling. These data indicate that SPR-mediated reduction of sepiapterin and redox cycling occur by distinct mechanisms. The identification of SPR as a key enzyme mediating chemical redox cycling suggests that it may be important in generating cytotoxic reactive oxygen species in the lung. This activity, together with inhibition of sepiapterin reduction by redox-active chemicals and consequent deficiencies in tetrahydrobiopterin, may contribute to tissue injury. PMID:23640889

Effect of Shenzhu Guanxin Recipe () on patients with angina pectoris after percutaneous coronary intervention: A prospective, randomized controlled trial.

PubMed

Xu, Dan-Ping; Wu, Huan-Lin; Lan, Tao-Hua; Wang, Xia; Sheng, Xiao-Gang; Lin, Yu; Li, Song; Zheng, Chao-Yang

2015-06-01

To evaluate the efficacy and safety of a combination therapy using Chinese medicine (CM) Shenzhu Guanxin Recipe (, SGR) and standard Western medicine treatment (SWMT) in patients with angina pectoris after percutaneous coronary intervention (PCI). Double-blind randomized controlled trial was used in this experimental procedure. One hundred and eighty-seven patients with coronary heart disease receiving SWMT after PCI were randomly assigned to the treatment (SGR) and control (placebo) groups. Outcome measures including angina pectoris score (APS), CM symptom score, and Seattle Angina Questionnaire (SAQ) score were evaluated in 1, 2, 3 and 12 months, and the death rate, restenosis and other emergency treatments were observed. The mixed-effects models were employed for the data analysis. In the treatment group, a larger within-treatment effect size (d=1.74) was found, with a 76.7% reduction in APS from pretreatment to 12-month follow-up assessment compared with the control group (d=0.83, 53.8% symptom reduction); betweentreatment (BT) effect size was d=0.66. CM symptom scores included an 18.3% reduction in the treatment group (d=0.46), and a 16.1% decrease in the control group (d=0.31); d=0.62 for BT effect size. In regard to scores of SAQ, the BT effect size of cognition level of disease was larger in the treatment group (d=0.63), followed by the level of body limitation of activity (d=0.62), condition of angina pectoris attacks (d=0.55), satisfaction level of treatments (d=0.31), and steady state of angina pectoris (d=0.30). Two cardiovascular related deaths and one incidental death were recorded in the control and treatment groups, respectively. No significant difference in any cardiovascular event (including death toll, frequency of cardiovascular hospitalization or emergency room visits) was found between the two groups. The combination therapy of SGR and SWMT is effective and safe in patients with angina pectoris after PCI when compared with SWMT alone.

Review of the Mechanisms and Effects of Noninvasive Body Contouring Devices on Cellulite and Subcutaneous Fat.

PubMed

Alizadeh, Zahra; Halabchi, Farzin; Mazaheri, Reza; Abolhasani, Maryam; Tabesh, Mastaneh

2016-10-01

Today, different kinds of non-invasive body contouring modalities, including cryolipolysis, radiofrequency (RF), low-level laser therapy (LLLT), and high-intensity focused ultrasound (HIFU) are available for reducing the volume of subcutaneous adipose tissue or cellulite. Each procedure has distinct mechanisms for stimulating apoptosis or necrosis adipose tissue. In addition to the mentioned techniques, some investigations are underway for analyzing the efficacy of other techniques such as whole body vibration (WBV) and extracorporeal shockwave therapy (ESWT). In the present review the mechanisms, effects and side effects of the mentioned methods have been discussed. The effect of these devices on cellulite or subcutaneous fat reduction has been assessed. We searched pubmed, google scholar and the cochrane databases for systemic reviews, review articles, meta-analysis and randomized clinical trials up to February 2015. The keywords were subcutaneous fat, cellulite, obesity, noninvasive body contouring, cryolipolysis, RF, LLLT, HIFU, ESWT and WBV with full names and abbreviations. We included seven reviews and 66 original articles in the present narrative review. Most of them were applied on normal weight or overweight participants (body mass index < 30 kg/m 2 ) in both genders with broad range of ages (18 to 50 years on average). In the original articles, the numbers of included methods were: 10 HIFU, 13 RF, 22 cryolipolysis, 11 LLLT, 5 ESWT and 4 WBV therapies. Six of the articles evaluated combination therapies and seven compared the effects of different devices. Some of the noninvasive body contouring devices in animal and human studies such as cryolipolysis, RF, LLLT and HIFU showed statistical significant effects on body contouring, removing unwanted fat and cellulite in some body areas. However, the clinical effects are mild to moderate, for example 2 - 4 cm circumference reduction as a sign of subcutaneous fat reduction during total treatment sessions. Overall, there is no definitive noninvasive treatment method for cellulite. Additionally, due to the methodological differences in the existing evidence, comparing the techniques is difficult.

Impact of Fe(III) as an effective electron-shuttle mediator for enhanced Cr(VI) reduction in microbial fuel cells: Reduction of diffusional resistances and cathode overpotentials.

PubMed

Wang, Qiang; Huang, Liping; Pan, Yuzhen; Quan, Xie; Li Puma, Gianluca

2017-01-05

The role of Fe(III) was investigated as an electron-shuttle mediator to enhance the reduction rate of the toxic heavy metal hexavalent chromium (Cr(VI)) in wastewaters, using microbial fuel cells (MFCs). The direct reduction of chromate (CrO 4 - ) and dichromate (Cr 2 O 7 2- ) anions in MFCs was hampered by the electrical repulsion between the negatively charged cathode and Cr(VI) functional groups. In contrast, in the presence of Fe(III), the conversion of Cr(VI) and the cathodic coulombic efficiency in the MFCs were 65.6% and 81.7%, respectively, 1.6 times and 1.4 folds as those recorded in the absence of Fe(III). Multiple analytical approaches, including linear sweep voltammetry, Tafel plot, cyclic voltammetry, electrochemical impedance spectroscopy and kinetic calculations demonstrated that the complete reduction of Cr(VI) occurred through an indirect mechanism mediated by Fe(III). The direct reduction of Cr(VI) with cathode electrons in the presence of Fe(III) was insignificant. Fe(III) played a critical role in decreasing both the diffusional resistance of Cr(VI) species and the overpotential for Cr(VI) reduction. This study demonstrated that the reduction of Cr(VI) in MFCs was effective in the presence of Fe(III), providing an alternative and environmentally benign approach for efficient remediation of Cr(VI) contaminated sites with simultaneous production of renewable energy. Copyright © 2016 Elsevier B.V. All rights reserved.

Aircraft noise reduction technology. [to show impact on individuals and communities, component noise sources, and operational procedures to reduce impact

NASA Technical Reports Server (NTRS)

1973-01-01

Aircraft and airport noise reduction technology programs conducted by NASA are presented. The subjects discussed are: (1) effects of aircraft noise on individuals and communities, (2) status of aircraft source noise technology, (3) operational procedures to reduce the impact of aircraft noise, and (4) NASA relations with military services in aircraft noise problems. References to more detailed technical literature on the subjects discussed are included.

Hybrid Nanoparticles as Oil Lubricant Additives for Friction and Wear Reduction

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

Zhao, Bin; Dai, Sheng; Qu, Jun

A new class of organic-inorganic/metallic hybrid nanoparticles (NPs), including oil-soluble polymer brush-grafted metal oxide NPs and organic-modified metallic NPs, was developed and used as oil lubricant additives for friction and wear reduction to improve engine energy efficiency. The tribological properties of these hybrid NPs in polyalphaolefin (PAO) base oil were investigated by high contact stress ball-on-flat reciprocating sliding tribological tests at 100 oC. Using surface-initiated “living”/controlled radical polymerization from initiator- or chain transfer agent-functionalized metal oxide (silica and titania) NPs, we synthesized a series of hairy NPs and systematically studied the effects of molecular weight and chemical composition of graftedmore » polymer brushes on oil dispersibility, stability, and lubrication properties of hairy NPs in PAO. In addition, several types of organic-modified metallic NPs, including silver and palladium NPs, were synthesized by using thiol compounds and ionic liquids (ILs) as ligands. Significant reductions in friction (up to 40%) and wear volume (up to 90%) were achieved by using PAO mixed with hairy NPs or organic-modified metal NPs compared to PAO base oil. Moreover, a positive effect on lubricating performance was observed when oil-soluble hairy silica NPs and an IL were used simultaneously as additives for PAO for friction reduction. The lubrication mechanisms of these hybrid NPs were elucidated by both experimental and simulation studies.« less

Successful weight reduction and maintenance by using a smartphone application in those with overweight and obesity

PubMed Central

Chin, Sang Ouk; Keum, Changwon; Woo, Junghoon; Park, Jehwan; Choi, Hyung Jin; Woo, Jeong-taek; Rhee, Sang Youl

2016-01-01

A discrepancy exists with regard to the effect of smartphone applications (apps) on weight reduction due to the several limitations of previous studies. This is a retrospective cohort study, aimed to investigate the effectiveness of a smartphone app on weight reduction in obese or overweight individuals, based on the complete enumeration study that utilized the clinical and logging data entered by Noom Coach app users between October 2012 and April 2014. A total of 35,921 participants were included in the analysis, of whom 77.9% reported a decrease in body weight while they were using the app (median 267 days; interquartile range = 182). Dinner input frequency was the most important factor for successful weight loss (OR = 10.69; 95% CI = 6.20–19.53; p < 0.001), and more frequent input of weight significantly decreased the possibility of experiencing the yo-yo effect (OR = 0.59, 95% CI = 0.39–0.89; p < 0.001). This study demonstrated the clinical utility of an app for successful weight reduction in the majority of the app users; the effects were more significant for individuals who monitored their weight and diet more frequently. PMID:27819345

Examining the effectiveness of a restorative justice program for various types of juvenile offenders.

PubMed

Bergseth, Kathleen J; Bouffard, Jeffrey A

2013-09-01

Restorative justice (RJ) programs have become widespread in the United States and in other countries. These programs are often seen as a viable alternative to traditional retributive processing, especially for minor, and sometimes more serious, forms of delinquency and adult criminality. The programs hold promise for achieving several goals, including increased community and victim involvement, greater satisfaction with the case outcomes, improved offender compliance, increased perceptions of fairness, and even recidivism reduction. Meta-analyses have demonstrated varying degrees of program success in recidivism reduction, which may in part reflect differential effectiveness of the RJ approach for various kinds of offenders. This study examined whether an RJ program for juvenile offenders had differential impacts on recidivism across various offender characteristics (including age, gender, racial group, offending history, and current offense). Results generally support the effectiveness of the program for many types of offenders. Implications for future research and potential improvements to the RJ model are discussed.

Characterization of U(VI) reduction in contaminated sediments with slow-degrading electron donor source

NASA Astrophysics Data System (ADS)

Wu, W.; Watson, D. B.; Zhang, G.; Mehlhorn, T.; Lowe, K.; Earles, J.; Phillips, J.; Kelly, S. D.; Boyanov, M.; Kemner, K. M.; Schadt, C.; Criddle, C. S.; Jardine, P. M.; Brooks, S. C.

2011-12-01

In order to select sustainable, high efficiency and cost effective electron donor source, oleate and emulsified vegetable oil (EVO) were tested uranium (VI) reduction in comparison with ethanol in microcosms using uranium contaminated sediments and groundwater from the US DOE Oak Ridge Integrated Field Research Challenge (ORIFRC) site. The effect of initial sulfate concentration on U(VI) reduction was also tested. Both oleate and EVO were effective electron donor sources for U(VI) reduction. Accumulation of acetate as a major product and the removal of aqueous U(VI) were observed and were associated with sulfate reduction. Both oleate and EVO supported U(VI) reduction but at slower rates with a comparable but slightly lower extent of reduction than ethanol. X-ray absorption near-edge spectroscopy (XANES) analysis confirmed reduction of U(VI) to U(IV). The extent of U(VI) reduction in solid phase was negatively influenced by aqueous calcium concentration. The majority of electrons of the three substrates were consumed by sulfate reduction, Fe(III) reduction, and methanogenesis. Initial U(VI) concentration in the aqueous phase increased with increased sulfate concentration (1 versus 5 mM), likely due to U(VI) desorption from the solid phase. At the higher initial sulfate concentration more U(VI) was reduced and fewer electrons were used in methanogenesis. Analysis of bacterial and archeal populations using 16S rRNA gene libraries showed a significant increase in Deltaproteobacteria after biostimulation. The microbial community structures developed with oleate and EVO were significantly distinct from those developed with ethanol. Bacteria similar to Desulforegula spp. was predominant for oleate and EVO degradation but were not observed in ethanol-amended microcosms. Known U(VI)-reducing bacteria in the microcosms amended with the three electron donor sources included iron(III) reducing Geobacter spp. but in lower abundances than sulfate-reducing Desulfovibrio spp. The test results were used for the design a field test by one-time injection of EVO to the subsurface for U(VI) reduction in Area 2 of the ORIFRC site.

Why sensitive bacteria are resistant to hospital infection control

PubMed Central

van Kleef, Esther; Luangasanatip, Nantasit; Bonten, Marc J; Cooper, Ben S

2017-01-01

Background: Large reductions in the incidence of antibiotic-resistant strains of Staphylococcus aureus and Clostridium difficile have been observed in response to multifaceted hospital-based interventions. Reductions in antibiotic-sensitive strains have been smaller or non-existent. It has been argued that since infection control measures, such as hand hygiene, should affect resistant and sensitive strains equally, observed changes must have largely resulted from other factors, including changes in antibiotic use. We used a mathematical model to test the validity of this reasoning. Methods: We developed a mechanistic model of resistant and sensitive strains in a hospital and its catchment area. We assumed the resistant strain had a competitive advantage in the hospital and the sensitive strain an advantage in the community. We simulated a hospital hand hygiene intervention that directly affected resistant and sensitive strains equally. The annual incidence rate ratio ( IRR) associated with the intervention was calculated for hospital- and community-acquired infections of both strains. Results: For the resistant strain, there were large reductions in hospital-acquired infections (0.1 ≤ IRR ≤ 0.6) and smaller reductions in community-acquired infections (0.2 ≤ IRR ≤  0.9). These reductions increased in line with increasing importance of nosocomial transmission of the strain. For the sensitive strain, reductions in hospital acquisitions were much smaller (0.6 ≤ IRR ≤ 0.9), while communityacquisitions could increase or decrease (0.9 ≤ IRR ≤ 1.2). The greater the importance of the community environment for the transmission of the sensitive strain, the smaller the reductions. Conclusions: Counter-intuitively, infection control interventions, including hand hygiene, can have strikingly discordant effects on resistant and sensitive strains even though they target them equally, following differences in their adaptation to hospital and community-based transmission. Observed lack of effectiveness of control measures for sensitive strains does not provide evidence that infection control interventions have been ineffective in reducing resistant strains. PMID:29260003

Meta-analysis of Air Versus Liquid Enema for Intussusception Reduction in Children.

PubMed

Sadigh, Gelareh; Zou, Kelly H; Razavi, Seyed Amirhossein; Khan, Ramsha; Applegate, Kimberly E

2015-11-01

The purpose of this study was to assess the effectiveness and safety of air versus liquid enema reduction in the treatment of intussusception in children. Literature searches of the PubMed, Embase, and Cochrane Library databases were conducted from January 1, 1966, through May 31, 2013. Articles on the use of air or liquid enema in children with a confirmed diagnosis of intussusception and reporting either a success rate for enema reduction of intussusception or a perforation rate were selected. Enema reduction success rate, perforation rate, and recurrence rate were the main outcomes and were calculated by random effects modeling. One hundred two articles (101 reporting success rate, 71 reporting perforation rate) were included that presented results for 32,451 children (age range, 1 day-22 years; boys, 66%; girls, 34%). In 44 studies (16,187 children), the combined estimate for success rate of air enema was 82.7% (95% CI, 79.9-85.6%; inconsistency index [I(2)] = 97%), and in 52 studies (13,081 children) of liquid enema, it was 69.6% (95% CI, 65.0-74.1%; I(2) = 98%). In 38 studies (15,752 children), the combined estimate of perforation rate for air enema was 0.39% (95% CI, 0.23- 0.55%; I(2) = 40%), and in 30 studies (9429 children) of liquid enema, it was 0.43% (95% CI, 0.24- 0.62%; I(2) = 9%). Among 10,494 children (26 studies) undergoing air enema reduction, the rate of first intussusception recurrence was 6% (95% CI, 4.5-7.5%; I(2) = 89%), similar to the 7.3% (95% CI, 5.8-8.8%; I(2) = 71%) found for 4004 children (24 studies) undergoing liquid enema reduction. Air enema was superior to liquid enema for intussusception reduction. The success rate was higher without a difference in perforation rate. Limitations included heterogeneity and publication bias.

Aeromechanical Evaluation of Smart-Twisting Active Rotor

NASA Technical Reports Server (NTRS)

Lim, Joon W.; Boyd, D. Douglas, Jr.; Hoffman, Frauke; van der Wall, Berend G.; Kim, Do-Hyung; Jung, Sung N.; You, Young H.; Tanabe, Yasutada; Bailly, Joelle; Lienard, Caroline;

Why sensitive bacteria are resistant to hospital infection control.

PubMed

van Kleef, Esther; Luangasanatip, Nantasit; Bonten, Marc J; Cooper, Ben S

2017-01-01

Large reductions in the incidence of antibiotic-resistant strains of Staphylococcus aureus and Clostridium difficile have been observed in response to multifaceted hospital-based interventions. Reductions in antibiotic-sensitive strains have been smaller or non-existent. It has been argued that since infection control measures, such as hand hygiene, should affect resistant and sensitive strains equally, observed changes must have largely resulted from other factors, including changes in antibiotic use. We used a mathematical model to test the validity of this reasoning. We developed a mechanistic model of resistant and sensitive strains in a hospital and its catchment area. We assumed the resistant strain had a competitive advantage in the hospital and the sensitive strain an advantage in the community. We simulated a hospital hand hygiene intervention that directly affected resistant and sensitive strains equally. The annual incidence rate ratio (IRR) associated with the intervention was calculated for hospital- and community-acquired infections of both strains. For the resistant strain, there were large reductions in hospital-acquired infections (0.1 ≤ IRR ≤ 0.6) and smaller reductions in community-acquired infections (0.2 ≤ IRR ≤ 0.9). These reductions increased in line with increasing importance of nosocomial transmission of the strain. For the sensitive strain, reductions in hospital acquisitions were much smaller (0.6 ≤ IRR ≤ 0.9), while community acquisitions could increase or decrease (0.9 ≤ IRR ≤ 1.2). The greater the importance of the community environment for the transmission of the sensitive strain, the smaller the reductions. Counter-intuitively, infection control interventions, including hand hygiene, can have strikingly discordant effects on resistant and sensitive strains even though they target them equally. This follows from differences in their adaptation to hospital- and community-based transmission. Observed lack of effectiveness of control measures for sensitive strains does not provide evidence that infection control interventions have been ineffective in reducing resistant strains.

Effectiveness of interventions to reduce aggression and injuries among ice hockey players: a systematic review.

PubMed

Cusimano, Michael D; Nastis, Sofia; Zuccaro, Laura

2013-01-08

The increasing incidence of injuries related to playing ice hockey is an important public health issue. We conducted a systematic review to evaluate the effectiveness of interventions designed to reduce injuries related to aggressive acts in ice hockey. We identified relevant articles by searching electronic databases from their inception through July 2012, by using Internet search engines, and by manually searching sports medicine journals, the book series Safety in Ice Hockey and reference lists of included articles. We included studies that evaluated interventions to reduce aggression-related injuries and reported ratings of aggressive behaviour or rates of penalties or injuries. We identified 18 eligible studies. Most involved players in minor hockey leagues. Of 13 studies that evaluated changes in mandatory rules intended to lessen aggression (most commonly the restriction of body-checking), 11 observed a reduction in penalty or injury rates associated with rule changes, and 9 of these showed a statistically significant decrease. The mean number of penalties decreased by 1.2-5.9 per game, and injury rates decreased 3- to 12-fold. All 3 studies of educational interventions showed a reduction in penalty rates, but they were not powered or designed to show a change in injury rates. In 2 studies of cognitive behavioural interventions, reductions in aggressive behaviours were observed. Changes to mandatory rules were associated with reductions in penalties for aggressive acts and in injuries related to aggression among ice hockey players. Effects of educational and cognitive behavioural interventions on injury rates are less clear. Well-designed studies of multifaceted strategies that combine such approaches are required.

Effect of long-term fertilization on humic redox mediators in multiple microbial redox reactions.

PubMed

Guo, Peng; Zhang, Chunfang; Wang, Yi; Yu, Xinwei; Zhang, Zhichao; Zhang, Dongdong

2018-03-01

This study investigated the effects of different long-term fertilizations on humic substances (HSs), humic acids (HAs) and humins, functioning as redox mediators for various microbial redox biotransformations, including 2,2',4,4',5,5'- hexachlorobiphenyl (PCB 153 ) dechlorination, dissimilatory iron reduction, and nitrate reduction, and their electron-mediating natures. The redox activity of HSs for various microbial redox metabolisms was substantially enhanced by long-term application of organic fertilizer (pig manure). As a redox mediator, only humin extracted from soils with organic fertilizer amendment (OF-HM) maintained microbial PCB 153 dechlorination activity (1.03 μM PCB 153 removal), and corresponding HA (OF-HA) most effectively enhanced iron reduction and nitrate reduction by Shewanella putrefaciens. Electrochemical analysis confirmed the enhancement of their electron transfer capacity and redox properties. Fourier transform infrared analysis showed that C=C and C=O bonds, and carboxylic or phenolic groups in HSs might be the redox functional groups affected by fertilization. This research enhances our understanding of the influence of anthropogenic fertility on the biogeochemical cycling of elements and in situ remediation ability in agroecosystems through microorganisms' metabolisms. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mindfulness-based stress reduction for treating chronic headache: A systematic review and meta-analysis.

PubMed

Anheyer, Dennis; Leach, Matthew J; Klose, Petra; Dobos, Gustav; Cramer, Holger

2018-01-01

Background Mindfulness-based stress reduction/cognitive therapy are frequently used for pain-related conditions, but their effects on headache remain uncertain. This review aimed to assess the efficacy and safety of mindfulness-based stress reduction/cognitive therapy in reducing the symptoms of chronic headache. Data sources and study selection MEDLINE/PubMed, Scopus, CENTRAL, and PsychINFO were searched to 16 June 2017. Randomized controlled trials comparing mindfulness-based stress reduction/cognitive therapy with usual care or active comparators for migraine and/or tension-type headache, which assessed headache frequency, duration or intensity as a primary outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Tool. Results Five randomized controlled trials (two on tension-type headache; one on migraine; two with mixed samples) with a total of 185 participants were included. Compared to usual care, mindfulness-based stress reduction/cognitive therapy did not improve headache frequency (three randomized controlled trials; standardized mean difference = 0.00; 95% confidence interval = -0.33,0.32) or headache duration (three randomized controlled trials; standardized mean difference = -0.08; 95% confidence interval = -1.03,0.87). Similarly, no significant difference between groups was found for pain intensity (five randomized controlled trials; standardized mean difference = -0.78; 95% confidence interval = -1.72,0.16). Conclusions Due to the low number, small scale and often high or unclear risk of bias of included randomized controlled trials, the results are imprecise; this may be consistent with either an important or negligible effect. Therefore, more rigorous trials with larger sample sizes are needed.

Antihypertensive treatment and stroke prevention: are angiotensin receptor blockers superior to other antihypertensive agents?

PubMed

Armario, Pedro; de la Sierra, Alejandro

2009-06-01

Stroke remains a common vascular event with high mortality and morbidity. After heart disease, stroke is the second leading cause of death worldwide in adult persons. Silent or subclinical stroke is likely to occur with even greater frequency than clinical stroke and increases the risk of subsequent cerebrovascular events. Hypertension is by far the single most important controllable risk factor for stroke. The relationship between blood pressure (BP) and stroke mortality is strong, linear, and continuous in subjects with levels of BP higher than 115/75 mm Hg. Blood pressure reduction by antihypertensive treatment is clearly efficacious in the prevention of stroke (both primary and secondary). Although meta-analyses suggest that BP reduction, per se, is the most important determinant for stroke risk reduction, the question is if specific classes of antihypertensive drugs offer special protection against stroke is still controversial. Some studies have suggested that angiotensin receptors blockers (ARBs) appear to offer additional protection against stroke. This has been hypothesized in studies in hypertensives, such as LIFE and SCOPE, and especially in the only comparative trial focused on secondary stroke prevention. In the MOSES trial, the comparison of eprosartan versus nitrendipine in patients with a previous stroke resulted, despite a similar BP reduction, in a significant reduction in the primary composite endpoint of total mortality plus cardiovascular and cerebrovascular events, including recurrent events. These results may suggest a blood pressure-independent effect of ARBs, which can be mediated through several mechanisms, including their ability to counteract other markers of target organ damage, but also through a direct neuroprotective effect.

Challenges and Recent Developments in Hearing Aids: Part I. Speech Understanding in Noise, Microphone Technologies and Noise Reduction Algorithms

PubMed Central

Chung, King

2004-01-01

This review discusses the challenges in hearing aid design and fitting and the recent developments in advanced signal processing technologies to meet these challenges. The first part of the review discusses the basic concepts and the building blocks of digital signal processing algorithms, namely, the signal detection and analysis unit, the decision rules, and the time constants involved in the execution of the decision. In addition, mechanisms and the differences in the implementation of various strategies used to reduce the negative effects of noise are discussed. These technologies include the microphone technologies that take advantage of the spatial differences between speech and noise and the noise reduction algorithms that take advantage of the spectral difference and temporal separation between speech and noise. The specific technologies discussed in this paper include first-order directional microphones, adaptive directional microphones, second-order directional microphones, microphone matching algorithms, array microphones, multichannel adaptive noise reduction algorithms, and synchrony detection noise reduction algorithms. Verification data for these technologies, if available, are also summarized. PMID:15678225

Exhaust Plume Effects on Sonic Boom for a Delta Wing and a Swept Wing-Body Model

NASA Technical Reports Server (NTRS)

Castner, Raymond; Lake, Troy

2012-01-01

Supersonic travel is not allowed over populated areas due to the disturbance caused by the sonic boom. Research has been performed on sonic boom reduction and has included the contribution of the exhaust nozzle plume. Plume effect on sonic boom has progressed from the study of isolated nozzles to a study with four exhaust plumes integrated with a wing-body vehicle. This report provides a baseline analysis of the generic wing-body vehicle to demonstrate the effect of the nozzle exhaust on the near-field pressure profile. Reductions occurred in the peak-to-peak magnitude of the pressure profile for a swept wing-body vehicle. The exhaust plumes also had a favorable effect as the nozzles were moved outward along the wing-span.

Effects of a Pilot Church-based Intervention to Reduce HIV Stigma and Promote HIV Testing among African Americans and Latinos

PubMed Central

Derose, Kathryn P.; Griffin, Beth Ann; Kanouse, David E.; Bogart, Laura M.; Williams, Malcolm V.; Haas, Ann C.; Flórez, Karen R.; Collins, Deborah Owens; Hawes-Dawson, Jennifer; Mata, Michael A.; Oden, Clyde W.; Stucky, Brian D.

2016-01-01

HIV-related stigma and mistrust contribute to HIV disparities. Addressing stigma with faith partners may be effective, but few church-based stigma reduction interventions have been tested. We implemented a pilot intervention with 3 Latino and 2 African American churches (4 in matched pairs) in high HIV prevalence areas of Los Angeles County to reduce HIV stigma and mistrust and increase HIV testing. The intervention included HIV education and peer leader workshops, pastor-delivered sermons on HIV with imagined contact scenarios, and HIV testing events. We surveyed congregants at baseline and 6 month follow-up (n=1235) and found statistically significant (p<.05) reductions in HIV stigma and mistrust in the Latino intervention churches but not in the African American intervention church nor overall across matched African American and Latino pairs. However, within matched pairs, intervention churches had much higher rates of HIV testing (p< .001). Stigma reduction and HIV testing may have synergistic effects in community settings. PMID:27000144

Analysis on LID for highly urbanized areas' waterlogging control: demonstrated on the example of Caohejing in Shanghai.

PubMed

Liao, Z L; He, Y; Huang, F; Wang, S; Li, H Z

2013-01-01

Although a commonly applied measure across the United States and Europe for alleviating the negative impacts of urbanization on the hydrological cycle, low impact development (LID) has not been widely used in highly urbanized areas, especially in rapidly urbanizing cities in developing countries like China. In this paper, given five LID practices including Bio-Retention, Infiltration Trench, Porous Pavement, Rain Barrels, and Green Swale, an analysis on LID for highly urbanized areas' waterlogging control is demonstrated using the example of Caohejing in Shanghai, China. Design storm events and storm water management models are employed to simulate the total waterlogging volume reduction, peak flow rate reduction and runoff coefficient reduction of different scenarios. Cost-effectiveness is calculated for the five practices. The aftermath shows that LID practices can have significant effects on storm water management in a highly urbanized area, and the comparative results reveal that Rain Barrels and Infiltration Trench are the two most suitable cost-effective measures for the study area.

Utilizing placebo mechanisms for dose reduction in pharmacotherapy.

PubMed

Doering, Bettina K; Rief, Winfried

2012-03-01

The knowledge and systematic application of the placebo effect remains limited, although its importance to the treatment of various medical conditions has increasingly been recognized. A possible application of the placebo effect to pharmacotherapy is seen in conditioning processes that aim at a placebo-controlled dose reduction of drugs while maintaining the efficacy of the medical treatment. The pairing of a placebo and a pharmacological agent may achieve satisfactory treatment outcomes in combination with a lower dose of medication. This procedure includes classic and instrumental conditioning processes that involve both conscious and non-conscious information processing. Although recent studies have gathered preliminary evidence for the efficacy of placebo-controlled dose reduction (e.g. in psoriasis and attention deficit hyperactivity disorder [ADHD]), they have also illustrated the difficulties that are inherent to this approach. We critically review previous approaches and discuss designs for clinical trials that seem appropriate to the investigation of conditioned placebo effects in pharmacotherapy. Copyright © 2011 Elsevier Ltd. All rights reserved.

Does the Police-Monitored CCTV Scheme Really Matter on Crime Reduction? A Quasi-Experimental Test in Taiwan's Taipei City.

PubMed

Lai, Yung-Lien; Sheu, Chuen-Jim; Lu, Yi-Fen

2018-06-01

Although numerous public closed-circuit television (CCTV) initiatives have been implemented at varying levels in Taiwan's cities and counties, systematic evaluations of these crime reduction efforts have been largely overlooked. To address this void, a quasi-experimental evaluation research project was designed to assess the effect of police-monitored CCTV on crime reduction in Taipei City for a period of 54 months, including data for both before and after camera installation dates. A total of 40 viewsheds within a 100-m (328 feet) radius were selected as research sites to observe variations in four types of crime incidents that became known to police during the January 2008 to June 2012 period. While crime incidents occurring in both the target and control sites were reduced in frequency after CCTV installation, results derived from time-series analysis indicated that the monitoring had no significant effect on the reduction of property crime incidents with the sole exception of robbery. With respect to the effects of comparing target and control sites, the average Crime Reduction Quotient (CRQ) was 0.36, suggesting that CCTV has an overall marginal yet noteworthy influence. Viewed broadly, however, the police-installed CCTV system in Taipei City did not appear to be as efficient as one would expect. Conversely, cameras installed in some observation sites proved to be significantly more effective than cameras in other sites. As a recommendation, future researchers should identify how particular micro-level attributes may lead to CCTV cameras working more effectively, thereby optimizing location choices where monitoring will prove to be most productive.

Applications of Computer-Assisted Navigation for the Minimally Invasive Reduction of Isolated Zygomatic Arch Fractures.

PubMed

Li, Zhi; Yang, Rong-Tao; Li, Zu-Bing

2015-09-01

Computer-assisted navigation has been widely used in oral and maxillofacial surgery. The purpose of this study was to describe the applications of computer-assisted navigation for the minimally invasive reduction of isolated zygomatic arch fractures. All patients identified as having isolated zygomatic arch fractures presenting to the authors' department from April 2013 through November 2014 were included in this prospective study. Minimally invasive reductions of isolated zygomatic arch fractures were performed on these patients under the guidance of computer-assisted navigation. The reduction status was evaluated by postoperative computed tomography (CT) 1 week after the operation. Postoperative complications and facial contours were evaluated during follow-up. Functional recovery was evaluated by the difference between the preoperative maximum interincisal mouth opening and that at the final follow-up. Twenty-three patients were included in this case series. The operation proceeded well in all patients. Postoperatively, all patients displayed uneventful healing without postoperative complication. Postoperative CT showed exact reduction in all cases. Satisfactory facial contour and functional recovery were observed in all patients. The preoperative maximal mouth opening ranged from 8 to 25 mm, and the maximal mouth opening at the final follow-up ranged from 36 to 42 mm. Computer-assisted navigation can be used not only for guiding zygomatic arch fracture reduction, but also for assessing reduction. Computer-assisted navigation is an effective and minimally invasive technique that can be applied in the reduction of isolated zygomatic arch fractures. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Does patent foramen ovale closure have an anti-arrhythmic effect? A meta-analysis.

PubMed

Jarral, Omar A; Saso, Srdjan; Vecht, Joshua A; Harling, Leanne; Rao, Christopher; Ahmed, Kamran; Gatzoulis, Michael A; Malik, Iqbal S; Athanasiou, Thanos

2011-11-17

Atrial tachyarrhythmias are associated with patent foramen ovale. The objective was to determine the anti-arrhythmic effect of patent foramen ovale closure on pre-existing atrial tachyarrhythmias. Medline, EMBASE, Cochrane Library, and Google Scholar databases were searched between 1967 and 2010. The search was expanded using the 'related articles' function and reference lists of key studies. All studies reporting pre- and post-closure incidence (or prevalence) of atrial tachyarrhythmia in the same patient population were included. Random and fixed effect meta-analyses were used to aggregate the data. Six studies were identified including 2570 patients who underwent percutaneous closure. Atrial fibrillation was in fact the only AT reported in all studies. Meta-analysis using a fixed effects model demonstrated a significant reduction in the prevalence of atrial fibrillation with an OR of 0.43 (95% CI 0.26-0.71). When using the random-effects model, OR was 0.44 (95% CI 0.18-1.04) with a statistically significant trend demonstrated (test for overall effect: Z=1.87, p=0.06). Closure of a patent foramen ovale may be associated with reduction in the prevalence of atrial fibrillation. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Noise reduction of a tilt-rotor aircraft including effects on weight and performance

NASA Technical Reports Server (NTRS)

Gibs, J.; Stepniewski, W. Z.; Spencer, R.; Kohler, G.

1973-01-01

Various methods for far-field noise reduction of a tilt-rotor acoustic signature and the performance and weight tradeoffs which result from modification of the noise sources are considered in this report. In order to provide a realistic approach for the investigation, the Boeing tilt-rotor flight research aircraft (Model 222), was selected as the baseline. This aircraft has undergone considerable engineering development. Its rotor has been manufactured and tested in the Ames full-scale wind tunnel. The study reflects the current state-of-the-art of aircraft design for far-field acoustic signature reduction and is not based solely on an engineering feasibility aircraft. This report supplements a previous study investigating reduction of noise signature through the management of the terminal flight trajectory.

Potentials for sustainable transportation in cities to alleviate climate change impacts.

PubMed

Mashayekh, Yeganeh; Jaramillo, Paulina; Samaras, Constantine; Hendrickson, Chris T; Blackhurst, Michael; MacLean, Heather L; Matthews, H Scott

2012-03-06

Reducing greenhouse gas emissions (GHG) is an important social goal to mitigate climate change. A common mitigation paradigm is to consider strategy "wedges" that can be applied to different activities to achieve desired GHG reductions. In this policy analysis piece, we consider a wide range of possible strategies to reduce light-duty vehicle GHG emissions, including fuel and vehicle options, low carbon and renewable power, travel demand management and land use changes. We conclude that no one strategy will be sufficient to meet GHG emissions reduction goals to avoid climate change. However, many of these changes have positive combinatorial effects, so the best strategy is to pursue combinations of transportation GHG reduction strategies to meet reduction goals. Agencies need to broaden their agendas to incorporate such combination in their planning.

Rye cover crop effects on soil quality in no-till corn silage-soybean cropping systems

USDA-ARS?s Scientific Manuscript database

Corn and soybean farmers in the upper Midwest are showing increasing interest in winter cover crops. Known benefits of winter cover crops include reductions in nutrient leaching, erosion prevention, and weed suppression; however, the effects of winter cover crops on soil quality in this region have ...

The VOICES/VOCES Success Story: Effective Strategies for Training, Technical Assistance and Community-Based Organization Implementation

ERIC Educational Resources Information Center

Hamdallah, Myriam; Vargo, Sue; Herrera, Jennifer

2006-01-01

The Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) project successfully disseminated VOICES/VOCES, a brief video-based HIV risk reduction intervention targeting African American and Latino heterosexual men and women at risk for HIV infection. Elements of the dissemination strategy included a…

The effect of coverings, including plastic bags and wraps, on mortality and morbidity in preterm and full-term neonates.

PubMed

Oatley, H K; Blencowe, H; Lawn, J E

2016-05-01

Neonatal hypothermia is an important risk factor for mortality and morbidity, and is common even in temperate climates. We conducted a systematic review to determine whether plastic coverings, used immediately following delivery, were effective in reducing the incidence of mortality, hypothermia and morbidity. A total of 26 studies (2271 preterm and 1003 term neonates) were included. Meta-analyses were conducted as appropriate. Plastic wraps were associated with a reduction in hypothermia in preterm (⩽29 weeks; risk ratio (RR)=0.57; 95% confidence interval (CI) 0.46 to 0.71) and term neonates (RR=0.76; 95% CI 0.60 to 0.96). No significant reduction in neonatal mortality or morbidity was found; however, the studies were underpowered for these outcomes. For neonates, especially preterm, plastic wraps combined with other environmental heat sources are effective in reducing hypothermia during stabilization and transfer within hospital. Further research is needed to quantify the effects on mortality or morbidity, and investigate the use of plastic coverings outside hospital settings or without additional heat sources.

The effect of coverings, including plastic bags and wraps, on mortality and morbidity in preterm and full-term neonates

PubMed Central

Oatley, H K; Blencowe, H; Lawn, J E

2016-01-01

Neonatal hypothermia is an important risk factor for mortality and morbidity, and is common even in temperate climates. We conducted a systematic review to determine whether plastic coverings, used immediately following delivery, were effective in reducing the incidence of mortality, hypothermia and morbidity. A total of 26 studies (2271 preterm and 1003 term neonates) were included. Meta-analyses were conducted as appropriate. Plastic wraps were associated with a reduction in hypothermia in preterm (⩽29 weeks; risk ratio (RR)=0.57; 95% confidence interval (CI) 0.46 to 0.71) and term neonates (RR=0.76; 95% CI 0.60 to 0.96). No significant reduction in neonatal mortality or morbidity was found; however, the studies were underpowered for these outcomes. For neonates, especially preterm, plastic wraps combined with other environmental heat sources are effective in reducing hypothermia during stabilization and transfer within hospital. Further research is needed to quantify the effects on mortality or morbidity, and investigate the use of plastic coverings outside hospital settings or without additional heat sources. PMID:27109095

Therapeutic Effects of Breviscapine in Cardiovascular Diseases: A Review.

PubMed

Gao, Jialiang; Chen, Guang; He, Haoqiang; Liu, Chao; Xiong, Xingjiang; Li, Jun; Wang, Jie

2017-01-01

Breviscapine is a crude extract of several flavonoids of Erigeron breviscapus (Vant.) Hand.-Mazz. , containing more than 85% of scutellarin, which has been traditionally used in China as an activating blood circulation medicine to improve cerebral blood supply. Accumulating evidence from various in vivo and in vitro studies has shown that breviscapine exerts a broad range of cardiovascular pharmacological effects, including vasodilation, protection against ischaemia/reperfusion (I/R), anti-inflammation, anticoagulation, antithrombosis, endothelial protection, myocardial protection, reduction of smooth muscle cell migration and proliferation, anticardiac remodeling, antiarrhythmia, blood lipid reduction, and improvement of erectile dysfunction. In addition, several clinical studies have reported that breviscapine could be used in conjunction with Western medicine for cardiovascular diseases (CVDs) including coronary heart disease, myocardial infarction, hypertension, atrial fibrillation, hyperlipidaemia, viral myocarditis, chronic heart failure, and pulmonary heart disease. However, the protective effects of breviscapine on CVDs based on experimental studies along with its underlying mechanisms have not been reviewed systematically. This paper reviewed the underlying pharmacological mechanisms in the cardioprotective effects of breviscapine and elucidated its clinical applications.

Therapeutic Effects of Breviscapine in Cardiovascular Diseases: A Review

PubMed Central

Gao, Jialiang; Chen, Guang; He, Haoqiang; Liu, Chao; Xiong, Xingjiang; Li, Jun; Wang, Jie

2017-01-01

Breviscapine is a crude extract of several flavonoids of Erigeron breviscapus (Vant.) Hand.-Mazz., containing more than 85% of scutellarin, which has been traditionally used in China as an activating blood circulation medicine to improve cerebral blood supply. Accumulating evidence from various in vivo and in vitro studies has shown that breviscapine exerts a broad range of cardiovascular pharmacological effects, including vasodilation, protection against ischaemia/reperfusion (I/R), anti-inflammation, anticoagulation, antithrombosis, endothelial protection, myocardial protection, reduction of smooth muscle cell migration and proliferation, anticardiac remodeling, antiarrhythmia, blood lipid reduction, and improvement of erectile dysfunction. In addition, several clinical studies have reported that breviscapine could be used in conjunction with Western medicine for cardiovascular diseases (CVDs) including coronary heart disease, myocardial infarction, hypertension, atrial fibrillation, hyperlipidaemia, viral myocarditis, chronic heart failure, and pulmonary heart disease. However, the protective effects of breviscapine on CVDs based on experimental studies along with its underlying mechanisms have not been reviewed systematically. This paper reviewed the underlying pharmacological mechanisms in the cardioprotective effects of breviscapine and elucidated its clinical applications. PMID:28588491

Efficacy of multisystemic therapy in youths aged 10-17 with severe antisocial behaviour and emotional disorders: systematic review.

PubMed

Tan, Jia Xuan; Fajardo, Maria Lourdes Restrepo

2017-11-01

Antisocial behaviour and conduct disorders are the most common behavioural and mental health problems in children and young people globally. An efficacious intervention is needed to manage these antisocial behaviours that have costly consequences. Multisystemic Therapy (MST), an intensive home-based intervention for youths with psychosocial and behavioural problems, is recommended under National Institute for Health and Clinical Excellence guidelines for conduct disorder. However, reviews on the efficacy of MST are mixed. To review randomised controlled trials (RCTs) reporting efficacy of MST among youths presenting with antisocial behaviour and emotional disorder respectively. A systematic map term to subject heading search was conducted in PsycINFO, Embase, and Ovid Medline databases for articles up to November 2015. RCTs comparing MST vs.treatment as usual (TAU) in youths presenting with antisocial behaviour and emotional disorder were included. 12 RCTs ( n  = 1425) reported efficacy of MST vs. TAU in youths presenting with antisocial behaviour and emotional disorder. Clinically significant treatment effects of MST showed a reduction of antisocial behaviour which includes delinquency. MST, vs. psychiatric hospitalisation, was associated with a reduction of suicidal attempts in youths presenting with psychiatric emergencies. 4 studies showed that MST was less costly than TAU in the short term, with further analysis required for long-term cost-effectiveness. MST is an efficacious intervention for severe antisocial behaviours in reduction of delinquency and should be included in clinical practices. MST was shown to have a positive effect on emotional disorder but further research is needed to evaluate the efficacy of MST with emotional disorder. Further analysis is required to assess the services utilized for long-term cost effectiveness.

Meta-analyses of structural regional cerebral effects in type 1 and type 2 diabetes.

PubMed

Moulton, Calum D; Costafreda, Sergi G; Horton, Paul; Ismail, Khalida; Fu, Cynthia H Y

2015-12-01

Diabetes is associated with macrovascular and microvascular complications and is a major risk factor for neurological and psychiatric disorders, such as dementia and depression. Type 1 diabetes (T1DM) and type 2 diabetes (T2DM) have distinct etiologies and pathophysiological effects while sharing a common endpoint of persistent hyperglycemia. Neuroimaging studies in T1DM have revealed reductions in numerous regions, including the parahippocampal and occipital regions, while in T2DM there have been numerous reports of hippocampal atrophy. This meta-analysis aimed to identify consistent regional abnormalities in cerebral structures in T1DM and T2DM respectively, and also to examine the impact of potential confounds, including age, depression and vascular risk factors. Neuroimaging studies of both voxel-based morphometry (VBM) data and volumetric data were included. Ten T1DM studies (n = 613 patients) and 23 T2DM studies (n = 1364 patients) fulfilled inclusion criteria. The T1DM meta-analysis revealed reduced bilateral thalamus grey matter density in adults. The T2DM meta-analysis revealed reduced global brain volume and regional atrophy in the hippocampi, basal ganglia, and orbitofrontal and occipital lobes. Moreover, hippocampal atrophy in T2DM was not modified by hypertension, although there were more marked reductions in younger patients relative to healthy controls. In conclusion, T1DM and T2DM demonstrated distinct cerebral effects with generalised and specific target areas of grey matter reduction. Thalamic atrophy in T1DM may be a substrate of associated cognitive deficits. In T2DM, global cerebral atrophy may reflect atherosclerotic factors, while hippocampal atrophy was an independent effect providing a potential common neuropathological etiology for the comorbidity of T2DM with dementia and depression.

Toxics Use Reduction in the Home: Lessons Learned from Household Exposure Studies

PubMed Central

Dunagan, Sarah C.; Dodson, Robin E.; Rudel, Ruthann A.; Brody, Julia G.

2010-01-01

Workers and fence-line communities have been the first to benefit from the substantial reductions in toxic chemical use and byproducts in industrial production resulting from the Massachusetts Toxics Use Reduction Act (TURA). As TURA motivates reformulation of products as well as retooling of production processes, benefits could extend more broadly to large-scale reductions in everyday exposures for the general population. Household exposure studies, including those conducted by Silent Spring Institute, show that people are exposed to complex mixtures of indoor toxics from building materials and a myriad of consumer products. Pollutants in homes are likely to have multiple health effects because many are classified as endocrine disrupting compounds (EDCs), with the ability to interfere with the body's hormone system. Product-related EDCs measured in homes include phthalates, halogenated flame retardants, and alkylphenols. Silent Spring Institute's chemical analysis of personal care and cleaning products confirms many are potential sources of EDCs, highlighting the need for a more comprehensive toxics use reduction (TUR) approach to reduce those exposures. Toxics use reduction targeted at EDCs in consumer products has the potential to substantially reduce occupational and residential exposures. The lessons that have emerged from household exposure research can inform improved chemicals management policies at the state and national levels, leading to safer products and widespread health and environmental benefits. PMID:21516227

Electroconvulsive therapy in Parkinson's disease.

PubMed

Calderón-Fajardo, Humberto; Cervantes-Arriaga, Amin; Llorens-Arenas, Rodrigo; Ramírez-Bermudez, Jesús; Ruiz-Chow, Ángel; Rodríguez-Violante, Mayela

2015-10-01

Purpose To analyze the effectiveness of electroconvulsive therapy for the management of depression and/or psychosis refractory to drug therapy in patients with Parkinson disease.Methods A retrospective study was carried out including patients treated with electroconvulsive therapy during the period between 2002 and 2013. A review of the literature was performed.Results A total of 27 patients were included. In regards to the neuropsychiatric diagnosis, 14 patients had major depression, 12 patients had both psychosis and depression, and only one patient had isolated psychosis. The mean number of electroconvulsive therapy sessions was 12 ± 2.8. After electroconvulsive therapy, all patients showed a statistically significant improvement in the Brief Psychiatric Rating scale (reduction of 52% points) and Hamilton Depression Rating Scale (reduction of 50% points) independent of the presence of psychosis, depression or both.Conclusion Electroconvulsive therapy is effective for the treatment of refractory neuropsychiatric symptoms in Parkinson's disease.

Workshop on Oxygen in Asteroids and Meteorites

NASA Technical Reports Server (NTRS)

2005-01-01

Contents include the following: Constraints on the detection of solar nebula's oxidation state through asteroid observation. Oxidation/Reduction Processes in Primitive Achondrites. Low-Temperature Chemical Processing on Asteroids. On the Formation Location of Asteroids and Meteorites. The Spectral Properties of Angritic Basalts. Correlation Between Chemical and Oxygen Isotopic Compositions in Chondrites. Effect of In-Situ Aqueous Alteration on Thermal Model Heat Budgets. Oxidation-Reduction in Meteorites: The Case of High-Ni Irons. Ureilite Atmospherics: Coming up for Air on a Parent Body. High Temperature Effects Including Oxygen Fugacity, in Pre-Planetary and Planetary Meteorites and Asteroids. Oxygen Isotopic Variation of Asteroidal Materials. High-Temperature Chemical Processing on Asteroids: An Oxygen Isotope Perspective. Oxygen Isotopes and Origin of Opaque Assemblages from the Ningqiang Carbonaceous Chondrite. Water Distribution in the Asteroid Belt. Comparative Planetary Mineralogy: V Systematics in Planetary Pyroxenes and fo 2 Estimates for Basalts from Vesta.

A Review on the Assessment of the Efficacy of Common Treatments in Polycystic Ovarian Syndrome on Prevention of Diabetes Mellitus

PubMed Central

Dashti, Sareh; Latiff, Latiffah Abdul; Zulkefli, Nor Afiah Binti Mohd; Baharom, Anisah Binti; Minhat, Halimatus Sakdiah; Hamid, Habibah Abdul; Ismail, Maimunah; Jafarzadeh Esfehani, Ali; Abu Bakar, Azrin Shah; Binti Sabri, Nur Amirah Inani

2017-01-01

Objective: Polycystic ovarian syndrome (PCOS) is a common condition amongst women of reproductive age that can result in increased mortality and morbidity in women due to increased risk of diabetes mellitus and cardiovascular diseases. The aim of this systematic review was to assess the effectiveness of common treatments of PCOS on the predictors of diabetes in non-diabetic PCOS women. Materials and methods: An extensive search was performed on the publications in three medical databases including pubmed, scopus and google scholar from 1995 till 2017. The articles were screened based on their quality and included in this systematic review. A total of 25 articles including cohort, randomised controlled trial, review and meta-analysis were included in the review. Results: This systematic review revealed that the effect of lifestyle modification might be low in PCOS subjects due to high drop-out rate while the benefits of this intervention including weight and fat reduction may not be achieved by medical interventions. Metformin treatment may result in improvements in insulin sensitivity while its weight reduction effect is still not documented in PCOS subjects. Thiazolidendiones might be tolerated by the PCOS subjects and may result in similar effects as metformin but this effect should be documented by further studies. Conclusion: Combination of lifestyle modification with metformin or thiazolidinedions might improve the outcome of the prevention strategies. On the other hand this study revealed a different response to treatments in non-obese compared with obese PCOS subjects. PMID:29282412

26 CFR 1.1301-1 - Averaging of farm income.

Code of Federal Regulations, 2010 CFR

2010-04-01

... −$150. (3) Effect on subsequent elections—(i) In general. The reduction and increases in taxable income... business. For this purpose, the term property does not include land, but does include structures affixed to...—(1) Short taxable year—(i) In general. If a base year or an election year is a short taxable year...

Effect of sibutramine on weight reduction in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial.

PubMed

Lindholm, Asa; Bixo, Marie; Björn, Inger; Wölner-Hanssen, Pål; Eliasson, Mats; Larsson, Anders; Johnson, Owe; Poromaa, Inger Sundström

2008-05-01

To examine the efficacy of sibutramine together with brief lifestyle modification for weight reduction in obese women with polycystic ovary syndrome (PCOS). Investigator-initiated, multicenter, double-blind, randomized, parallel-group clinical trial. Departments of Obstetrics and Gynecology in primary care, referral centers, and private practice. Forty-two patients with confirmed PCOS were included in the study, and 34 patients completed the study. Sibutramine 15 mg once daily together with brief lifestyle modification was compare with placebo together with brief lifestyle modification. The primary endpoint was to assess weight loss. Secondary endpoints included the efficacy of sibutramine for treatment of menstrual pattern and cardiovascular risk factors. After 6 months the sibutramine group had lost 7.8 +/- 5.1 kg compared with a weight loss of 2.8 +/- 6.2 kg in the placebo group. Sibutramine treatment resulted in significant decreases in apolipoprotein B, apolipoprotein B/apolipoprotein A ratio, triglycerides, and cystatin C levels. Sibutramine in combination with lifestyle intervention results in significant weight reduction in obese patients with PCOS. In addition to the weight loss, sibutramine seems to have beneficial effects on metabolic and cardiovascular risk factors.

Exposure to gemfibrozil and atorvastatin affects cholesterol metabolism and steroid production in zebrafish (Danio rerio).

PubMed

Al-Habsi, Aziz A; Massarsky, Andrey; Moon, Thomas W

2016-09-01

The commonly used lipid-lowering pharmaceuticals gemfibrozil (GEM) and atorvastatin (ATV) are detected in the aquatic environment; however, their potential effects on non-target fish species are yet to be fully understood. This study examined the effects of GEM and/or ATV on female and male adult zebrafish after a 30d dietary exposure. The exposure led to changes in several biochemical parameters, including reduction in cholesterol, triglycerides, cortisol, testosterone, and estradiol. Changes in cholesterol and triglycerides were also associated with changes in transcript levels of key genes involved with cholesterol and lipid regulation, including SREBP2, HMGCR1, PPARα, and SREBP1. We also noted higher CYP3A65 and atrogin1 mRNA levels in drug-treated male fish. Sex differences were apparent in some of the examined parameters at both biochemical and molecular levels. This study supports these drugs affecting cholesterol metabolism and steroid production in adult zebrafish. We conclude that the reduction in cortisol may impair the ability of these fish to mount a suitable stress response, whereas the reduction of sex steroids may negatively affect reproduction. Copyright © 2015 Elsevier Inc. All rights reserved.

DEVELOPING AN INTEGRATED MANAGEMENT SYSTEM FOR URBAN AND ENERGY PLANNING TOWARDS A LOW-CARBON CITY

NASA Astrophysics Data System (ADS)

Maeda, Hideto; Nakakubo, Toyohiko; Tokai, Akihiro

In this study, we developed an integrated management model that supports local government to make a promising energy saving measure on a block-scale combined with urban planning. We applied the model to Osaka city and estimated CO2 emissions from the residential and commercial buildings to 2050. The urban renewal cases selected in this study included advanced multipole accumulation case, normal multipole accumulation case, and actual trend continuation case. The energy saving options introduced in each case included all-electric HP system, micro grid system, and we also set the option where the greater CO2 reduction one is selected in each block. The results showed that CO2 emission in 2050 would be reduced by 54.8-57.6% relative to the actual condition by introducing the new energy system in all cases. In addition, the amount of CO2 reduction in actual trend continuation case was highest. The major factor was that the effect of CO2 emission reductions by installing the solar power generation panel was higher than the effect by utilizing heated water mutually on the high-density blocks in terms of total urban buildings' energy consumption.

Prebiotics and probiotics: the prevention and reduction in severity of atopic dermatitis in children.

PubMed

Foolad, N; Armstrong, A W

2014-06-01

The purpose of this review was to identify whether supplementation with prebiotics and/or probiotics help prevent the development or reduce the severity of atopic dermatitis in children less than three years of age. Since 1997, immunostimulatory supplements, such as prebiotics and probiotics, have been investigated. Various supplementations include probiotics (single strain or mix), probiotics with formula, probiotics mix with prebiotics, and prebiotics. In this narrative review, we examined 13 key articles on prebiotics and/or probiotics, and their effects on infant atopic dermatitis. Among the selected studies, a total of 3,023 participants received supplements or placebo. Eight out of the 13 (61.5%) studies reported a significant effect on the prevention of atopic dermatitis after supplementation with probiotics and/or prebiotics. Five out of the 13 (38.5%) studies indicated significant reduction in the severity of atopic dermatitis after supplementation. Based on the available studies, supplementation with certain probiotics (Lactobacillus rhamnosus GG) appears to be an effective approach for the prevention and reduction in severity of atopic dermatitis. A mix of specific probiotic strains prevented atopic dermatitis among infants. Based on studies with prebiotics, there was a long-term reduction in the incidence of atopic dermatitis. Supplementation with prebiotics and probiotics appears useful for the reduction in the severity of atopic dermatitis. Additional interventional studies exploring prebiotics and probiotics are imperative before recommendations can be made.

TEM Cell Testing of Cable Noise Reduction Techniques from 2 MHz to 200 MHz -- Part 2

NASA Technical Reports Server (NTRS)

Bradley, Arthur T.; Evans, William C.; Reed, Joshua L.; Shimp, Samuel K., III; Fitzpatrick, Fred D.

2008-01-01

This paper presents empirical results of cable noise reduction techniques as demonstrated in a TEM cell operating with radiated fields from 2 - 200 MHz. It is the second part of a two-paper series. The first paper discussed cable types and shield connections. In this second paper, the effects of load and source resistances and chassis connections are examined. For each topic, well established theories are compared to data from a real-world physical system. Finally, recommendations for minimizing cable susceptibility (and thus cable emissions) are presented. There are numerous papers and textbooks that present theoretical analyses of cable noise reduction techniques. However, empirical data is often targeted to low frequencies (e.g. <50 KHz) or high frequencies (>100 MHz). Additionally, a comprehensive study showing the relative effects of various noise reduction techniques is needed. These include the use of dedicated return wires, twisted wiring, cable shielding, shield connections, changing load or source impedances, and implementing load- or source-to-chassis isolation. We have created an experimental setup that emulates a real-world electrical system, while still allowing us to independently vary a host of parameters. The goal of the experiment was to determine the relative effectiveness of various noise reduction techniques when the cable is in the presence of radiated emissions from 2 MHz to 200 MHz.

Consumer acceptance of reformulated food products: A systematic review and meta-analysis of salt-reduced foods.

PubMed

Jaenke, Rachael; Barzi, Federica; McMahon, Emma; Webster, Jacqui; Brimblecombe, Julie

2017-11-02

Food product reformulation is promoted as an effective strategy to reduce population salt intake and address the associated burden of chronic disease. Salt has a number of functions in food processing, including impacting upon physical and sensory properties. Manufacturers must ensure that reformulation of foods to reduce salt does not compromise consumer acceptability. The aim of this systematic review is to determine to what extent foods can be reduced in salt without detrimental effect on consumer acceptability. Fifty studies reported on salt reduction, replacement or compensation in processed meats, breads, cheeses, soups, and miscellaneous products. For each product category, levels of salt reduction were collapsed into four groups: <40%, 40-59%, 60-79% and ≥80%. Random effects meta-analyses conducted on salt-reduced products showed that salt could be reduced by approximately 40% in breads [mean change in acceptability for reduction <40% (-0.27, 95% confidence interval (CI) -0.62, 0.08; p = 0.13)] and approximately 70% in processed meats [mean change in acceptability for reductions 60-69% (-0.18, 95% CI -0.44, 0.07; p = 0.15)] without significantly impacting consumer acceptability. Results varied for other products. These results will support manufacturers to make greater reductions in salt when reformulating food products, which in turn will contribute to a healthier food supply.

The vagal nerve stimulation outcome, and laryngeal effect: Otolaryngologists roles and perspective.

PubMed

Al Omari, Ahmad I; Alzoubi, Firas Q; Alsalem, Mohammad M; Aburahma, Samah K; Mardini, Diala T; Castellanos, Paul F

Epilepsy is one of the most common neurologic disorders. Vagus nerve stimulation (VNS), first investigated in 1938 and subsequently studied as a potential therapy for epilepsy. The FDA approved the use of VNS in 1997 as an adjunctive non-pharmacologic symptomatic treatment option for refractory epilepsy for adults and adolescents over 12years. VNS can cause laryngeal and voice side effects that can be managed by otolaryngologists safely and effectively. This study is to review the outcomes of vagal nerve stimulator (VNS) implantation in terms of the surgical procedures, complications, seizure frequency, and the clinical effect on larynx and vocal folds motion. Series of thirty consecutive patients who had VNS implantation between 2007 and 2014 were recruited. Seizure-frequency outcome, surgical complications and device adverse effects of VNS were retrospectively reviewed. Additional evaluation included use of the Voice Handicap Index and Maximum Phonation Time (MPT) were conducted before and after the implantation. Videolaryngoscopy was used to evaluate the vocal fold mobility before and after the VNS implantation. Seizure frequency reduction over a minimum of 2years of follow up demonstrated: 100% in seizure frequency reduction in 1 patient, drastic reduction in seizure frequency (70-90%) in 9 patients, a good reduction in terms of seizure frequency (50%) in 8 patients, a 30% reduction in 5 patients, no response in 6 patients, and 1 patient had increased frequency. The most commonly reported adverse effects after VNS activation were coughing and voice changes with pitch breaks, as well as mild intermittent shortness of breath in 33% of patients. For those patients secondary supraglottic muscle tension and hyper function with reduced left vocal fold mobility were noticed on videolaryngoscopy, though none had aspiration problems. Surgical complications included a wound dehiscence in one patient (3%) which was surgically managed, minor intra-operative bleeding 3%; a superficial wound infection in one patient (3%) which was treated conservatively, none of the complications necessitated VNS removal. VNS appears to be an effective non-pharmacologic adjuvant therapy in patients with medically refractory seizures. With the favorable adverse-effect profile previously described, VNS is generally well tolerated and of a great benefit to such patients. Laryngeal side effects, of which hoarseness being of the greatest repetition, are the most common after the VNS implantation. VNS can affect the voice and reduced vocal cord motion on the implantation side with secondary supraglottic muscle tension. Otolaryngologists are not only capable of performing VNS implantation, but can also manage surgical complications, assess laryngeal side effects and treat them as needed. Copyright © 2017 Elsevier Inc. All rights reserved.

A comparison of the light-reduction capacity of commonly used incubator covers.

PubMed

Lee, Yi-Hui; Malakooti, Nima; Lotas, Marilyn

2005-01-01

The use of incubator covers to enhance preterm infants' rest and recovery is common in the NICU. However, the kinds of covers used vary extensively among and within nurseries. Few data exist on the effectiveness of different types of covers in reducing light levels to the infant. This study compared several types of commonly used incubator covers as to efficacy of light reduction. A descriptive, comparative design was used in this study. Twenty-three incubator covers were tested, including professional, receiving blanket, hand-crocheted, three-layer quilt, and flannel. The percentage of light level reduction of different incubator covers under various ambient light level settings. The amount of light reduction provided by incubator covers varies depending on type of fabric as well as percentage of incubator surface shielded by the cover. Dark-colored covers provided greater light reduction than bright/light-colored covers when covers identical in fabric type were compared. The light-reduction efficiency of the covers varied depending on the level of ambient light. Covers provided less light reduction in higher ambient light levels.

Taking stock of decentralized disaster risk reduction in Indonesia

NASA Astrophysics Data System (ADS)

Grady, Anthony; Gersonius, Berry; Makarigakis, Alexandros

2016-09-01

The Sendai Framework, which outlines the global course on disaster risk reduction until 2030, places strong importance on the role of local government in disaster risk reduction. An aim of decentralization is to increase the influence and authority of local government in decision making. Yet, there is limited empirical evidence of the extent, character and effects of decentralization in current disaster risk reduction implementation, and of the barriers that are most critical to this. This paper evaluates decentralization in relation to disaster risk reduction in Indonesia, chosen for its recent actions to decentralize governance of DRR coupled with a high level of disaster risk. An analytical framework was developed to evaluate the various dimensions of decentralized disaster risk reduction, which necessitated the use of a desk study, semi-structured interviews and a gap analysis. Key barriers to implementation in Indonesia included: capacity gaps at lower institutional levels, low compliance with legislation, disconnected policies, issues in communication and coordination and inadequate resourcing. However, any of these barriers are not unique to disaster risk reduction, and similar barriers have been observed for decentralization in other developing countries in other public sectors.

[Topiramate in substance-related and addictive disorders].

PubMed

Cohen, Johan; Dervaux, Alain; Laqueille, Xavier

2014-09-01

Drug treatments used in substance use disorders are not effective in all patients. To assess the effectiveness of topiramate use in the treatment of substance use disorders. Medline database from January 1966 to December 2013, Cochrane database and clinicaltrials.gov. We used keywords topiramate, addiction, substance abuse, alcohol, tobacco, nicotine, cocaine, methamphetamine, opiate, heroin, benzodiazepine, cannabis, bulimia nervosa, binge eating disorder, gambling. All clinical trials were included. Animal trials, laboratory tests, reviews, answers to writers, case-reports, case series and publications unrelated to the topic were excluded. Twenty-eight articles investigating the efficacy of topiramate in substance use were included. In alcohol-related disorder, several trials and a meta-analysis showed a reduction of days of consumption. In a single-center trial on tobacco-related disorder, topiramate was not found effective in reducing the carbon monoxide expired. In cocaine-related disorder, one single-center trial showed a reduction of days of consumption and two single-center trials have found a trend in favour of topiramate. In alcohol and cocaine co-dependency, a single-center trial found a trend in favour of topiramate. In methamphetamine-related disorder, a multicenter trial found a trend in favour of topiramate. In bulimia nervosa, two single-center trials showed a reduction in binge eating and compensatory behaviours. In binge eating disorder, several trials showed a reduction of binge eating and weight. In gambling, one single-center trial did not show any significant results. There were no randomized controlled trials found in opioid-related disorder, benzodiazepines-related disorder, and cannabis-related disorder. Definition of abstinence and methods to assess the efficacy of topiramate differed between trials. The methodological quality of included trials was variable, especially with no double-blind procedure in eight trials. Topiramate showed interest mainly in alcoholism, binge eating disorder and bulimia nervosa. No definitive conclusions can be reached for other substance use disorders such as nicotine dependence, cocaine dependence, amphetamine dependence or cannabis dependence and for gambling. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Supersonic Aerodynamic Design Improvements of an Arrow-Wing HSCT Configuration Using Nonlinear Point Design Methods

NASA Technical Reports Server (NTRS)

Unger, Eric R.; Hager, James O.; Agrawal, Shreekant

1999-01-01

This paper is a discussion of the supersonic nonlinear point design optimization efforts at McDonnell Douglas Aerospace under the High-Speed Research (HSR) program. The baseline for these optimization efforts has been the M2.4-7A configuration which represents an arrow-wing technology for the High-Speed Civil Transport (HSCT). Optimization work on this configuration began in early 1994 and continued into 1996. Initial work focused on optimization of the wing camber and twist on a wing/body configuration and reductions of 3.5 drag counts (Euler) were realized. The next phase of the optimization effort included fuselage camber along with the wing and a drag reduction of 5.0 counts was achieved. Including the effects of the nacelles and diverters into the optimization problem became the next focus where a reduction of 6.6 counts (Euler W/B/N/D) was eventually realized. The final two phases of the effort included a large set of constraints designed to make the final optimized configuration more realistic and they were successful albeit with a loss of performance.

In vivo photosystem I reduction in thermophilic and mesophilic cyanobacteria: the thermal resistance of the process is limited by factors other than the unfolding of the partners.

PubMed

Durán, Raúl V; Hervás, Manuel; De la Rosa, Miguel A; Navarro, José A

2005-08-19

Photosystem I reduction by plastocyanin and cytochrome c(6) in cyanobacteria has been extensively studied in vitro, but much less information is provided on this process inside the cell. Here, we report an analysis of the electron transfer from both plastocyanin and cytochrome c(6) to photosystem I in intact cells of several cyanobacterial species, including a comparative study of the temperature effect in mesophilic and thermophilic organisms. Our data show that cytochrome c(6) reduces photosystem I by following a reaction mechanism involving complex formation, whereas the copper-protein follows a simpler collisional mechanism. These results contrast with previous kinetic studies in vitro. The effect of temperature on photosystem I reduction leads us to conclude that the thermal resistance of this process is determined by factors other than the proper stability of the protein partners.

Researching of the reduction of shock waves intensivity in the “pseudo boiling” layer

NASA Astrophysics Data System (ADS)

Pavlov, G. I.; Telyashov, D. A.; Kochergin, A. V.; Nakoryakov, P. V.; Sukhovaya, E. A.

2017-09-01

This article applies to the field of acoustics and deals with noise reduction of pulsating combustion chambers, in particular the reduction of the shock waves’ intensity with the help of pseudo boiling layer. In the course of work on a test stand that included a pulsator, a compressor with the receiver and a high pressure fan was simulated gas jet flowing from the chamber pulsating combustion and studied the effect of different types of fluidization on effect of reducing the sound pressure levels. Were obtained the experimental dependence of the sound pressure levels from parameters such as: height of the layer of granules; diameter of the used granules; amplitude of the pressure pulsations in the gas stream at the entrance to the camera; frequency of pressure pulsations. Based on the results of the study, it was concluded that the using of a pseudo boiling layer is promising for reducing shock wave noise.

The Development And Implementation Of A Concept To Permanent Reduction Of Noise Pollution In Production Taking Into Account The Legal And Economic Framework Conditions

NASA Astrophysics Data System (ADS)

Zaušková, Lucia; Czán, Andrej; Babík, Ondrej; Piešová, Marianna

2015-12-01

Article deals with the issue of reducing noise impact in real conditions of industrial production. The solution includes measurements and calculations of noise level the person is exposed to and developing proposals for effective reduction of noise levels at the specific workplace. When assessing noise levels and design to reduce it to an acceptable level we will consider the legal, safety and economic conditions.

Effects of feeding diets naturally contaminated with Fusarium mycotoxins on protein metabolism in late gestation and lactation of first-parity sows.

PubMed

Díaz-Llano, G; Smith, T K; Boermans, H J; Caballero-Cortes, C; Friendship, R

2010-03-01

A study was conducted to assess the effects of feeding a blend of grains naturally contaminated with Fusarium mycotoxins to sows on the capacity for protein synthesis in skeletal muscle, the protein content per cellular unit, and the efficacy of a polymeric glucomannan adsorbent (GMA) to prevent these effects in late gestation and in lactation. Thirty-two Yorkshire sows were assigned to 4 treatment groups (8 per treatment) from 91 +/- 3 d of gestation up to weaning on d 21 after farrowing. Diets included 1) control, 2) contaminated grains, and 3) contaminated grains + 0.2% GMA. A fourth treatment of feeding sows the control diet at a restricted feed allowance was also included. The variables measured include ADFI, average daily BW change, serum total protein, urea, and ammonia, and skeletal muscle DNA, RNA, and protein. To assess the capacity for protein synthesis, ratios of RNA:DNA, and RNA:protein were compared among dietary treatments. To assess the degree of muscle protein mobilization in gestation and lactation, ratios of protein:DNA were compared among dietary treatments. Muscle samples were obtained from the triceps brachii. Blood and muscle samples were obtained 3 times: the first was obtained 1 d before the sows began to receive the experimental diets (90 +/- 3 d of gestation), a second sample was obtained 14 d later (104 +/- 3 d of gestation), and the third sample was obtained 10 d after farrowing. Serum ammonia concentrations were similar in sows fed the contaminated feed and sows fed the restricted feed compared with controls, but serum ammonia concentrations were greater in sows fed contaminated feed (P = 0.02) and restricted-fed sows (P = 0.008) compared with sows fed the contaminated grains plus GMA on 104 +/- 3 d of gestation. There were no reductions in the capacity for protein synthesis caused by mycotoxins or restricted feeding compared with controls. A reduction in ADFI (P = 0.003) was observed in sows fed the 2 contaminated diets in lactation. Muscle protein mobilization was not affected by diet, but a reduction (P = 0.04) in the content of protein per cellular unit was observed in lactation compared with gestation. Reduction in protein:DNA could be caused by the catabolic state in lactation, which was augmented by a low ADFI. The rate of muscle mobilization could be the result of the indirect effect of the reduction in ADFI in lactation rather than a direct effect of Fusarium mycotoxins in the capacity for protein synthesis.

Effect of Music on Outpatient Urological Procedures: A Systematic Review and Meta-Analysis from the European Association of Urology Section of Uro-Technology.

PubMed

Kyriakides, Rena; Jones, Patrick; Geraghty, Robert; Skolarikos, Andreas; Liatsikos, Evangellos; Traxer, Olivier; Pietropaolo, Amelia; Somani, Bhaskar K

2018-05-01

Music is a practical, inexpensive and harmless analgesic and anxiolytic. An increasing number of original studies have been performed to investigate its potential application in urology. Our aim was to identify the effect of music on outpatient based urological procedures. We systematically reviewed the effect of using music during all reported outpatient urology procedures, including transrectal ultrasound guided prostate biopsy, shock wave lithotripsy, urodynamic studies, percutaneous nephrostomy tube placement and cystoscopy. Data were included on all randomized trials from 1980 to 2017 and no language restrictions were applied. Included in analysis were 16 randomized studies in which 972 of 1,950 patients (49.8%) were exposed to music during an outpatient procedure. The procedures included transrectal ultrasound guided prostate biopsy in 4 studies in a total of 286 patients, shock wave lithotripsy in 6 studies in a total of 1,023, cystoscopy in 3 studies in a total of 331, urodynamics in 2 studies in a total of 210 and percutaneous nephrostomy in 1 study in a total of 100. All studies incorporated a visual analog score to measure pain. Anxiety was measured by STAI (State-Trait Anxiety Inventory) in 13 studies and by a visual analog scale in 2. While 14 of the 16 studies showed a reduction in self-reported pain, a reduction in anxiety was seen in 14. When using music, overall procedural satisfaction was better in 9 studies and patient willingness to repeat the procedure was also higher in 7. Our meta-analysis revealed a significant reduction in visual analog scale and STAI findings across all studies (p <0.001). Our systematic review demonstrated a beneficial effect of music on urological outpatient procedures. Music seemed to decrease anxiety and pain. It might serve as a useful adjunct to increase procedural satisfaction and patient willingness to undergo the procedure again. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Not in My Navy. A Legal Guide to Drug Abuse.

DTIC Science & Technology

1984-06-01

opiates produces drowsiness, sleep, and a reduction in physical activity. Side effects can include nausea and vomiting, constipation, itching, flushing...diarrhea, pallor, and dilation of the pupils. Such effects are generally seen only with high doses or as occasional side effects with therapeutic doses...that will produce low-level side effects . or, a person might be drowsy from ingesting a nonprescription product - such as an antihistamine. A clue to

Is harm reduction profitable? An analytical framework for corporate social responsibility based on an epidemic model of addictive consumption.

PubMed

Massin, Sophie

2012-06-01

This article aims to help resolve the apparent paradox of producers of addictive goods who claim to be socially responsible while marketing a product clearly identified as harmful. It advances that reputation effects are crucial in this issue and that determining whether harm reduction practices are costly or profitable for the producers can help to assess the sincerity of their discourse. An analytical framework based on an epidemic model of addictive consumption that includes a deterrent effect of heavy use on initiation is developed. This framework enables us to establish a clear distinction between a simple responsible discourse and genuine harm reduction practices and, among harm reduction practices, between use reduction practices and micro harm reduction practices. Using simulations based on tobacco sales in France from 1950 to 2008, we explore the impact of three corresponding types of actions: communication on damage, restraining selling practices and development of safer products on total sales and on the social cost. We notably find that restraining selling practices toward light users, that is, preventing light users from escalating to heavy use, can be profitable for the producer, especially at early stages of the epidemic, but that such practices also contribute to increase the social cost. These results suggest that the existence of a deterrent effect of heavy use on the initiation of the consumption of an addictive good can shed new light on important issues, such as the motivations for corporate social responsibility and the definition of responsible actions in the particular case of harm reduction. Copyright © 2012 Elsevier Ltd. All rights reserved.

Harm Reduction Agencies as a Potential Site for Buprenorphine Treatment.

PubMed

Fox, Aaron D; Chamberlain, Adam; Frost, Taeko; Cunningham, Chinazo O

2015-01-01

Harm reduction agencies complement addiction treatment by providing diverse services that improve the health of people who use drugs. Buprenorphine maintenance treatment (BMT) is an effective opioid addiction treatment that may be provided from flexible settings, potentially including harm reduction agencies. This study investigated attitudes toward different potential sites for BMT (harm reduction agencies, general medical clinics, and drug treatment programs) among harm reduction clients. Using computer-based interviews, participants indicated preferred potential site for BMT (harm reduction agency, drug treatment program, or general medical clinic), interest in BMT by potential site, motivation for treatment, and barriers to BMT. Multivariable logistic regression was used to determine factors associated with harm reduction agency preference. Of 102 opioid users, the most preferred potential site for BMT was a harm reduction agency (51%), whereas fewer preferred general medical clinics (13%), drug treatment programs (12%), or were not interested in BMT (25%). In multivariable analysis, experiencing ≥1 barrier to BMT was strongly associated with preferring harm reduction agencies (adjusted odds ratio [aOR] = 3.39, 95% confidence interval [CI]: 1.00-11.43). The potential to initiate BMT at harm reduction agencies is highly favorable among harm reduction clients, especially among those experiencing barriers to BMT. Offering BMT at harm reduction agencies could improve access to treatment, but studies are needed to determine safety and efficacy of this approach.

Perioperative bromelain reduces pain and swelling and improves quality of life measures after mandibular third molar surgery: a randomized, double-blind, placebo-controlled clinical trial.

PubMed

Majid, Omer Waleed; Al-Mashhadani, Bashar Adil

2014-06-01

The purpose of the present study was to compare the effect of oral bromelain (4 × 250 mg) versus oral diclofenac sodium (4 × 25 mg) on pain, swelling, trismus, and quality of life (QOL) after surgical removal of impacted lower third molars. A randomized, double-blind, placebo-controlled study was planned. The sample included patients requiring extraction under local anesthesia of a single partial bony impacted mandibular third molar. The patients were randomly distributed into 1 of 3 groups: bromelain, diclofenac, and placebo. Treatment started 1 day before surgery and continued for 4 days. The predictor variable was the type of the drug given to the patients. The outcome variables were pain, swelling, and trismus, which were measured at 1, 3, and 7 days postoperatively. The other study variables included QOL measures to assess the patients' perception regarding the effect of surgery on their well-being and daily activities. A validated questionnaire was used to measure QOL. The data were analyzed using analysis of variance, multiple measures analysis of variance, or Pearson's χ(2) test, as appropriate. P < .05 was considered significant. A total of 45 subjects requiring surgical removal of a single impacted mandibular third molar under local anesthesia were included in the present study. The bromelain and diclofenac groups both showed a significant reduction in pain compared with the placebo group at all intervals (P < .05). Diclofenac also resulted in a significant reduction of swelling at 3 and 7 days, and bromelain resulted in an insignificant reduction. A nonsignificant reduction in trismus occurred in both treatment groups compared with the placebo group. Both treatment groups also showed a significant difference in the effect on QOL in most subscales and total scores (P < .05). The effect was comparable between the 2 treatment groups for all parameters and at all intervals. The results of our study have shown that oral bromelain is an effective therapy to improve the QOL after surgical removal of impacted lower third molars, with an effect on the postoperative sequelae comparable to that of preemptive diclofenac sodium. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Reductant injection and mixing system

DOEpatents

Reeves, Matt; Henry, Cary A.; Ruth, Michael J.

2016-02-16

A gaseous reductant injection and mixing system is described herein. The system includes an injector for injecting a gaseous reductant into an exhaust gas stream, and a mixer attached to a surface of the injector. The injector includes a plurality of apertures through which the gaseous reductant is injected into an exhaust gas stream. The mixer includes a plurality of fluid deflecting elements.

Microbial Transformations of Selenium Species of Relevance to Bioremediation

PubMed Central

Eswayah, Abdurrahman S.; Smith, Thomas J.

2016-01-01

Selenium species, particularly the oxyanions selenite (SeO32−) and selenate (SeO42−), are significant pollutants in the environment that leach from rocks and are released by anthropogenic activities. Selenium is also an essential micronutrient for organisms across the tree of life, including microorganisms and human beings, particularly because of its presence in the 21st genetically encoded amino acid, selenocysteine. Environmental microorganisms are known to be capable of a range of transformations of selenium species, including reduction, methylation, oxidation, and demethylation. Assimilatory reduction of selenium species is necessary for the synthesis of selenoproteins. Dissimilatory reduction of selenate is known to support the anaerobic respiration of a number of microorganisms, and the dissimilatory reduction of soluble selenate and selenite to nanoparticulate elemental selenium greatly reduces the toxicity and bioavailability of selenium and has a major role in bioremediation and potentially in the production of selenium nanospheres for technological applications. Also, microbial methylation after reduction of Se oxyanions is another potentially effective detoxification process if limitations with low reaction rates and capture of the volatile methylated selenium species can be overcome. This review discusses microbial transformations of different forms of Se in an environmental context, with special emphasis on bioremediation of Se pollution. PMID:27260359

Effect of comfort pads and incubator design on neonatal radiography.

PubMed

Jiang, Xia; Baad, Michael; Reiser, Ingrid; Feinstein, Kate A; Lu, Zhengfeng

2016-01-01

There has been increasing interest in patient dose reduction in neonatal intensive care units. Removing comfort pads for radiography has been identified as a potential means to decrease patient dose. To assess the effect of comfort pads and support trays on detector entrance exposure (DEE) and image quality for neonatal radiography, and its implication for patient dose. Comfort pads and support trays from three incubator and warmer systems were examined. The attenuation of the primary beam by these structures was measured using a narrow beam geometry. Their effect on DEE and image quality was then assessed using typical neonatal chest radiography techniques with three configurations: 1) both the comfort pad and support included in the beam, 2) only the support tray included and 3) both the comfort pad and support tray removed. Comfort pads and support trays were found to attenuate the primary beam by 6-15%. Eliminating these structures from the X-ray beam's path was found to increase the detector entrance exposure by 28-36% and increase contrast-to-noise ratio by more than 21%, suggesting room for patient dose reduction when the same image quality is maintained. Comfort pads and tray support devices can have a considerable effect on DEE and image quality, with large variations among different incubator designs. Positioning the image detector directly underneath neonatal patients for radiography is a potential means for patient dose reduction. However, such benefit should be weighed against the risks of moving the patient.

The analgesic effect of wound infiltration with local anaesthetics after breast surgery: a qualitative systematic review.

PubMed

Byager, N; Hansen, M S; Mathiesen, O; Dahl, J B

2014-04-01

Wound infiltration with local anaesthetics is commonly used during breast surgery in an attempt to reduce post-operative pain and opioid consumption. The aim of this review was to evaluate the effect of wound infiltration with local anaesthetics compared with a control group on post-operative pain after breast surgery. A systematic review was performed by searching PubMed, Google Scholar, the Cochrane database and Embase for randomised, blinded, controlled trials of wound infiltration with local anaesthetics for post-operative pain relief in female adults undergoing breast surgery. The analgesic effect was evaluated in a qualitative analysis by assessment of significant difference between groups (P < 0.05) in pain scores and supplemental analgesic consumption. Ten trials including 699 patients were included in the final analysis. Three trials investigated mastectomy, four trials partial or segmental mastectomy, and three trials breast reduction, excision of benign lump and unspecified breast surgery, respectively. Six trials demonstrated a small and short-lasting, but statistically significant reduction of post-operative pain scores, and four trials observed a statistically significant reduction in post-operative, supplemental opioid consumption that was, however, of limited clinical relevance. Wound infiltration with local anaesthetics may have a modest analgesic effect in the first few hours after surgery. Pain after breast surgery is, however, generally mild to moderate, and other non-invasive analgesic methods may be preferable in this surgical population. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Reducing Adolescent Obesity through a School Health Program.

ERIC Educational Resources Information Center

Botvin, G. J.; And Others

1979-01-01

A 10-session weight reduction program that included behavior modification, nutrition education, and exercise management was found to be effective in reducing weight. (Author/DLS) Journal Availability: C. V. Mosby Company, 11830 Westline Industrial Dr., St. Louis, MO 63141

EFFECT OF BACTERIAL SULFATE REDUCTION ON IRON-CORROSION SCALES

EPA Science Inventory

Iron-sulfur geochemistry is important in many natural and engineered environments including drinking water systems. In the anaerobic environment beneath scales of corroding iron drinking water distribution system pipes, sulfate reducing bacteria (SRB) produce sulfide from natura...

Bilateral Breast Reduction Without Opioid Analgesics: A Comparative Study.

PubMed

Parsa, Fereydoun Don; Cheng, Justin; Stephan, Brad; Castel, Nikki; Kim, Leslie; Murariu, Daniel; Parsa, Alan A

2017-09-01

Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. A total of 83 female patients were enrolled in this study. Group 1 includes a retrospective series of 39 patients that underwent breast reduction via general anesthesia with adjunct opioid use. This series was compared to 2 prospective groups of patients who did not receive opioids either preoperatively or intraoperatively. In group 2, twenty-six patients underwent surgery under intravenous sedation and local anesthesia. In group 3, eighteen patients underwent surgery with general anesthesia. All patients in groups 2 and 3 received preoperative gabapentin and celecoxib along with infiltration of local anesthetics during the operation and prior to discharge to the Post-Anesthesia Care Unit (PACU). Primary outcome measures included the duration of surgery, time from end of operation to discharge home, postoperative opioid and antiemetic use, and unplanned postoperative hospitalizations. When compared to group 1, groups 2 and 3 experienced a shorter time from end of operation to discharge home (P < 0.05), fewer unplanned hospital admissions (P < 0.05), and highly significant decrease in postoperative opioid use (P < 0.001). This multimodal approach allows patients to safely undergo opioid-free bilateral breast reduction either under local or general anesthesia as an outpatient. This method resulted in significantly less morbidity, use of opioids postoperatively, as well as unplanned hospital admissions compared to "traditional" breast reduction under general anesthesia with the use of opioids. 3. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Fetal shielding combined with state of the art CT dose reduction strategies during maternal chest CT.

PubMed

Chatterson, Leslie C; Leswick, David A; Fladeland, Derek A; Hunt, Megan M; Webster, Stephen; Lim, Hyun

2014-07-01

Custom bismuth-antimony shields were previously shown to reduce fetal dose by 53% on an 8DR (detector row) CT scanner without dynamic adaptive section collimation (DASC), automatic tube current modulation (ATCM) or adaptive statistical iterative reconstruction (ASiR). The purpose of this study is to compare the effective maternal and average fetal organ dose reduction both with and without bismuth-antimony shields on a 64DR CT scanner using DASC, ATCM and ASiR during maternal CTPA. A phantom with gravid prosthesis and a bismuth-antimony shield were used. Thermoluminescent dosimeters (TLDs) measured fetal radiation dose. The average fetal organ dose and effective maternal dose were determined using 100 kVp, scanning from the lung apices to the diaphragm utilizing DASC, ATCM and ASiR on a 64DR CT scanner with and without shielding in the first and third trimester. Isolated assessment of DASC was done via comparing a new 8DR scan without DASC to a similar scan on the 64DR with DASC. Average third trimester unshielded fetal dose was reduced from 0.22 mGy ± 0.02 on the 8DR to 0.13 mGy ± 0.03 with the conservative 64DR protocol that included 30% ASiR, DASC and ATCM (42% reduction, P<0.01). Use of a shield further reduced average third trimester fetal dose to 0.04 mGy ± 0.01 (69% reduction, P<0.01). The average fetal organ dose reduction attributable to DASC alone was modest (6% reduction from 0.17 mGy ± 0.02 to 0.16 mGy ± 0.02, P=0.014). First trimester fetal organ dose on the 8DR protocol was 0.07 mGy ± 0.03. This was reduced to 0.05 mGy ± 0.03 on the 64DR protocol without shielding (30% reduction, P=0.009). Shields further reduced this dose to below accurately detectable levels. Effective maternal dose was reduced from 4.0 mSv on the 8DR to 2.5 mSv on the 64DR scanner using the conservative protocol (38% dose reduction). ASiR, ATCM and DASC combined significantly reduce effective maternal and fetal organ dose during CTPA. Shields continue to be an effective means of fetal dose reduction. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Confinement and the Glass Transition Temperature in Supported Polymer Films: Molecular Weight, Repeat Unit Modification, and Cooperativity Length Scale Investigations

NASA Astrophysics Data System (ADS)

Mundra, Manish K.

2005-03-01

It is well known that the glass transition temperatures, Tgs, of supported polystyrene (PS) films decrease dramatically with decreasing film thickness below 60-80 nm. However, a detailed understanding of the cause of this effect is lacking. We have investigated the impact of several parameters, including polymer molecular weight (MW), repeat unit structure, and the length scale of cooperatively rearranging regions in bulk. There is no significant effect of PS MW on the Tg-confinement effect over a range of 5,000 to 3,000,000 g/mol. In contrast, the strength of the Tg reduction and the onset of the confinement effect increase dramatically upon changing the polymer from PS to poly(4-tert-butylstyrene) (PTBS), with PTBS exhibiting a Tg reduction relative to bulk at a thickness of 300-400 nm. PTBS also shows a Tg reduction relative to bulk of 47 K in a 21-nm-thick film, more than twice that observed in a PS film of identical thickness. Characterization of the length scale of cooperatively rearranging regions has been done by differential scanning calorimetry but reveals at best a limited correlation with the confinement effect.

Large Reduction of Hot Spot Temperature in Graphene Electronic Devices with Heat-Spreading Hexagonal Boron Nitride.

PubMed

Choi, David; Poudel, Nirakar; Park, Saungeun; Akinwande, Deji; Cronin, Stephen B; Watanabe, Kenji; Taniguchi, Takashi; Yao, Zhen; Shi, Li

2018-04-04

Scanning thermal microscopy measurements reveal a significant thermal benefit of including a high thermal conductivity hexagonal boron nitride (h-BN) heat-spreading layer between graphene and either a SiO 2 /Si substrate or a 100 μm thick Corning flexible Willow glass (WG) substrate. At the same power density, an 80 nm thick h-BN layer on the silicon substrate can yield a factor of 2.2 reduction of the hot spot temperature, whereas a 35 nm thick h-BN layer on the WG substrate is sufficient to obtain a factor of 4.1 reduction. The larger effect of the h-BN heat spreader on WG than on SiO 2 /Si is attributed to a smaller effective heat transfer coefficient per unit area for three-dimensional heat conduction into the thick, low-thermal conductivity WG substrate than for one-dimensional heat conduction through the thin oxide layer on silicon. Consequently, the h-BN lateral heat-spreading length is much larger on WG than on SiO 2 /Si, resulting in a larger degree of temperature reduction.

Ending AIDS as a Public Health Threat: Treatment-as-Usual Risk Reduction Services for Persons With Mental Illness in Brazil.

PubMed

Wainberg, Milton L; McKinnon, Karen; Norcini-Pala, Andrea; Hughes, Olivia K; Schrage, Ezra; Erby, Whitney; Mann, Claudio G; Cournos, Francine

2018-04-01

Persons with mental illness have higher HIV infection rates than the general population. Little is known about whether care systems for this population are effectively participating in global efforts to end AIDS as a public health threat. This study examined treatment-as-usual HIV risk reduction services within public mental health settings. The authors interviewed 641 sexually active adults attending eight public psychiatric clinics in Rio de Janeiro about participation in a sexual risk reduction program, HIV testing, HIV knowledge, and sexual behaviors. Nine percent reported participation in a risk reduction program in the past year, and 75% reported having unprotected sex in the past three months. Program participants had greater HIV knowledge (p=.04) and were more likely to have had HIV testing in the past three months (p=.02), compared with nonparticipants. Participation was not associated with sexual behaviors. Including persons with mental illness in efforts to end AIDS requires a greater commitment to implementing effective interventions in public mental health systems.

Use of simulation tools to illustrate the effect of data management practices for low and negative plate counts on the estimated parameters of microbial reduction models.

PubMed

Garcés-Vega, Francisco; Marks, Bradley P

2014-08-01

In the last 20 years, the use of microbial reduction models has expanded significantly, including inactivation (linear and nonlinear), survival, and transfer models. However, a major constraint for model development is the impossibility to directly quantify the number of viable microorganisms below the limit of detection (LOD) for a given study. Different approaches have been used to manage this challenge, including ignoring negative plate counts, using statistical estimations, or applying data transformations. Our objective was to illustrate and quantify the effect of negative plate count data management approaches on parameter estimation for microbial reduction models. Because it is impossible to obtain accurate plate counts below the LOD, we performed simulated experiments to generate synthetic data for both log-linear and Weibull-type microbial reductions. We then applied five different, previously reported data management practices and fit log-linear and Weibull models to the resulting data. The results indicated a significant effect (α = 0.05) of the data management practices on the estimated model parameters and performance indicators. For example, when the negative plate counts were replaced by the LOD for log-linear data sets, the slope of the subsequent log-linear model was, on average, 22% smaller than for the original data, the resulting model underpredicted lethality by up to 2.0 log, and the Weibull model was erroneously selected as the most likely correct model for those data. The results demonstrate that it is important to explicitly report LODs and related data management protocols, which can significantly affect model results, interpretation, and utility. Ultimately, we recommend using only the positive plate counts to estimate model parameters for microbial reduction curves and avoiding any data value substitutions or transformations when managing negative plate counts to yield the most accurate model parameters.

Attention Deficit Disorder with Hyperactivity

DTIC Science & Technology

1991-01-01

fewer side effects and is the drug of choice (Shaywitz & Shaywitz, 1984). Pemoline is considered a second line drug due to possible hepatic adverse...which require this behavior (Barkley, 1977). The primary side effects observed with stimulants include insomnia, anorexia, weight loss or irritability...These side effects appear to be transitory and tend to disappear with a reduction in drug dosage (Barkley, 1977). Amery, Minichello and Brown (1984

The effect of SST emissions on the earth's ozone layer

NASA Technical Reports Server (NTRS)

Whitten, R. C.; Turco, R. P.

1974-01-01

The work presented here is directed toward assessment of environmental effects of the supersonic transport (SST). The model used for the purpose includes vertical eddy transport and the photochemistry of the O-H-N system. It is found that the flight altitude has a pronounced effect on ozone depletion. The largest ozone reduction occurs for NO deposition above an altitude of 20 km.

“I felt like a new person.” The effects of mindfulness meditation on older adults with chronic pain: qualitative narrative analysis of diary entries

PubMed Central

Morone, Natalia E.; Lynch, Cheryl S.; Greco, Carol M.; Tindle, Hilary A.; Weiner, Debra K.

2008-01-01

To identify the effects of mindfulness meditation on older adults with chronic low back pain (CLBP) we conducted a qualitative study based on grounded theory and used content analysis of diary entries from older adults who had participated in a clinical trial of an eight week mindfulness meditation program. Participants were 27 adults ≥ 65 years with CLBP of at least moderate severity and of at least three months duration. We found several themes reflecting the beneficial effects of mindfulness meditation on pain, attention, sleep, and achieving well-being. Various methods of pain reduction were used, including distraction, increased body awareness leading to behavior change, better pain coping, and direct pain reduction through meditation. Participants described improved attention skills. A number of participants reported improved sleep latency as well as quality of sleep. Participants described achieving well-being during and after a meditation session that had immediate effects on mood elevation but also long-term global effects on improved quality of life. Several themes were identified related to pain reduction, improved attention, improved sleep, and achieving well-being resulting from mindfulness meditation that suggest it has promising potential as a non-pharmacologic treatment of chronic pain for older adults. Perspective Community dwelling older adults with chronic low back pain experience numerous benefits from mindfulness meditation including less pain, improved attention, better sleep, more energy, enhanced well-being, and improved quality of life. Additional research is needed to determine how mindfulness meditation works and how it might help with other chronic illnesses. PMID:18550444

Ultralow-dose computed tomography imaging for surgery of midfacial and orbital fractures using ASIR and MBIR.

PubMed

Widmann, G; Dalla Torre, D; Hoermann, R; Schullian, P; Gassner, E M; Bale, R; Puelacher, W

2015-04-01

The influence of dose reductions on diagnostic quality using a series of high-resolution ultralow-dose computed tomography (CT) scans for computer-assisted planning and surgery including the most recent iterative reconstruction algorithms was evaluated and compared with the fracture detectability of a standard cranial emergency protocol. A human cadaver head including the mandible was artificially prepared with midfacial and orbital fractures and scanned using a 64-multislice CT scanner. The CT dose index volume (CTDIvol) and effective doses were calculated using application software. Noise was evaluated as the standard deviation in Hounsfield units within an identical region of interest in the posterior fossa. Diagnostic quality was assessed by consensus reading of a craniomaxillofacial surgeon and radiologist. Compared with the emergency protocol at CTDIvol 35.3 mGy and effective dose 3.6 mSv, low-dose protocols down to CTDIvol 1.0 mGy and 0.1 mSv (97% dose reduction) may be sufficient for the diagnosis of dislocated craniofacial fractures. Non-dislocated fractures may be detected at CTDIvol 2.6 mGy and 0.3 mSv (93% dose reduction). Adaptive statistical iterative reconstruction (ASIR) 50 and 100 reduced average noise by 30% and 56%, and model-based iterative reconstruction (MBIR) by 93%. However, the detection rate of fractures could not be improved due to smoothing effects. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Development of reduction scenarios for criteria air pollutants emission in Tehran Traffic Sector, Iran.

PubMed

Mohammadiha, Amir; Malakooti, Hossein; Esfahanian, Vahid

2018-05-01

Transport-related pollution as the main source of air pollution must be reduced in Tehran mega-city. The performance of various developed scenarios including BAU (Business As Usual) as baseline scenario, ECV (Elimination of carburetor equipped Vehicle), NEM (New Energy Motorcycles), HES (Higher Emission Standard), VCR (Vehicle Catalyst Replacement), FQE (Fuel Quality Enhancement), DPF (Diesel Particulate Filter) and TSA (Total Scenarios Aggregation) are evaluated by International Vehicle Model up to 2028. In the short term, the ECV, VCR, and FQE scenarios provided high performance in CO, VOCs and NOx emissions control. Also FQE has an excellent effect on SOx emission reduction (86%) and DPF on PM emissions (20%). In the mid-term, the VCR, ECV, and FQE scenarios were presented desirable mean emission reduction on CO, VOCs, and NOx. Moreover, NOx emission reduction of DPF scenario is the most common (14%). Again FQE scenario proves to have great effect on SOx emission reduction in mid-term (86%), DPF and HES scenarios on PM (DPF: 49% and HES: 17%). Finally for the long term, VCR, ECV, FQE, and NEM scenarios were shown good performance in emission control on CO, VOCs and NOx. For SOx only FQE has a good effect in all time periods (FQE: 86%) and DPF and HES scenarios have the best effect on PM emission reduction respectively (DPF: 51% and HES: 27%) compared with BAU scenario. However, DPF scenario increases 12% SOx emission in long-term (2028). It can be generally concluded that VCR and ECV scenarios would achieve a significant reduction on gaseous pollutants emission except for SOx in general and FQE scenarios have desirable performance for all gaseous pollutants in the short term and also for SOx and VOCs in long term. In addition, the DPF and HES would be desirable scenario for emission control on PM in Tehran Traffic Sector. Copyright © 2017 Elsevier B.V. All rights reserved.

Laser modification of graphene oxide layers

NASA Astrophysics Data System (ADS)

Malinský, Petr; Macková, Anna; Cutroneo, Mariapompea; Siegel, Jakub; Bohačová, Marie; Klímova, Kateřina; Švorčík, Václav; Sofer, Zdenĕk

2018-01-01

The effect of linearly polarized laser irradiation with various energy densities was successfully used for reduction of graphene oxide (GO). The ion beam analytical methods (RBS, ERDA) were used to follow the elemental composition which is expected as the consequence of GO reduction. The chemical composition analysis was accompanied by structural study showing changed functionalities in the irradiated GO foils using spectroscopy techniques including XPS, FTIR and Raman spectroscopy. The AFM was employed to identify the surface morphology and electric properties evolution were subsequently studied using standard two point method measurement. The used analytical methods report on reduction of irradiated graphene oxide on the surface and the decrease of surface resistivity as a growing function of the laser beam energy density.

[Vitamin K3-induced activation of molecular oxygen in glioma cells].

PubMed

Krylova, N G; Kulagova, T A; Semenkova, G N; Cherenkevich, S N

2009-01-01

It has been shown by the method of fluorescent analysis that the rate of hydrogen peroxide generation in human U251 glioma cells under the effect of lipophilic (menadione) or hydrophilic (vikasol) analogues of vitamin K3 was different. Analyzing experimental data we can conclude that menadione underwent one- and two-electron reduction by intracellular reductases in glioma cells. Reduced forms of menadione interact with molecular oxygen leading to reactive oxygen species (ROS) generation. The theoretical model of ROS generation including two competitive processes of one- and two-electron reduction of menadione has been proposed. Rate constants of ROS generation mediated by one-electron reduction process have been estimated.

The field performance of frontal air bags: a review of the literature.

PubMed

Kent, Richard; Viano, David C; Crandall, Jeff

2005-03-01

This article presents a broad review of the literature on frontal air bag field performance, starting with the initial government and industry projections of effectiveness and concluding with the most recent assessments of depowered systems. This review includes as many relevant metrics as practicable, interprets the findings, and provides references so the interested reader can further evaluate the limitations, confounders, and utility of each metric. The evaluations presented here range from the very specific (individual case studies) to the general (statistical analyses of large databases). The metrics used to evaluate air bag performance include fatality reduction or increase; serious, moderate, and minor injury reduction or increase; harm reduction or increase; and cost analyses, including insurance costs and the cost of life years saved for various air bag systems and design philosophies. The review begins with the benefits of air bags. Fatality and injury reductions attributable to the air bag are presented. Next, the negative consequences of air bag deployment are described. Injuries to adults and children and the current trends in air bag injury rates are discussed, as are the few documented instances of inadvertent deployments or non-deployment in severe crashes. In the third section, an attempt is made to quantify the influence of the many confounding factors that affect air bag performance. The negative and positive characteristics of air bags are then put into perspective within the context of societal costs and benefits. Finally, some special topics, including risk homeostasis and the performance of face bags, are discussed.

Correction to storm, Tressoldi, and di Risio (2010).

PubMed

2015-03-01

Reports an error in "Meta-analysis of free-response studies, 1992-2008: Assessing the noise reduction model in parapsychology" by Lance Storm, Patrizio E. Tressoldi and Lorenzo Di Risio (Psychological Bulletin, 2010[Jul], Vol 136[4], 471-485). In the article, the sentence giving the formula in the second paragraph on p. 479 was stated incorrectly. The corrected sentence is included. (The following abstract of the original article appeared in record 2010-12718-001.) [Correction Notice: An erratum for this article was reported in Vol 136(5) of Psychological Bulletin (see record 2010-17510-009). In the article, the second to last sentence of the abstract (p. 471) was stated incorrectly. The sentence should read as follows: "The mean effect size value of the ganzfeld database was significantly higher than the mean effect size of the standard free-response database but was not higher than the effect size of the nonganzfeld noise reduction database."] We report the results of meta-analyses on 3 types of free-response study: (a) ganzfeld (a technique that enhances a communication anomaly referred to as "psi"); (b) nonganzfeld noise reduction using alleged psi-enhancing techniques such as dream psi, meditation, relaxation, or hypnosis; and (c) standard free response (nonganzfeld, no noise reduction). For the period 1997-2008, a homogeneous data set of 29 ganzfeld studies yielded a mean effect size of 0.142 (Stouffer Z = 5.48, p = 2.13 × 10-8). A homogeneous nonganzfeld noise reduction data set of 16 studies yielded a mean effect size of 0.110 (Stouffer Z = 3.35, p = 2.08 × 10-4), and a homogeneous data set of 14 standard free-response studies produced a weak negative mean effect size of -0.029 (Stouffer Z = -2.29, p = .989). The mean effect size value of the ganzfeld database were significantly higher than the mean effect size of the nonganzfeld noise reduction and the standard free-response databases. We also found that selected participants (believers in the paranormal, meditators, etc.) had a performance advantage over unselected participants, but only if they were in the ganzfeld condition. PsycINFO Database Record (c) 2015 APA, all rights reserved.

In-vivo efficacy of hand sanitisers against feline calicivirus: a surrogate for norovirus.

PubMed

Lages, S L S; Ramakrishnan, M A; Goyal, S M

2008-02-01

Hand disinfection is considered important in preventing the transmission of viruses, including norovirus. We investigated the virucidal efficacy of nine hand sanitisers (four alcohol-based sanitisers, three non-alcoholic sanitisers and two triclosan-containing antimicrobial liquid soaps) against feline calicivirus, a surrogate for norovirus, on artificially contaminated fingertips for 30 s and 2 min contact periods. Among alcohol-based sanitisers, a product containing 99.5% ethanol was more effective than those containing 62% ethanol, 70% isopropanol or 91% isopropanol. A log(10) virus reduction factor of 1.00-1.30 was achieved with 99.5% ethanol but those containing a lower alcohol concentration only achieved a log(10) reduction factor of

Modelling of aflatoxin G1 reduction by kefir grain using response surface methodology.

PubMed

Ansari, Farzaneh; Khodaiyan, Faramarz; Rezaei, Karamatollah; Rahmani, Anosheh

2015-01-01

Aflatoxin G1 (AFG1) is one of the main toxic contaminants in pistachio nuts and causes potential health hazards. Hence, AFG1 reduction is one of the main concerns in food safety. Kefir-grains contain symbiotic association of microorganisms well known for their aflatoxin decontamination effects. In this study, a central composite design (CCD) using response surface methodology (RSM) was applied to develop a model in order to predict AFG1 reduction in pistachio nuts by kefir-grain (already heated at 70 and 110°C). The independent variables were: toxin concentration (X1: 5, 10, 15, 20 and 25 ng/g), kefir-grain level (X2: 5, 10, 20, 10 and 25%), contact time (X3: 0, 2, 4, 6 and 8 h), and incubation temperature (X4: 20, 30, 40, 50 and 60°C). There was a significant reduction in AFG1 (p < 0.05) when pre-heat-treated kefir-grain used. The variables including X1, X3 and the interactions between X2-X4 as well as X3-X4 have significant effects on AFG1 reduction. The model provided a good prediction of AFG1 reduction under the assay conditions. Optimization was used to enhance the efficiency of kefir-grain on AFG1 reduction. The optimum conditions for the highest AFG1 reduction (96.8%) were predicted by the model as follows: toxin concentration = 20 ng/g, kefir-grain level = 10%, contact time = 6 h, and incubation temperature = 30°C which validated practically in six replications.

Differential effect of biochar upon reduction-induced mobility and bioavailability of arsenate and chromate.

PubMed

Choppala, Girish; Bolan, Nanthi; Kunhikrishnan, Anitha; Bush, Richard

2016-02-01

Heavy metals such as chromium (Cr) and arsenic (As) occur in ionic form in soil, with chromate [Cr(VI)] and arsenate As(V) being the most pre-dominant forms. The application of biochar to Cr(VI) and As(V) spiked and field contaminated soils was evaluated on the reduction processes [(Cr(VI) to Cr(III)] and [As(V) to As(III))], and subsequent mobility and bioavailability of both As(V) and Cr(VI). The assays used in this study included leaching, soil microbial activity and XPS techniques. The reduction rate of As(V) was lower than that of Cr(VI) with and without biochar addition, however, supplementation with biochar enhanced the reduction process of As(V). Leaching experiments indicated Cr(VI) was more mobile than As(V). Addition of biochar reversed the effect by reducing the mobility of Cr and increasing that of As. The presence of Cr and As in both spiked and contaminated soils reduced microbial activity, but with the addition of biochar to these soils, the microbial activity increased in the Cr(VI) contaminated soils, while it was further decreased with As(V) contaminated soils. The addition of biochar was effective in mitigating Cr toxicity by reducing Cr(VI) to Cr(III). In contrast, the conversion process of As(V) to As(III) hastened by biochar was not favourable, as As(III) is more toxic in soils. Overall, the presence of functional groups on biochar promotes reduction by providing the electrons required for reduction processes to occur as determined by XPS data. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effectiveness of intra-articular lidocaine injection for reduction of anterior shoulder dislocation: randomized clinical trial.

PubMed

Tamaoki, Marcel Jun Sugawara; Faloppa, Flavio; Wajnsztejn, André; Archetti Netto, Nicola; Matsumoto, Marcelo Hide; Belloti, João Carlos

2012-01-01

Shoulder dislocation is the most common dislocation among the large joints. The aim here was to compare the effectiveness of reduction of acute anterior shoulder dislocation with or without articular anesthesia. Prospective randomized trial conducted in Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp). From March 2008 to December 2009, 42 patients with shoulder dislocation were recruited. Reductions using traction-countertraction for acute anterior shoulder dislocation with and without lidocaine articular anesthesia were compared. As the primary outcome, pain was assessed through application of a visual analogue scale before reduction, and one and five minutes after the reduction maneuver was performed. Complications were also assessed. Forty-two patients were included: 20 in the group without analgesia (control group) and 22 in the group that received intra-articular lidocaine injection. The group that received intra-articular lidocaine had a statistically greater decrease in pain over time than shown by the control group, both in the first minute (respectively: mean 2.1 (0 to 5.0), standard deviation, SD 1.3, versus mean 4.9 (2.0 to 7.0, SD 1.5; P < 0.001) and the fifth minute (respectively: mean 1.0; 0 to 3.0; SD = 1.0 versus mean 4.0; 1.0 to 6.0; SD = 1.4; P < 0.001). There was one failure in the control group. There were no other complications in either group. Reduction of anterior shoulder dislocation using intra-articular lidocaine injection is effective, since it is safe and diminishes the pain. ISRCTN27127703.

Paper Bag Books: A Creative Intervention with Elementary School Children Experiencing High-Conflict Parental Divorce

ERIC Educational Resources Information Center

Somody, Catherine; Hobbs, Marsha

2007-01-01

Research has found that school-based interventions for children of divorce help counter the adverse effects. Studies of school-based interventions have identified effective means for helping children of divorce cope with their situation and produce a significant reduction in clinical symptoms. Those components include activities that: (a) help…

The Jigsaw Technique and Self-Efficacy of Vocational Training Students: A Practice Report

ERIC Educational Resources Information Center

Darnon, Celine; Buchs, Celine; Desbar, Delphine

2012-01-01

Can teenagers' self-efficacy be improved in a short time? Previous research has shown the positive effect of cooperative learning methods, including "jigsaw classrooms" (Aronson and Patnoe, 1997), on various outcomes (e.g., the liking of school, self-esteem, and reduction of prejudices). The present practice report investigated the effects of…

Fe Isotope Fractionation During Fe(III) Reduction to Fe(II)

NASA Astrophysics Data System (ADS)

Baker, E. A.; Greene, S.; Hardin, E. E.; Hodierne, C. E.; Rosenberg, A.; John, S.

2014-12-01

The redox chemistry of Fe(III) and Fe(II) is tied to a variety of earth processes, including biological, chemical, or photochemical reduction of Fe(III) to Fe(II). Each process may fractionate Fe isotopes, but the magnitudes of the kinetic isotope effects have not been greatly explored in laboratory conditions. Here, we present the isotopic fractionation of Fe during reduction experiments under a variety of experimental conditions including photochemical reduction of Fe(III) bound to EDTA or glucaric acid, and chemical reduction of Fe-EDTA by sodium dithionite, hydroxylamine hydrochloride, Mn(II), and ascorbic acid. A variety of temperatures and pHs were tested. In all experiments, Fe(III) bound to an organic ligand was reduced in the presence of ferrozine. Ferrozine binds with Fe(II), forming a purple complex which allows us to measure the extent of reaction. The absorbance of the experimental solutions was measured over time to determine the Fe(II)-ferrozine concentration and thus the reduction rate. After about 5% of the Fe(III) was reduced, Fe(III)-EDTA and Fe(II)-ferrozine were separated using a C-18 column to which Fe(II)-ferrozine binds. The Fe(II) was eluted and purified through anion exchange chromatography for analysis of δ56Fe by MC-ICPMS. Preliminary results show that temperature and pH both affect reduction rate. All chemical reductants tested reduce Fe(III) at a greater rate as temperature increases. The photochemical reductant EDTA reduces Fe(III) at a greater rate under more acidic conditions. Comparison of the two photochemical reductants shows that glucaric acid reduces Fe(III) significantly faster than EDTA. For chemical reduction, the magnitude of isotopic fractionation depends on the reductant used. Temperature and pH also affect the isotopic fractionation of Fe. Experiments using chemical reductants show that an increase in temperature at low temperatures produces lighter 56Fe ratios, while at high temperatures some reductants produce heavier 56Fe ratios. The magnitude of isotope fractionation is not related to the reduction rate generalized over all reductants. The measured isotopic fractionations produce δ56Fe from -3.82 to +3.05 across all of the reductants tested, highlighting the large impact that redox chemistry may have on fractionating Fe isotopes in the environment.

A LATIN-based model reduction approach for the simulation of cycling damage

NASA Astrophysics Data System (ADS)

Bhattacharyya, Mainak; Fau, Amelie; Nackenhorst, Udo; Néron, David; Ladevèze, Pierre

2017-11-01

The objective of this article is to introduce a new method including model order reduction for the life prediction of structures subjected to cycling damage. Contrary to classical incremental schemes for damage computation, a non-incremental technique, the LATIN method, is used herein as a solution framework. This approach allows to introduce a PGD model reduction technique which leads to a drastic reduction of the computational cost. The proposed framework is exemplified for structures subjected to cyclic loading, where damage is considered to be isotropic and micro-defect closure effects are taken into account. A difficulty herein for the use of the LATIN method comes from the state laws which can not be transformed into linear relations through an internal variable transformation. A specific treatment of this issue is introduced in this work.

Single and combined effects of microplastics and mercury on juveniles of the European seabass (Dicentrarchus labrax): Changes in behavioural responses and reduction of swimming velocity and resistance time.

PubMed

Barboza, Luís Gabriel Antão; Vieira, Luís Russo; Guilhermino, Lúcia

2018-05-01

Microplastics and mercury are environmental pollutants of great concern. The main goal of the present study was to investigate the effects of these pollutants, both individually and in binary mixtures, on the swimming performance of juvenile European seabass, Dicentrarchus labrax. Microplastics alone, mercury alone and all the mixtures caused significant reduction of the swimming velocity and resistance time of fish. Moreover, changes in behavioural responses including lethargic and erratic swimming behaviour were observed. These results highlight that fish behavioural responses can be used as sensitive endpoint to establish the effects of contamination by microplastics and also emphasizes the need to assess the combined effects of microplastics and other environmental contaminants, with special attention to the effects on behavioural responses in fish and other aquatic species. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ethical considerations of e-cigarette use for tobacco harm reduction.

PubMed

Franck, Caroline; Filion, Kristian B; Kimmelman, Jonathan; Grad, Roland; Eisenberg, Mark J

2016-05-17

Due to their similarity to tobacco cigarettes, electronic cigarettes (e-cigarettes) could play an important role in tobacco harm reduction. However, the public health community remains divided concerning the appropriateness of endorsing a device whose safety and efficacy for smoking cessation remain unclear. We identified the major ethical considerations surrounding the use of e-cigarettes for tobacco harm reduction, including product safety, efficacy for smoking cessation and reduction, use among non-smokers, use among youth, marketing and advertisement, use in public places, renormalization of a smoking culture, and market ownership. Overall, the safety profile of e-cigarettes is unlikely to warrant serious public health concerns, particularly given the known adverse health effects associated with tobacco cigarettes. As a result, it is unlikely that the population-level harms resulting from e-cigarette uptake among non-smokers would overshadow the public health gains obtained from tobacco harm reduction among current smokers. While the existence of a gateway effect for youth remains uncertain, e-cigarette use in this population should be discouraged. Similarly, marketing and advertisement should remain aligned with the degree of known product risk and should be targeted to current smokers. Overall, the available evidence supports the cautionary implementation of harm reduction interventions aimed at promoting e-cigarettes as attractive and competitive alternatives to cigarette smoking, while taking measures to protect vulnerable groups and individuals.

Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation.

PubMed

Brown, Tamara J; Todd, Adam; O'Malley, Claire; Moore, Helen J; Husband, Andrew K; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F; Steed, Liz; Smith, Sarah; Nield, Lucie; Summerbell, Carolyn D

2016-02-29

To systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management. Systematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014. randomised and non-randomised controlled trials; controlled before/after studies, interrupted times series. any relevant intervention set in a community pharmacy, delivered by the pharmacy team. No restrictions on duration, country, age, or language. 19 studies were included: 2 alcohol reduction, 12 smoking cessation and 5 weight management. Study quality rating: 6 'strong', 4 'moderate' and 9 'weak'. 8 studies were conducted in the UK, 4 in the USA, 2 in Australia, 1 each in 5 other countries. Evidence from 2 alcohol-reduction interventions was limited. Behavioural support and/or nicotine replacement therapy are effective and cost-effective for smoking cessation: pooled OR was 2.56 (95% CI 1.45 to 4.53) for active intervention vs usual care. Pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control. Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations. Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions. Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

5 CFR 630.212 - Use of annual leave to establish initial eligibility for retirement or continuation of health...

Code of Federal Regulations, 2010 CFR

2010-01-01

... decline relocation (including transfer of function). (b)(1) Annual leave that may be used for the purposes... transfer of function) and annual leave earned by an employee while in a paid leave status after the effective date of the reduction in force or relocation (including transfer of function). (2) Annual leave...

Trauma Informed Guilt Reduction (TrIGR) Intervention

DTIC Science & Technology

2016-10-01

posttraumatic distress and a range of adverse outcomes, including posttraumatic stress disorder (PTSD), depression and suicidality , and alcohol/substance use...and a range of adverse outcomes, including posttraumatic stress disorder (PTSD), depression and suicidality , and alcohol/substance use disorders...and depression with medium to large effect sizes. The overall objective of this study is to examine the efficacy of TrIGR in reducing deployment

Spillover effects of Medicare fee reductions: evidence from ophthalmology.

PubMed

Mitchell, Jean M; Hadley, Jack; Gaskin, Darrell J

2002-09-01

Relatively little research has examined physicians' supply responses to Medicare fee cuts especially whether fee reductions for specific procedures have "spillover" effects that cause physicians to increase the supply of other services they provide. In this study we investigate whether ophthalmologist changed their provision of non-cataract services to Medicare patients over the time period 1992-1994, when the Medicare Fee Schedule (MFS) resulted in a 17.4% reduction in the average fee paid for a cataract extraction. Following the McGuire-Pauly model of physician behavior (McGuire and Pauly, 1991), we estimated a supply function for non-cataract procedures that included three price variables (own-price, a Medicare cross-price and a private cross-price) and an income effect. The Medicare cross-price and income variables capture spillover effects. Consistent with the model's predictions, we found that the Medicare cross-price is significant and negative, implying that a 10% reduction in the fee for a cataract extraction will cause ophthalmologists to supply about 5% more non-cataract services. Second, the income variable is highly significant, but its impact on the supply of non-cataract services is trivial. The suggests that physicians behave more like profit maximizing firms than target income seekers. We also found that the own-price and the private cross-price variables are highly significant and have the expected positive and negative effects on the volume of non-cataract services respectively. Our results demonstrate the importance of evaluating volume responses to fee changes for the array of services the physician performs, not just the procedure whose fee has been reduced. Focusing only on the procedure whose fee has been cut will yield an incomplete picture of how fee reductions for specific procedures affect physician supply decisions.

Cost effectiveness of lung-volume-reduction surgery for patients with severe emphysema.

PubMed

Ramsey, Scott D; Berry, Kristin; Etzioni, Ruth; Kaplan, Robert M; Sullivan, Sean D; Wood, Douglas E

2003-05-22

The National Emphysema Treatment Trial, a randomized clinical trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema, included a prospective economic analysis. After pulmonary rehabilitation, 1218 patients at 17 medical centers were randomly assigned to lung-volume-reduction surgery or continued medical treatment. Costs for the use of medical care, medications, transportation, and time spent receiving treatment were derived from Medicare claims and data from the trial. Cost effectiveness was calculated over the duration of the trial and was estimated for 10 years of follow-up with the use of modeling based on observed trends in survival, cost, and quality of life. Interim analyses identified a group of patients with excess mortality and little chance of improved functional status after surgery. When these patients were excluded, the cost-effectiveness ratio for lung-volume-reduction surgery as compared with medical therapy was 190,000 dollars per quality-adjusted life-year gained at 3 years and 53,000 dollars per quality-adjusted life-year gained at 10 years. Subgroup analyses identified patients with predominantly upper-lobe emphysema and low exercise capacity after pulmonary rehabilitation who had lower mortality and better functional status than patients who received medical therapy. The cost-effectiveness ratio in this subgroup was 98,000 dollars per quality-adjusted life-year gained at 3 years and 21,000 dollars at 10 years. Bootstrap analysis revealed substantial uncertainty for the subgroup and 10-year estimates. Given its cost and benefits over three years of follow-up, lung-volume-reduction surgery is costly relative to medical therapy. Although the predictions are subject to substantial uncertainty, the procedure may be cost effective if benefits can be maintained over time. Copyright 2003 Massachusetts Medical Society

Reduction of Ochratoxin A in Oat Flakes by Twin-Screw Extrusion Processing.

PubMed

Lee, Hyun Jung; Dahal, Samjhana; Perez, Enrique Garcia; Kowalski, Ryan Joseph; Ganjyal, Girish M; Ryu, Dojin

2017-10-01

Ochratoxin A (OTA) is one of the most important mycotoxins owing to its widespread occurrence and toxicity, including nephrotoxicity and potential carcinogenicity to humans. OTA has been detected in a wide range of agricultural commodities, including cereal grains and their processed products. In particular, oat-based products show a higher incidence and level of contamination. Extrusion cooking is widely used in the manufacturing of breakfast cereals and snacks and may reduce mycotoxins to varying degrees. Hence, the effects of extrusion cooking on the stability of OTA in spiked (100 μg/kg) oat flake was investigated by using a laboratory-scale twin-screw extruder with a central composite design. Factors examined were moisture content (20, 25, and 30% dry weight basis), temperature (140, 160, and 180°C), screw speed (150, 200, and 250 rpm), and die size (1.5, 2, and 3 mm). Both nonextruded and extruded samples were analyzed for reductions of OTA by high-performance liquid chromatography, coupled with fluorescence detection. The percentage of reductions in OTA in the contaminated oat flakes upon extrusion processing were in the range of 0 to 28%. OTA was partially stable during extrusion, with only screw speed and die size having significant effect on reduction (P < 0.005). The highest reduction of 28% was achieved at 180°C, 20% moisture, 250 rpm screw speed, and a 3-mm die with 193 kJ/kg specific mechanical energy. According to the central composite design analyses, up to 28% of OTA can be reduced by a combination of 162°C, 30% moisture, and 221 rpm, with a 3-mm die.

Interventions to Reduce Harm from Smoking with Families in Infancy and Early Childhood: A Systematic Review

PubMed Central

Brown, Nicola; Luckett, Tim; Davidson, Patricia M.; Di Giacomo, Michelle

2015-01-01

Exposure to adult smoking can have deleterious effects on children. Interventions that assist families with smoking cessation/reduction and environmental tobacco smoke (ETS) avoidance can improve child health outcomes and reduce the risk of smoking initiation. The purpose of this review was to describe the state of the science of interventions with families to promote smoke-free home environments for infants and young children, including parent smoking reduction and cessation interventions, ETS reduction, and anti-smoking socialisation interventions, using the socio-ecological framework as a guide. A systematic review of peer-reviewed articles identified from journal databases from 2000 to 2014 was undertaken. Of 921 articles identified, 28 were included in the review. Considerable heterogeneity characterised target populations, intervention types, complexity and intensity, precluding meta-analysis. Few studies used socio-ecological approaches, such as family theories or concepts. Studies in early parenthood (child age newborn to one year) tended to focus on parent smoking cessation, where studies of families with children aged 1–5 years were more likely to target household SHSe reduction. Results suggest that interventions for reduction in ETS may be more successful than for smoking cessation and relapse prevention in families of children aged less than 5 years. There is a need for a range of interventions to support families in creating a smoke free home environment that are both tailored and targeted to specific populations. Interventions that target the social and psychodynamics of the family should be considered further, particularly in reaching vulnerable populations. Consideration is also required for approaches to interventions that may further stigmatise families containing smokers. Further research is required to identify successful elements of interventions and the contexts in which they are most effective. PMID:25785496

CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience.

PubMed

Tzadok, Michal; Uliel-Siboni, Shimrit; Linder, Ilan; Kramer, Uri; Epstein, Orna; Menascu, Shay; Nissenkorn, Andrea; Yosef, Omer Bar; Hyman, Eli; Granot, Dorit; Dor, Michael; Lerman-Sagie, Tali; Ben-Zeev, Bruria

2016-02-01

To describe the experience of five Israeli pediatric epilepsy clinics treating children and adolescents diagnosed as having intractable epilepsy with a regimen of medical cannabis oil. A retrospective study describing the effect of cannabidiol (CBD)-enriched medical cannabis on children with epilepsy. The cohort included 74 patients (age range 1-18 years) with intractable epilepsy resistant to >7 antiepileptic drugs. Forty-nine (66%) also failed a ketogenic diet, vagal nerve stimulator implantation, or both. They all started medical cannabis oil treatment between 2-11/2014 and were treated for at least 3 months (average 6 months). The selected formula contained CBD and tetrahydrocannabinol at a ratio of 20:1 dissolved in olive oil. The CBD dose ranged from 1 to 20mg/kg/d. Seizure frequency was assessed by parental report during clinical visits. CBD treatment yielded a significant positive effect on seizure load. Most of the children (66/74, 89%) reported reduction in seizure frequency: 13 (18%) reported 75-100% reduction, 25 (34%) reported 50-75% reduction, 9 (12%) reported 25-50% reduction, and 19 (26%) reported <25% reduction. Five (7%) patients reported aggravation of seizures which led to CBD withdrawal. In addition, we observed improvement in behavior and alertness, language, communication, motor skills and sleep. Adverse reactions included somnolence, fatigue, gastrointestinal disturbances and irritability leading to withdrawal of cannabis use in 5 patients. The results of this multicenter study on CBD treatment for intractable epilepsy in a population of children and adolescents are highly promising. Further prospective, well-designed clinical trials using enriched CBD medical cannabis are warranted. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Effect of a herbal extract powder (YY-312) from Imperata cylindrica Beauvois, Citrus unshiu Markovich, and Evodia officinalis Dode on body fat mass in overweight adults: a 12-week, randomized, double-blind, placebo-controlled, parallel-group clinical trial.

PubMed

Cho, Young-Gyu; Jung, Ji-Hye; Kang, Jae-Heon; Kwon, Jin Soo; Yu, Seung Pil; Baik, Tae Gon

2017-07-28

YY-312 is a herbal extract powder from Imperata cylindrica Beauvois, Citrus unshiu Markovich, and Evodia officinalis Dode, which have health promoting effects, including body fat reduction. We aimed to evaluate the efficacy and safety of YY-312 for body fat reduction in overweight adults. This was a 12-week, randomized, double-blind, placebo-controlled, parallel-group clinical trial performed in overweight Korean adults aged 19-60 years with a body mass index of 25.0-29.9 kg/m 2 . The daily dose of YY-312 was 2400 mg (containing 1800 mg of active herbal extract and 600 mg of cyclodextrin). Primary outcomes were reductions in body fat mass (BFM) and body fat percentage (BF%) after 12 weeks. Secondary outcomes included reductions in body weight and waist circumference (WC) after 12 weeks. After 12 weeks, BFM (1.6 kg vs. 0.1 kg; P = 0.023) and BF% (1.5% vs. -0.2%; P = 0.018) decreased significantly more in the YY-312 group than in the placebo group, as did body weight (2.7 kg vs. 1.0 kg; P = 0.014) and WC (2.2 cm vs. 0.8 cm; P = 0.049). All safety parameters were within normal limits; no serious adverse events occurred in either group. In a 12-week clinical trial in overweight adults, YY-312 resulted in significantly greater reduction in body fat vs. placebo, while being safe and well tolerated. cris.nih.go.kr: ( KCT0001225 ).

Effectiveness of interventions to reduce aggression and injuries among ice hockey players: a systematic review

PubMed Central

Cusimano, Michael D.; Nastis, Sofia; Zuccaro, Laura

2013-01-01

Background: The increasing incidence of injuries related to playing ice hockey is an important public health issue. We conducted a systematic review to evaluate the effectiveness of interventions designed to reduce injuries related to aggressive acts in ice hockey. Methods: We identified relevant articles by searching electronic databases from their inception through July 2012, by using Internet search engines, and by manually searching sports medicine journals, the book series Safety in Ice Hockey and reference lists of included articles. We included studies that evaluated interventions to reduce aggression-related injuries and reported ratings of aggressive behaviour or rates of penalties or injuries. Results: We identified 18 eligible studies. Most involved players in minor hockey leagues. Of 13 studies that evaluated changes in mandatory rules intended to lessen aggression (most commonly the restriction of body-checking), 11 observed a reduction in penalty or injury rates associated with rule changes, and 9 of these showed a statistically significant decrease. The mean number of penalties decreased by 1.2–5.9 per game, and injury rates decreased 3- to 12-fold. All 3 studies of educational interventions showed a reduction in penalty rates, but they were not powered or designed to show a change in injury rates. In 2 studies of cognitive behavioural interventions, reductions in aggressive behaviours were observed. Interpretation: Changes to mandatory rules were associated with reductions in penalties for aggressive acts and in injuries related to aggression among ice hockey players. Effects of educational and cognitive behavioural interventions on injury rates are less clear. Well-designed studies of multifaceted strategies that combine such approaches are required. PMID:23209118

Posttraumatic stress symptoms and tobacco abstinence effects in a non-clinical sample: evaluating the mediating role of negative affect reduction smoking expectancies.

PubMed

Langdon, Kirsten J; Leventhal, Adam M

2014-11-01

The relation between posttraumatic stress symptoms and smoking is well documented but poorly understood. The present investigation sought to evaluate the impact of posttraumatic stress symptoms on subjective and behavioral tobacco abstinence effects both directly and indirectly through negative affect reduction smoking outcome expectancies. Participants included 275 (68.7% male; Mage =43.9, 10+ cig/day) adult non-treatment seeking smokers, who attended two counterbalanced laboratory sessions (16 h of smoking deprivation vs ad libitum smoking), during which they completed self-report measures of withdrawal symptoms and mood followed by a smoking lapse task in which they could earn money for delaying smoking and purchase cigarettes to smoke. Results supported a mediational pathway whereby higher baseline symptoms of posttraumatic stress predicted greater endorsement of expectancies that smoking will effectively reduce negative affect, which in turn predicted greater abstinence-provoked exacerbations in nicotine withdrawal symptoms and negative affect. Posttraumatic stress symptoms also predicted number of cigarettes purchased independent of negative affect reduction expectancies, but did not predict delaying smoking for money. Findings highlight tobacco abstinence effects as a putative mechanism underlying posttraumatic stress disorder (PTSD)-smoking comorbidity, indicate an important mediating role of beliefs for smoking-induced negative affect reduction, and shed light on integrated treatment approaches for these two conditions. © The Author(s) 2014.

Probiotic Supplementation in Preterm Infants Does Not Affect the Risk of Bronchopulmonary Dysplasia: A Meta-Analysis of Randomized Controlled Trials

PubMed Central

Mosca, Fabio; Kramer, Boris

2017-01-01

Probiotic supplementation reduces the risk of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in preterm infants, but it remains to be determined whether this reduction translates into a reduction of other complications. We conducted a systematic review and meta-analysis to evaluate the possible role of probiotics in altering the risk of bronchopulmonary dysplasia (BPD). Fifteen randomized controlled trials (4782 infants; probiotics: 2406) were included. None of the included studies assessed BPD as the primary outcome. Meta-analysis confirmed a significant reduction of NEC (risk ratio (RR) 0.52, 95% confidence interval (CI) 0.33 to 0.81, p = 0.004; random effects model), and an almost significant reduction of LOS (RR 0.82, 95% CI 0.65 to 1.03, p = 0.084). In contrast, meta-analysis could not demonstrate a significant effect of probiotics on BPD, defined either as oxygen dependency at 28 days of life (RR 1.01, 95% CI 0.91 to 1.11, p = 0.900, 6 studies) or at 36 weeks of postmenstrual age (RR 1.07, 95% CI 0.96 to 1.20, p = 0.203, 12 studies). Meta-regression did not show any significant association between the RR for NEC or LOS and the RR for BPD. In conclusion, our results suggest that NEC and LOS prevention by probiotics does not affect the risk of developing BPD in preterm infants. PMID:29088103

Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control.

PubMed

Chrvala, Carole A; Sherr, Dawn; Lipman, Ruth D

2016-06-01

Assess effect of diabetes self-management education and support methods, providers, duration, and contact time on glycemic control in adults with type 2 diabetes. We searched MEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO to December 2013 for interventions which included elements to improve participants' knowledge, skills, and ability to perform self-management activities as well as informed decision-making around goal setting. This review included 118 unique interventions, with 61.9% reporting significant changes in A1C. Overall mean reduction in A1C was 0.74 and 0.17 for intervention and control groups; an average absolute reduction in A1C of 0.57. A combination of group and individual engagement results in the largest decreases in A1C (0.88). Contact hours ≥10 were associated with a greater proportion of interventions with significant reduction in A1C (70.3%). In patients with persistently elevated glycemic values (A1C>9), a greater proportion of studies reported statistically significant reduction in A1C (83.9%). This systematic review found robust data demonstrating that engagement in diabetes self-management education results in a statistically significant decrease in A1C levels. The data suggest mode of delivery, hours of engagement, and baseline A1C can affect the likelihood of achieving statistically significant and clinically meaningful improvement in A1C. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Modulation of oxidative damage by nitroxide free radicals.

PubMed

Dragutan, Ileana; Mehlhorn, Rolf J

2007-03-01

Piperidine nitroxides like 2,2,6,6-tetramethyl-1-piperidinyloxy (TEMPO) are persistent free radicals in non-acidic aqueous solutions and organic solvents that may have value as therapeutic agents in medicine. In biological environments, they undergo mostly reduction to stable hydroxylamines but can also undergo oxidation to reactive oxoammonium compounds. Reactions of the oxoammonium derivatives could have adverse consequences including chemical modification of vital macromolecules and deleterious effects on cell signaling. An examination of their reactivity in aqueous solution has shown that oxoammonium compounds can oxidize almost any organic as well as many inorganic molecules found in biological systems. Many of these reactions appear to be one-electron transfers that reduce the oxoammonium to the corresponding nitroxide species, in contrast to a prevalence of two-electron reductions of oxoammonium in organic solvents. Amino acids, alcohols, aldehydes, phospholipids, hydrogen peroxide, other nitroxides, hydroxylamines, phenols and certain transition metal ions and their complexes are among reductants of oxoammonium, causing conversion of this species to the paramagnetic nitroxide. On the other hand, thiols and oxoammonium yield products that cannot be detected by ESR even under conditions that would oxidize hydroxylamines to nitroxides. These products may include hindered secondary amines, sulfoxamides and sulfonamides. Thiol oxidation products other than disulfides cannot be restored to thiols by common enzymatic reduction pathways. Such products may also play a role in cell signaling events related to oxidative stress. Adverse consequences of the reactions of oxoammonium compounds may partially offset the putative beneficial effects of nitroxides in some therapeutic settings.

Phosphorus Amendment Efficacy for In Situ Remediation of ...

EPA Pesticide Factsheets

A validated method is needed to measure reductions of in vitro bioaccessible (IVBA) Pb in urban soil remediated with amendments. This study evaluated the effect of in vitro extraction solution pH and glycine buffer on bioaccesible Pb in P-treated soils. Two Pb-contaminated soils (790-1300 mg Pb kg-1), one from a garden and one from a city lot in Cleveland, OH, were incubated in a bench scale experiment for 1 yr. Six phosphate amendments, including bone meal, fish bone, poultry litter, monoammonium phosphate, diammonium phosphate, and triple superphosphate, were added to containers at two application rates. Lead IVBA was assessed using USEPA Method 1340 and three modified versions of this method. Modifications included using solutions with pH 1.5 and 2.5 as well as using solutions with and without 0.4 mol L-1 glycine. Soil amendments were effective in reducing IVBA Pb in these soils as measured by pH 1.5 with glycine buffer. The greatest reductions in IVBA Pb, from 5 to 26%, were found using pH 2.5 extractions. Lead mineral results showed several soil amendments promoted Pb phosphate formation, an indicator of remediation success. A significant negative linear relationship between reduction in IVBA Pb and Pb-phosphate formation was found only for pH 2.5 without glycine extraction solution. A modified USEPA Method 1340 without glycine and using pH 2.5 has the potential to predict P soil treatment efficacy and reductions in bioavailable Pb. Developing mana

Global measles mortality, 2000-2008.

PubMed

2009-12-04

The United Nations (UN) Millennium Development Goals include a goal (MDG 4) to achieve a two thirds overall reduction of child deaths by 2015 compared with the 1990 level. Because many unvaccinated children die from measles, routine measles vaccination coverage is used as an indicator of progress toward this goal. In 2008, all UN member states reaffirmed their commitment to achieving a 90% reduction in measles mortality by 2010 compared with 2000, from an estimated 733,000 deaths in 2000 worldwide to <73,300 by 2010. The World Health Organization (WHO) and UNICEF have identified 47 priority countries with the highest burden of measles for an accelerated strategy for measles mortality reduction. The strategy includes 1) achieving and maintaining high coverage (>or=90% nationally and >or=80% in each district) with 2 doses of measles-containing vaccine (MCV) delivered through routine services or supplemental immunization activities (SIAs) , 2) implementing effective laboratory-supported disease surveillance, and 3) providing appropriate clinical management for measles cases. This report updates a previously published report, provides details on activities implemented during 2008, assesses progress toward the 2010 goal, and evaluates the potential effects of decreased financial support. During 2000--2008, global measles mortality declined by 78%, from an estimated 733,000 deaths in 2000 to 164,000 in 2008, but the reduction in measles mortality has been leveling off since 2007. To reach the 2010 goal, India should fully implement the recommended strategies, and financial support for sustaining measles control in the other 46 priority countries should be secured.

The first dedicated life sciences mission - Spacelab 4

NASA Technical Reports Server (NTRS)

Cramer, D. R.; Reid, D. H.; Klein, H. P.

1983-01-01

The details of the payload and the experiments in Spacelab 4, the first Spacelab mission dedicated entirely to the life sciences, are discussed. The payload of Spacelab 4, carried in the bay of the Shuttle Orbiter, consists of 25 tentatively selected investigations combined into a comprehensive integrated exploration of the effects of acute weightlessness on living systems. The payload contains complementary designs in the human and animal investigations in order to validate animal models of human physiology in weightlessness. Animals used as experimental subjects will include squirrel monkeys, laboratory rats, several species of plants, and frog eggs. The main scientific objectives of the investigations include the study of the acute cephalic fluid shift, cardiovascular adaptation to weightlessness, including postflight reductions in orthostatic tolerance and exercise capacity, and changes in vestibular function, including space motion sickness, associated with weightlessness. Other scientific objective include the study of red cell mass reduction, negative nitrogen balance, altered calcium metabolism, suppressed in vitro lymphocyte reactivity, gravitropism and photropism in plants, and fertilization and early development in frog eggs.

Effect of reductant and PVP on morphology and magnetic property of ultrafine Ni powders prepared via hydrothermal route

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

Zhang, Jun, E-mail: j-zhang@126.com; Wang, Xiucai; Li, Lili

2013-10-15

Graphical abstract: The ultrafine Ni powders with the shapes including sphere, pearl-string, leaf, fish-bone, hexagonal sheet and silknet were prepared through one-step hydrothermal reduction using different reductants. Their saturation magnetization, remanent magnetization and coercivity sequentially increase, and the coercivity of hexagonal sheet-like Ni powders increases by 25% compared with the Ni bulk counterpart. - Highlights: • The ultrafine Ni powders with various shapes of sphere, fish-bone, hexagonal sheet, etc. • Facile and one-step hydrothermal reduction using three reductants and PVP additive was developed. • Magnetic properties of the ultrafine Ni powders with different shapes were measured. • Compared with bulkmore » Ni material, coercivity of hexagonal sheet Ni increases by 25%. • The formation mechanism of the shapes was suggested. - Abstract: The ultrafine nickel particles with different shapes including sphere, pearl-string, leaf, fish-bone, hexagonal sheet and silknet were prepared through one-step hydrothermal reduction using hydrazine hydrate, sodium hypophosphite and ethylene glycol as reductants, polyvinylpyrrolidone as structure-directing agent. It has been verified with the characterization of X-ray powder diffraction and transmission/scanning electronic microscopy that as-prepared products belong to face-centered cubic structure of nickel microcrystals with high purity and fine dispersity. The magnetic hysteresis loops measured at room temperature reveal that the values of saturation magnetization, remanent magnetization and coercivity rise sequentially from silknet, sphere to hexagonal sheet. In comparison with nickel bulk counterpart, the coercivity of the hexagonal sheet nickel powders increases by 25%.« less

Washington’s target zero teams project : reduction in fatalities during year one.

DOT National Transportation Integrated Search

2012-11-01

Highly visible sobriety checkpoint programs have : been shown to be an effective method of reducing : alcohol-related driving crashes (Elder et al., 2002). : However, the use of checkpoints is prohibited in 12 : States, including Washington. These St...

Teamwork and Collaboration for Prevention of Surgical Site Infections.

PubMed

Dellinger, E Patchen

2016-04-01

The surgeon has been regarded as the "captain of the ship" in the operating room (OR) for many years, but cannot accomplish successful operative intervention without the rest of the team. Review of the pertinent English-language literature. Many reports demonstrate very different impressions of teamwork and communication in the OR held by different members of the surgical team. Objective measures of teamwork and communication demonstrate a reduction in complications including surgical site infections with improved teamwork and communication, with fewer distractions such as noise, and with effective use of checklists. Efforts to improve teamwork and communication and promote the effective use of checklists promote patient safety and improved outcomes for patients with reduction in surgical site infections.

Psychological reactions after multifetal pregnancy reduction: a 2-year follow-up study.

PubMed

Garel, M; Stark, C; Blondel, B; Lefebvre, G; Vauthier-Brouzes, D; Zorn, J R

1997-03-01

This study had two objectives. Firstly we assessed the effects of multifetal pregnancy reduction on the mothers' emotional well-being and the relationship with the children during the 2 years following intervention. Secondly at 2 years we compared mothers who had a reduction with mothers who had not and had delivered triplets. The comparisons focused on the mothers' health and their relationship with the children. Women having had a reduction in two hospitals in Paris, between May 1992 and June 1993, were contacted just after intervention for a prospective study. In all, 18 women were included. At 1 and 2 years, 10 women participated. At 2 years, 10 additional women were included. The answers of these 20 mothers were compared to those of 11 consecutive mothers of 2 year old triplets, assessed by the same psychologist in a previous prospective study. Semi-structured interviews were conducted at home. The mothers' social characteristics, their parity, the children's condition at birth and 4 months were very similar between the reduction and triplet groups. One year after birth one-third of the women in the reduction group reported persistent depressive symptoms related to the reduction, mainly sadness and guilt. The others made medical and rational comments expressing no emotion. At 2 years all but two women seemed to have overcome the emotional pain associated with the reduction. The comparison with mothers of triplets indicated that the mothers' anxiety and depression, and difficult relationship with the children were less acute in the reduction group. These results presented some limitations, since a high number of women who miscarried or refused to participate in the follow-up were not assessed at 1 and 2 years. However, a majority of women who participated in the study 2 years after intervention seemed able to accept a multifetal pregnancy reduction to achieve parental goals.

The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: a randomized trial

PubMed Central

Henderson, Virginia P.; Clemow, Lynn; Massion, Ann O.; Hurley, Thomas G.; Druker, Susan

2013-01-01

The aim of this study was determine the effectiveness of a mindfulness-based stress-reduction (MBSR) program on quality of life (QOL) and psychosocial outcomes in women with early-stage breast cancer, using a three-arm randomized controlled clinical trial (RCT). This RCT consisting of 172 women, aged 20–65 with stage I or II breast cancer consisted of the 8-week MBSR, which was compared to a nutrition education program (NEP) and usual supportive care (UC). Follow-up was performed at three post-intervention points: 4 months, 1, and 2 years. Standardized, validated self-administered questionnaires were adopted to assess psychosocial variables. Statistical analysis included descriptive and regression analyses incorporating both intention-to-treat and post hoc multivariable approaches of the 163 women with complete data at baseline, those who were randomized to MBSR experienced a significant improvement in the primary measures of QOL and coping outcomes compared to the NEP, UC, or both, including the spirituality subscale of the FACT-B as well as dealing with illness scale increases in active behavioral coping and active cognitive coping. Secondary outcome improvements resulting in significant between-group contrasts favoring the MBSR group at 4 months included meaningfulness, depression, paranoid ideation, hostility, anxiety, unhappiness, and emotional control. Results tended to decline at 12 months and even more at 24 months, though at all times, they were as robust in women with lower expectation of effect as in those with higher expectation. The MBSR intervention appears to benefit psychosocial adjustment in cancer patients, over and above the effects of usual care or a credible control condition. The universality of effects across levels of expectation indicates a potential to utilize this stress reduction approach as complementary therapy in oncologic practice. PMID:21901389

Opiate treatment for opiate withdrawal in newborn infants.

PubMed

Osborn, D A; Jeffery, H E; Cole, M

2005-07-20

Neonatal abstinence syndrome (NAS) due to opiate withdrawal may result in disruption of the mother-infant relationship, sleep-wake abnormalities, feeding difficulties, weight loss and seizures. Treatments used to ameliorate symptoms and reduce morbidity include opiates, sedatives and non-pharmacological treatments. To assess the effectiveness and safety of using an opiate, compared to a sedative or non-pharmacological treatment, for treatment of NAS due to withdrawal from opiates. The previous review was updated with additional searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2005), MEDLINE (1966-December 2004) and EMBASE (1980-December 2004) supplemented by searches of conference abstracts and citation lists of published articles. Trials enrolling infants with NAS born to mothers with an opiate dependence, with > 80% follow up and using random or quasi-random allocation to opiate or control. Control could include an opiate, sedative or non-pharmacological treatment. Each author assessed study quality and extracted data independently. Primary outcomes included control of symptoms, seizure occurrence, mortality and neurodevelopment. Treatment effect was expressed using relative risk (RR), risk difference (RD), mean difference (MD) and weighted mean difference (WMD). Meta-analysis was performed using a fixed effect model. Seven studies enrolling a total of 585 infants met inclusion criteria (Carin 1983; Finnegan 1984; Jackson 2004; Kaltenbach 1986; Kandall 1983; Khoo 1995; Madden 1977); however, two (Finnegan 1984; Kaltenbach 1986) may be sequential reports that include some identical patients. The studies enrolled infants of mothers who had used opiates with or without other drugs during pregnancy. Methodological concerns included the use of quasi-random rather than random patient allocation methods in three studies; sizeable, largely unexplained differences in reported numbers allocated to each group in four studies; and imbalances in group characteristics after randomisation in one study. Opiate (morphine) vs supportive care only: One study (Khoo 1995) found no significant effect on treatment failure (RR 1.29, 95% CI 0.41, 4.07), a significant increase in hospital stay (MD 15.0 days, 95% CI 8.9, 21.1) and significant reductions in time to regain birthweight (MD -2.8 days, 95% -5.3, -0.3) and duration of supportive care (MD -197.2 minutes/day, 95% CI -274.2, -120.3). Opiate vs phenobarbitone: Meta-analysis of four studies found no significant difference in treatment failure (typical RR 0.76, 95% CI 0.51, 1.11). One of these studies (Finnegan 1984) reported that opiate treatment resulted in a significant reduction in treatment failure among infants of mothers who had used only opiates; however, as this was a post-hoc analysis, this result should be interpreted with caution. One study (Jackson 2004) reported a significant reduction in duration of treatment and admission to the nursery for infants receiving morphine compared to phenobarbitone. One study (Kandall 1983) reported a reduction in seizures, of borderline statistical significance, with the use of opiate. Opiate vs diazepam: Meta-analysis of two studies found a significant reduction in treatment failure (RR 0.43, 95% CI 0.23, 0.80) with the use of opiate. No study reported neurodevelopment by allocated treatment group. Opiates, as compared to supportive care only, appear to reduce the time to regain birth weight and reduce the duration of supportive care, but increase the duration of hospital stay; there is no evidence of effect on treatment failure. When compared to phenobarbitone, opiates may reduce the incidence of seizures but, overall, there is no evidence of effect on treatment failure. One study reported a reduction in duration of treatment and nursery admission for infants on morphine. When compared to diazepam, opiates reduce the incidence of treatment failure. A post-hoc analysis generates the hypothesis that treatment effects may vary according to whether the population includes infants born to all opiate users (i.e. with or without other drug exposure) or is restricted to infants of mothers who used opiates only. In view of the methodologic limitations of the included studies the conclusions of this review should be treated with caution.

Effect of the antimicrobial photodynamic therapy on microorganism reduction in deep caries lesions: a systematic review and meta-analysis.

PubMed

Ornellas, Pâmela Oliveira; Antunes, Leonardo Dos Santos; Fontes, Karla Bianca Fernandes da Costa; Póvoa, Helvécio Cardoso Corrêa; Küchler, Erika Calvano; Iorio, Natalia Lopes Pontes; Antunes, Lívia Azeredo Alves

2016-09-01

This study aimed to perform a systematic review to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) in the reduction of microorganisms in deep carious lesions. An electronic search was conducted in Pubmed, Web of Science, Scopus, Lilacs, and Cochrane Library, followed by a manual search. The MeSH terms, MeSH synonyms, related terms, and free terms were used in the search. As eligibility criteria, only clinical studies were included. Initially, 227 articles were identified in the electronic search, and 152 studies remained after analysis and exclusion of the duplicated studies; 6 remained after application of the eligibility criteria; and 3 additional studies were found in the manual search. After access to the full articles, three were excluded, leaving six for evaluation by the criteria of the Cochrane Collaboration’s tool for assessing risk of bias. Of these, five had some risk of punctuated bias. All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth. The meta-analysis demonstrated a significant reduction in microorganism counts in all analyses (p<0.00001). Based on these findings, there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions.

Effect of the antimicrobial photodynamic therapy on microorganism reduction in deep caries lesions: a systematic review and meta-analysis

NASA Astrophysics Data System (ADS)

Ornellas, Pâmela Oliveira; Antunes, Leonardo Santos; Fontes, Karla Bianca Fernandes da Costa; Póvoa, Helvécio Cardoso Corrêa; Küchler, Erika Calvano; Iorio, Natalia Lopes Pontes; Antunes, Lívia Azeredo Alves

2016-09-01

This study aimed to perform a systematic review to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) in the reduction of microorganisms in deep carious lesions. An electronic search was conducted in Pubmed, Web of Science, Scopus, Lilacs, and Cochrane Library, followed by a manual search. The MeSH terms, MeSH synonyms, related terms, and free terms were used in the search. As eligibility criteria, only clinical studies were included. Initially, 227 articles were identified in the electronic search, and 152 studies remained after analysis and exclusion of the duplicated studies; 6 remained after application of the eligibility criteria; and 3 additional studies were found in the manual search. After access to the full articles, three were excluded, leaving six for evaluation by the criteria of the Cochrane Collaboration's tool for assessing risk of bias. Of these, five had some risk of punctuated bias. All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth. The meta-analysis demonstrated a significant reduction in microorganism counts in all analyses (p<0.00001). Based on these findings, there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions.

Virtual reality for acute pain reduction in adolescents undergoing burn wound care: a prospective randomized controlled trial.

PubMed

Kipping, Belinda; Rodger, Sylvia; Miller, Kate; Kimble, Roy M

2012-08-01

Effective pain management remains a challenge for adolescents during conscious burn wound care procedures. Virtual reality (VR) shows promise as a non-pharmacological adjunct in reducing pain. This study assessed off-the-shelf VR for (1) its effect on reducing acute pain intensity during adolescent burn wound care, and (2) its clinical utility in a busy hospital setting. Forty-one adolescents (11-17 years) participated in this prospective randomized controlled trial. Acute pain outcomes including adolescent self-report, nursing staff behavioral observation, caregiver observation and physiological measures were collected. Length of procedure times and adolescent reactions were also recorded to inform clinical utility. Nursing staff reported a statistically significant reduction in pain scores during dressing removal, and significantly less rescue doses of Entonox given to those receiving VR, compared to those receiving standard distraction. For all other pain outcomes and length of treatment, there was a trend for lower pain scores and treatment times for those receiving VR, but these differences were not statistically significant. Despite only minimal pain reduction achieved using off-the-shelf VR, other results from this trial and previous research on younger children with burns suggest a customized, adolescent and hospital friendly device may be more effective in pain reduction. Copyright © 2012. Published by Elsevier Ltd.

A Review of In Vitro and In Vivo Studies on the Efficacy of Herbal Medicines for Primary Dysmenorrhea

PubMed Central

Park, Kyoung-Sun; Lee, Jin-Moo; Jang, Jun-Bock; Lee, Chang-Hoon

2014-01-01

Purpose. Primary dysmenorrhea (PD) is a common gynecological complaint among adolescent girls and women of reproductive age. This study aims to review the findings of published articles on the in vitro and in vivo efficacy of herbal medicines for PD. Methods. In vitro and in vivo studies of herbal compounds, individual herbal extracts, or herbal formula decoctions published from their inception to April 2014 were included in this review. Results. A total of 18 studies involving herbal medicines exhibited their inhibitory effect on PD. The majority of in vitro studies investigated the inhibition of uterine contractions. In vivo studies suggest that herbal medicines exert a peripheral analgesic effect and a possible anti-inflammatory activity via the inhibition of prostaglandin (PG) synthesis. The mechanisms of herbal medicines for PD are associated with PG level reduction, suppression of cyclooxygenase-2 expression, superoxide dismutase activation and malondialdehyde reduction, nitric oxide, inducible nitric oxide synthase, and nuclear factor-kappa B reduction, stimulation of somatostatin receptor, intracellular Ca2+ reduction, and recovery of phospholipid metabolism. Conclusions. Herbal medicines are thought to be promising sources for the development of effective therapeutic agents for PD. Further investigations on the appropriate herbal formula and their constituents are recommended. PMID:25431607

Efficacy of ε-polylysine, lauric arginate, or acidic calcium sulfate applied sequentially for Salmonella reduction on membrane filters and chicken carcasses.

PubMed

Benli, Hakan; Sanchez-Plata, Marcos X; Keeton, Jimmy T

2011-05-01

Salmonella contamination continues to be one of the major concerns for the microbiological safety of raw poultry products. Application of more than one decontamination agent as a multihurdle intervention to carcasses in a processing line might produce greater reductions than one treatment alone due to different modes of action of individual antimicrobials. In this study, all possible two-way combinations and individual applications of ε-polylysine (EPL), lauric arginate (LAE), and acidic calcium sulfate (ACS) solutions were evaluated for their effects against Salmonella enterica serovars, including Enteritidis and Typhimurium, using a sterile membrane filter model system. The combinations that provided higher Salmonella reductions were further evaluated on inoculated chicken carcasses in various concentrations applied in a sequential manner. Sequential spray applications of 300 mg of EPL per liter followed by 30% ACS and of 200 mg of LAE per liter followed by 30% ACS produced the highest Salmonella reductions on inoculated chicken carcasses, by 2.1 and 2.2 log CFU/ml, respectively. Our results indicated that these sequential spray applications of decontamination agents are effective for decreasing Salmonella contamination on poultry carcasses, but further studies are needed to determine the effectiveness of these combinations over a storage period.

Program evaluation of remote heart failure monitoring: healthcare utilization analysis in a rural regional medical center.

PubMed

Riley, William T; Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A Susana; Carroll, Mark

2015-03-01

Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. "Care Beyond Walls and Wires," a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems.

Blood Glucose Reduction by Diabetic Drugs with Minimal Hypoglycemia Risk for Cardiovascular Outcomes: Evidence from Meta-regression Analysis of Randomized Controlled Trials.

PubMed

Huang, Chi-Jung; Wang, Wei-Ting; Sung, Shih-Hsien; Chen, Chen-Huan; Lip, Gregory Yh; Cheng, Hao-Min; Chiang, Chern-En

2018-05-02

To investigate the effects of blood glucose control with antihyperglycemic agents with minimal hypoglycemia risk on cardiovascular outcomes in patients with type 2 diabetes (T2D). Randomized controlled trials (RCTs) comparing the relative efficacy and safety of antidiabetic drugs with less hypoglycemia risk were comprehensively searched in MEDLINE, Embase, and the Cochrane Library up to January 27, 2018. Mixed-effects meta-regression analysis was conducted to explore the relationship between haemoglobin A1c (HbA1c) reduction and the risk of major adverse cardiovascular events (MACE), myocardial infarction, stroke, cardiovascular death, all-cause death, and hospitalization for heart failure. Ten RCTs comprising 92400 participants with T2D were included and provided information on 9773 MACE during a median follow-up of 2.6 years. The mean HbA1c concentration was 0.42% lower (median, 0.27-0.86%) for participants given antihyperglycemic agents than those given placebo. The meta-regression analysis demonstrated that HbA1c reduction was significantly associated with a decreased risk of MACE (β value, -0.39 to -0.55; P<0.02) even after adjusting for each of the following possible confounding factors including age, sex, baseline HbA1c, duration of follow-up, difference in achieved systolic blood pressure, difference in achieved body weight, or risk difference in hypoglycemia. Lowering HbA1c by 1% conferred a significant risk reduction of 30% (95% CI, 17-40%) for MACE. By contrast, the meta-regression analysis for trials using conventional agents failed to demonstrate a significant relationship between achieved HbA1c difference and MACE risk (P>0.74). Compared with placebo, newer T2D agents with less hypoglycemic hazard significantly reduced the risk of MACE. The MACE reduction seems to be associated with HbA1c reduction in a linear relationship. This article is protected by copyright. All rights reserved.

Innovative techniques for the production of energetic radicals for lunar processing including cold plasma processing of local planetary ores

NASA Technical Reports Server (NTRS)

Bullard, D.; Lynch, D. C.

1992-01-01

Hydrogen reduction of ilmenite has been studied by a number of investigators as a potential means for recovery of oxygen from lunar soil. Interest in this process has always rested with the simplicity of the flow diagram and the utilization of established technology. Effective utilization of hydrogen in the reduction process at temperatures of 1200 C and below has always been disappointing and, as such, has led other investigators to focus attention on other systems. Effective utilization of hydrogen in the reduction of ilmenite can be significantly enhanced in the presence of a non-equilibrium hydrogen plasma. Ilmenite at solid specimen temperatures of 600 C to 970 C were reacted in a hydrogen plasma. Those experiments revealed that hydrogen utilization can be significantly enhanced. At a specimen temperature of 850 C the fraction of H2 reacted was 24 percent compared to the 7 percent theoretical limit calculated with thermodynamic theory for the same temperature. An added advantage for a hydrogen plasma involves further reduction of TiO2. Reduction of the iron oxide in ilmenite yields TiO2 and metallic iron as by products. Titanium forms a number of oxides including TiO, Ti2O3, Ti3O5 and the Magneli oxides (Ti4O7 to Ti50O99). In conventional processing of ilmenite with hydrogen it is possible to reduce TiO2 to Ti7O13 within approximately an hour, but with poor utilization of hydrogen on the order of one mole of H2 per thousand. In the cold or non-equilibrium plasma TiO2 can be rapidly reduced to Ti2O3 with hydrogen utilization exceeding 10 percent. Based on design considerations of the plasma reactor greater utilization of the hydrogen in the reduction of TiO2 is possible.

Dispersal and fallout simulations for urban consequences management (u)

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

Grinstein, Fernando F; Wachtor, Adam J; Nelson, Matt

2010-01-01

Hazardous chemical, biological, or radioactive releases from leaks, spills, fires, or blasts, may occur (intentionally or accidentally) in urban environments during warfare or as part of terrorist attacks on military bases or other facilities. The associated contaminant dispersion is complex and semi-chaotic. Urban predictive simulation capabilities can have direct impact in many threat-reduction areas of interest, including, urban sensor placement and threat analysis, contaminant transport (CT) effects on surrounding civilian population (dosages, evacuation, shelter-in-place), education and training of rescue teams and services. Detailed simulations for the various processes involved are in principle possible, but generally not fast. Predicting urban airflowmore » accompanied by CT presents extremely challenging requirements. Crucial technical issues include, simulating turbulent fluid and particulate transport, initial and boundary condition modeling incorporating a consistent stratified urban boundary layer with realistic wind fluctuations, and post-processing of the simulation results for practical consequences management. Relevant fluid dynamic processes to be simulated include, detailed energetic and contaminant sources, complex building vortex shedding and flows in recirculation zones, and modeling of particle distributions, including particulate fallout, as well as deposition, re-suspension and evaporation. Other issues include, modeling building damage effects due to eventual blasts, addressing appropriate regional and atmospheric data reduction.« less

Energy savings for heat-island reduction strategies in Chicago and Houston (including updates for Baton Rouge, Sacramento, and Salt Lake City)

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

Konopacki, S.; Akbari, H.

2002-02-28

In 1997, the U.S. Environmental Protection Agency (EPA) established the ''Heat Island Reduction Initiative'' to quantify the potential benefits of Heat-Island Reduction (HIR) strategies (i.e., shade trees, reflective roofs, reflective pavements and urban vegetation) to reduce cooling-energy use in buildings, lower the ambient air temperature and improve urban air quality in cities, and reduce CO2 emissions from power plants. Under this initiative, the Urban Heat Island Pilot Project (UHIPP) was created with the objective of investigating the potential of HIR strategies in residential and commercial buildings in three initial UHIPP cities: Baton Rouge, LA; Sacramento, CA; and Salt Lake City,more » UT. Later two other cities, Chicago, IL and Houston, TX were added to the UHIPP. In an earlier report we summarized our efforts to calculate the annual energy savings, peak power avoidance, and annual CO2 reduction obtainable from the introduction of HIR strategies in the initial three cities. This report summarizes the results of our study for Chicago and Houston. In this analysis, we focused on three building types that offer the highest potential savings: single-family residence, office and retail store. Each building type was characterized in detail by vintage and system type (i.e., old and new building constructions, and gas and electric heat). We used the prototypical building characteristics developed earlier for each building type and simulated the impact of HIR strategies on building cooling- and heating-energy use and peak power demand using the DOE-2.1E model. Our simulations included the impact of (1) strategically-placed shade trees near buildings [direct effect], (2) use of high-albedo roofing material on the building [direct effect], (3) urban reforestation with high-albedo pavements and building surfaces [indirect effect] and (4) combined strategies 1, 2, and 3 [direct and indirect effects]. We then estimated the total roof area of air-conditioned buildings in each city using readily obtainable data to calculate the metropolitan-wide impact of HIR strategies. The results show that in Chicago, potential annual energy savings of $30M could be realized by ratepayers from the combined direct and indirect effects of HIR strategies. Additionally, peak power avoidance is estimated at 400 MW and the reduction in annual carbon emissions at 58 ktC. In Houston, the potential annual energy savings are estimated at $82M, with an avoidance of 730 MW in peak power and a reduction in annual carbon emissions of 170 ktC.« less

Epitaxy versus oriented heterogeneous nucleation of organic crystals on ionic substrates

NASA Astrophysics Data System (ADS)

Sarma, K. R.; Shlichta, P. J.; Wilcox, W. R.; Lefever, R. A.

1997-04-01

It is plausible to assume that epitaxy is a special case of heterogeneous nucleation in which a restrictive crystallographic relationship exists between substrate and deposit orientations. This would mean that epitaxial substrates should always induce a perceptible reduction in the critical supercooling for nucleation of the deposit. To test this hypothesis, the critical supercoolings of six organic compounds were measured on glass and 11 single-crystal cleaved substrates including (0001) graphite, (001) mica, (111) BaF 2, SrF 2, and CaF 2, and (100) KCl, KBr, KI, NaCl, NaF, and LiF. Reductions in supercooling (with reference to glass substrates) were checked many times for repeatability and reproducibility and shown in almost all cases to have a standard deviation of 1 C or less. Acetanilide, benzoic acid, and p-bromochlorobenzene showed a wide range of supercooling reductions and were oriented on all crystalline substrates. Naphthalene and p-dibromobenzene showed only slight supercooling reductions but were oriented on all substrates, including glass. Benzil showed strong supercooling reductions only for mica and KI but was oriented not only in these cases but also with KI, BaF 2, CaF 2, and graphite. There was little correlation between degree of lattice match and either supercooling reduction or degree of preferred orientation. These results suggest that, for the systems and geometry studied, forces such as molecular dipole binding and growth anisotropy had a stronger effect than lattice match.

Sacubitril/valsartan in heart failure: latest evidence and place in therapy

PubMed Central

Kaplinsky, Edgardo

2016-01-01

Despite significant therapeutic advances, patients with chronic heart failure (HF) remain at high risk for HF progression and death. Sacubitril/valsartan (previously known as LCZ696) is a first-in-class medicine that contains a neprilysin (NEP) inhibitor (sacubitril) and an angiotensin II (Ang-II) receptor blocker (valsartan). NEP is an endopeptidase that metabolizes different vasoactive peptides including natriuretic peptides, bradykinin and Ang-II. In consequence, its inhibition increases mainly the levels of both, natriuretic peptides (promoting diuresis, natriuresis and vasodilatation) and Ang-II whose effects are blocked by the angiotensin receptor blocker, valsartan (reducing vasoconstriction and aldosterone release). Results from the 8442 patient PARADIGM-HF study showed in patients with New York Heart Association (NYHA) class II–IV and reduced ejection fraction treated with LCZ696 (versus enalapril), the following benefits: reduction of the risk of death from cardiovascular causes by 20%; reduction of HF hospitalizations by 21%; reduction of the risk of all-cause mortality by 16%. Overall there was a 20% risk reduction on the primary endpoint, composite measure of cardiovascular (CV) death or time to first HF hospitalization. PARADIGM-HF was stopped early after a median follow up of 27 months. Post hoc analyses of PARADIGM-HF as well as the place in therapy of sacubitril/valsartan, including future directions, are included in the present review. PMID:27803793

Co-control of urban air pollutants and greenhouse gases in Mexico City.

PubMed

West, J Jason; Osnaya, Patricia; Laguna, Israel; Martínez, Julia; Fernández, Adrián

2004-07-01

This study addresses the synergies of mitigation measures to control urban air pollutant and greenhouse gas (GHG) emissions, in developing integrated "co-control" strategies for Mexico City. First, existing studies of emissions reduction measures--PROAIRE (the air quality plan for Mexico City) and separate GHG studies--are used to construct a harmonized database of options. Second, linear programming (LP) is developed and applied as a decision-support tool to analyze least-cost strategies for meeting co-control targets for multiple pollutants. We estimate that implementing PROAIRE measures as planned will reduce 3.1% of the 2010 metropolitan CO2 emissions, in addition to substantial local air pollutant reductions. Applying the LP, PROAIRE emissions reductions can be met at a 20% lower cost, using only the PROAIRE measures, by adjusting investments toward the more cost-effective measures; lower net costs are possible by including cost-saving GHG mitigation measures, but with increased investment. When CO2 emission reduction targets are added to PROAIRE targets, the most cost-effective solutions use PROAIRE measures for the majority of local pollutant reductions, and GHG measures for additional CO2 control. Because of synergies, the integrated planning of urban-global co-control can be beneficial, but we estimate that for Mexico City these benefits are often small.

Cryogenic Treatment of Al-Li Alloys for Improved Weldability, Repairability, and Reduction of Residual Stresses

NASA Technical Reports Server (NTRS)

Malone, Tina W.; Graham, Benny F.; Gentz, Steven J. (Technical Monitor)

2001-01-01

Service performance has shown that cryogenic treatment of some metals provides improved strength, fatigue life, and wear resistance to the processed material. Effects such as these were initially discovered by NASA engineers while evaluating spacecraft that had returned from the cold vacuum of space. Factors such as high cost, poor repairability, and poor machinability are currently prohibitive for wide range use of some aerospace aluminum alloys. Application of a cryogenic treatment process to these alloys is expected provide improvements in weldability and weld properties coupled with a reduction in repairs resulting in a significant reduction in the cost to manufacture and life cycle cost of aerospace hardware. The primary purpose of this effort was to evaluate the effects of deep cryogenic treatment of some aluminum alloy plate products, welds, and weld repairs, and optimize a process for the treatment of these materials. The optimized process is being evaluated for improvements in properties of plate and welds, improvements in weldability and repairability of treated materials, and as an alternative technique for the reduction of residual stresses in repaired welds. This paper will present the results of testing and evaluation conducted in this effort. These results will include assessments of changes in strength, toughness, stress corrosion susceptability, weldability, repairability, and reduction in residual stresses of repaired welds.

Ultrasound-guided hydrostatic reduction of intussusception with saline: Safe and effective.

PubMed

Karadağ, Çetin Ali; Abbasoğlu, Latif; Sever, Nihat; Kalyoncu, Meltem Kaba; Yıldız, Abdullah; Akın, Melih; Candan, Mustafa; Dokucu, Ali İhsan

2015-09-01

The study was undertaken to assess the efficacy of ultrasound-guided saline enema in reducing intussusception and to determine the role of age and duration of symptoms on this event. The case records of patients who were treated for intussusception at our institutions over the past 10 years were retrospectively analyzed. A total of 419 patients were treated for intussusception and 375 of them were included into the study. Patients were excluded if they had symptoms and signs of acute abdominal disease and required surgery as an initial treatment. Hydrostatic reduction was successful in 313 of the 375 patients (83.46%). The procedure-related complication rate was nil. There were 29 episodes of recurrences in 23 patients, and recurrence rates did not differ between patients who responded to hydrostatic reduction and those who required surgery. Younger age [median (range); 11 months (3-108 months) vs. 20 months (1-180 months); p<0.05], rectal bleeding (p<0.01) and long duration of symptoms [mean (range); 1.95 days (1-7 days) vs. 1.44 days (1-10 days); p<0.01] were significantly associated with failed hydrostatic reduction. Ultrasound-guided hydrostatic reduction is an easy, safe and effective method for the treatment of intussusception in the absence of acute abdominal findings. Copyright © 2015 Elsevier Inc. All rights reserved.

Reflections on 30+ years of smoking cessation research: from the individual to the world.

PubMed

Lando, Harry A

2006-01-01

This is a personal retrospective in which I describe my career as a smoking cessation researcher and place cessation into an overall perspective of tobacco reduction. I spent approximately the first 15 years focusing primarily upon small group approaches to cessation emphasising relatively intensive behavioural interventions. It became apparent, however, that these types of approaches in isolation, even if broadly disseminated, would have relatively minimal impact on overall tobacco use. In part because I became discouraged with the potential of group programmes to reduce overall smoking prevalence, I began to focus more on population-based studies, especially in the context of 'teachable moments' including pregnancy, hospitalisation, forced abstinence in the military and existing smoking-related disease. I became concerned especially with the fact that there has been relatively little work with hard-core medically compromised smokers. It also became apparent that promoting cessation would be most likely to be effective with a comprehensive evidence-based tobacco reduction strategy including school and community-based prevention programmes, enforcement of ordinances restricting minors' access to tobacco, restrictions on tobacco advertising and promotion, counter advertising and strong smoke-free policies. In recent years I have become very concerned about the overall global tobacco epidemic and the projections of dramatically increasing tobacco morbidity and mortality in developing countries. I am now devoting my primary career emphasis to global tobacco reduction initiatives, including cessation research in India and Indonesia, cessation as part of broader tobacco reduction strategies and networking to increase resources and emphasis devoted to global tobacco reduction.

Reduction of facial redness with resveratrol added to topical product containing green tea polyphenols and caffeine.

PubMed

Ferzli, Georgina; Patel, Mital; Phrsai, Natasha; Brody, Neil

2013-07-01

Many topical formulations include antioxidants to improve the antioxidant capability of the skin. This study evaluated the ability of a unique combination of antioxidants including resveratrol, green tea polyphenols, and caffeine to reduce facial redness. Subjects (n=16) presenting with facial redness applied the resveratrol-enriched product twice daily to the entire face. Reduction in redness was evaluated by trained staff members and dermatology house staff officers. Evaluators compared clinical photographs and spectrally enhanced images taken before treatment and at 2-week intervals for up to 12 weeks. 16 of 16 clinical images showed improvement and 13 of 16 spectrally enhanced images were improved. Reduction in facial redness continued to evolve over the duration of the study period but was generally detectable by 6 weeks of treatment. Adverse effects were not observed in any subject. The skin product combination of resveratrol, green tea polyphenols, and caffeine safely reduces facial redness in most patients by 6 weeks of continuous treatment and may provide further improvement with additional treatment.

Numerical Prediction of Chevron Nozzle Noise Reduction using Wind-MGBK Methodology

NASA Technical Reports Server (NTRS)

Engblom, W.A.; Bridges, J.; Khavarant, A.

2005-01-01

Numerical predictions for single-stream chevron nozzle flow performance and farfield noise production are presented. Reynolds Averaged Navier Stokes (RANS) solutions, produced via the WIND flow solver, are provided as input to the MGBK code for prediction of farfield noise distributions. This methodology is applied to a set of sensitivity cases involving varying degrees of chevron inward bend angle relative to the core flow, for both cold and hot exhaust conditions. The sensitivity study results illustrate the effect of increased chevron bend angle and exhaust temperature on enhancement of fine-scale mixing, initiation of core breakdown, nozzle performance, and noise reduction. Direct comparisons with experimental data, including stagnation pressure and temperature rake data, PIV turbulent kinetic energy fields, and 90 degree observer farfield microphone data are provided. Although some deficiencies in the numerical predictions are evident, the correct farfield noise spectra trends are captured by the WIND-MGBK method, including the noise reduction benefit of chevrons. Implications of these results to future chevron design efforts are addressed.

Research progress in photolectric materials of CuFeS2

NASA Astrophysics Data System (ADS)

Jing, Mingxing; Li, Jing; Liu, Kegao

2018-03-01

CuFeS2 as a photoelectric material, there are many advantages, such as high optical absorption coefficient, direct gap semiconductor, thermal stability, no photo-recession effect and so on. Because of its low price, abundant reserves and non-toxic, CuFeS2 has attracted extensive attention of scientists.Preparation method of thin film solar cells are included that Electrodeposition, sputtering, thermal evaporation, thermal spraying method, co-reduction method.In this paper, the development of CuFeS2 thin films prepared by co-reduction method and co-reduction method is introduced.In this paper, the structure and development of solar cells, advantages of CuFeS2 as solar cell material, the structure and photoelectric properties and magnetic properties of CuFeS2, preparation process analysis of CuFeS2 thin film, research and development of CuFeS2 in solar cells is included herein. Finally, the development trend of CuFeS2 optoelectronic materials is analyzed and further research directions are proposed.

Thiosulfoxide (Sulfane) Sulfur: New Chemistry and New Regulatory Roles in Biology

PubMed Central

Toohey, John I.; Cooper, Arthur J. L.

2014-01-01

The understanding of sulfur bonding is undergoing change. Old theories on hypervalency of sulfur and the nature of the chalcogen-chalcogen bond are now questioned. At the same time, there is a rapidly expanding literature on the effects of sulfur in regulating biological systems. The two fields are inter-related because the new understanding of the thiosulfoxide bond helps to explain the newfound roles of sulfur in biology. This review examines the nature of thiosulfoxide (sulfane, S0) sulfur, the history of its regulatory role, its generation in biological systems, and its functions in cells. The functions include synthesis of cofactors (molybdenum cofactor, iron-sulfur clusters), sulfuration of tRNA, modulation of enzyme activities, and regulating the redox environment by several mechanisms (including the enhancement of the reductive capacity of glutathione). A brief review of the analogous form of selenium suggests that the toxicity of selenium may be due to over-reduction caused by the powerful reductive activity of glutathione perselenide. PMID:25153879

Cardiovascular benefits of dietary fiber.

PubMed

Satija, Ambika; Hu, Frank B

2012-12-01

The relationship between dietary fiber and risk of cardiovascular disease (CVD) has been extensively studied. There is considerable epidemiological evidence indicating an inverse association between dietary fiber intake and CVD risk. The association has been found to be stronger for cereal fiber than for fruit or vegetable fiber, and several studies have also found increased whole grain consumption to be associated with CVD risk reduction. In light of this evidence, recent US dietary guidelines have endorsed increased consumption of fiber rich whole grains. Regular consumption of dietary fiber, particularly fiber from cereal sources, may improve CVD health through multiple mechanisms including lipid reduction, body weight regulation, improved glucose metabolism, blood pressure control, and reduction of chronic inflammation. Future research should focus on various food sources of fiber, including different types of whole grains, legumes, fruits, vegetables, and nuts, as well as resistant starch in relation to CVD risk and weight control; explore the biological mechanisms underlying the cardioprotective effect of fiber-rich diets; and study different ethnic groups and populations with varying sources of dietary fiber.

Research on the use of space resources

NASA Technical Reports Server (NTRS)

Carroll, W. F. (Editor)

1983-01-01

The second year of a multiyear research program on the processing and use of extraterrestrial resources is covered. The research tasks included: (1) silicate processing, (2) magma electrolysis, (3) vapor phase reduction, and (4) metals separation. Concomitant studies included: (1) energy systems, (2) transportation systems, (3) utilization analysis, and (4) resource exploration missions. Emphasis in fiscal year 1982 was placed on the magma electrolysis and vapor phase reduction processes (both analytical and experimental) for separation of oxygen and metals from lunar regolith. The early experimental work on magma electrolysis resulted in gram quantities of iron (mixed metals) and the identification of significant anode, cathode, and container problems. In the vapor phase reduction tasks a detailed analysis of various process concepts led to the selection of two specific processes designated as ""Vapor Separation'' and ""Selective Ionization.'' Experimental work was deferred to fiscal year 1983. In the Silicate Processing task a thermophysical model of the casting process was developed and used to study the effect of variations in material properties on the cooling behavior of lunar basalt.

Effects of zinc supplementation on diabetes mellitus: a systematic review and meta-analysis

PubMed Central

2012-01-01

The number of people with diabetes and pre-diabetes are exponentially increasing. Studies on humans have shown the beneficial effects of Zinc supplementation in patients with diabetes. The present study aims to systematically evaluate the literature and meta-analyze the effects of Zinc supplementation on diabetes. A systematic review of published studies reporting the effects of Zinc supplementations on diabetes mellitus was undertaken. The literature search was conducted in the following databases; PubMed, Web of Science and SciVerse Scopus. A meta-analysis of studies examining the effects of Zinc supplementation on clinical and biochemical parameters in patients with diabetes was performed. The total number of articles included in the present review is 25, which included 3 studies on type-1 diabetes and 22 studies on type-2 diabetes. There were 12 studies comparing the effects of Zinc supplementation on fasting blood glucose in patients with type-2 diabetes. The pooled mean difference in fasting blood glucose between Zinc supplemented and placebo groups was 18.13mg/dl (95%CI:33.85,2.41; p<0.05). 2-h post-prandial blood sugar also shows a similar distinct reduction in (34.87mg/dl [95%CI:75.44; 5.69]) the Zinc treated group. The reduction in HbA1c was 0.54% (95%CI:0.86;0.21) in the Zinc treated group. There were 8 studies comparing the effects of Zinc supplementation on lipid parameters in patients with type-2 diabetes. The pooled mean difference for total cholesterol between Zinc supplemented and placebo groups was 32.37mg/dl (95%CI:57.39,7.35; p<0.05). Low-density lipoprotein cholesterol also showed a similar distinct reduction in the Zinc treated group, the pooled mean difference from random effects analysis was 11.19mg/dl (95%CI:21.14,1.25; p<0.05). Studies have also shown a significant reduction in systolic and diastolic blood pressures after Zinc supplementation. This first comprehensive systematic review and meta-analysis on the effects of Zinc supplementation in patients with diabetes demonstrates that Zinc supplementation has beneficial effects on glycaemic control and promotes healthy lipid parameters. Further studies are required to identify the exact biological mechanisms responsible for these results. PMID:22515411

Controlling the Growth of Au on Icosahedral Seeds of Pd by Manipulating the Reduction Kinetics

DOE PAGES

Lv, Tian; Yang, Xuan; Zheng, Yiqun; ...

2016-03-29

This article reports a systematic study of how Au atoms nucleate and grow on Pd icosahedral seeds with a multiply twinned structure. By manipulating the reduction kinetics, we obtained Pd–Au bimetallic nanocrystals with two distinct shapes and structures. Specifically, Pd@Au core–shell icosahedra were formed when a relatively fast reduction rate was used for the HAuCl 4 precursor. At a slow reduction rate, in contrast, the nucleation and growth of Au atoms were mainly confined to one of the vertices of a Pd icosahedral seed, resulting in the formation of a Au icosahedron by sharing five adjacent faces with the Pdmore » seed. The same growth pattern was observed for Pd icosahedral seeds with both sizes of 32 and 20 nm. Also, we have also investigated the effects of other kinetic parameters, including the concentration of reducing agent and reaction temperature, on the growth pathway undertaken by the Au atoms. In conclusion, we believe that the mechanistic insights obtained from this study can be extended to other systems, including the involvement of different metals and/or seeds with different morphologies.« less

Non-steroidal anti-inflammatory drugs for sciatica.

PubMed

Rasmussen-Barr, Eva; Held, Ulrike; Grooten, Wilhelmus Ja; Roelofs, Pepijn Ddm; Koes, Bart W; van Tulder, Maurits W; Wertli, Maria M

2016-10-15

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most frequently prescribed drugs for the treatment of sciatica. A previous Cochrane review on the efficacy of NSAIDs summarised findings for acute and chronic low back pain (LBP) and sciatica. This is an update of the original review (2008) focusing on people suffering from sciatica. To determine the efficacy of NSAIDs in pain reduction, overall improvement, and reported side effects in people with sciatica. We performed electronic searches up to 24 June 2015 in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PubMed, and two trials registers. We searched reference lists of included studies and relevant reviews on the topics for additional trials. We included randomised controlled trials (double-blind, single-blind, and open-label) that assessed the efficacy of NSAIDs in sciatica. We included all trials that compared NSAIDs to placebo, to other NSAIDs, or to other medication. Additional interventions were allowed if there was a clear contrast for the treatment with NSAIDs in the trial. Three review authors independently assessed the risk of bias and extracted the data. Where feasible we calculated pooled results using Review Manager 5.3. We reported pain relief outcomes using mean difference (MD) with 95% confidence intervals (95% CI). We used risk ratios (RR) with 95% CI to report global improvement of treatment, adverse effects, and additional medication. We performed a meta-analysis if possible. We assessed level of evidence using the GRADE approach. We used standard methodological procedures recommended by The Cochrane Collaboration. We included 10 trials reported in 9 publications (N = 1651). Only one trial out of 10 was assessed at low risk of bias. Five trials used the currently recommended daily dose for the drug, and two trials used lower daily doses available over the counter. Three trials investigated NSAIDs no longer approved for human use. The follow-up duration was short in all studies but one.Three trials (n = 918) compared the effects of NSAIDs to those of placebo on pain reduction. The pooled mean difference showed comparable pain reduction (visual analogue scale, 0 to 100) in the NSAIDs and placebo groups (MD -4.56, 95% CI -11.11 to 1.99). Heterogeneity was high (I 2 = 82%), and the quality of the evidence was very low. When we excluded one trial with a short follow-up of eight hours, the mean difference further decreased (MD -0.09, 95% CI -9.89 to 9.71). Three trials (n = 753) compared NSAIDs to placebo regarding global improvement. We found low-quality evidence that NSAIDs are more effective than placebo with a risk ratio of 1.14 (95% CI 1.03 to 1.27). One trial (n = 214) studied the effect of NSAIDs on disability, finding very low-quality evidence that NSAIDs are no more effective than placebo on disability. Four trials (n = 967) comparing NSAIDs to placebo reported adverse effects, with low-quality evidence that the risk for adverse effects is higher in the NSAID group than in the placebo group (RR 1.40, 95% CI 1.02 to 1.93). The adverse effects reported in this review are consistent with those previously reported in the literature. This updated systematic review including 10 trials evaluating the efficacy of NSAIDs versus placebo or other drugs in people with sciatica reports low- to very low-level evidence using the GRADE criteria. The efficacy of NSAIDs for pain reduction was not significant. NSAIDs showed a better global improvement compared to placebo. These findings must be interpreted with caution, as the level of evidence according to the GRADE classification was very low for the outcome pain reduction and low for global improvement due to small study samples, inconsistent results, imprecision, and a high risk of bias in the included trials. While the trials included in the analysis were not powered to detect potential rare side effects, we found an increased risk for side effects in the short-term NSAIDs use. As NSAIDs are frequently prescribed, the risk-benefit ratio of prescribing the drug needs to be considered.

Flexible multibody simulation of automotive systems with non-modal model reduction techniques

NASA Astrophysics Data System (ADS)

Shiiba, Taichi; Fehr, Jörg; Eberhard, Peter

2012-12-01

The stiffness of the body structure of an automobile has a strong relationship with its noise, vibration, and harshness (NVH) characteristics. In this paper, the effect of the stiffness of the body structure upon ride quality is discussed with flexible multibody dynamics. In flexible multibody simulation, the local elastic deformation of the vehicle has been described traditionally with modal shape functions. Recently, linear model reduction techniques from system dynamics and mathematics came into the focus to find more sophisticated elastic shape functions. In this work, the NVH-relevant states of a racing kart are simulated, whereas the elastic shape functions are calculated with modern model reduction techniques like moment matching by projection on Krylov-subspaces, singular value decomposition-based reduction techniques, and combinations of those. The whole elastic multibody vehicle model consisting of tyres, steering, axle, etc. is considered, and an excitation with a vibration characteristics in a wide frequency range is evaluated in this paper. The accuracy and the calculation performance of those modern model reduction techniques is investigated including a comparison of the modal reduction approach.

Economics of polysilicon processes

NASA Technical Reports Server (NTRS)

Yaws, C. L.; Li, K. Y.; Chou, S. M.

1986-01-01

Techniques are being developed to provide lower cost polysilicon material for solar cells. Existing technology which normally provides semiconductor industry polysilicon material is undergoing changes and also being used to provide polysilicon material for solar cells. Economics of new and existing technologies are presented for producing polysilicon. The economics are primarily based on the preliminary process design of a plant producing 1,000 metric tons/year of silicon. The polysilicon processes include: Siemen's process (hydrogen reduction of trichlorosilane); Union Carbide process (silane decomposition); and Hemlock Semiconductor process (hydrogen reduction of dichlorosilane). The economics include cost estimates of capital investment and product cost to produce polysilicon via the technology. Sensitivity analysis results are also presented to disclose the effect of major paramentes such as utilities, labor, raw materials and capital investment.

Mindfulness meditation-based stress reduction: experience with a bilingual inner-city program.

PubMed

Roth, B; Creaser, T

1997-03-01

This article describes a bilingual mindfulness meditation-based stress reduction program in an inner-city setting. Mindfulness meditation is defined, and the practices of breathing meditation, eating meditation, walking meditation, and mindful yoga are described. Data analysis examined compliance, medical and psychologic symptom reduction, and changes in self-esteem, of English- and Spanish-speaking patients who completed the 8-week Stress Reduction and Relaxation Program at the Community Health Center in Meriden, Conn. Statistically significant decreases in medical and psychologic symptoms and improvement in self-esteem were found. Many program completers reported dramatic changes in attitudes, beliefs, habits, and behaviors. Despite the limitations of the research design, these findings suggest that a mindfulness meditation course can be an effective health care intervention when utilized by English- and Spanish-speaking patients in an inner-city community health center. The article includes a discussion of factors to be considered when establishing a mindfulness meditation-based stress reduction program in a health care setting.

Anxiety sensitivity class membership moderates the effects of pre-quit reduction in anxiety sensitivity on quit-day tobacco craving.

PubMed

Bakhshaie, Jafar; Zvolensky, Michael J; Langdon, Kirsten J; Leventhal, Adam M; Smits, Jasper A J; Allan, Nicholas; Schmidt, Norman B

2016-04-01

Although anxiety sensitivity has been primarily conceptualized as a dimensional latent construct, empirical evidence suggests that it also maintains a latent class structure, reflecting low-, moderate-, and high-risk underlying classes. The present study sought to explore whether these anxiety sensitivity classes moderated the relations between the degree of pre-quit reductions in anxiety sensitivity and the severity of nicotine withdrawal symptoms and craving experienced on quit-day. Participants included 195 adult smokers (47% female; Mage=39.4) participating in a larger "anxiety sensitivity reduction-smoking cessation" intervention trial. Anxiety sensitivity class significantly moderated relations between pre-quit reduction in anxiety sensitivity and quit-day craving. Specifically, smokers within the anxiety sensitivity high-risk class, who also demonstrated lesser pre-quit reductions in anxiety sensitivity, experienced the highest levels of craving on quit-day. These findings highlight the importance of 'high-risk' classes of anxiety sensitivity to better understand the experience of craving on quit day. Copyright © 2016. Published by Elsevier Ltd.

Mindfulness-based stress reduction as a stress management intervention for healthy individuals: a systematic review.

PubMed

Sharma, Manoj; Rush, Sarah E

2014-10-01

Stress is a global public health problem with several negative health consequences, including anxiety, depression, cardiovascular disease, and suicide. Mindfulness-based stress reduction offers an effective way of reducing stress by combining mindfulness meditation and yoga in an 8-week training program. The purpose of this study was to look at studies from January 2009 to January 2014 and examine whether mindfulness-based stress reduction is a potentially viable method for managing stress. A systematic search from Medline, CINAHL, and Alt HealthWatch databases was conducted for all types of quantitative articles involving mindfulness-based stress reduction. A total of 17 articles met the inclusion criteria. Of the 17 studies, 16 demonstrated positive changes in psychological or physiological outcomes related to anxiety and/or stress. Despite the limitations of not all studies using randomized controlled design, having smaller sample sizes, and having different outcomes, mindfulness-based stress reduction appears to be a promising modality for stress management. © The Author(s) 2014.

Rationale and design of the NO-PARTY trial: near-zero fluoroscopic exposure during catheter ablation of supraventricular arrhythmias in young patients.

PubMed

Casella, Michela; Dello Russo, Antonio; Pelargonio, Gemma; Bongiorni, Maria Grazia; Del Greco, Maurizio; Piacenti, Marcello; Andreassi, Maria Grazia; Santangeli, Pasquale; Bartoletti, Stefano; Moltrasio, Massimo; Fassini, Gaetano; Marini, Massimiliano; Di Cori, Andrea; Di Biase, Luigi; Fiorentini, Cesare; Zecchi, Paolo; Natale, Andrea; Picano, Eugenio; Tondo, Claudio

2012-10-01

Radiofrequency catheter ablation is the mainstay of therapy for supraventricular tachyarrhythmias. Conventional radiofrequency catheter ablation requires the use of fluoroscopy, thus exposing patients to ionising radiation. The feasibility and safety of non-fluoroscopic radiofrequency catheter ablation has been recently reported in a wide range of supraventricular tachyarrhythmias using the EnSite NavX™ mapping system. The NO-PARTY is a multi-centre, randomised controlled trial designed to test the hypothesis that catheter ablation of supraventricular tachyarrhythmias guided by the EnSite NavX™ mapping system results in a clinically significant reduction in exposure to ionising radiation compared with conventional catheter ablation. The study will randomise 210 patients undergoing catheter ablation of supraventricular tachyarrhythmias to either a conventional ablation technique or one guided by the EnSite NavX™ mapping system. The primary end-point is the reduction of the radiation dose to the patient. Secondary end-points include procedural success, reduction of the radiation dose to the operator, and a cost-effectiveness analysis. In a subgroup of patients, we will also evaluate the radiobiological effectiveness of dose reduction by assessing acute chromosomal DNA damage in peripheral blood lymphocytes. NO-PARTY will determine whether radiofrequency catheter ablation of supraventricular tachyarrhythmias guided by the EnSite NavX™ mapping system is a suitable and cost-effective approach to achieve a clinically significant reduction in ionising radiation exposure for both patient and operator.

Randomised trial of low-dose amiodarone in severe congestive heart failure. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA)

PubMed

Doval, H C; Nul, D R; Grancelli, H O; Perrone, S V; Bortman, G R; Curiel, R

1994-08-20

In severe heart failure many deaths are sudden and are presumed to be due to ventricular arrhythmias. The GESICA trial evaluated the effect of low-dose amiodarone on two-year mortality in patients with severe heart failure. Our prospective multicentre trial included 516 patients on optimal standard treatment for heart failure. Patients were randomised to 300 mg/day amiodarone (260) or to standard treatment (256). Intention-to-treat analysis showed 87 deaths in the amiodarone group (33.5%) compared with 106 in the control group (41.4%) (risk reduction 28%; 95% CI 4%-45%; log rank test p = 0.024). There were reductions in both sudden death (risk reduction 27%; p = 0.16) and death due to progressive heart failure (risk reduction 23%; p = 0.16). Fewer patients in the amiodarone group died or were admitted to hospital due to worsening heart failure (119 versus 149 in the control group; risk reduction 31%; 95% CI 13-46%; p = 0.0024). The decrease in mortality and hospital admission was present in all subgroups examined and independent of the presence of non-sustained ventricular tachycardia. Side-effects were reported in 17 patients (6.1%); amiodarone was withdrawn in 12. Low-dose amiodarone proved to be an effective and reliable treatment, reducing mortality and hospital admission in patients with severe heart failure independently of the presence of complex ventricular arrhythmias.

Laser and Light Treatments for Hair Reduction in Fitzpatrick Skin Types IV-VI: A Comprehensive Review of the Literature.

PubMed

Fayne, Rachel A; Perper, Marina; Eber, Ariel E; Aldahan, Adam S; Nouri, Keyvan

2018-04-01

Unwanted facial and body hair presents as a common finding in many patients, such as females with hirsutism. With advances in laser and light technology, a clinically significant reduction in hair can be achieved in patients with light skin. However, in patients with darker skin, Fitzpatrick skin types (FST) IV-VI, the higher melanin content of the skin interferes with the proposed mechanism of laser-induced selective photothermolysis, which is to target the melanin in the hair follicle to cause permanent destruction of hair bulge stem cells. Many prospective and retrospective studies have been conducted with laser and light hair-removal devices, but most exclude patients with darkly pigmented skin, considering them a high-risk group for unwanted side effects, including pigmentation changes, blisters, and crust formation. We reviewed the published literature to obtain studies that focused on hair reduction for darker skin types. The existing literature for this patient population identifies longer wavelengths as a key element of the treatment protocol and indicates neodymium-doped yttrium aluminum garnet (Nd:YAG), diode, alexandrite, and ruby lasers as well as certain intense pulsed light sources for safe hair reduction with minimal side effects in patients with FST IV-VI, so long as energy settings and wavelengths are appropriate. Based on the findings in this review, safe and effective hair reduction for patients with FST IV-VI is achievable under proper treatment protocols and energy settings.

Systematic review on the cost-effectiveness of self-management education programme for type 2 diabetes mellitus.

PubMed

Lian, J X; McGhee, S M; Chau, J; Wong, Carlos K H; Lam, Cindy L K; Wong, William C W

2017-05-01

A review of cost-effectiveness studies on self-management education programmes for Type 2 diabetes mellitus. Cochrane, PubMed and PsycINFO databases were searched for papers published from January 2003 through September 2015. Further hand searching using the reference lists of included papers was carried out. In total, 777 papers were identified and 12 papers were finally included. We found eight programmes whose effectiveness analyses were based on randomised controlled trials and whose costs were comprehensively estimated from the stated perspective. Among these eight, four studies showed a cost per unit reduction in clinical risk factors (HbA1c or BMI) of US$491 to US$7723 or cost per glycaemic symptom day avoided of US$39. In three studies the cost per QALY gained, as estimated from a life-time model, was less than US$50,000. However, one study found the programme was not cost-effective despite a gain in QALYs at the one-year follow up. A small number of cost-effectiveness studies were identified with only eight of sufficiently good quality. The cost of a self-management education programme achieving reduction in clinical risk factors seems to be modest and is likely to be cost-effective in the long-term. Copyright © 2017 Elsevier B.V. All rights reserved.

Reduced nicotine product standards for combustible tobacco: Building an empirical basis for effective regulation

PubMed Central

Donny, Eric C.; Hatsukami, Dorothy K.; Benowitz, Neal L.; Sved, Alan F.; Tidey, Jennifer W.; Cassidy, Rachel N.

2014-01-01

Introduction Both the Tobacco Control Act in the U.S. and Article 9 of the Framework Convention on Tobacco Control enable governments to directly address the addictiveness of combustible tobacco by reducing nicotine through product standards. Although nicotine may have some harmful effects, the detrimental health effects of smoked tobacco are primarily due to non-nicotine constituents. Hence, the health effects of nicotine reduction would likely be determined by changes in behavior that result in changes in smoke exposure. Methods Herein, we review the current evidence on nicotine reduction and discuss some of the challenges in establishing the empirical basis for regulatory decisions. Results To date, research suggests that very low nicotine content cigarettes produce a desirable set of outcomes, including reduced exposure to nicotine, reduced smoking, and reduced dependence, without significant safety concerns. However, much is still unknown, including the effects of gradual versus abrupt changes in nicotine content, effects in vulnerable populations, and impact on youth. Discussion A coordinated effort must be made to provide the best possible scientific basis for regulatory decisions. The outcome of this effort may provide the foundation for a novel approach to tobacco control that dramatically reduces the devastating health consequences of smoked tobacco. PMID:24967958

Reduced nicotine product standards for combustible tobacco: building an empirical basis for effective regulation.

PubMed

Donny, Eric C; Hatsukami, Dorothy K; Benowitz, Neal L; Sved, Alan F; Tidey, Jennifer W; Cassidy, Rachel N

2014-11-01

Both the Tobacco Control Act in the U.S. and Article 9 of the Framework Convention on Tobacco Control enable governments to directly address the addictiveness of combustible tobacco by reducing nicotine through product standards. Although nicotine may have some harmful effects, the detrimental health effects of smoked tobacco are primarily due to non-nicotine constituents. Hence, the health effects of nicotine reduction would likely be determined by changes in behavior that result in changes in smoke exposure. Herein, we review the current evidence on nicotine reduction and discuss some of the challenges in establishing the empirical basis for regulatory decisions. To date, research suggests that very low nicotine content cigarettes produce a desirable set of outcomes, including reduced exposure to nicotine, reduced smoking, and reduced dependence, without significant safety concerns. However, much is still unknown, including the effects of gradual versus abrupt changes in nicotine content, effects in vulnerable populations, and impact on youth. A coordinated effort must be made to provide the best possible scientific basis for regulatory decisions. The outcome of this effort may provide the foundation for a novel approach to tobacco control that dramatically reduces the devastating health consequences of smoked tobacco. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of alcohol taxes on alcohol-related mortality in Florida: time-series analyses from 1969 to 2004.

PubMed

Maldonado-Molina, Mildred M; Wagenaar, Alexander C

2010-11-01

Over a hundred studies have established the effects of beverage alcohol taxes and prices on sales and drinking behaviors. Yet, relatively few studies have examined effects of alcohol taxes on alcohol-related mortality. We evaluated effects of multiple changes in alcohol tax rates in the state of Florida from 1969 to 2004 on disease (not injury) mortality. A time-series quasi-experimental research design was used, including non-alcohol deaths within Florida and other states' rates of alcohol-related mortality for comparison. A total of 432 monthly observations of mortality in Florida were examined over the 36-year period. Analyses included ARIMA, fixed-effects, and random-effects models, including a noise model, tax independent variables, and structural covariates. We found significant reductions in mortality related to chronic heavy alcohol consumption following legislatively induced increases in alcohol taxes in Florida. The frequency of deaths (t = -2.73, p = 0.007) and the rate per population (t = -2.06, p = 0.04) declined significantly. The elasticity effect estimate is -0.22 (t = -1.88, p = 0.06), indicating a 10% increase in tax is associated with a 2.2% decline in deaths. Increased alcohol taxes are associated with significant and sizable reductions in alcohol-attributable mortality in Florida. Results indicate that 600 to 800 lives per year could be saved if real tax rates were returned to 1983 levels (when the last tax increase occurred). Findings highlight the role of tax policy as an effective means for reducing deaths associated with chronic heavy alcohol use. Copyright © 2010 by the Research Society on Alcoholism.

Effects of alcohol taxes on alcohol-related mortality in Florida: Time-series analyses from 1969–2004

PubMed Central

Maldonado-Molina, Mildred M.; Wagenaar, Alexander C.

2010-01-01

Background Over a hundred studies have established the effects of beverage alcohol taxes and prices on sales and drinking behaviors. Yet, relatively few studies have examined effects of alcohol taxes on alcohol-related mortality. We evaluated effects of multiple changes in alcohol tax rates in the State of Florida from 1969–2004 on disease (not injury) mortality. Methods A time-series quasi-experimental research design was used, including non-alcohol deaths within Florida and other states’ rates of alcohol-related mortality for comparison. A total of 432 monthly observations of mortality in Florida were examined over the 36-year period. Analyses included ARIMA, fixed-effects, and random effects models, including a noise model, tax independent variables, and structural covariates. Results We found significant reductions in mortality related to chronic heavy alcohol consumption following legislatively induced increases in alcohol taxes in Florida. The frequency of deaths (t=−2.73, p=.007) and the rate per population (t=−2.06, p=.04) declined significantly. The elasticity effect estimate is −0.22 (t=−1.88, p=.06), indicating a 10% increase in tax is associated with a 2.2% decline in deaths. Conclusions Increased alcohol taxes are associated with significant and sizable reductions in alcohol-attributable mortality in Florida. Results indicate that 600–800 lives per year could be saved if real tax rates were returned to 1983 levels (when the last tax increase occurred). Findings highlight the role of tax policy as an effective means for reducing deaths associated with chronic heavy alcohol use. PMID:20659073

Nonvitamin-K-antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and previous stroke or transient ischemic attack: An updated systematic review and meta-analysis of randomized controlled trials.

PubMed

Ntaios, George; Papavasileiou, Vasileios; Diener, Hans-Chris; Makaritsis, Konstantinos; Michel, Patrik

2017-08-01

Background In a previous systematic review and meta-analysis, we assessed the efficacy and safety of nonvitamin-K antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and stroke or transient ischemic attack. Since then, new information became available. Aim The aim of the present work was to update the results of the previous systematic review and meta-analysis. Methods We searched PubMed until 24 August 2016 for randomized controlled trials using the following search items: "atrial fibrillation" and "anticoagulation" and "warfarin" and "previous stroke or transient ischemic attack." Eligible studies had to be phase III trials in patients with atrial fibrillation comparing warfarin with nonvitamin-K antagonist oral anticoagulants currently on the market or with the intention to be brought to the market in North America or Europe. The outcomes assessed in the efficacy analysis included stroke or systemic embolism, stroke, ischemic or unknown stroke, disabling or fatal stroke, hemorrhagic stroke, cardiovascular death, death from any cause, and myocardial infarction. The outcomes assessed in the safety analysis included major bleeding, intracranial bleeding, and major gastrointestinal bleeding. We performed fixed effects analyses on intention-to-treat basis. Results Among 183 potentially eligible articles, four were included in the meta-analysis. In 20,500 patients, compared to warfarin, nonvitamin-K antagonist oral anticoagulants were associated with a significant reduction of stroke/systemic embolism (relative risk reduction: 13.7%, absolute risk reduction: 0.78%, number needed to treat to prevent one event: 127), hemorrhagic stroke (relative risk reduction: 50.0%, absolute risk reduction: 0.63%, number needed to treat: 157), any stroke (relative risk reduction: 13.1%, absolute risk reduction: 0.7%, number needed to treat: 142), and intracranial hemorrhage (relative risk reduction: 46.1%, absolute risk reduction: 0.88%, number needed to treat: 113) over 1.8-2.8 years. Conclusions This updated meta-analysis in 20,500 atrial fibrillation patients with previous stroke or transient ischemic attack shows that compared to warfarin non-vitamin-K antagonist oral anticoagulants are associated with a significant reduction of stroke, stroke or systemic embolism, hemorrhagic stroke, and intracranial bleeding.

TRACI 2.0 - The Tool for the Reduction and Assessment of ...

EPA Pesticide Factsheets

TRACI 2.0, the Tool for the Reduction and Assessment of Chemical and other environmental Impacts 2.0, has been expanded and developed for sustainability metrics, life cycle impact assessment, industrial ecology, and process design impact assessment for developing increasingly sustainable products, processes, facilities, companies, and communities. TRACI 2.0 allows the quantification of stressors that have potential effects, including ozone depletion, global warming, acidification, eutrophication, tropospheric ozone (smog) formation, human health criteria-related effects, human health cancer, human health noncancer, ecotoxicity, and fossil fuel depletion effects. Research is on going to quantify the use of land and water in a future version of TRACI. The original version of TRACI released in August 2002, has been used in many prestigious applications including: the US Green Building Council’s LEED Certification, the National Institute of Standards and Technology’s BEES (Building for Environment and Economic Sustainability) which is used by US EPA for Environmentally Preferable Purchasing, the US Marine Corps’ EKAT (Environmental Knowledge and Assessment Tool) for military and non-military uses, and within numerous college curriculums in engineering and design departments. To inform the public.

Assessment of some cultural experimental methods to study the effects of antibiotics on microbial activities in a soil: An incubation study

PubMed Central

Molaei, Ali; Haghnia, Gholamhosain; Astaraei, Alireza; Rasouli-Sadaghiani, MirHassan; Teresa Ceccherini, Maria; Datta, Rahul

2017-01-01

Oxytetracycline (OTC) and sulfamethoxazole (SMX) are two of most widely used antibiotics in livestock and poultry industry. After consumption of antibiotics, a major portion of these compounds is excreted through the feces and urine of animals. Land application of antibiotic-treated animal wastes has caused increasing concern about their adverse effects on ecosystem health. In this regard, inconsistent results have been reported regarding the effects of antibiotics on soil microbial activities. This study was conducted based on the completely randomized design to the measure microbial biomass carbon, cumulative respiration and iron (III) reduction bioassays. Concentrations of OTC and SMX including 0, 1, 10, 25, 50, and 100 mg/kg were spiked in triplicate to a sandy loam soil and incubated for 21 days at 25°C. Results showed that the effects of OTC and SMX antibiotics on cumulative respiration and microbial biomass carbon were different. SMX antibiotic significantly affected soil microbial biomass carbon and cumulative respiration at different treatments compared to control with increasing incubation time. OTC antibiotic, on the other hand, negatively affected cumulative respiration compared to control treatment throughout the incubation period. Although OTC antibiotic positively affected microbial biomass carbon at day one of incubation, there was no clear trend in microbial biomass carbon between different treatments of this antibiotic after that time period. Nevertheless, sulfamethoxazole and oxytetracycline antibiotics had similar effects on iron (III) reduction such that they considerably affected iron (III) reduction at 1 and 10 mg/kg, and iron (III) reduction was completely inhibited at concentrations above 10 mg/kg. Hence, according to our results, microbial biomass carbon and cumulative respiration experiments are not able alone to exhibit the effect of antibiotics on soil microbial activity, but combination of these two experiments with iron (III) reduction test could well display the effects of sulfamethoxazole (SMX) and oxytetracycline (OTC) antibiotics on soil biochemical activities. PMID:28683144

Lighting levels for isolated intersections : leading to safety improvements : final report.

DOT National Transportation Integrated Search

2015-01-01

A number of studies have linked the benefits of roadway lighting to a reduction in crash rates at night for a variety : of roadway types including rural intersections. Assessing the effectiveness of intersection lighting has primarily : relied upon c...

Insect repellents and associated personal protection for a reduction in human disease

USDA-ARS?s Scientific Manuscript database

Personal protection measures against biting arthropods include topical insect repellents, area repellents, insecticide-treated bednets and treated clothing. The literature on the effectiveness of personal protection products against arthropods is mainly limited to studies of prevention of bites, rat...

Methionine: a new biopesticide for use in mosquito management

USDA-ARS?s Scientific Manuscript database

Mosquito larvicides are an effective means of source reduction, controlling the population size so that the number of adult females that are present to bite and potentially spread pathogenic organisms is decreased. Currently utilized mosquito larvicides include insect growth regulators, organophosph...

Dietary salt intake and risk of gastric cancer.

PubMed

D'Elia, Lanfranco; Galletti, Ferruccio; Strazzullo, Pasquale

2014-01-01

Humans began to use large amounts of salt for the main purpose of food preservation approximately 5,000 years ago and, although since then advanced technologies have been developed allowing drastic reduction in the use of salt for food storage, excess dietary salt intake remains very common. Gastric cancer is a common neoplasia, and dietary factors, including salt consumption, are considered relevant to its causation. A number of experimental studies supported the cocarcinogenic effect of salt through synergic action with Helicobacter pylori infection, in addition to some independent effects such as increase in the rate of cell proliferation and of endogenous mutations. Many epidemiological studies analyzed the relationship between excess salt intake and risk of gastric cancer. Both cross-sectional and prospective studies indicated a possibly dose-dependent positive association. In particular, a comprehensive meta-analysis of longitudinal studies detected a strong adverse effect of total salt intake and salt-rich foods on the risk of gastric cancer in the general population. Altogether, the epidemiological, clinical, and experimental evidence supports the possibility of a substantial reduction in the rates of gastric cancer through progressive reduction in population salt intake.

Effects of a Pilot Church-Based Intervention to Reduce HIV Stigma and Promote HIV Testing Among African Americans and Latinos.

PubMed

Derose, Kathryn P; Griffin, Beth Ann; Kanouse, David E; Bogart, Laura M; Williams, Malcolm V; Haas, Ann C; Flórez, Karen R; Collins, Deborah Owens; Hawes-Dawson, Jennifer; Mata, Michael A; Oden, Clyde W; Stucky, Brian D

2016-08-01

HIV-related stigma and mistrust contribute to HIV disparities. Addressing stigma with faith partners may be effective, but few church-based stigma reduction interventions have been tested. We implemented a pilot intervention with 3 Latino and 2 African American churches (4 in matched pairs) in high HIV prevalence areas of Los Angeles County to reduce HIV stigma and mistrust and increase HIV testing. The intervention included HIV education and peer leader workshops, pastor-delivered sermons on HIV with imagined contact scenarios, and HIV testing events. We surveyed congregants at baseline and 6 month follow-up (n = 1235) and found statistically significant (p < 0.05) reductions in HIV stigma and mistrust in the Latino intervention churches but not in the African American intervention church nor overall across matched African American and Latino pairs. However, within matched pairs, intervention churches had much higher rates of HIV testing (p < 0.001). Stigma reduction and HIV testing may have synergistic effects in community settings.

Comparative intelligibility investigation of single-channel noise-reduction algorithms for Chinese, Japanese, and English.

PubMed

Li, Junfeng; Yang, Lin; Zhang, Jianping; Yan, Yonghong; Hu, Yi; Akagi, Masato; Loizou, Philipos C

2011-05-01

A large number of single-channel noise-reduction algorithms have been proposed based largely on mathematical principles. Most of these algorithms, however, have been evaluated with English speech. Given the different perceptual cues used by native listeners of different languages including tonal languages, it is of interest to examine whether there are any language effects when the same noise-reduction algorithm is used to process noisy speech in different languages. A comparative evaluation and investigation is taken in this study of various single-channel noise-reduction algorithms applied to noisy speech taken from three languages: Chinese, Japanese, and English. Clean speech signals (Chinese words and Japanese words) were first corrupted by three types of noise at two signal-to-noise ratios and then processed by five single-channel noise-reduction algorithms. The processed signals were finally presented to normal-hearing listeners for recognition. Intelligibility evaluation showed that the majority of noise-reduction algorithms did not improve speech intelligibility. Consistent with a previous study with the English language, the Wiener filtering algorithm produced small, but statistically significant, improvements in intelligibility for car and white noise conditions. Significant differences between the performances of noise-reduction algorithms across the three languages were observed.

Enhanced Nitrobenzene reduction by zero valent iron pretreated with H2O2/HCl.

PubMed

Yang, Zhe; Ma, Xiaowen; Shan, Chao; Fang, Zhuoyao; Pan, Bingcai

2018-04-01

In this study a novel iron-based reducing agent of highly effective reduction toward nitrobenzene (NB) was obtained by pretreating zero valent iron (ZVI) with H 2 O 2 /HCl. During the H 2 O 2 /HCl pretreatment, ZVI undergoes an intensive corrosion process with formation of various reducing corrosion products (e.g., Fe 2+ , ferrous oxides/hydroxides, Fe 3 O 4 ), yielding a synergetic system (prtZVI) including liquid, suspensions and solid phase. The pretreatment process remarkably enhances the reductive performance of ZVI, where a rapid reduction of NB (200 mg L -1 ) in the prtZVI suspension was accomplished in a broad pH range (3-9) and at low dosage. Nitrosobenzene and phenylhydroxylamine are identified as the intermediates for NB reduction with the end-product of aniline. Compared with the virgin ZVI as well as another nanosized ZVI, the prtZVI system exhibits much higher electron efficiency for NB reduction as well as higher utilization ratio of Fe 0 . A rapid reduction of various nitroaromatics in an actual pharmaceutical wastewater further demonstrated the feasibility of the prtZVI system in real wastewater treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

Production of oxygen from lunar ilmenite

NASA Technical Reports Server (NTRS)

Zhao, Y.; Shadman, F.

1990-01-01

The following subjects are addressed: (1) the mechanism and kinetics of carbothermal reduction of simulated lunar ilmenite using carbon and, particularly, CO as reducing agents; (2) the determination of the rate-limiting steps; (3) the investigation of the effect of impurities, particularly magnesium; (4) the search for catalysts suitable for enhancement of the rate-limiting step; (5) the comparison of the kinetics of carbothermal reduction with those of hydrogen reduction; (6) the study of the combined use of CO and hydrogen as products of gasification of carbonaceous solids; (7) the development of reduction methods based on the use of waste carbonaceous compounds for the process; (8) the development of a carbothermal reaction path that utilizes gasification of carbonaceous solids to reducing gaseous species (hydrocarbons and carbon monoxide) to facilitate the reduction reaction kinetics and make the process more flexible in using various forms of carbonaceous feeds; (9) the development of advanced gas separation techniques, including the use of high-temperature ceramic membranes; (10) the development of an optimum process flow sheet for carbothermal reduction, and comparison of this process with the hydrogen reduction scheme, as well as a general comparison with other leading oxygen production schemes; and (11) the use of new and advanced material processing and separation techniques.

Effectiveness of interventions to screen and manage infections during pregnancy on reducing stillbirths: a review

PubMed Central

2011-01-01

Background Infection is a well acknowledged cause of stillbirths and may account for about half of all perinatal deaths today, especially in developing countries. This review presents the impact of interventions targeting various important infections during pregnancy on stillbirth or perinatal mortality. Methods We undertook a systematic review including all relevant literature on interventions dealing with infections during pregnancy for assessment of effects on stillbirths or perinatal mortality. The quality of the evidence was assessed using the adapted Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach by Child Health Epidemiology Reference Group (CHERG). For the outcome of interest, namely stillbirth, we applied the rules developed by CHERG to recommend a final estimate for reduction in stillbirth for input to the Lives Saved Tool (LiST) model. Results A total of 25 studies were included in the review. A random-effects meta-analysis of observational studies of detection and treatment of syphilis during pregnancy showed a significant 80% reduction in stillbirths [Relative risk (RR) = 0.20; 95% confidence interval (CI): 0.12 - 0.34) that is recommended for inclusion in the LiST model. Our meta-analysis showed the malaria prevention interventions i.e. intermittent preventive treatment (IPTp) and insecticide-treated mosquito nets (ITNs) can reduce stillbirths by 22%, however results were not statistically significant (RR = 0.78; 95% CI: 0.59 – 1.03). For human immunodeficiency virus infection, a pooled analysis of 6 radomized controlled trials (RCTs) failed to show a statistically significant reduction in stillbirth with the use of antiretroviral in pregnancy compared to placebo (RR = 0.93; 95% CI: 0.45 – 1.92). Similarly, pooled analysis combining four studies for the treatment of bacterial vaginosis (3 for oral and 1 for vaginal antibiotic) failed to yield a significant impact on perinatal mortality (OR = 0.88; 95% CI: 0.50 – 1.55). Conclusions The clearest evidence of impact in stillbirth reduction was found for adequate prevention and treatment of syphilis infection and possibly malaria. At present, large gaps exist in the growing list of stillbirth risk factors, especially those that are infection related. Potential causes of stillbirths including HIV and TORCH infections need to be investigated further to help establish the role of prevention/treatment and its subsequent impact on stillbirth reduction. PMID:21501448

Mindfulness-based Intervention for Perinatal Grief Education and Reduction among Poor Women in Chhattisgarh, India: a Pilot Study.

PubMed

Roberts, Lisa; Montgomery, Susanne

2016-04-01

Stillbirth is a significant public health problem in low-to-middle-income countries and results in perinatal grief, often with negative psychosocial impact. In low-resource settings, such as Chhattisgarh, India, where needs are high, it is imperative to utilize low-cost, effective interventions. Mindfulness-based stress reduction (MBSR) is an empirically sound intervention that has been utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The main objective of this pilot study was to explore the feasibility and effectiveness of a shortened, culturally adapted mindfulness-based intervention to address complex grief after stillbirth. We used an observational, pre-post-6-week post study design. The study instrument was made up of descriptive demographic questions and validated scales and was administered as a structured interview due to low literacy rates. We used a community participatory approach to culturally adapt the five-week mindfulness-based intervention and delivered it through two trained local nurses. Quantitative and qualitative data analyses explored study outcomes as well as acceptability and feasibility of the intervention. 29 women with a history of stillbirth enrolled, completed the pretest and began the intervention; 26 completed the five-week intervention and post-test (89.7%), and 23 completed the six-week follow-up assessment (88.5%). Pretest results included elevated psychological symptoms and high levels of perinatal grief, including the active grief, difficulty coping, and despair subscales. General linear modeling repeated measures was used to explore posttest and six-week follow up changes from baseline, controlling for significantly correlated demographic variables. These longitudinal results included significant reduction in psychological symptoms; four of the five facets of mindfulness changed in the desired direction, two significantly; as well as significant reduction in overall perinatal grief and on each of the three subscales. The shortened, culturally adapted, mindfulness-based intervention pilot study was well received and had very low attrition. We also found significant reductions of perinatal grief and mental health symptoms over time, as well as a high degree of practice of mindfulness skills by participants. This study not only sheds light on the tremendous mental health needs among rural women of various castes who have experienced stillbirth in Chhattisgarh, it also points to a promising effective intervention with potential to be taken to scale for wider delivery.

[EFFECT OF A HEALTHY EATING AND PHYSICAL ACTIVITY INTERVENTION PROGRAM ON CHILHOOD OBESITY].

PubMed

Díaz Martínez, Ximena; Mena Bastías, Carmen; Celis-Moralesl, Carlos; Salas, Carlos; Valdivia Moral, Pedro

2015-07-01

interventions aiming to develop healthy lifestyle behaviours at early age could be an effective way of reducing childhood obesity. to evaluate the effect of a dietary and physical activity intervention on reducing childhood obesity. 312 students took part on this 5 month intervention study. The intervention included dietary talk delivered to children and their parents in addition to 45 minutes of daily physical activity modules. Nutritional status was assessed using the Obesity Task Force criteria. Changes in dietary behaviours and physical activity were assessed using questionnaires administrated to the parents. body mass index decreased significantly post intervention (-0.2 kg.m-2), however, this reduction was driven by boys (-0.3 kg.m-2). Similarly, waist circumference shows a significant reduction in boys (-0.4 cm) but not girls. Children with overweight or obesity shows greater reductions in obesity-related traits, which were related to changes in dietary and physical activity post interventions. multidisciplinary interventions applied to children between 5 and 7 years old are effective on reducing body mass index and improving dietary and physical activity behaviours in overweight and obese children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Gender-based violence and HIV: relevance for HIV prevention in hyperendemic countries of southern Africa.

PubMed

Andersson, Neil; Cockcroft, Anne; Shea, Bev

2008-12-01

Gender-based violence (GBV) is common in southern Africa. Here we use GBV to include sexual and non-sexual physical violence, emotional abuse, and forms of child sexual abuse. A sizeable literature now links GBV and HIV infection.Sexual violence can lead to HIV infection directly, as trauma increases the risk of transmission. More importantly, GBV increases HIV risk indirectly. Victims of childhood sexual abuse are more likely to be HIV positive, and to have high risk behaviours.GBV perpetrators are at risk of HIV infection, as their victims have often been victimised before and have a high risk of infection. Including perpetrators and victims, perhaps one third of the southern African population is involved in the GBV-HIV dynamic.A randomised controlled trial of income enhancement and gender training reduced GBV and HIV risk behaviours, and a trial of a learning programme reported a non-significant reduction in HIV incidence and reduction of male risk behaviours (primary prevention). Interventions among survivors of GBV can reduce their HIV risk (secondary prevention). Various strategies can reduce spread of HIV from infected GBV survivors (tertiary prevention). Dealing with GBV could have an important effect on the HIV epidemic.A policy shift is necessary. HIV prevention policy should recognise the direct and indirect implications of GBV for HIV prevention, the importance of perpetrator dynamics, and that reduction of GBV should be part of HIV prevention programmes. Effective interventions are likely to include a structural component, and a GBV awareness component.

The effects of a new therapeutic triclosan/copolymer/sodium-fluoride dentifrice on oral bacteria, including odorigenic species.

PubMed

Furgang, David; Sreenivasan, Prem K; Zhang, Yun Po; Fine, Daniel H; Cummins, Diane

2003-09-01

This investigation examined the in vitro and ex vivo antimicrobial effects of a new dentifrice, Colgate Total Advanced Fresh, formulated with triclosan/copolymer/sodium fluoride, on oral bacteria, including those odorigenic bacteria implicated in bad breath. The effects of Colgate Total Advanced Fresh were compared to commercially available fluoride dentifrices that served as controls. Three experimental approaches were undertaken for these studies. In the first approach, the dentifrice formulations were tested in vitro against 13 species of oral bacteria implicated in bad breath. The second approach examined the antimicrobial activity derived from dentifrice that was adsorbed to and released from hydroxyapatite disks. In this approach, dentifrice-treated hydroxyapatite disks were immersed in a suspension of bacteria, and reduction in bacterial viability from the release of bioactive agents from hydroxyapatite was determined. The third approach examined the effect of treating bacteria immediately after their removal from the oral cavity of 11 adult human volunteers. This ex vivo study examined the viability of cultivable oral bacteria after dentifrice treatment for 2 minutes. Antimicrobial effects were determined by plating Colgate Total Advanced Fresh and control-dentifrice-treated samples on enriched media (for all cultivable oral bacteria) and indicator media (for hydrogen-sulfide-producing organisms), respectively. Results indicated that the antimicrobial effects of Colgate Total Advanced Fresh were significantly greater than either of the other dentifrices for all 13 oral odorigenic bacterial strains tested in vitro (P < or = 0.05). In the second approach, Colgate Total Advanced Fresh-treated hydroxyapatite disks were significantly more active in reducing bacterial growth than the other dentifrices tested (P < or = 0.05). Finally, ex vivo treatment of oral bacteria with Colgate Total Advanced Fresh demonstrated a 90.9% reduction of all oral cultivable bacteria and a 91.5% reduction of oral bacteria producing hydrogen sulfide compared with the control dentifrice. In conclusion, these results, taken together with the significant reductions in clinical malodor scores by Colgate Total Advanced Fresh demonstrated in organoleptic studies, strongly suggest that this dentifrice kills the bacteria that are implicated in the cause of bad breath.

The Effectiveness of a Peer-Led HIV/AIDS and STI Health Education Intervention for Prison Inmates in South Africa

ERIC Educational Resources Information Center

Sifunda, Sibusiso; Reddy, Priscilla S.; Braithwaite, Ronald; Stephens, Torrence; Bhengu, Sibusisiwe; Ruiter, Rob A. C.; van den Borne, Bart

2008-01-01

This article reports on the effectiveness of the first systematically developed health education intervention for the reduction of risky sexual behavior among soon-to-be-released prisoners in South Africa. Data from three out of four prisons are eligible for data analysis including 263 inmates. Using a nested experimental design, short-term…

Effects of the KiVa Anti-bullying Program on Adolescents' Depression, Anxiety, and Perception of Peers

ERIC Educational Resources Information Center

Williford, Anne; Boulton, Aaron; Noland, Brian; Little, Todd D.; Karna, Antti; Salmivalli, Christina

2012-01-01

The present study investigated the effects of the KiVa antibullying program on students' anxiety, depression, and perception of peers in Grades 4-6. Furthermore, it was investigated whether reductions in peer-reported victimization predicted changes in these outcome variables. The study participants included 7,741 students from 78 schools who were…

Effects of thinning intensity and crown class on cherrybark oak epicormic branching five years after treatment

Treesearch

Luben D. Dimov; Erika Stelzer; Kristi Wharton; James S. Meadows; Jim L. Chambers; Kenny Ribbeck; E. Barry Moser

2006-01-01

Thinning in oak-dominated stands may have many desirable consequences, including increases in tree growth and mast production. One of the potential disadvantages, however, is the proliferation of epicormic branches, which leads to reduction in lumber quality and value. We assessed the effects of thinning intensity and initial crown class on cherrybark oak (...

Treatment of blood with a pathogen reduction technology using ultraviolet light and riboflavin inactivates Ebola virus in vitro.

PubMed

Cap, Andrew P; Pidcoke, Heather F; Keil, Shawn D; Staples, Hilary M; Anantpadma, Manu; Carrion, Ricardo; Davey, Robert A; Frazer-Abel, Ashley; Taylor, Audra L; Gonzales, Richard; Patterson, Jean L; Goodrich, Raymond P

2016-03-01

Transfusion of plasma from recovered patients after Ebolavirus (EBOV) infection, typically called "convalescent plasma," is an effective treatment for active disease available in endemic areas, but carries the risk of introducing other pathogens, including other strains of EBOV. A pathogen reduction technology using ultraviolet light and riboflavin (UV+RB) is effective against multiple enveloped, negative-sense, single-stranded RNA viruses that are similar in structure to EBOV. We hypothesized that UV+RB is effective against EBOV in blood products without activating complement or reducing protective immunoglobulin titers that are important for the treatment of Ebola virus disease (EVD). Four in vitro experiments were conducted to evaluate effects of UV+RB on green fluorescent protein EBOV (EBOV-GFP), wild-type EBOV in serum, and whole blood, respectively, and on immunoglobulins and complement in plasma. Initial titers for Experiments 1 to 3 were 4.21 log GFP units/mL, 4.96 log infectious units/mL, and 4.23 log plaque-forming units/mL. Conditions tested in the first three experiments included the following: 1-EBOV-GFP plus UV+RB; 2-EBOV-GFP plus RB only; 3-EBOV-GFP plus UV only; 4-EBOV-GFP without RB or UV; 5-virus-free control plus UV only; and 6-virus-free control without RB or UV. UV+RB reduced EBOV titers to nondetectable levels in both nonhuman primate serum (≥2.8- to 3.2-log reduction) and human whole blood (≥3.0-log reduction) without decreasing protective antibody titers in human plasma. Our in vitro results demonstrate that the UV+RB treatment efficiently reduces EBOV titers to below limits of detection in both serum and whole blood. In vivo testing to determine whether UV+RB can improve convalescent blood product safety is indicated. © 2016 AABB.

Treatment of blood with a pathogen reduction technology using UV light and riboflavin inactivates Ebola virus in vitro

PubMed Central

Cap, Andrew P.; Pidcoke, Heather F.; Keil, Shawn D.; Staples, Hilary M.; Anantpadma, Manu; Carrion, Ricardo; Davey, Robert A.; Frazer-Abel, Ashley; Taylor, Audra L.; Gonzales, Richard; Patterson, Jean L.; Goodrich, Raymond P.

2018-01-01

BACKGROUND Transfusion of plasma from recovered patients after Ebolavirus (EBOV) infection, typically called ‘convalescent plasma,’ is an effective treatment for active disease available in endemic areas, but carries the risk of introducing other pathogens, including other strains of EBOV. A pathogen reduction technology using ultraviolet light and riboflavin (UV + RB) is effective against multiple enveloped, negative-sense, single-stranded RNA viruses that are similar in structure to EBOV. We hypothesized that UV + RB is effective against EBOV in blood products without activating complement or reducing protective immunoglobulin titers that are important for the treatment of ebolavirus disease (EVD). STUDY DESIGN AND METHODS Four in vitro experiments were conducted to evaluate effects of UV + RB on green fluorescent protein EBOV (EBOV-GFP), wild-type EBOV in serum and whole blood, respectively, and on immunoglobulins and complement in plasma. Initial titers for Experiments 1–3 were: 4.21 log10 GFP units/mL, 4.96 log10 infectious units per mL, and 4.23 log10 plaque forming units per mL (PFU/mL). Conditions tested in the first three experiments included: 1. EBOV-GFP + UV + RB; 2. EBOV-GFP + RB only; 3 EBOV-GFP + UV only; 4. EBOV-GFP without RB or UV; 5. Virus-free control + UV only; and 6. Virus-free control without RB or UV. RESULTS UV + RB reduced EBOV titers to non-detectable levels in both non-human primate serum (≥ 2.8 to 3.2 log reduction) and human whole blood (≥ 3.0 log reduction) without decreasing protective antibody titers in human plasma. CONCLUSION Our in vitro results demonstrate that the UV + RB treatment efficiently reduces EBOV titers to below limits of detection in both serum and whole blood. In vivo testing to determine whether UV + RB can improve convalescent blood product safety is indicated. PMID:27001363

E-mail management of the modified Atkins Diet for adults with epilepsy is feasible and effective.

PubMed

Cervenka, Mackenzie C; Terao, Natalie N; Bosarge, Jennifer L; Henry, Bobbie J; Klees, Angela A; Morrison, Peter F; Kossoff, Eric H

2012-04-01

The modified Atkins Diet (MAD) is an effective dietary treatment for children with epilepsy. However, adults may have limited access to this therapy because of lack of availability of dietitian or nutrition support or familiarity with the diet by their treating neurologist. This study was designed to investigate the tolerability and efficacy of the MAD administered solely via e-mail to adults with pharmacoresistant epilepsy. A prospective, open-label, proof-of-principle 3-month study design was employed. Adults were enrolled, instructed on how to self-administer a 20 g carbohydrate per day MAD, and followed by the investigators only via e-mail. There were no clinic visits or dietitian contacts during the study period. Twenty-five participants (median age 30 years [range 18-66 years], 68% female) consented and 22 started the MAD. The median prior anticonvulsants was 5 (range 2-10) and seizure frequency was 5 per week (range 1-140). Urinary ketosis was achieved in 21 participants (95%), of which 16 (76%) reported at least 40 mg/dl (moderate). Twenty-one participants (95%) remained on the MAD at 1 month and 14 (64%) at 3 months. After 1 month, 9 (41%) had >50% seizure reduction including one (5%) with >90% seizure reduction using intent-to-treat analysis. After 3 months, 6 (27%) had >50% seizure reduction including 3 (14%) with >90% seizure reduction. The mean ketogenic ratio was 1.1:1 (fat:carbohydrates and protein) for those who provided a MAD food record at follow-up. Over the study period, the median number of e-mails sent by the participants was 6 (range 1-19). The most frequent side effect was weight loss. E-mail administration of the MAD to adults with refractory epilepsy appears to be feasible and effective. Therefore, when dietitian or physician support is limited for adult patients with epilepsy, remote access via telemedicine could provide an alternative. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

Extreme Cost Reductions with Multi-Megawatt Centralized Inverter Systems

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

Schwabe, Ulrich; Fishman, Oleg

2015-03-20

The objective of this project was to fully develop, demonstrate, and commercialize a new type of utility scale PV system. Based on patented technology, this includes the development of a truly centralized inverter system with capacities up to 100MW, and a high voltage, distributed harvesting approach. This system promises to greatly impact both the energy yield from large scale PV systems by reducing losses and increasing yield from mismatched arrays, as well as reduce overall system costs through very cost effective conversion and BOS cost reductions enabled by higher voltage operation.

Mindfulness-based stress reduction added to care as usual for lung cancer patients and/or their partners: A multicentre randomized controlled trial.

PubMed

Schellekens, M P J; van den Hurk, D G M; Prins, J B; Donders, A R T; Molema, J; Dekhuijzen, R; van der Drift, M A; Speckens, A E M

2017-12-01

Lung cancer patients report among the highest distress rates of all cancer patients. Partners report similar distress rates. The present study examined the effectiveness of additional mindfulness-based stress reduction (care as usual [CAU] + MBSR) versus solely CAU to reduce psychological distress in lung cancer patients and/or their partners. We performed a multicentre, parallel-group, randomized controlled trial. Mindfulness-based stress reduction is an 8-week group-based intervention, including mindfulness practice and teachings on stress. Care as usual included anticancer treatment, medical consultations, and supportive care. The primary outcome was psychological distress. Secondary outcomes included quality of life, caregiver burden, relationship satisfaction, mindfulness skills, self-compassion, rumination, and posttraumatic stress symptoms. Outcomes were assessed at baseline, post-intervention, and 3-month follow-up. Linear mixed modeling was conducted on an intention-to-treat sample. Moderation (gender, disease stage, baseline distress, participation with/without partner) and mediation analyses were performed. A total of 31 patients and 21 partners were randomized to CAU + MBSR and 32 patients and 23 partners to CAU. After CAU + MBSR patients reported significantly less psychological distress (p = .008, d = .69) than after CAU. Baseline distress moderated outcome: those with more distress benefitted most from MBSR. Additionally, after CAU + MBSR patients showed more improvements in quality of life, mindfulness skills, self-compassion, and rumination than after CAU. In partners, no differences were found between groups. Our findings suggest that psychological distress in lung cancer patients can be effectively treated with MBSR. No effect was found in partners, possibly because they were more focused on patients' well-being rather than their own. Copyright © 2017 John Wiley & Sons, Ltd.

Mineralogical, Physical and Geochemical Factors that Drive Microbial Reduction of Iron Oxides and Diagenesis under Broad Environmental Conditions

NASA Astrophysics Data System (ADS)

Dong, Y.; Sanford, R. A.; Boyanov, M.; Kemner, K. M.; Flynn, T. M.; O'Loughlin, E. J.; George, S.; Fouke, K.; Fouke, B. W.

2016-12-01

Iron reduction by dissimilatory iron-reducing bacteria (DIRB), coupled with the oxidation of organic compounds or H2, causes formation of post-depositional (diagenetic) Fe(II)-containing minerals. Previous studies on the composition, distribution and precipitation rates of secondary minerals during microbial iron reduction have primarily focused on ferrihydrite reduction by Shewanella spp. However, comparatively little is known about these processes by a variety of other DIRB and the effect of specific environmental factors on Fe(II)-bearing mineral diagenesis. Here we examine how environmental conditions influence the reduction of ferric iron minerals by Orenia metallireducens strain Z6, a DIRB from the phylum Firmicutes. This includes the effects of: (1) pH at 6.5-8.5; (2) temperature at 22-50 °C; (3) salinity at 2-20% NaCl; (4) solution chemistry of phosphate and sulfate; (5) electron shuttles (e.g., anthraquinone-2,6-disulfonate (AQDS)); and (6) iron oxides, including ferrihydrite, lepidocrocite, goethite, hematite, and magnetite. For a total of 19 culturing conditions, we measured ferrous iron produced over time using the ferrozine assay and formation of secondary minerals using scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDS), X-Ray Diffraction (XRD), and extended X-ray absorption fine structure spectroscopy (Fe-edge XANES and EXAFS). Results show that both the rate and extent of DIRB reduction of ferrihydrite and lepidocrocite vastly exceeded those of the more crystalline minerals. The microscopic and spectroscopic analyses indicate diversity in the composition and relative abundance of Fe(II)-containing minerals such as green rust, siderite, magnetite and/or vivianite under the different experimental conditions. However, the secondary mineralization products cannot be attributed to either the extent or kinetics of Fe(II) generation. Instead, the composition of these digenetic minerals resulted from the intricate interplay of precipitation dynamics, adsorption of Fe(II), and subsequent transformation (dissolution and reprecipitation). This study establishes the first mechanistic understanding of biomineralization of Fe(II) bearing minerals during microbial iron reduction under a broad range of environmental conditions.

Review of the Mechanisms and Effects of Noninvasive Body Contouring Devices on Cellulite and Subcutaneous Fat

PubMed Central

Alizadeh, Zahra; Halabchi, Farzin; Mazaheri, Reza; Abolhasani, Maryam; Tabesh, Mastaneh

2016-01-01

Context Today, different kinds of non-invasive body contouring modalities, including cryolipolysis, radiofrequency (RF), low-level laser therapy (LLLT), and high-intensity focused ultrasound (HIFU) are available for reducing the volume of subcutaneous adipose tissue or cellulite. Each procedure has distinct mechanisms for stimulating apoptosis or necrosis adipose tissue. In addition to the mentioned techniques, some investigations are underway for analyzing the efficacy of other techniques such as whole body vibration (WBV) and extracorporeal shockwave therapy (ESWT). In the present review the mechanisms, effects and side effects of the mentioned methods have been discussed. The effect of these devices on cellulite or subcutaneous fat reduction has been assessed. Evidence Acquisition We searched pubmed, google scholar and the cochrane databases for systemic reviews, review articles, meta-analysis and randomized clinical trials up to February 2015. The keywords were subcutaneous fat, cellulite, obesity, noninvasive body contouring, cryolipolysis, RF, LLLT, HIFU, ESWT and WBV with full names and abbreviations. Results We included seven reviews and 66 original articles in the present narrative review. Most of them were applied on normal weight or overweight participants (body mass index < 30 kg/m2) in both genders with broad range of ages (18 to 50 years on average). In the original articles, the numbers of included methods were: 10 HIFU, 13 RF, 22 cryolipolysis, 11 LLLT, 5 ESWT and 4 WBV therapies. Six of the articles evaluated combination therapies and seven compared the effects of different devices. Conclusions Some of the noninvasive body contouring devices in animal and human studies such as cryolipolysis, RF, LLLT and HIFU showed statistical significant effects on body contouring, removing unwanted fat and cellulite in some body areas. However, the clinical effects are mild to moderate, for example 2 - 4 cm circumference reduction as a sign of subcutaneous fat reduction during total treatment sessions. Overall, there is no definitive noninvasive treatment method for cellulite. Additionally, due to the methodological differences in the existing evidence, comparing the techniques is difficult. PMID:28123436

Understanding Acceptable Level of Risk: Incorporating the Economic Cost of Under-Managing Invasive Species.

PubMed

Davidson, Alisha D; Hewitt, Chad L; Kashian, Donna R

2015-01-01

Management of nonindigenous species includes prevention, early detection and rapid response and control. Early detection and rapid response depend on prioritizing and monitoring sites at risk for arrival or secondary spread of nonindigenous species. Such monitoring efforts require sufficient biosecurity budgets to be effective and meet management or policy directives for reduced risk of introduction. Such consideration of risk reduction is rarely considered, however. Here, we review the concepts of acceptable level of risk (ALOR) and associated costs with respect to nonindigenous species and present a framework for aligning risk reduction priorities with available biosecurity resources. We conclude that available biosecurity resources may be insufficient to attain stated and desired risk reduction. This outcome highlights the need to consider policy and management directives when beginning a biosecurity program to determine the feasibility of risk reduction goals, given available resources.

Interface morphology and mechanical properties of Al-Cu-Al laminated composites fabricated by explosive welding and subsequent rolling process

NASA Astrophysics Data System (ADS)

Hoseini-Athar, M. M.; Tolaminejad, B.

2016-07-01

Explosive welding is a well-known solid state method for joining similar and dissimilar materials. In the present study, tri-layered Al-Cu-Al laminated composites with different interface morphologies were fabricated by explosive welding and subsequent rolling. Effects of explosive ratio and rolling thickness reduction on the morphology of interface and mechanical properties were evaluated through optical/scanning electron microscopy, micro-hardness, tensile and tensile-shear tests. Results showed that by increasing the thickness reduction, bonding strength of specimens including straight and wavy interfaces increases. However, bonding strength of the specimens with melted layer interface decreases up to a threshold thickness reduction, then rapidly increases by raising the reduction. Hardness Values of welded specimens were higher than those of original material especially near the interface and a more uniform hardness profile was obtained after rolling process.

An overview of salt intake reduction efforts in the Gulf Cooperation Council countries.

PubMed

Alhamad, Nawal; Almalt, Elsayed; Alamir, Najeeba; Subhakaran, Monica

2015-06-01

Globally, morbidity and mortality from non-communicable diseases (NCDs) are increasing steadily and at an alarming rate. High blood pressure is a major risk factor for cardiovascular disease (CVD) and salt reduction is an effective measure to decrease mortality rates. In the Eastern Mediterranean region, current salt intake is high, with an average intake of >12 g per person per day. Reducing the intake of salt has been identified as a priority intervention to reduce NCDs. Countries of the Gulf Cooperation Council (GCC) are showing a willingness to comply with the World Health Organization (WHO) recommendations and an eagerness to reduce the burden of NCDs. However, they face some challenges, including lack of political commitment, lack of experience, and shortage of qualified human resources. Salt intake reduction efforts vary in the GCC region, from achieving 20% salt reduction in bread, to the very early stages of planning.

Mechanism of Mo-Dependent Nitrogenase

PubMed Central

Seefeldt, Lance C.; Hoffman, Brian M.; Dean, Dennis R.

2010-01-01

Nitrogen-fixing bacteria catalyze the reduction of dinitrogen (N2) to two ammonia molecules (NH3), the major contribution of fixed nitrogen into the biogeochemical nitrogen cycle. The most widely studied nitrogenase is the Mo-dependent enzyme. The reduction of N2 by this enzyme involves the transient interaction of two component proteins, designated the Fe protein and the MoFe protein, and minimally requires sixteen MgATP, eight protons, and eight electrons. The current state of knowledge on how these proteins and small molecules together effect the reduction of N2 to ammonia is reviewed. Included is a summary of the roles of the Fe protein and MgATP hydrolysis, information on the roles of the two metal clusters contained in the MoFe protein in catalysis, insights gained from recent success in trapping substrates and inhibitors at the active site metal cluster FeMo-cofactor, and finally, considerations of the mechanism of N2 reduction catalyzed by nitrogenase. PMID:19489731

Comparison of automated satellite systems with conventional systems for hydrologic data collection in west-central Florida

USGS Publications Warehouse

Woodham, W.M.

1982-01-01

This report provides results of reliability and cost-effective studies of the goes satellite data-collection system used to operate a small hydrologic data network in west-central Florida. The GOES system, in its present state of development, was found to be about as reliable as conventional methods of data collection. Benefits of using the GOES system include some cost and manpower reduction, improved data accuracy, near real-time data availability, and direct computer storage and analysis of data. The GOES system could allow annual manpower reductions of 19 to 23 percent with reduction in cost for some and increase in cost for other single-parameter sites, such as streamflow, rainfall, and ground-water monitoring stations. Manpower reductions of 46 percent or more appear possible for multiple-parameter sites. Implementation of expected improvements in instrumentation and data handling procedures should further reduce costs. (USGS)

A theoretical investigation of noise reduction through the cylindrical fuselage of a twin-engine, propeller-driven aircraft

NASA Technical Reports Server (NTRS)

Bhat, R. B.; Mixson, J. S.

1978-01-01

Interior noise in the fuselage of a twin-engine, propeller-driven aircraft with two propellers rotating in opposite directions is studied analytically. The fuselage was modeled as a stiffened cylindrical shell with simply supported ends, and the effects of stringers and frames were averaged over the shell surface. An approximate mathematical model of the propeller noise excitation was formulated which includes some of the propeller noise characteristics such as sweeping pressure waves around the sidewalls due to propeller rotation and the localized nature of the excitation with the highest levels near the propeller plane. Results are presented in the form of noise reduction, which is the difference between the levels of external and interior noise. The influence of propeller noise characteristics on the noise reduction was studied. The results indicate that the sweep velocity of the excitation around the fuselage sidewalls is critical to noise reduction.

An overview of salt intake reduction efforts in the Gulf Cooperation Council countries

PubMed Central

Almalt, Elsayed; Alamir, Najeeba; Subhakaran, Monica

2015-01-01

Globally, morbidity and mortality from non-communicable diseases (NCDs) are increasing steadily and at an alarming rate. High blood pressure is a major risk factor for cardiovascular disease (CVD) and salt reduction is an effective measure to decrease mortality rates. In the Eastern Mediterranean region, current salt intake is high, with an average intake of >12 g per person per day. Reducing the intake of salt has been identified as a priority intervention to reduce NCDs. Countries of the Gulf Cooperation Council (GCC) are showing a willingness to comply with the World Health Organization (WHO) recommendations and an eagerness to reduce the burden of NCDs. However, they face some challenges, including lack of political commitment, lack of experience, and shortage of qualified human resources. Salt intake reduction efforts vary in the GCC region, from achieving 20% salt reduction in bread, to the very early stages of planning. PMID:26090327

ELECTRON CLOUD OBSERVATIONS AND CURES IN RHIC

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

FISCHER,W.; BLASKIEWICZ, M.; HUANG, H.

Since 2001 RHIC has experienced electron cloud effects, which have limited the beam intensity. These include dynamic pressure rises - including pressure instabilities, tune shifts, a reduction of the stability threshold for bunches crossing the transition energy, and possibly incoherent emittance growth. We summarize the main observations in operation and dedicated experiments, as well as countermeasures including baking, NEG coated warm beam pipes, solenoids, bunch patterns, anti-grazing rings, pre-pumped cold beam pipes, scrubbing, and operation with long bunches.

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.

Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

PubMed Central

Schwalm, Jon-David; McKee, Martin; Huffman, Mark D.; Yusuf, Salim

2016-01-01

Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality. PMID:26903017

CHROTRAN, 1.0

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

Hansen, Scott K.; Pandey, Sachin; Karra, Satish

2017-04-13

CHROTRAN is a fork of the widely-used PFLOTRAN flow and reactive transport numerical simulation code. It implements custom physics and chemistry appropriate to the design of in-situ reduction of heavy metals such as Cr(VI) in groundwater. CHROTRAN includes full dynamics for five species: the metal to be remediated, an electron donor, biofilm, a nontoxic conservative bio-inhibitor, and a biocide. Direct abiotic reduction by donor-metal interaction as well as donor-driven biomass growth and bio-reduction are modeled, along with crucial processes such as donor sorption, and biofilm inactivation. The software implementation handles heterogeneous flow fields, arbitrarily many chemical species and amendment injectionmore » points, and features full coupling between flow and reactive transport, allowing for assessment of the effect of bio-fouling.« less

[Evidence-based effectiveness of road safety interventions: a literature review].

PubMed

Novoa, Ana M; Pérez, Katherine; Borrell, Carme

2009-01-01

Only road safety interventions with scientific evidence supporting their effectiveness should be implemented. The objective of this study was to identify and summarize the available evidence on the effectiveness of road safety interventions in reducing road traffic collisions, injuries and deaths. All literature reviews published in scientific journals that assessed the effectiveness of one or more road safety interventions and whose outcome measure was road traffic crashes, injuries or fatalities were included. An exhaustive search was performed in scientific literature databases. The interventions were classified according to the evidence of their effectiveness in reducing road traffic injuries (effective interventions, insufficient evidence of effectiveness, ineffective interventions) following the structure of the Haddon matrix. Fifty-four reviews were included. Effective interventions were found before, during and after the collision, and across all factors: a) the individual: the graduated licensing system (31% road traffic injury reduction); b) the vehicle: electronic stability control system (2 to 41% reduction); c) the infrastructure: area-wide traffic calming (0 to 20%), and d) the social environment: speed cameras (7 to 30%). Certain road safety interventions are ineffective, mostly road safety education, and others require further investigation. The most successful interventions are those that reduce or eliminate the hazard and do not depend on changes in road users' behavior or on their knowledge of road safety issues. Interventions based exclusively on education are ineffective in reducing road traffic injuries.

Embolization of renal angiomyolipomas: short-term and long-term outcomes, complications, and tumor shrinkage.

PubMed

Lee, Shen-Yang; Hsu, Hsiang-Hao; Chen, Yung-Chang; Huang, Chen-Chih; Wong, Yon-Cheong; Wang, Li-Jen; Chuang, Cheng-Keng; Yang, Chih-Wei

2009-11-01

This study retrospectively evaluated outcomes, complications, and tumor shrinkage in renal angiomyolipomas after transcatheter arterial embolization (TAE). All renal angiomyolipoma patients who underwent TAE between August 2000 and December 2008 and had short-term (6 months) follow-up images were evaluated. Complications and tumor relapse after TAE were reviewed. The sizes of embolized tumors were measured to calculate size reductions and reduction rates after TAE. Differences in tumor size, size reduction, and reduction rate between different time points (pre-TAE, short-term follow-up, and long-term follow-up) and groups (completely and incompletely embolized) were determined. Eleven renal angiomyolipoma patients who had undergone TAE were included. Seven (63.6%) patients had postembolization syndrome and one had abscess formation following TAE. Two patients had a tumor relapse (18.2%). The mean tumor size was 8.57+/-2.66 cm on pre-TAE images. The mean size reduction was 3.1 cm (33.3%) and 3.8 cm (43.0%) at short-term and long-term follow-up. Tumor sizes differed significantly between pre-TAE and short-term (p=0.004) or long-term images (p=0.022) but not between short-term and long-term images (p=0.059). Results stratified by the completeness of embolization indicate that only the short-term size reduction rate differed significantly (p=0.025), while the long-term reduction rate and short- and long-term follow-up tumor size and size reduction were comparable between the two groups. In conclusion, selective TAE is effective for tumor shrinkage in most renal angiomyolipomas, with acceptable complication and relapse rates. Tumor shrinkage occurring within 6 months after TAE may reflect the long-term effect of TAE.

Potential benefits of farm scale measures versus landscape measures for reducing nitrate loads in a Danish catchment.

PubMed

Hashemi, Fatemeh; Olesen, Jørgen E; Børgesen, Christen D; Tornbjerg, Henrik; Thodsen, Hans; Dalgaard, Tommy

2018-05-08

To comply with the EU Water Framework Directive, Denmark must further reduce the nitrate (N)-load to marine ecosystems from agricultural areas. Under the anticipated future spatially targeted regulation, the required N-load reductions will differ between catchments, and these are expected to be mitigated by a combination of land and water management measures. Here, we explored how the expected N-load reduction target of 38% for a Danish catchment (River Odense) could be achieved through a combination of farm and landscape measures. These include: (a) N-leaching reduction through changing the crop rotation and applying cover crops, (b) enhancing N-reduction through (re)establishment of wetlands, and (c) reducing N-leaching through spatially targeting of set-aside to high N-load areas. Changes in crop rotations were effective in reducing N-leaching by growing crops with a longer growing season and by allowing a higher use of cover crops. A combination of wetlands and changes in crop rotations were needed for reaching the N-load reduction target without use of set-aside. However, not all combinations of wetlands and crop rotation changes achieved the required N-load reduction, resulting in a need for targeted set-aside, implying a need for balancing measures at farm and landscape scale to maximize N load reduction while minimizing loss of productive land. The effectiveness of farm scale measures is affected by farm and soil types as well as by N-reduction in groundwater, while the possibilities for using wetlands for decreasing the N-load depends on landscape features, allowing the establishment of wetlands connected to streams and rivers. Copyright © 2018 Elsevier B.V. All rights reserved.

Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis.

PubMed

Naslund, John A; Whiteman, Karen L; McHugo, Gregory J; Aschbrenner, Kelly A; Marsch, Lisa A; Bartels, Stephen J

2017-07-01

To conduct a systematic review and meta-analysis to estimate effects of lifestyle intervention participation on weight reduction among overweight and obese adults with serious mental illness. We systematically searched electronic databases for randomized controlled trials comparing lifestyle interventions with other interventions or usual care controls in overweight and obese adults with serious mental illness, including schizophrenia spectrum or mood disorders. Included studies reported change in weight [kg] or body mass index (BMI) [kg/m 2 ] from baseline to follow-up. Standardized mean differences (SMD) were calculated for change in weight from baseline between intervention and control groups. Seventeen studies met inclusion criteria (1968 participants; 50% male; 66% schizophrenia spectrum disorders). Studies were grouped by intervention duration (≤6-months or ≥12-months). Lifestyle interventions of ≤6-months duration showed greater weight reduction compared with controls as indicated by effect size for weight change from baseline (SMD=-0.20; 95% CI=-0.34, -0.05; 10 studies), but high statistical heterogeneity (I 2 =90%). Lifestyle interventions of ≥12-months duration also showed greater weight reduction compared with controls (SMD=-0.24; 95% CI=-0.36, -0.12; 6 studies) with low statistical heterogeneity (I 2 =0%). Lifestyle interventions appear effective for treating overweight and obesity among people with serious mental illness. Interventions of ≥12-months duration compared to ≤6-months duration appear to achieve more consistent outcomes, though effect sizes are similar for both shorter and longer duration interventions. Copyright © 2017. Published by Elsevier Inc.

A Meta-Analysis of Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain.

PubMed

Jauregui, Julio J; Cherian, Jeffrey J; Gwam, Chukwuweike U; Chughtai, Morad; Mistry, Jaydev B; Elmallah, Randa K; Harwin, Steven F; Bhave, Anil; Mont, Michael A

2016-04-01

Transcutaneous electrical nerve stimulation (TENS) may provide a safe alternative to current side-effect-heavy narcotics and anti-inflammatories utilized in chronic low back pain. Therefore, we performed a meta-analysis to evaluate the efficacy of TENS for the treatment of chronic low back pain. We included randomized controlled trials (RCTs), cohort studies, and randomized crossover studies on TENS for the management of low back pain. We utilized a visual analogue scale (VAS) for pain as our primary outcome. Effectiveness of treatment was quantified using improvement in outcome scores for each study. Of the studies that met the criteria, 13 allowed for calculation of weighted mean differences in pain reduction. We used a random model effect to evaluate changes in pain produced by the intervention. Included were nine level I and four level II, encompassing 267 patients (39% male) who had a mean follow-up of seven weeks (range; 2 to 24 weeks). The mean duration of treatment was six weeks (range; 2 to 24 weeks). The standardized mean difference in pain from pre- to post-treatment for TENS was 0.844, which demonstrated significant improvement of TENS on pain reduction. When subdividing treatment duration, patients that were treated for < 5 weeks had significant effects on pain, while those treated for > 5 weeks did not. Treatment of chronic low back pain with TENS demonstrated significant pain reduction. The application of TENS may lead to less pain medication usage and should be incorporated into the treatment armamentarium for chronic low back pain.

Microstructural brain abnormalities in medication-free patients with major depressive disorder: a systematic review and meta-analysis of diffusion tensor imaging

PubMed Central

Jiang, Jing; Zhao, You-Jin; Hu, Xin-Yu; Du, Ming-Ying; Chen, Zi-Qi; Wu, Min; Li, Kai-Ming; Zhu, Hong-Yan; Kumar, Poornima; Gong, Qi-Yong

2017-01-01

Background Multiple meta-analyses of diffusion tensor imaging (DTI) studies have reported impaired white matter integrity in patients with major depressive disorder (MDD). However, owing to inclusion of medicated patients in these studies, it is difficult to conclude whether these reported alterations are associated with MDD or confounded by medication effects. A meta-analysis of DTI studies on medication-free (medication-naive and medication washout) patients with MDD would therefore be necessary to disentangle MDD-specific effects. Methods We analyzed white matter alterations between medication-free patients with MDD and healthy controls using anisotropic effect size–signed differential mapping (AES-SDM). We used DTI query software for fibre tracking. Results Both pooled and subgroup meta-analyses in medication washout patients showed robust fractional anisotropy (FA) reductions in white matter of the right cerebellum hemispheric lobule, body of the corpus callosum (CC) and bilateral superior longitudinal fasciculus III (SLF III), whereas FA reductions in the genu of the CC and right anterior thalamic projections were seen in only medication-naive patients. Fibre tracking showed that the main tracts with observed FA reductions included the right cerebellar tracts, body of the CC, bilateral SLF III and arcuate fascicle. Limitations The analytic techniques, patient characteristics and clinical variables of the included studies were heterogeneous; we could not exclude the effects of nondrug therapies owing to a lack of data. Conclusion By excluding the confounding influences of current medication status, findings from the present study may provide a better understanding of the underlying neuropathology of MDD. PMID:27780031

Stiripentol add-on therapy for focal refractory epilepsy.

PubMed

Brigo, Francesco; Igwe, Stanley C; Bragazzi, Nicola Luigi

2018-05-10

This is an updated version of the Cochrane review last published in 2015 (Issue 10). For nearly 30% of people with epilepsy, seizures are not controlled by current treatments. Stiripentol is a new antiepileptic drug (AED) that was developed in France and was approved by the European Medicines Agency (EMA) in 2007 for the treatment of Dravet syndrome as an adjunctive therapy with valproate and clobazam, with promising effects. To evaluate the efficacy and tolerability of stiripentol as add-on treatment for people with focal refractory epilepsy who are taking AEDs. For the latest update, we searched the following databases on 21 August 2017: Cochrane Epilepsy Specialized Register, CENTRAL , MEDLINE, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP). We contacted Biocodex (the manufacturer of stiripentol) and epilepsy experts to identify published, unpublished and ongoing trials. Randomised, controlled, add-on trials of stiripentol in people with focal refractory epilepsy. Review authors independently selected trials for inclusion and extracted data. Outcomes investigated included 50% or greater reduction in seizure frequency, seizure freedom, adverse effects, treatment withdrawal and changes in quality of life. On the basis of our selection criteria, we included no new studies in the present review. Only one study was included from the earlier review (32 children with focal epilepsy). This study adopted a 'responder enriched' design and found no clear evidence of a reduction in seizure frequency (≥ 50% seizure reduction) (risk ratio (RR) 1.51, 95% confidence interval (CI) 0.81 to 2.82, low-quality evidence) nor evidence of seizure freedom (RR 1.18, 95% CI 0.31 to 4.43, low-quality evidence) when add-on stiripentol was compared with placebo. Stiripentol led to a greater risk of adverse effects considered as a whole (RR 2.65, 95% CI 1.08 to 6.47, low-quality evidence). When specific adverse events were considered, confidence intervals were very wide and showed the possibility of substantial increases and small reductions in risks of neurological (RR 2.65, 95% CI 0.88 to 8.01, low-quality evidence) or gastrointestinal adverse effects (RR 11.56, 95% CI 0.71 to 189.36, low-quality evidence). Researchers noted no clear reduction in the risk of study withdrawal (RR 0.66, 95% CI 0.30 to 1.47, low-quality evidence), which was high in both groups (35.0% in add-on placebo and 53.3% in stiripentol group, low-quality evidence). The external validity of this study was limited because only responders to stiripentol (i.e. patients experiencing a ≥ 50% decrease in seizure frequency compared with baseline) were included in the randomised, add-on, placebo-controlled, double-blind phase. Furthermore, carry-over and withdrawal effects probably influenced outcomes related to seizure frequency. Very limited information derived from the only included study shows that adverse effects considered as a whole seemed to occur significantly more often with add-on stiripentol than with add-on placebo. Since the last version of this review was published, we have found no new studies. Hence, we have made no changes to the conclusions of this update as presented in the initial review. We can draw no conclusions to support the use of stiripentol as add-on treatment for focal refractory epilepsy. Additional large, randomised, well-conducted trials are needed.

The effect of cactus pear (Opuntia ficus-indica) on body weight and cardiovascular risk factors: a systematic review and meta-analysis of randomized clinical trials.

PubMed

Onakpoya, Igho J; O'Sullivan, Jack; Heneghan, Carl J

2015-05-01

Hundreds of dietary supplements are currently marketed as weight loss supplements. However, the advertised health claims of effectiveness for most of these have not been proven. The aim of this study was to critically appraise and evaluate the evidence for effectiveness of cactus pear, Opuntia ficus-indica (OFI), using data from published randomized clinical trials. We conducted electronic searches in Medline, Embase, Amed, Cinahl, and the Cochrane Library. No restrictions on age, time, or language were imposed. The risk for bias in the studies included was assessed using the Cochrane Collaboration criteria. Two reviewers independently determined the eligibility of included studies, assessed reporting quality, and extracted data. We identified seven eligible studies, of which five were included. The studies varied in design and reporting quality. Meta-analysis revealed a nonsignificant difference in body weight between OFI and controls (mean difference = -0.83 kg; 95% confidence interval, -2.49 to 0.83; I(2) = 93%). Significant reductions in body mass index, percentage body fat, systolic and diastolic blood pressures, and total cholesterol were observed. Adverse events included gastric intolerance and flu symptoms. The evidence from randomized clinical trials does not indicate that supplementation with OFI generates statistically significant effects on body weight. Consumption of OFI can cause significant reductions in percentage body fat, blood pressure, and total cholesterol. Few clinical trials evaluating the effects of OFI have been published. They vary in design and methodology, and are characterized by inconsistent quality of reporting. Further clinical trials evaluating the effects of OFI on body composition and metabolic parameters are warranted. Copyright © 2015 Elsevier Inc. All rights reserved.

Pharmaceutical policies: effects of financial incentives for prescribers.

PubMed

Rashidian, Arash; Omidvari, Amir-Houshang; Vali, Yasaman; Sturm, Heidrun; Oxman, Andrew D

2015-08-04

The proportion of total healthcare expenditures spent on drugs has continued to grow in countries of all income categories. Policy-makers are under pressure to control pharmaceutical expenditures without adversely affecting quality of care. Financial incentives seeking to influence prescribers' behaviour include budgetary arrangements at primary care and hospital settings (pharmaceutical budget caps or targets), financial rewards for target behaviours or outcomes (pay for performance interventions) and reduced benefit margin for prescribers based on medicine sales and prescriptions (pharmaceutical reimbursement rate reduction policies). This is the first update of the original version of this review. To determine the effects of pharmaceutical policies using financial incentives to influence prescribers' practices on drug use, healthcare utilisation, health outcomes and costs (expenditures). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (searched 29/01/2015); MEDLINE, Ovid SP (searched 29/01/2015); EMBASE, Ovid SP (searched 29/01/2015); International Network for Rational Use of Drugs (INRUD) Bibliography (searched 29/01/2015); National Health Service (NHS) Economic Evaluation Database (searched 29/01/2015); EconLit - ProQuest (searched 02/02/2015); and Science Citation Index and Social Sciences Citation Index, Institute for Scientific Information (ISI) Web of Knowledge (citation search for included studies searched 10/02/2015). We screened the reference lists of relevant reports and contacted study authors and organisations to identify additional studies. We included policies that intend to affect prescribing by means of financial incentives for prescribers. Included in this category are pharmaceutical budget caps or targets, pay for performance and drug reimbursement rate reductions and other financial policies, if they were specifically targeted at prescribing or drug utilisation. Policies in this review were defined as laws, rules, regulations and financial and administrative orders made or implemented by payers such as national or local governments, non-government organisations, private or social insurers and insurance-like organisations. One of the following outcomes had to be reported: drug use, healthcare utilisation, health outcomes or costs. The study had to be a randomised or non-randomised trial, an interrupted time series (ITS) analysis, a repeated measures study or a controlled before-after (CBA) study. At least two review authors independently assessed eligibility for inclusion of studies and risks of bias using Cochrane Effective Practice and Organisation of Care (EPOC) criteria and extracted data from the included studies. For CBA studies, we reported relative effects (e.g. adjusted relative change). The review team re-analysed all ITS results. When possible, the review team also re-analysed CBA data as ITS data. Eighteen evaluations (six new studies) of pharmaceutical policies from six high-income countries met our inclusion criteria. Fourteen studies evaluated pharmaceutical budget policies in the UK (nine studies), two in Germany and Ireland and one each in Sweden and Taiwan. Three studies assessed pay for performance policies in the UK (two) and the Netherlands (one). One study from Taiwan assessed a reimbursement rate reduction policy. ITS analyses had some limitations. All CBA studies had serious limitations. No study from low-income or middle-income countries met the inclusion criteria.Pharmaceutical budgets may lead to a modest reduction in drug use (median relative change -2.8%; low-certainty evidence). We are uncertain of the effects of the policy on drug costs or healthcare utilisation, as the certainty of such evidence has been assessed as very low. Effects of this policy on health outcomes were not reported. Effects of pay for performance policies on drug use and health outcomes are uncertain, as the certainty of such evidence has been assessed as very low. Effects of this policy on drug costs and healthcare utilisation have not been measured. Effects of the reimbursement rate reduction policy on drug use and drug costs are uncertain, as the certainty of such evidence has been assessed as very low. No included study assessed the effects of this policy on healthcare utilisation or health outcomes. Administration costs of the policies were not reported in any of the included studies. Although financial incentives are considered an important element in strategies to change prescribing patterns, limited evidence of their effects can be found. Effects of policies, including pay for performance policies, in improving quality of care and health outcomes remain uncertain. Because pharmaceutical policies have uncertain effects, and because they might cause harm as well as benefit, proper evaluation of these policies is needed. Future studies should consider the impact of these policies on health outcomes, drug use and overall healthcare expenditures, as well as on drug expenditures.

Effectiveness of intensive smoking reduction counselling plus combination nicotine replacement therapy in promoting long-term abstinence in patients with chronic obstructive pulmonary disease not ready to quit smoking: Protocol of the REDUQ trial.

PubMed

Hagens, Petra; Pieterse, Marcel; van der Valk, Paul; van der Palen, Job

2017-12-01

Limited tobacco dependence treatment resources exist for smoking COPD patients not ready to quit. Smoking reduction may be a viable treatment approach if it prompts quit attempts and subsequent abstinence. This article describes the protocol of the REDUQ (REDUce and Quit) study, which examines whether smoking reduction counselling plus combination nicotine replacement therapy (NRT) is (cost-)effective in achieving long-term abstinence in smoking COPD patients not ready to quit. We conducted a two-centre, parallel-group, randomised controlled trial with 18 months follow-up in smoking outpatients with COPD. Patients not ready to quit within the next month but willing to reduce their smoking, were randomised to receive either intensive smoking reduction counselling plus combination NRT or a single information meeting plus self-help manual. Outcomes were assessed at baseline, 6, 12 and 18 months. The primary outcome is ≥ 1-year prolonged abstinence. Secondary outcomes are point prevalence abstinence, successful (i.e. ≥ 50%) smoking reduction, and incidence of quit attempts reported at follow-up assessments. Smoking status is biochemically verified by salivary cotinine and expired CO. Other variables include smoking-related cognitions, intention and motivation to reduce and quit smoking, withdrawal symptoms, health-related quality of life, symptoms of anxiety and depression, state of mindfulness, lung function, use of health care resources, and costs. The outcomes of the REDUQ trial will advance knowledge on treatment of smoking COPD patients not ready to quit. If (cost-)effective, the smoking reduction intervention can be offered to this difficult-to-treat target group as a valuable adjunct to smoking cessation treatment.

Reductions in knee joint forces with weight loss are attenuated by gait adaptations in class III obesity.

PubMed

DeVita, Paul; Rider, Patrick; Hortobágyi, Tibor

2016-03-01

A consensus exists that high knee joint forces are a precursor to knee osteoarthritis and weight loss reduces these forces. Because large weight loss also leads to increased step length and walking velocity, knee contact forces may be reduced less than predicted by the magnitude of weight loss. The purpose was to determine the effects of weight loss on knee muscle and joint loads during walking in Class III obese adults. We determined through motion capture, force platform measures and biomechanical modeling the effects of weight loss produced by gastric bypass surgery over one year on knee muscle and joint loads during walking at a standard, controlled velocity and at self-selected walking velocities. Weight loss equaling 412 N or 34% of initial body weight reduced maximum knee compressive force by 824 N or 67% of initial body weight when walking at the controlled velocity. These changes represent a 2:1 reduction in knee force relative to weight loss when walking velocity is constrained to the baseline value. However, behavioral adaptations including increased stride length and walking velocity in the self-selected velocity condition attenuated this effect by ∼50% leading to a 392 N or 32% initial body weight reduction in compressive force in the knee joint. Thus, unconstrained walking elicited approximately 1:1 ratio of reduction in knee force relative to weight loss and is more indicative of walking behavior than the standard velocity condition. In conclusion, massive weight loss produces dramatic reductions in knee forces during walking but when patients stride out and walk faster, these favorable reductions become substantially attenuated. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of lactic acid and commercial chilling processes on survival of Salmonella, Yersinia enterocolitica, and Campylobacter coli in pork variety meats.

PubMed

King, Amanda M; Miller, Rhonda K; Castillo, Alejandro; Griffin, Davey B; Hardin, Margaret D

2012-09-01

Current industry chilling practices with and without the application of 2% L-lactic acid were compared for their effectiveness at reducing levels of Salmonella, Yersinia enterocolitica, and Campylobacter coli on pork variety meats. Pork variety meats (livers, intestines, hearts, and stomachs) were inoculated individually with one of the three pathogens and subjected to five different treatment combinations that included one or more of the following: water wash (25°C), lactic acid spray (2%, 40 to 50°C), chilling (4°C), and freezing (-15°C). Samples were analyzed before treatment, after each treatment step, and after 2, 4, and 6 months of frozen storage. Results showed that when a lactic acid spray was used in combination with water spray, immediate reductions were approximately 0.5 log CFU per sample of Salmonella, 0.8 log CFU per sample of Y. enterocolitica, and 1.1 log CFU per sample of C. coli. Chilling, both alone and in combination with spray treatments, had little effect on pathogens, while freezing resulted in additional 0.5-log CFU per sample reductions in levels of Salmonella and Y. enterocolitica, and an additional 1.0-log CFU per sample reduction in levels of C. coli. While reductions of at least 1 log CFU per sample were observed on variety meats treated with only a water wash and subsequently frozen, samples treated with lactic acid had greater additional reductions than those treated with only a water spray throughout frozen storage. The results of this study suggest that the use of lactic acid as a decontamination intervention, when used in combination with good manufacturing practices during processing, causes significant reductions in levels of Salmonella, Y. enterocolitica, and C. coli on pork variety meats.

Application of ozonated dry ice (ALIGAL™ Blue Ice) for packaging and transport in the food industry.

PubMed

Fratamico, Pina M; Juneja, Vijay; Annous, Bassam A; Rasanayagam, Vasuhi; Sundar, M; Braithwaite, David; Fisher, Steven

2012-05-01

Dry ice is used by meat and poultry processors for temperature reduction during processing and for temperature maintenance during transportation. ALIGAL™ Blue Ice (ABI), which combines the antimicrobial effect of ozone (O(3)) along with the high cooling capacity of dry ice, was investigated for its effect on bacterial reduction in air, in liquid, and on food and glass surfaces. Through proprietary means, O(3) was introduced to produce dry ice pellets to a concentration of 20 parts per million (ppm) by total weight. The ABI sublimation rate was similar to that of dry ice pellets under identical conditions, and ABI was able to hold the O(3) concentration throughout the normal shelf life of the product. Challenge studies were performed using different microorganisms, including E. coli, Campylobacter jejuni, Salmonella, and Listeria, that are critical to food safety. ABI showed significant (P < 0.05) microbial reduction during bioaerosol contamination (up to 5-log reduction of E. coli and Listeria), on chicken breast (approximately 1.3-log reduction of C. jejuni), on contact surfaces (approximately 3.9 log reduction of C. jejuni), and in liquid (2-log reduction of C. jejuni). Considering the stability of O(3), ease of use, and antimicrobial efficacy against foodborne pathogens, our results suggest that ABI is a better alternative, especially for meat and poultry processors, as compared to dry ice. Further, ABI can potentially serve as an additional processing hurdle to guard against pathogens during processing, transportation, distribution, and/or storage. © 2012 Institute of Food Technologists®

The effect of photodynamic therapy in root canal disinfection: a systematic review.

PubMed

Chrepa, Vanessa; Kotsakis, Georgios A; Pagonis, Tom C; Hargreaves, Kenneth M

2014-07-01

Effective root canal disinfection is a fundamental component of successful root canal treatment. Photodynamic therapy (PDT) has been proposed as a new adjunctive method for additional disinfection of the root canal system with the possibility of improved treatment outcomes. The aim of this systematic review was to investigate the effect of PDT on bacterial load reduction during root canal disinfection. Two reviewers independently conducted a comprehensive literature search using a combination of medical subject heading terms and key words to identify studies relevant to the Population Intervention Control Outcome question. The selection of articles for inclusion was performed in 2 phases based on predetermined eligibility criteria according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inter-reviewer agreement for each phase was recorded. The effect of PDT on bacterial load reduction during root canal disinfection was evaluated as the primary outcome variable during data extraction. The literature search provided 57 titles and abstracts. Three articles met the inclusion criteria and were selected for this systematic review. The reasons for study exclusion in each phase were recorded. Because of the heterogeneity in clinical indications and PDT protocols among the included studies, a meta-analysis could not be performed. All included studies showed a positive effect of PDT in the reduction of microbial load in root canal treatment ranging from 91.3%-100%. Limited clinical information is currently available on the use of PDT in root canal disinfection. If supported by future clinical research, PDT may have efficacy for additional root canal disinfection, especially in the presence of multi-drug-resistant bacteria. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A Prospective Study of Axillary Hair Reduction in Patients Treated With Microwave Technology.

PubMed

Brauer, Jeremy A; Neckman, Julia P; Zelickson, Brian; Vasily, David B; Geronemus, Roy G

2017-04-01

Removing unwanted body hair is a growing trend in society today, and there are many laser-based devices for hair reduction. There are some limitations to those methods, including the lack of efficacy for lighter color hair. The objective was to quantify hair reduction in the axillae after treatment with a noninvasive microwave energy device. A prospective, multicenter study was performed at 3 private dermatology clinics. Fifty-six adult subjects seeking axillary hair reduction were enrolled and treated with the device in 1 or 2 treatment sessions 3 months apart at various energy levels, and followed for 12 months. The primary analysis was monitoring reduction of hair counts from baseline to follow-up visits. A subject assessment of overall satisfaction, odor ratings, and sweat reduction ratings was provided at follow-up visits. Fifty-six subjects received treatment, with an average total underarm hair reduction of approximately 70% for both light and dark hair. Percentage of patients with hair reduction of 30% or more was significantly higher than 50% at all follow-up visits. Half of treated subjects reported expected mild transient post-treatment effects such as localized edema, discomfort, and bruising. Other reported events were mild. This clinical study provides evidence for safe and permanent axillary hair reduction, showing stable average reduction that lasted through the year of follow-up. Most notably, the study has shown the treatment's efficacy for reduction of light-colored axillary hair.

BEST PRACTICES TO SUPPORT AND IMPROVE PAVEMENT MANAGEMENT SYSTEMS FOR LOW-VOLUME PAVED ROADS – PHASE I

DOT National Transportation Integrated Search

2018-02-02

The Colorado Department of Transportation (CDOT) has been trying to identify the most effective methods for managing low-volume roads (LVRs). These roads are facing multiple challenges including: reductions in maintenance budgets, impact of industria...

Neuroimaging and Fetal Alcohol Spectrum Disorders

ERIC Educational Resources Information Center

Norman, Andria L.; Crocker, Nicole; Mattson, Sarah N.; Riley, Edward P.

2009-01-01

The detrimental effects of prenatal alcohol exposure on the developing brain include structural brain anomalies as well as cognitive and behavioral deficits. Initial neuroimaging studies of fetal alcohol spectrum disorders (FASD) using magnetic resonance imaging (MRI) confirmed previous autopsy reports of overall reduction in brain volume and…

Self-Desensitization and Meditation in the Reduction of Public Speaking Anxiety.

ERIC Educational Resources Information Center

Kirsch, Irving; Henry, David

1979-01-01

Speech-anxious students were assigned to self-administered treatment conditions: (1) systematic desensitization, (2) desensitization with meditation replacing progressive relaxation, and (3) meditation only. Treatment manuals included coping-skill instructions. Treatments were equally effective in reducing anxiety and produced a greater reduction…

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

32 CFR 162.3 - Definition.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Benefits resulting from PECIs are classified as savings or as cost avoidance: (1) Savings. Benefits that... achieved. Examples include costs for manpower authorizations and or funded work-year reductions, reduced or... manpower or costs that would be necessary, if present management practices were continued. The effect of...

Overview of the ACT program

NASA Technical Reports Server (NTRS)

Davis, John G., Jr.

1992-01-01

NASA's Advanced Composites Program (ACT) was initiated in 1988. A National Research Announcement was issued to solicit innovative ideas that could significantly contribute to development and demonstration of an integrated technology data base and confidence level that permits cost-effective use of composite primary structures in transport aircraft. Fifteen contracts were awarded by the Spring of 1989 and the participants include commercial and military airframe manufacturers, materials developers and suppliers, universities, and government laboratories. The program approach is to develop materials, structural mechanics methodology, design concepts, and fabrication procedures that offer the potential to make composite structures cost-effective compared to aluminum structure. Goals for the ACT program included 30-50 percent weight reduction, 20-25 percent acquisition cost reduction, and provided the scientific basis for predicting materials and structures performance. This paper provides an overview of the ACT program status, plans, and selected technical accomplishments. Sixteen additional papers, which provide more detailed information on the research and development accomplishments, are contained in this publication.

The reductive degradation of 1,1,1-trichloroethane by Fe(0) in a soil slurry system.

PubMed

Wu, Xiaoliang; Lu, Shuguang; Qiu, Zhaofu; Sui, Qian; Lin, Kuangfei; Du, Xiaoming; Luo, Qishi

2014-01-01

Most studies on the treatment of chlorinated contaminants by Fe(0) focus on aqueous system tests. However, few is known about the effectiveness of these tests for degrading chlorinated contaminants such as 1,1,1-trichloroethane (TCA) in soil. In this work, the reductive degradation performance of 1,1,1-TCA by Fe(0) was thoroughly investigated in a soil slurry system. The effects of various factors including acid-washed iron, the initial 1,1,1-TCA concentration, Fe(0) dosage, slurry pH, and common constituents in groundwater and soil such as Cl(-), HCO3 (-), SO4 (2-), and NO3 (-) anions and humic acid (HA) were evaluated. The experimental results showed that 1,1,1-TCA could be effectively degraded in 12 h for an initial Fe(0) dosage of 10 g L(-1) and a soil/water mass ratio of 1:5. The soil slurry experiments showed two-stage degradation kinetics: a slow reaction in the first stage and a fast reductive degradation of 1,1,1-TCA in the second stage. The reductive degradation of 1,1,1-TCA was expedited as the mass concentration of Fe(0) increased. In addition, high pHs adversely affected the degradation of 1,1,1-TCA over a pH range of 5.4-8.0 and the reductive degradation efficiency decreased with increasing slurry pH. The initial 1,1,1-TCA concentration and the presence of Cl(-) and SO4(2-) anions had negligible effects. HCO3(-) anions had a accelerative effect on 1,1,1-TCA removal, and both NO3(-) and HA had inhibitory effects. A Cl(-) mass balance showed that the amount of Cl(-) ions released into the soil slurry system during the 1,1,1-TCA degradation increased with increasing reaction time, suggesting that the main degradation mechanism of 1,1,1-TCA by Fe(0) in a soil slurry system was reductive dechlorination with 1,1-DCA as the main intermediate. In conclusion, this study provides a theoretical basis for the practical application of the remediation of contaminated sites containing chlorinated solvent.

Chlorhexidine mouthwash plaque levels and gingival health.

PubMed

Richards, Derek

2017-06-23

Data sourcesCochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL) Medline; clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform. There were no language or date restrictions on searches.Study selectionRandomised controlled trials (RCTs) assessing the effects of chlorhexidine mouthrinse used as an adjunct to mechanical oral hygiene procedures for at least four weeks on gingivitis in children and adults.Data extraction and synthesisTwo reviewers independently abstracted data and assessed risk of bias. Mean and standardised mean differences were used for continuous outcomes and risk ratios for dichotomous outcomes. Meta-analysis was carried out where studies of similar comparisons reported the same outcomes at the same time interval.ResultsFifty-one RCTs involving a total of 5,345 patients were included. Only one study was at low risk of bias, the other 50 were at high risk. For patients with mild gingivitis (gingival index [GI] 0 to 3 scale) four to six weeks' use of chlorhexidine mouthrinse reduced gingivitis by 0.21 (95% CI; 0.11 to 0.31) with a similar effect at six months. There were insufficient data to assess the effect on patients with moderate or severe gingival inflammation. For plaque there was a larger effect in favour of chlorhexidine mouthrinse at four to six weeks, SMD (standardised mean difference) = -1.45 (95% CI; -1.90 to -1.00), with a similarly large reduction at six months. A large increase in extrinsic tooth staining was seen with chlorhexidine use at four to six weeks, SMD = 1.07 (95%CI; 0.80 to 1.34) and seven to twelve weeks and six months. A range of other adverse effects were reported including taste disturbance/alteration, oral mucosa symptoms including soreness, irritation, mild desquamation and mucosal ulceration/erosions, and a general burning sensation or a burning tongue or both.ConclusionsThere is high quality evidence from studies that reported the Löe and Silness Gingival Index of a reduction in gingivitis in individuals with mild gingival inflammation on average (mean score of 1 on the 0 to 3 GI scale) that was not considered to be clinically relevant. There is high quality evidence of a large reduction in dental plaque with chlorhexidine mouthrinse used as an adjunct to mechanical oral hygiene procedures for four to six weeks and six months. There is no evidence that one concentration of chlorhexidine rinse is more effective than another. There is insufficient evidence to determine the reduction in gingivitis associated with chlorhexidine mouthrinse use in individuals with mean GI scores of 1.1 to 3 indicating moderate or severe levels of gingival inflammation. Rinsing with chlorhexidine mouthrinse for four weeks or longer causes extrinsic tooth staining. In addition, other adverse effects such as calculus build up, transient taste disturbance and effects on the oral mucosa were reported in the included studies.

Effect of Laterally Wedged Insoles on the External Knee Adduction Moment across Different Reference Frames.

PubMed

Yamaguchi, Satoshi; Kitamura, Masako; Ushikubo, Tomohiro; Murata, Atsushi; Akagi, Ryuichiro; Sasho, Takahisa

2015-01-01

Biomechanical effects of laterally wedged insoles are assessed by reduction in the knee adduction moment. However, the degree of reduction may vary depending on the reference frame with which it is calculated. The purpose of this study was to clarify the effect of reference frame on the reduction in the knee adduction moment by laterally wedged insoles. Twenty-nine healthy participants performed gait trials with a laterally wedged insole and with a flat insole as a control. The knee adduction moment, including the first and second peaks and the angular impulse, were calculated using four different reference frames: the femoral frame, tibial frame, laboratory frame and the Joint Coordinate System. There were significant effects of reference frame on the knee adduction moment first and second peaks (P < 0.001 for both variables), while the effect was not significant for the angular impulse (P = 0.84). No significant interaction between the gait condition and reference frame was found in either of the knee adduction moment variables (P = 0.99 for all variables), indicating that the effects of laterally wedged insole on the knee adduction moments were similar across the four reference frames. On the other hand, the average percent changes ranged from 9% to 16% for the first peak, from 16% to 18% for the second peak and from 17% to 21% for the angular impulse when using the different reference frames. The effects of laterally wedged insole on the reduction in the knee adduction moment were similar across the reference frames. On the other hand, Researchers need to recognize that when the percent change was used as the parameter of the efficacy of laterally wedged insole, the choice of reference frame may influence the interpretation of how laterally wedged insoles affect the knee adduction moment.

Reductions in levels of the Alzheimer's amyloid beta peptide after oral administration of ginsenosides.

PubMed

Chen, Feng; Eckman, Elizabeth A; Eckman, Christopher B

2006-06-01

For millennia, ginseng and some of its components have been used to treat a wide variety of medical conditions, including age-related memory impairment. Because of its purported effects and apparently low rate of side effects, ginseng remains one of the top selling natural product remedies in the United States. Given its potential role for improving age-related memory impairments and its common use in China for the treatment of Alzheimer's disease-like symptoms, we analyzed the effects of commercially available preparations of ginseng on the accumulation of the Alzheimer's amyloid beta peptide (Abeta) in a cell-based model system. In this model system, ginseng treatment resulted in a significant reduction in the levels of Abeta in the conditioned medium. We next examined the effects of several compounds isolated from ginseng and found that certain ginsenosides lowered Abeta concentration in a dose-dependent manner with ginsenoside Rg3 having an approximate IC50 of under 25 microM against Abeta42. Furthermore, we found that three of these isolated components, ginsenoside Rg1, Rg3, and RE, resulted in significant reductions in the amount of Abeta detected in the brains of animals after single oral doses of these agents. The results indicate that ginseng itself, or purified ginsenosides, may have similarly useful effects in human disease.

Protocol: a multi-level intervention program to reduce stress in 9-1-1 telecommunicators.

PubMed

Meischke, Hendrika; Lilly, Michelle; Beaton, Randal; Calhoun, Rebecca; Tu, Ann; Stangenes, Scott; Painter, Ian; Revere, Debra; Baseman, Janet

2018-05-02

Nationwide, emergency response systems depend on 9-1-1 telecommunicators to prioritize, triage, and dispatch assistance to those in distress. 9-1-1 call center telecommunicators (TCs) are challenged by acute and chronic workplace stressors: tense interactions with citizen callers in crisis; overtime; shift-work; ever-changing technologies; and negative work culture, including co-worker conflict. This workforce is also subject to routine exposures to secondary traumatization while handling calls involving emergency situations and while making time urgent, high stake decisions over the phone. Our study aims to test the effectiveness of a multi-part intervention to reduce stress in 9-1-1 TCs through an online mindfulness training and a toolkit containing workplace stressor reduction resources. The study employs a randomized controlled trial design with three data collection points. The multi-part intervention includes an individual-level online mindfulness training and a call center-level organizational stress reduction toolkit. 160 TCs will be recruited from 9-1-1 call centers, complete a baseline survey at enrollment, and are randomly assigned to an intervention or a control group. Intervention group participants will start a 7-week online mindfulness training developed in-house and tailored to 9-1-1 TCs and their call center environment; control participants will be "waitlisted" and start the training after the study period ends. Following the intervention group's completion of the mindfulness training, all participants complete a second survey. Next, the online toolkit with call-center wide stress reduction resources is made available to managers of all participating call centers. After 3 months, a third survey will be completed by all participants. The primary outcome is 9-1-1 TCs' self-reported symptoms of stress at three time points as measured by the C-SOSI (Calgary Symptoms of Stress Inventory). Secondary outcomes will include: perceptions of social work environment (measured by metrics of social support and network conflict); mindfulness; and perceptions of social work environment and mindfulness as mediators of stress reduction. This study will evaluate the effectiveness of an online mindfulness training and call center-wide stress reduction toolkit in reducing self-reported stress in 9-1-1 TCs. The results of this study will add to the growing body of research on worksite stress reduction programs. ClinicalTrials.gov Registration Number: NCT02961621 Registered on November 7, 2016 (retrospectively registered).

PEPFAR Funding and Reduction in HIV Infection Rates in 12 Focus Sub-Saharan African Countries: A Quantitative Analysis.

PubMed

Chin, Roger J; Sangmanee, Domrongphol; Piergallini, Lisa

2015-01-01

HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the President's Emergency Plan for AIDS Relief (PEPFAR) with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote d'Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP)) allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the country's HIV infection rate decreased by 0.355 percentage points. While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR.

The effects of a mass media HIV-risk reduction strategy on HIV-related stigma and knowledge among African American adolescents.

PubMed

Kerr, Jelani C; Valois, Robert F; DiClemente, Ralph J; Carey, Michael P; Stanton, Bonita; Romer, Daniel; Fletcher, Faith; Farber, Naomi; Brown, Larry K; Vanable, Peter A; Salazar, Laura F; Juzang, Ivan; Fortune, Thierry

2015-03-01

HIV-related stigma undermines HIV prevention, testing, and treatment. Multipronged risk-reduction strategies may reduce stigma among African American adolescents. To test the effectiveness of a risk-reduction strategy in addressing stigma, 1613 African American adolescents from four mid-sized cities participated in a randomized control trial. Participants received a sexual-risk reduction [Focus on Youth (FOY)] or general health curriculum [Promoting Health Among Teens (PHAT)]. Two cities received a culturally-tailored media intervention. Participants completed baseline, 3-, 6-, and 12-month surveys to measure HIV-related stigma and knowledge. Analysis of covariance tested for stigma and knowledge differences by media city status and curriculum/media city status (PHAT media vs. PHAT non-media, FOY media vs. FOY non-media; FOY media vs. PHAT media; FOY non-media vs. PHAT non-media) at each measurement. Hierarchical linear modeling (HLM) determined stigma and knowledge differences over time. Media participants demonstrated greater HIV-related knowledge (p<0.10) at 6 months and lower stigma at 3 months (p<0.10). FOY media participants had lower 3-month (p<0.05) and 12-month (p<0.10) stigma scores than non-media FOY participants. FOY media and non-media participants had greater knowledge than PHAT for all intervals after baseline. FOY media had lower stigma than PHAT media after baseline for all intervals after baseline. HLM indicated greater knowledge slopes for the media group (p<0.05). FOY media participants had greater knowledge slopes (p<0.05) relative to non-media FOY participants and media PHAT participants (p<0.01). A combination of a HIV risk-reduction curriculum and culturally-tailored media demonstrated some effectiveness in reducing stigma. Future use of media in HIV-prevention should include and evaluate effects on stigma.

Effects of nonsurgical periodontal therapy on C-reactive protein and serum lipids in Jordanian adults with advanced periodontitis.

PubMed

Kamil, W; Al Habashneh, R; Khader, Y; Al Bayati, L; Taani, D

2011-10-01

Data on whether periodontal therapy affects serum CRP levels are inconclusive. The aim of this study was to determine if nonsurgical periodontal therapy has any effect on CRP and serum lipid levels in patients with advanced periodontitis. Thirty-six systemically healthy patients, ≥ 40 years of age and with advanced periodontitis, were recruited for the study. Patients were randomized consecutively to one of two groups: the treatment group (n = 18) or the control group (n = 18). Treated subjects received nonsurgical periodontal therapy, which included oral hygiene instructions and subgingival scaling and root planing. Systemic levels of inflammatory markers [C-reactive protein (CRP) and the lipid profile] were measured at baseline and 3 mo after periodontal therapy. Nonsurgical periodontal therapy in the treatment group resulted in a significant reduction in the serum CRP level. The average CRP level decreased from 2.3 mg/dL at baseline to 1.8 mg/dL (p < 0.005) after 3 mo of periodontal therapy. The average reduction (95% confidence interval) in CRP was 0.498 (95% confidence interval = 0.265-0.731). In the treatment group, the reduction in CRP was significantly, linearly and directly correlated with the reduction in the plaque index, the gingival index and the percentage of sites with pocket depth ≥ 7 mm (Pearson correlation coefficient = 0.746, 0.425 and 0.621, respectively). Nonsurgical periodontal therapy had no effect on the lipid parameters. This study demonstrated that nonsurgical periodontal therapy results in a significant reduction in the serum CRP level. The effect of this outcome on systemic disease is still unknown. © 2011 John Wiley & Sons A/S.

Benefit transfer protocol for long-term health risk valuation: A case of surface water contamination

NASA Astrophysics Data System (ADS)

Kask, Susan B.; Shogren, Jason F.

1994-10-01

In response to scarce financial resources, economists have promoted the concept of benefit transfer as a cost-effective alternative to new nonmarket valuation studies. Recent discussion on benefit transfer for improved water quality has focused on recreational benefits. While useful, the discussion must now be expanded to include another key benefit from improved water quality: the reduction in risk to public health. This paper develops a protocol for benefit transfer of long-term health risk reduction and presents a case study for surface water contamination. Challenges such as the multiple sources of risk, the mortality and morbidity effects indicated by a variety of symptoms, the long latency period between cause and effect, and an individual's ability to privately or collectively reduce the probability or severity of the risk are discussed.

The effect of antihypertensive treatment on the incidence of stroke and cognitive decline in the elderly: a meta-analysis.

PubMed

Parsons, Christine; Murad, Mohammad Hassan; Andersen, Stuart; Mookadam, Farouk; Labonte, Helene

2016-03-01

To evaluate the effectiveness of antihypertensives in reducing neurocognitive outcomes in elderly patients. We conducted a systematic literature search of randomized trials in which hypertensive patients with a mean age ≥65 years received antihypertensive or control treatment. Outcomes were stroke, transient ischemic attack, cognitive decline and dementia. We included 14 trials for meta-analysis. Compared to placebo, antihypertensive treatment reduced the risk of stroke (RR: 0.67 [95% CI: 0.57-0.79]). Reduced risk was significant for transient ischemic attack, fatal stroke, nonfatal stroke and total stroke. There were insufficient data to compare individual agents. Antihypertensive treatment is associated with a significant reduction in stroke in elderly individuals. Reductions in dementia and cognitive decline were not significant; however, there was short follow-up. Comparative effectiveness evidence is limited.

Attention management as a treatment for chronic pain.

PubMed

Elomaa, Minna M; de C Williams, Amanda C; Kalso, Eija A

2009-11-01

Attention management is often included in cognitive-behavioural treatments (CBT). The aim of this study was to evaluate the effects of attention management strategies in the treatment for chronic pain. The present pilot study consisted of six weekly 90-min treatment sessions and was based on a CBT attention management manual describing techniques such as attention diversion, imagery and mindfulness exercises. The intended outcomes were reduction in pain-related anxiety and hypervigilance to pain and decrease in pain impact of everyday life, measured by self-report. Information was collected at baseline, pre-treatment, post-treatment, and at 3 and 6 months follow-up. The results at the end of treatment, and at 3-month follow-up, show significant reductions in pain-related anxiety, hypervigilance and interference of pain (effect sizes 0.40-0.90). Reduction in pain-related interference and anxiety remained at the 6-month follow-up. The results indicate that attention control skills can be a useful method to reduce anxiety in the short term. Clinical implications of the results are discussed.

Microenterprise Development Interventions for Sexual Risk Reduction: A Systematic Review

PubMed Central

Lee, Ramon; Thirumurthy, Harsha; Muessig, Kathryn E.; Tucker, Joseph D.

2013-01-01

Comprehensive interventions that address both individual and structural determinants associated with HIV/STI risk are gaining increasing attention over the past decade. Microenterprise development offers an appealing model for HIV prevention by addressing poverty and gender equality. This study systematically reviewed the effects of microenterprise development interventions on HIV/STI incidence and sexual risk behaviors. Microenterprise development was defined as developing small business capacity among individuals to alleviate poverty. Seven eligible research studies representing five interventions were identified and included in this review. All of the studies targeted women, and three focused on sex workers. None measured biomarker outcomes. All three sex worker studies showed significant reduction in sexual risk behaviors when compared to the control group. Non-sex worker studies showed limited changes in sexual risk behavior. This review indicates the potential utility of microenterprise development in HIV risk reduction programs. More research is needed to determine how microenterprise development can be effectively incorporated in comprehensive HIV control strategies. PMID:23963497

Microenterprise development interventions for sexual risk reduction: a systematic review.

PubMed

Cui, Rosa R; Lee, Ramon; Thirumurthy, Harsha; Muessig, Kathryn E; Tucker, Joseph D

2013-11-01

Comprehensive interventions that address both individual and structural determinants associated with HIV/STI risk are gaining increasing attention over the past decade. Microenterprise development offers an appealing model for HIV prevention by addressing poverty and gender equality. This study systematically reviewed the effects of microenterprise development interventions on HIV/STI incidence and sexual risk behaviors. Microenterprise development was defined as developing small business capacity among individuals to alleviate poverty. Seven eligible research studies representing five interventions were identified and included in this review. All of the studies targeted women, and three focused on sex workers. None measured biomarker outcomes. All three sex worker studies showed significant reduction in sexual risk behaviors when compared to the control group. Non-sex worker studies showed limited changes in sexual risk behavior. This review indicates the potential utility of microenterprise development in HIV risk reduction programs. More research is needed to determine how microenterprise development can be effectively incorporated in comprehensive HIV control strategies.

Inocoterone and acne. The effect of a topical antiandrogen: results of a multicenter clinical trial.

PubMed

Lookingbill, D P; Abrams, B B; Ellis, C N; Jegasothy, B V; Lucky, A W; Ortiz-Ferrer, L C; Savin, R C; Shupack, J L; Stiller, M J; Zone, J J

1992-09-01

Because acne is androgen dependent, antiandrogen therapy might improve the condition. Inocoterone acetate (RU 882) is a nonsteroidal antiandrogen that binds to the androgen receptor and has antiandrogenic activity in animal models. To test its topical effect on acne, 126 male subjects with facial acne completed a 16-week, multi-center, double-blind study in which the twice-daily application of a 10% solution of inocoterone was compared with vehicle solution. Baseline and monthly examinations included acne lesion counts and general and endocrine laboratory tests. Inflammatory papules and pustules showed greater reduction in the inocoterone-treated subjects than in the subjects treated with vehicle. This difference achieved statistical significance by week 12 (24% reduction vs 10%) and week 16 (26% reduction vs 13%) and, with longitudinal analysis, throughout the course of the study. Global assessments and changes in comedo counts and sebum excretion rates were not significantly different between the groups. No serious adverse reactions were encountered. In this double-blind study of 126 male subjects with acne, a topical solution of the antiandrogen inocoterone, compared with vehicle, produced a modest but statistically significant reduction in the number of inflammatory acne lesions.

Comparative Evaluation of Cutting Methods of Activated Concrete from Nuclear Power Plant Decommissioning - 13548

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

Kim, HakSoo; Chung, SungHwan; Maeng, SungJun

2013-07-01

The amount of radioactive wastes from decommissioning of a nuclear power plant varies greatly depending on factors such as type and size of the plant, operation history, decommissioning options, and waste treatment and volume reduction methods. There are many methods to decrease the amount of decommissioning radioactive wastes including minimization of waste generation, waste reclassification through decontamination and cutting methods to remove the contaminated areas. According to OECD/NEA, it is known that the radioactive waste treatment and disposal cost accounts for about 40 percentage of the total decommissioning cost. In Korea, it is needed to reduce amount of decommissioning radioactivemore » waste due to high disposal cost, about $7,000 (as of 2010) per a 200 liter drum for the low- and intermediate-level radioactive waste (LILW). In this paper, cutting methods to minimize the radioactive waste of activated concrete were investigated and associated decommissioning cost impact was assessed. The cutting methods considered are cylindrical and volume reductive cuttings. The study showed that the volume reductive cutting is more cost-effective than the cylindrical cutting. Therefore, the volume reductive cutting method can be effectively applied to the activated bio-shield concrete. (authors)« less

Catalan speakers' perception of word stress in unaccented contexts.

PubMed

Ortega-Llebaria, Marta; del Mar Vanrell, Maria; Prieto, Pilar

2010-01-01

In unaccented contexts, formant frequency differences related to vowel reduction constitute a consistent cue to word stress in English, whereas in languages such as Spanish that have no systematic vowel reduction, stress perception is based on duration and intensity cues. This article examines the perception of word stress by speakers of Central Catalan, in which, due to its vowel reduction patterns, words either alternate stressed open vowels with unstressed mid-central vowels as in English or contain no vowel quality cues to stress, as in Spanish. Results show that Catalan listeners perceive stress based mainly on duration cues in both word types. Other cues pattern together with duration to make stress perception more robust. However, no single cue is absolutely necessary and trading effects compensate for a lack of differentiation in one dimension by changes in another dimension. In particular, speakers identify longer mid-central vowels as more stressed than shorter open vowels. These results and those obtained in other stress-accent languages provide cumulative evidence that word stress is perceived independently of pitch accents by relying on a set of cues with trading effects so that no single cue, including formant frequency differences related to vowel reduction, is absolutely necessary for stress perception.

New developments in isotropic turbulent models for FENE-P fluids

NASA Astrophysics Data System (ADS)

Resende, P. R.; Cavadas, A. S.

2018-04-01

The evolution of viscoelastic turbulent models, in the last years, has been significant due to the direct numeric simulation (DNS) advances, which allowed us to capture in detail the evolution of the viscoelastic effects and the development of viscoelastic closures. New viscoelastic closures are proposed for viscoelastic fluids described by the finitely extensible nonlinear elastic-Peterlin constitutive model. One of the viscoelastic closure developed in the context of isotropic turbulent models, consists in a modification of the turbulent viscosity to include an elastic effect, capable of predicting, with good accuracy, the behaviour for different drag reductions. Another viscoelastic closure essential to predict drag reduction relates the viscoelastic term involving velocity and the tensor conformation fluctuations. The DNS data show the high impact of this term to predict correctly the drag reduction, and for this reason is proposed a simpler closure capable of predicting the viscoelastic behaviour with good performance. In addition, a new relation is developed to predict the drag reduction, quantity based on the trace of the tensor conformation at the wall, eliminating the need of the typically parameters of Weissenberg and Reynolds numbers, which depend on the friction velocity. This allows future developments for complex geometries.

Heart rate reduction and longevity in mice.

PubMed

Gent, Sabine; Kleinbongard, Petra; Dammann, Philip; Neuhäuser, Markus; Heusch, Gerd

2015-03-01

Heart rate correlates inversely with life span across all species, including humans. In patients with cardiovascular disease, higher heart rate is associated with increased mortality, and such patients benefit from pharmacological heart rate reduction. However, cause-and-effect relationships between heart rate and longevity, notably in healthy individuals, are not established. We therefore prospectively studied the effects of a life-long pharmacological heart rate reduction on longevity in mice. We hypothesized, that the total number of cardiac cycles is constant, and that a 15% heart rate reduction might translate into a 15% increase in life span. C57BL6/J mice received either placebo or ivabradine at a dose of 50 mg/kg/day in drinking water from 12 weeks to death. Heart rate and body weight were monitored. Autopsy was performed on all non-autolytic cadavers, and parenchymal organs were evaluated macroscopically. Ivabradine reduced heart rate by 14% (median, interquartile range 12-15%) throughout life, and median life span was increased by 6.2% (p = 0.01). Body weight and macroscopic findings were not different between placebo and ivabradine. Life span was not increased to the same extent as heart rate was reduced, but nevertheless significantly prolonged by 6.2%.

Lung volume reduction for emphysema.

PubMed

Shah, Pallav L; Herth, Felix J; van Geffen, Wouter H; Deslee, Gaetan; Slebos, Dirk-Jan

2017-02-01

Advanced emphysema is a lung disease in which alveolar capillary units are destroyed and supporting tissue is lost. The combined effect of reduced gas exchange and changes in airway dynamics impairs expiratory airflow and leads to progressive air trapping. Pharmacological therapies have limited effects. Surgical resection of the most destroyed sections of the lung can improve pulmonary function and exercise capacity but its benefit is tempered by significant morbidity. This issue stimulated a search for novel approaches to lung volume reduction. Alternative minimally invasive approaches using bronchoscopic techniques including valves, coils, vapour thermal ablation, and sclerosant agents have been at the forefront of these developments. Insertion of endobronchial valves in selected patients could have benefits that are comparable with lung volume reduction surgery. Endobronchial coils might have a role in the treatment of patients with emphysema with severe hyperinflation and less parenchymal destruction. Use of vapour thermal energy or a sclerosant might allow focal treatment but the unpredictability of the inflammatory response limits their current use. In this Review, we aim to summarise clinical trial evidence on lung volume reduction and provide guidance on patient selection for available therapies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Optimization of air injection parameters toward optimum fuel saving effect for ships

NASA Astrophysics Data System (ADS)

Lee, Inwon; Park, Seong Hyeon

2016-11-01

Air lubrication method is the most promising commercial strategy for the frictional drag reduction of ocean going vessels. Air bubbles are injected through the array of holes or the slots installed onto the flat bottom surface of vessel and a sufficient supply of air is required to ensure the formation of stable air layer by the by the coalescence of the bubbles. The air layer drag reduction becomes economically meaningful when the power gain through the drag reduction exceeds the pumping power consumption. In this study, a model ship of 50k medium range tanker is employed to investigate air lubrication method. The experiments were conducted in the 100m long towing tank facility at the Pusan National University. To create the effective air lubrication with lower air flow rate, various configurations including the layout of injection holes, employment of side fences and static trim have been tested. In the preliminary series of model tests, the maximum 18.13%(at 15kts) of reduction of model resistance was achieved. This research was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korea government (MEST) through GCRC-SOP (Grant No. 2011-0030013).

The impact of stress and psychosocial interventions on assisted reproductive technology outcome.

PubMed

Morreale, Mary; Balon, Richard; Tancer, Manuel; Diamond, Michael

2011-01-01

In natural cycles of attempted conception, stress has been shown to predict lower conception rates. The objective of this article is to determine whether stress affects the outcome of assisted reproductive technology (ART) as well. In addition, this article analyzes the effect that psychosocial interventions targeting the reduction of stress have on ART outcomes. This review examined available PubMed articles published in the past 15 years, and 28 articles were included. Looking specifically at numbers of women studied, stress appears to negatively affect ART outcome; interventions targeting stress reduction appear beneficial. Because stress appears to negatively affect ART outcome, and psychosocial interventions do not have detrimental effects, screening for stress should occur and some type of intervention considered during the ART process.

Party drugs - use and harm reduction.

PubMed

Frei, Matthew

2010-08-01

Party drug use, the intermittent use of stimulants, ecstasy and so-called 'designer drugs' at dance parties or 'raves', is now part of the culture of many young Australians. This article discusses the risks associated with the use of 'party drugs' and describes an useful approach to general practitioner assessment and management of patients who may be using party drugs. Party drug use is associated with a range of harms, including risks associated with behaviour while drug affected, toxicity and overdose, mental health complications and physical morbidity. Multiple substance use, particularly combining sedatives, further amplifies risk. If GPs have some understanding of these drugs and their effects, they are well placed to provide an effective intervention in party drug users by supporting the reduction of harm.

Neurocognitive Impairment and HIV Risk Factors: A Reciprocal Relationship

PubMed Central

Anand, Pria; Springer, Sandra A.; Copenhaver, Michael M.

2010-01-01

Cognitive impairment among populations at risk for HIV poses a significant barrier to managing risk behaviors. The impact of HIV and several cofactors, including substance abuse and mental illness, on cognitive function is discussed in the context of HIV risk behaviors, medication adherence, and risk-reduction interventions. Literature suggests that cognitive impairment is intertwined in a close, reciprocal relationship with both risk behaviors and medication adherence. Not only do increased risk behaviors and suboptimal adherence exacerbate cognitive impairment, but cognitive impairment also reduces the effectiveness of interventions aimed at optimizing medication adherence and reducing risk. In order to be effective, risk-reduction interventions must therefore take into account the impact of cognitive impairment on learning and behavior. PMID:20232242

Differences by gender at twelve months in a brief intervention trial among Mexican-origin young adults in the emergency department.

PubMed

Bernstein, Judith; Bernstein, Edward; Hudson, Dantia; Belanoff, Candice; Cabral, Howard J; Cherpitel, Cheryl J; Bond, Jason; Ye, Yu; Woolard, Robert; Villalobos, Susana; Ramos, Rebeca

2017-01-01

In this study, we investigate the role of gender in prevalence and consequences of binge drinking and brief intervention outcomes among Mexican-origin young adults aged 18-30 years at the U.S.-Mexico border. We conducted a secondary analysis, stratified by gender, from a randomized controlled trial of a brief motivational intervention in a hospital emergency department. Intervention effects for males included reductions in drinking frequency, binge drinking, and alcohol-related consequences. For females the intervention was associated with reduction in drinking frequency and binge drinking but did not have a significant effect on alcohol-related consequences. Results suggest a new direction for tailoring interventions to gender.

Effects of alcohol taxes on alcohol-related disease mortality in New York State from 1969 to 2006.

PubMed

Delcher, Chris; Maldonado-Molina, Mildred M; Wagenaar, Alexander C

2012-07-01

The relationship of increased alcohol taxes to reductions in alcohol-related harm is well established. Few studies, however, have examined the effects of sudden decreases in alcohol tax rates or effects of narrow tax changes limited to specific beverage types. In the current study, we: (1) examine whether tax increases on spirits have similar effects in reducing alcohol-related disease mortality as increasing taxes on all types of alcoholic beverages simultaneously, and (2) evaluate effects of beer-specific tax decreases in New York State on mortality. We used a time-series, quasi-experimental research design, including non-alcohol deaths within New York State and other states' rates of alcohol-related disease mortality for comparison. The dataset included 456 monthly observations of mortality in New York State over a 38-year period (1969-2006). We used a random-effects approach and included several other important covariates. Alcohol-related disease mortality declined by 7.0% after a 1990 tax increase for spirits and beer. A spirits-only tax increase (in 1972) was not significantly associated with mortality but a data anomaly increased error in this effect estimate. Small tax decreases on beer between 1996 and 2006 had no measurable effect on mortality. Doubling the beer tax from $0.11 to $0.22 per gallon, a return to New York State's 1990 levels, would decrease deaths by an estimated 250 deaths per year. Excise tax increases on beer and spirits were associated with reductions in alcohol-related disease mortality. Modifying tax rates on a single beverage type does not appear to be as effective as doing so on multiple alcoholic beverages simultaneously. In New York, small decreases in beer taxes were not significantly associated with alcohol-related disease mortality. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effects of alcohol taxes on alcohol-related disease mortality in New York State from 1969 to 2006

PubMed Central

Delcher, Chris; Maldonado-Molina, Mildred M.; Wagenaar, Alexander C.

2013-01-01

Objective The relationship of increased alcohol taxes to reductions in alcohol-related harm is well established. Few studies, however, have examined the effects of sudden decreases in alcohol tax rates or effects of narrow tax changes limited to specific beverage types. In the current study, we: (1) examine whether tax increases on spirits have similar effects in reducing alcohol-related disease mortality as increasing taxes on all types of alcoholic beverages simultaneously, and (2) evaluate effects of beer-specific tax decreases in New York State on mortality. Method We used a time-series, quasi-experimental research design, including non-alcohol deaths within New York State and other states’ rates of alcohol-related disease mortality for comparison. The dataset included 456 monthly observations of mortality in New York State over a 38-year period (1969–2006). We used a random-effects approach and included several other important covariates. Results Alcohol-related disease mortality declined by 7.0% after a 1990 tax increase for spirits and beer. A spirits-only tax increase (in 1972) was not significantly associated with mortality but a data anomaly increased error in this effect estimate. Small tax decreases on beer between 1996 and 2006 had no measurable effect on mortality. Doubling the beer tax from $0.11 to $0.22 per gallon, a return to New York State’s 1990 levels, would decrease deaths by an estimated 250 deaths per year. Conclusions Excise tax increases on beer and spirits were associated with reductions in alcohol-related disease mortality. Modifying tax rates on a single beverage type does not appear to be as effective as doing so on multiple alcoholic beverages simultaneously. In New York, small decreases in beer taxes were not significantly associated with alcohol-related disease mortality. PMID:22436591

Attenuation of autoimmune responses to oxidative specific epitopes, but not nitroso-adducts, is associated with a better clinical outcome in Myalgic Encephalomyelitis/chronic fatigue syndrome.

PubMed

Maes, Michael; Leunis, Jean-Claude

2014-01-01

There is evidence that inflammatory, oxidative and nitrosative stress (IO&NS) pathways participate in the pathophysiology of a subgroup of patients with Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS). Increased IgM-related autoimmune responses to oxidative specific epitopes (OSEs), including malondialdehyde (MDA), oleic acid and phosphatidyl inositol (Pi), and nitroso-(NO)-adducts, including NO-tryptophan (NOW), NO-arginine and NO-cysteinyl, are frequently observed in ME/CFS. Autoimmune responses in ME/CFS may be driven by increased bacterial translocation as measured by IgM and IgA responses to LPS of gram negative bacteria. The aim of this study is to examine whether IgM responses to OSEs and NO-adducts are related to a better outcome as measured by the Fibromyalgia and Fatigue Rating Scale (FF). 76 ME/CFS patients with initially abnormal autoimmune responses were treated with care-as-usual, including nutraceuticals with anti-IO&NS effects (NAIOS), such as L-carnitine, coenzyme Q10, taurine + lipoic acid, with or without curcumine + quercitine or N-acetyl-cysteine, zinc + glutamine. We found that use of these NAIOS was associated with highly significant reductions in initially increased IgM-mediated autoimmune responses to OSEs and NO-adducts. A greater reduction in autoimmune responses to OSEs during intake of these NAIOS was associated with a lower FF score. Reductions in IgM responses to oleic acid, MDA and Pi, but not in any of the NO-adducts, were associated with reductions in severity of illness. These associations remained significant after adjusting for possible effects of increased bacterial translocation (leaky gut). Our results show that autoimmune responses to OSEs are involved in the pathophysiology of ME/CFS and that these pathways are a new drug target in a subgroup of ME/CFS patients. Although hypernitrosylation and nitrosative stress play a role in ME/CFS, reductions in these pathways are not associated with lowered severity of illness. Randomized controlled trials with NAIOS should be carried out in the subgroup of ME/CFS patients with initially increased autoimmune responses to OSEs.

Degradation of Zearalenone by Essential Oils under In vitro Conditions

PubMed Central

Perczak, Adam; Juś, Krzysztof; Marchwińska, Katarzyna; Gwiazdowska, Daniela; Waśkiewicz, Agnieszka; Goliński, Piotr

2016-01-01

Essential oils are volatile compounds, extracted from plants, which have a strong odor. These compounds are known for their antibacterial and antifungal properties. However, data concerning degradation of mycotoxins by these metabolites are very limited. The aim of the present study was to investigate the effect of essential oils (cedarwood, cinnamon leaf, cinnamon bark, white grapefruit, pink grapefruit, lemon, eucalyptus, palmarosa, mint, thymic, and rosemary) on zearalenone (ZEA) reduction under various in vitro conditions, including the influence of temperature, pH, incubation time and mycotoxin and essential oil concentrations. The degree of ZEA reduction was determined by HPLC method. It was found that the kind of essential oil influences the effectiveness of toxin level reduction, the highest being observed for lemon, grapefruit, eucalyptus and palmarosa oils, while lavender, thymic and rosemary oils did not degrade the toxin. In addition, the decrease in ZEA content was temperature, pH as well as toxin and essential oil concentration dependent. Generally, higher reduction was observed at higher temperature in a wide range of pH, with clear evidence that the degradation rate increased gradually with time. In some combinations (e.g., palmarosa oil at pH 6 and 4 or 20°C) a toxin degradation rate higher than 99% was observed. It was concluded that some of the tested essential oils may be effective in detoxification of ZEA. We suggested that essential oils should be recognized as an interesting and effective means of ZEA decontamination and/or detoxification. PMID:27563298

The Clinical Effectiveness of Post-Brushing Rinsing in Reducing Plaque and Gingivitis: A Systematic Review

PubMed Central

Patthi, Basavaraj; Singla, Ashish; Gupta, Ritu; Jankiram, Chandrasheker; Kumar, Jishnu Krishna; Vashishtha, Vaibhav; Malhi, Ravneet

2016-01-01

Introduction Dental plaque is the major etiological factor associated with the development of gingivitis. Hence, maintenance of oral hygiene is very essential. Aim To systematically review the literature on the effects of a post toothbrushing rinsing on plaque and parameters of gingival inflammation. Materials and Methods A literature review was performed in PubMed Central and Cochrane library, embase, google scholar were searched up to February 2015 to identify appropriate studies. The primary outcome measure was plaque and gingival inflammation reduction. Results Out of the total 56 titles appeared, 08articles fulfilled the criteria and were selected for the review. One article which was hand searched and one article which was through e-mail was included. A statistically significant reduction in overall plaque and gingivitis was noted when different mouth rinses were compared to the control (p<0.05). It was seen that chlorhexidine is the best antiplaque and antigingivitis agent but due to its side effects after continuous use, was not indicated for long term use. Probiotic was superior to chlorhexidine in terms of reduction of gingival inflammation. Conclusion There are relatively few studies evaluating the association between post toothbrushing rinsing and gingivitis. A clear effect was observed, indicating that different mouthrinses (chlorhexidine, probiotic, herbal, essential oil mouthrinse) when used as an adjunct to mechanical means of oral hygiene, provides an additional benefit with regard to plaque and gingivitis reduction as compared to a placebo or control. PMID:27437376

Effects of the Introduction of Intranasal Fentanyl on Reduction of Pain Severity Score in Children: An Interrupted Time-Series Analysis.

PubMed

Lord, Bill; Jennings, Paul A; Smith, Karen

2017-12-01

Children are at risk of inadequate analgesia due to paramedics' inexperience in assessing children and challenges in administering analgesics when the patient is distressed and uncooperative. This study reports on the outcome of a change to practice guidelines that added intranasal fentanyl and intramuscular morphine within a large statewide ambulance service. This retrospective study included patients younger than 15 years treated by paramedics between January 2008 and December 2011. The primary outcome of interest was the proportion of patients having a 2/10 or greater reduction in pain severity score using an 11-point Verbal Numeric Rating Scale before and after the intervention. Segmented regression analysis was used to estimate the effect of the intervention over time. A multiple regression model calculated odds ratios with 95% confidence intervals. A total of 92,378 children were transported by paramedics during the study period, with 9833 cases included in the analysis. The median age was 11 years; 61.6% were male. Before the intervention, 88.1% (n = 3114) of children receiving analgesia had a reduction of pain severity of 2 or more points, with 94.2% (n = 5933) achieving this benchmark after intervention (P < 0.0001). The odds of a reduction in pain of 2 or more points increased by 1.01 per month immediately before the intervention and 2.33 after intervention (<0.0001). This large study of a system-wide clinical practice guideline change has demonstrated a significant improvement in the outcome of interest. However, a proportion of children with moderate to severe pain did not receive analgesia.

Changes in the Healthy Beverage Index in Response to an Intervention Targeting a Reduction in Sugar-Sweetened Beverage Consumption as Compared to an Intervention Targeting Improvements in Physical Activity: Results from the Talking Health Trial.

PubMed

Hedrick, Valisa E; Davy, Brenda M; Myers, Emily A; You, Wen; Zoellner, Jamie M

2015-12-04

The recently developed Healthy Beverage Index (HBI) was designed to evaluate overall beverage intake quality (including total fluid consumption and beverage calories), yet no known intervention studies have assessed longitudinal changes to the HBI. The objective of this investigation was to assess changes in HBI scores in response to a sugar-sweetened beverage (SSB) reduction trial as compared to a physical activity comparison group. Participants were enrolled into a six-month, community-based, controlled behavioral trial and randomized into either a SSB reduction group (SIPsmartER) or a physical activity group (MoveMore). Correlations and multilevel mixed-effects linear regression with intention-to-treat analyses are presented. Total HBI score significantly increased for SIPsmartER (n = 149) (mean increase = 7.5 points (5.4, 9.7), p ≤ 0.001) and MoveMore (n = 143) (mean increase = 3.4 points (1.6, 5.2), p ≤ 0.001) participants, with a significant between group effect (p ≤ 0.05), over the six-month intervention. Other significant changes in HBI components for SIPsmartER included increased SSB and total beverage calorie scores, and decreased low-fat milk and diet soda scores. Changes in total HBI scores were significantly correlated with changes in total Healthy Eating Index-2010 scores (r = 0.15, p ≤ 0.01). Our findings suggest that individual HBI component scores, beyond the SSB component, are influenced by intervention strategies that primarily focus on SSB reduction.

The influence of Kinesiology Taping on the reduction of lymphoedema among women after mastectomy – preliminary study

PubMed Central

Karczmarek-Borowska, Bożenna; Tymczak, Monika; Hałas, Ireneusz; Banaś, Joanna

2014-01-01

Introduction Kinesiology Taping is a method that assists healing processes and improves the physical efficiency. The aim of the study The aim of the study was to assess the influence of Kinesiology Taping on the lymphoedema reduction among women after mastectomy. Material and methods The subject of the research included 44 women underwent single mastectomy along with the removal of lymph nodes. The examination was carried out from the 4th of January to the 4th of February, 2013. The traditional taping method was implemented among 22 women, whereas the own taping method was used among the other 22 women. The therapy took 21 days, during which the tapes were applied three times every 7 days. The measurements were made before every application and at the end of the therapy. In the study, a questionnaire was used and it included questions concerning basic demographic, epidemiological data as well as the evaluation of the therapy effectiveness. The linear measurements of the upper limbs, the measurements of the range of joints’ motion in the upper limb were taken as well as grip strength was made. Results The reduction of the volume of lymphoedema of 55% was reported in the study group, whereas the oedema reduced by 27% in the clinical control one. Conclusions In the reduction of lymphoedema, the greater effectiveness of the own taping method in comparison to the traditional one was reported. Kinesiology Taping exerted an influence on the improvement of the upper limb's joints movability and the grip strength. PMID:24966797

Cost-effectiveness of the Norwegian breast cancer screening program.

PubMed

van Luijt, P A; Heijnsdijk, E A M; de Koning, H J

2017-02-15

The Norwegian Breast Cancer Screening Programme (NBCSP) has a nation-wide coverage since 2005. All women aged 50-69 years are invited biennially for mammography screening. We evaluated breast cancer mortality reduction and performed a cost-effectiveness analysis, using our microsimulation model, calibrated to most recent data. The microsimulation model allows for the comparison of mortality and costs between a (hypothetical) situation without screening and a situation with screening. Breast cancer incidence in Norway had a steep increase in the early 1990s. We calibrated the model to simulate this increase and included recent costs for screening, diagnosis and treatment of breast cancer and travel and productivity loss. We estimate a 16% breast cancer mortality reduction for a cohort of women, invited to screening, followed over their complete lifetime. Cost-effectiveness is estimated at NOK 112,162 per QALY gained, when taking only direct medical costs into account (the cost of the buses, examinations, and invitations). We used a 3.5% annual discount rate. Cost-effectiveness estimates are substantially below the threshold of NOK 1,926,366 as recommended by the WHO guidelines. For the Norwegian population, which has been gradually exposed to screening, breast cancer mortality reduction for women exposed to screening is increasing and is estimated to rise to ∼30% in 2020 for women aged 55-80 years. The NBCSP is a highly cost-effective measure to reduce breast cancer specific mortality. We estimate a breast cancer specific mortality reduction of 16-30%, at the cost of 112,162 NOK per QALY gained. © 2016 UICC.

Long-lasting reduction in postural asymmetry by prism adaptation after right brain lesion without neglect.

PubMed

Hugues, Aurélien; Di Marco, Julie; Lunven, Marine; Jacquin-Courtois, Sophie; Rossetti, Yves; Bonan, Isabelle; Rode, Gilles

2015-09-01

Right brain damage (RBD) involves postural asymmetry and spatial frame disorders. In acute RBD patients, postural asymmetry is immediately reduced after one single session of prism adaptation (PA), without assessment of effects on spatial frames. To assess long-term effects of PA on posture and spatial frames in chronic RBD patients, without neglect. Six chronic RBD patients without neglect (mean delay 45 months) were included. Each patient sustained 10 PA sessions of 20 min during 2 weeks. Outcome measures were: (1) posturographic analysis (mediolateral position of centre of pressure (X cop), (2) subjective straight ahead (SSA) and perception of longitudinal body axis (LBA). Each parameter was assessed by three pretests and three post-tests (+2 h, day + 3 and day + 7). In pretests, patients showed a shift of the X cop and SSA. In post-tests, results displayed (1) a significant reduction in mediolateral postural asymmetry at D + 7; (2) a significant left deviation of SSA at D + 3 and enduring at D + 7; and (3) no significant modification of LBA. The mean curves of X cop and SSA between pre- and post-tests were similar. PA involves persistent reduction in postural asymmetry in RBD patients without neglect. These findings were obtained at a chronic stage. This new effect cannot be explained by reduction in spatial attentional shift. Improvement may be explained by a better calibration of extra personal space frames used for posture, without effect on personal space frame. Findings argue in favour of a bottom-up effect of PA on mechanisms underlying spatial cognition.

The potential for tree planting strategies to reduce local and regional ecosystem impacts of agricultural ammonia emissions.

PubMed

Bealey, W J; Dore, A J; Dragosits, U; Reis, S; Reay, D S; Sutton, M A

2016-01-01

Trees are very effective at capturing both gaseous and particulate pollutants from the atmosphere. But while studies have often focussed on PM and NOx in the urban environment, little research has been carried out on the tree effect of capturing gaseous emissions of ammonia in the rural landscape. To examine the removal or scavenging of ammonia by trees a long-range atmospheric model (FRAME) was used to compare two strategies that could be used in emission reduction policies anywhere in the world where nitrogen pollution from agriculture is a problem. One strategy was to reduce the emission source strength of livestock management systems by implementing two 'tree-capture' systems scenarios - tree belts downwind of housing and managing livestock under trees. This emission reduction can be described as an 'on-farm' emission reduction policy, as ammonia is 'stopped' from dispersion outside the farm boundaries. The second strategy was to apply an afforestation policy targeting areas of high ammonia emission through two planting scenarios of increasing afforestation by 25% and 50%. Both strategies use trees with the aim of intercepting NH3 emissions to protect semi-natural areas. Scenarios for on-farm emission reductions showed national reductions in nitrogen deposition to semi-natural areas of 0.14% (0.2 kt N-NHx) to 2.2% (3.15 kt N-NHx). Scenarios mitigating emissions from cattle and pig housing gave the highest reductions. The afforestation strategy showed national reductions of 6% (8.4 kt N-NHx) to 11% (15.7 kt N-NHx) for 25% and 50% afforestation scenarios respectively. Increased capture by the planted trees also showed an added benefit of reducing long range effects including a decrease in wet deposition up to 3.7 kt N-NHx (4.6%) and a decrease in export from the UK up to 8.3 kt N-NHx (6.8%). Copyright © 2015 Elsevier Ltd. All rights reserved.

Source reduction for prevention of methylene chloride hazards: cases from four industrial sectors.

PubMed

Roelofs, Cora R; Ellenbecker, Michael J

2003-07-21

Source reduction, defined as chemical, equipment and process changes that intervene in an industrial process to eliminate or reduce hazards, has not figured as a front-line strategy for the protection of workers' health. Such initiatives are popular for environmental protection, but their feasibility and effectiveness as an industrial hygiene approach have not been well described. We investigated four cases of source reduction as a hazard prevention strategy in Massachusetts companies that had used methylene chloride, an occupational carcinogen, for cleaning and adhesive thinning. Three cases were retrospective and one was prospective, where the researchers assisted with the source reduction process change. Data were collected using qualitative research methods, including in-depth interviews and site visits. Motivated by environmental restrictions, a new worker health standard, and opportunity for productivity improvements, three companies eliminated their use of methylene chloride by utilizing available technologies and drop-in substitutes. Aided by technical assistance from the investigators, a fourth case dramatically reduced its use of methylene chloride via process and chemistry changes. While the companies' evaluations of potential work environment impacts of substitutes were not extensive, and in two cases new potential hazards were introduced, the overall impact of the source reduction strategy was deemed beneficial, both from a worker health and a production standpoint. The findings from these four cases suggest that source reduction should be considered potentially feasible and effective for reducing or eliminating the potential hazards of methylene chloride exposure. Especially when faced with a hazard that is both an environmental and worker health concern, companies may chose to change their processes rather than rely on local exhaust ventilation equipment or personal protective equipment that might not be as effective, might transfer risk and/or not be integrated with financial goals. However, technical assistance sensitive to environmental and health and safety impacts as well as production issues should be provided to guide companies' source reduction efforts.

Source reduction for prevention of methylene chloride hazards: cases from four industrial sectors

PubMed Central

Roelofs, Cora R; Ellenbecker, Michael J

2003-01-01

Background Source reduction, defined as chemical, equipment and process changes that intervene in an industrial process to eliminate or reduce hazards, has not figured as a front-line strategy for the protection of workers' health. Such initiatives are popular for environmental protection, but their feasibility and effectiveness as an industrial hygiene approach have not been well described. Methods We investigated four cases of source reduction as a hazard prevention strategy in Massachusetts companies that had used methylene chloride, an occupational carcinogen, for cleaning and adhesive thinning. Three cases were retrospective and one was prospective, where the researchers assisted with the source reduction process change. Data were collected using qualitative research methods, including in-depth interviews and site visits. Results Motivated by environmental restrictions, a new worker health standard, and opportunity for productivity improvements, three companies eliminated their use of methylene chloride by utilizing available technologies and drop-in substitutes. Aided by technical assistance from the investigators, a fourth case dramatically reduced its use of methylene chloride via process and chemistry changes. While the companies' evaluations of potential work environment impacts of substitutes were not extensive, and in two cases new potential hazards were introduced, the overall impact of the source reduction strategy was deemed beneficial, both from a worker health and a production standpoint. Conclusion The findings from these four cases suggest that source reduction should be considered potentially feasible and effective for reducing or eliminating the potential hazards of methylene chloride exposure. Especially when faced with a hazard that is both an environmental and worker health concern, companies may chose to change their processes rather than rely on local exhaust ventilation equipment or personal protective equipment that might not be as effective, might transfer risk and/or not be integrated with financial goals. However, technical assistance sensitive to environmental and health and safety impacts as well as production issues should be provided to guide companies' source reduction efforts. PMID:12904266

AN EXPERIMENTAL COMPARISON OF A CONVENTIONAL TV LESSON WITH A PROGRAMMED TV LESSON REQUIRING ACTIVE STUDENT RESPONSE. STUDIES IN TELEVISED INSTRUCTION, REPORT 2.

ERIC Educational Resources Information Center

GROPPER, GEORGE L.; LUMSDAINE, ARTHUR A.

A SERIES OF EXPERIMENTS WAS CONDUCTED TO TEST THE EFFECTIVENESS OF TELEVISED INSTRUCTION. THIS REPORT, THE SECOND IN A SERIES, EXAMINED THE EFFECTIVENESS OF ACTIVE STUDENT RESPONSE ON LEARNING DURING TELEVISED LESSON. PRINCIPLES OF PROGRAMING DERIVED FROM TEACHING-MACHINE RESEARCH AND APPLIED IN THIS STUDY INCLUDED (1) THE REDUCTION OF LESSON…

Effect of Mixing Enhancement Devices on Turbulence in Separate Flow Nozzles

NASA Technical Reports Server (NTRS)

Bridges, James

2001-01-01

This paper presents the effects of several mixing enhancement devices on turbulence in jet nozzles. The topics include: 1) The Advanced Subsonic Technology (AST) Program; 2) Test Programs SFNT97 and SFNT2K; 3) Facility; 4) Mixing Enhancement Nozzles; 5) IR reductions; 6) Schlieren of Chevrons; and 7) Aeroacoustics of Enhanced Mixing-Paradigm. This paper is presented in viewgraph form.

Modeling cover Crop Effectiveness on Maryland's Eastern Shore

USDA-ARS?s Scientific Manuscript database

Cover cropping has become a widely used conservation practice on Maryland’s Eastern shore. It is one of the main practices funded by the Maryland Department of Agriculture’s (MDA) Maryland Agricultural Water Quality Cost Share (MACS) program. The major benefits of this practice include reduction of ...

76 FR 2011 - High Seas Driftnet Fishing Moratorium Protection Act; Identification and Certification Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

... unauthorized or other IUU catch; Catch and effort monitoring, including licensing and permitting schemes, reporting, and vessel monitoring systems (VMS); Bycatch reduction and mitigation strategies and techniques... effective sanctions and monitoring, control and surveillance (MCS) capacity; and Participation in voluntary...

Theories and Possible Processes of Action in Animal Assisted Interventions

ERIC Educational Resources Information Center

Beetz, Andrea M.

2017-01-01

Different positive effects of interactions with animals, such as reduction of stress reactions, depressive mood, anxiety, aggression, and pain, and promotion of trust, calmness, motivation, and concentration have been documented by research on human-animal interaction (HAI), including animal assisted interventions (AAIs). Potential biological,…

Climate and Health Impacts of US Emissions Reductions Consistent with 2 C

NASA Technical Reports Server (NTRS)

Shindell, Drew T.; Lee, Yunha; Faluvegi, Greg

2016-01-01

An emissions trajectory for the US consistent with 2 C warming would require marked societal changes, making it crucial to understand the associated benefits. Previous studies have examined technological potentials and implementation costs and public health benefits have been quantified for less-aggressive potential emissions-reduction policies, but researchers have not yet fully explored the multiple benefits of reductions consistent with 2 C. We examine the impacts of such highly ambitious scenarios for clean energy and vehicles. US transportation emissions reductions avoid approx.0.03 C global warming in 2030 (0.15 C in 2100), whereas energy emissions reductions avoid approx.0.05-0.07 C 2030 warming (approx.0.25 C in 2100). Nationally, however, clean energy policies produce climate disbenefits including warmer summers (although these would be eliminated by the remote effects of similar policies if they were undertaken elsewhere). The policies also greatly reduce damaging ambient particulate matter and ozone. By 2030, clean energy policies could prevent approx.175,000 premature deaths, with approx.22,000 (11,000-96,000; 95% confidence) fewer annually thereafter, whereas clean transportation could prevent approx.120,000 premature deaths and approx.14,000 (9,000-52,000) annually thereafter. Near-term national benefits are valued at approx.US$250 billion (140 billion to 1,050billion) per year, which is likely to exceed implementation costs. Including longer-term, worldwide climate impacts, benefits roughly quintuple, becoming approx.5-10 times larger than estimated implementation costs. Achieving the benefits, however, would require both larger and broader emissions reductions than those in current legislation or regulations.

Which type of sedentary behaviour intervention is more effective at reducing body mass index in children? A meta-analytic review.

PubMed

Liao, Y; Liao, J; Durand, C P; Dunton, G F

2014-03-01

Sedentary behaviour is emerging as an independent risk factor for paediatric obesity. Some evidence suggests that limiting sedentary behaviour alone could be effective in reducing body mass index (BMI) in children. However, whether adding physical activity and diet-focused components to sedentary behaviour reduction interventions could lead to an additive effect is unclear. This meta-analysis aims to assess the overall effect size of sedentary behaviour interventions on BMI reduction and to compare whether interventions that have multiple components (sedentary behaviour, physical activity and diet) have a higher mean effect size than interventions with single (sedentary behaviour) component. Included studies (n = 25) were randomized controlled trials of children (<18 years) with intervention components aimed to reduce sedentary behaviour and measured BMI at pre- and post-intervention. Effect size was calculated as the mean difference in BMI change between children in an intervention group and a control group. Results indicated that sedentary behaviour interventions had a significant effect on BMI reduction. The pooled effect sizes of multi-component interventions (g = -0.060∼-0.089) did not differ from the single-component interventions (g = -0.154), and neither of them had a significant effect size on its own. Future paediatric obesity interventions may consider focusing on developing strategies to decrease multiple screen-related sedentary behaviours. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.

Identification of Effects of Regulatory Actions on Air Quality in Goods Movement Corridors in California.

PubMed

Su, Jason G; Meng, Ying-Ying; Pickett, Melissa; Seto, Edmund; Ritz, Beate; Jerrett, Michael

2016-08-16

Few studies have assessed the impact of regulatory actions on air quality improvement through a comprehensive monitoring effort. In this study, we designed saturation sampling of nitrogen oxides (NOX) for the counties of Los Angeles and Alameda (San Francisco Bay) before (2003-2007) and after (2008-2013) implementation of goods movement actions in California. We further separated the research regions into three location categories, including goods movement corridors (GMCs), nongoods movement corridors (NGMCs), and control areas (CTRLs). Linear mixed models were developed to identify whether reductions in NOX were greater in GMCs than in other areas, after controlling for potential confounding, including weather conditions (e.g., wind speed and temperature) and season of sampling. We also considered factors that might confound the relationship, including traffic and cargo volumes that may have changed due to economic downturn impacts. Compared to the pre-policy period, we found reductions of average pollutant concentrations for nitrogen dioxide (NO2) and NOX in GMCs of 6.4 and 21.7 ppb. The reductions were smaller in NGMCs (5.9 and 16.3 ppb, respectively) and in CTRLs (4.6 and 12.1 ppb, respectively). After controlling for potential confounding from weather conditions, season of sampling, and the economic downturn in 2008, the linear mixed models demonstrated that reductions in NO2 and NOX were significantly greater in GMCs compared to reductions observed in CTRLs; there were no statistically significant differences between NGMCs and CTRLs. These results indicate that policies regulating goods movement are achieving the desired outcome of improving air quality for the state, particularly in goods movement corridors where most disadvantaged communities live.

The effects of scene content parameters, compression, and frame rate on the performance of analytics systems

NASA Astrophysics Data System (ADS)

Tsifouti, A.; Triantaphillidou, S.; Larabi, M. C.; Doré, G.; Bilissi, E.; Psarrou, A.

2015-01-01

In this investigation we study the effects of compression and frame rate reduction on the performance of four video analytics (VA) systems utilizing a low complexity scenario, such as the Sterile Zone (SZ). Additionally, we identify the most influential scene parameters affecting the performance of these systems. The SZ scenario is a scene consisting of a fence, not to be trespassed, and an area with grass. The VA system needs to alarm when there is an intruder (attack) entering the scene. The work includes testing of the systems with uncompressed and compressed (using H.264/MPEG-4 AVC at 25 and 5 frames per second) footage, consisting of quantified scene parameters. The scene parameters include descriptions of scene contrast, camera to subject distance, and attack portrayal. Additional footage, including only distractions (no attacks) is also investigated. Results have shown that every system has performed differently for each compression/frame rate level, whilst overall, compression has not adversely affected the performance of the systems. Frame rate reduction has decreased performance and scene parameters have influenced the behavior of the systems differently. Most false alarms were triggered with a distraction clip, including abrupt shadows through the fence. Findings could contribute to the improvement of VA systems.

The cost-effectiveness of NBPTS teacher certification.

PubMed

Yeh, Stuart S

2010-06-01

A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of value-added statistical methods to identify effective teachers, and the implementation of systems where student performance in math and reading is rapidly assessed 2-5 times per week. The most cost-effective approach, rapid assessment, is three magnitudes as cost-effective as Board certification.

ZnCr2S4: Highly effective photocatalyst converting nitrate into N2 without over-reduction under both UV and pure visible light

NASA Astrophysics Data System (ADS)

Yue, Mufei; Wang, Rong; Cheng, Nana; Cong, Rihong; Gao, Wenliang; Yang, Tao

2016-08-01

We propose several superiorities of applying some particular metal sulfides to the photocatalytic nitrate reduction in aqueous solution, including the high density of photogenerated excitons, high N2 selectivity (without over-reduction to ammonia). Indeed, ZnCr2S4 behaved as a highly efficient photocatalyst, and with the assistance of 1 wt% cocatalysts (RuOx, Ag, Au, Pd, or Pt), the efficiency was greatly improved. The simultaneous loading of Pt and Pd led to a synergistic effect. It offered the highest nitrate conversion rate of ~45 mg N/h together with the N2 selectivity of ~89%. Such a high activity remained steady after 5 cycles. The optimal apparent quantum yield at 380 nm was 15.46%. More importantly, with the assistance of the surface plasma resonance effect of Au, the visible light activity achieved 1.352 mg N/h under full arc Xe-lamp, and 0.452 mg N/h under pure visible light (λ > 400 nm). Comparing to the previous achievements in photocatalytic nitrate removal, our work on ZnCr2S4 eliminates the over-reduction problem, and possesses an extremely high and steady activity under UV-light, as well as a decent conversion rate under pure visible light.

ZnCr2S4: Highly effective photocatalyst converting nitrate into N2 without over-reduction under both UV and pure visible light.

PubMed

Yue, Mufei; Wang, Rong; Cheng, Nana; Cong, Rihong; Gao, Wenliang; Yang, Tao

2016-08-03

We propose several superiorities of applying some particular metal sulfides to the photocatalytic nitrate reduction in aqueous solution, including the high density of photogenerated excitons, high N2 selectivity (without over-reduction to ammonia). Indeed, ZnCr2S4 behaved as a highly efficient photocatalyst, and with the assistance of 1 wt% cocatalysts (RuOx, Ag, Au, Pd, or Pt), the efficiency was greatly improved. The simultaneous loading of Pt and Pd led to a synergistic effect. It offered the highest nitrate conversion rate of ~45 mg N/h together with the N2 selectivity of ~89%. Such a high activity remained steady after 5 cycles. The optimal apparent quantum yield at 380 nm was 15.46%. More importantly, with the assistance of the surface plasma resonance effect of Au, the visible light activity achieved 1.352 mg N/h under full arc Xe-lamp, and 0.452 mg N/h under pure visible light (λ > 400 nm). Comparing to the previous achievements in photocatalytic nitrate removal, our work on ZnCr2S4 eliminates the over-reduction problem, and possesses an extremely high and steady activity under UV-light, as well as a decent conversion rate under pure visible light.

Multi-objective optimisation of wastewater treatment plant control to reduce greenhouse gas emissions.

PubMed

Sweetapple, Christine; Fu, Guangtao; Butler, David

2014-05-15

This study investigates the potential of control strategy optimisation for the reduction of operational greenhouse gas emissions from wastewater treatment in a cost-effective manner, and demonstrates that significant improvements can be realised. A multi-objective evolutionary algorithm, NSGA-II, is used to derive sets of Pareto optimal operational and control parameter values for an activated sludge wastewater treatment plant, with objectives including minimisation of greenhouse gas emissions, operational costs and effluent pollutant concentrations, subject to legislative compliance. Different problem formulations are explored, to identify the most effective approach to emissions reduction, and the sets of optimal solutions enable identification of trade-offs between conflicting objectives. It is found that multi-objective optimisation can facilitate a significant reduction in greenhouse gas emissions without the need for plant redesign or modification of the control strategy layout, but there are trade-offs to consider: most importantly, if operational costs are not to be increased, reduction of greenhouse gas emissions is likely to incur an increase in effluent ammonia and total nitrogen concentrations. Design of control strategies for a high effluent quality and low costs alone is likely to result in an inadvertent increase in greenhouse gas emissions, so it is of key importance that effects on emissions are considered in control strategy development and optimisation. Copyright © 2014 Elsevier Ltd. All rights reserved.